Your 53 year old male patient seems very vague and his partner tells you that he has been very forgetful and low in mood recently. He feels weak and achey and has to force himself to go downstairs to eat. He has not left the house for 2 weeks.
He can’t remember when he last opened his bowels but he is thirsty so is drinking and peeing plenty. He doesn’t really know if he has lost any weight. He has felt under the weather for a few months now.
He had a back injury 8 months ago. He can’t really remember what happened, just that it seems to have gotten worse rather than improved over time.
Medication: Paracetamol and ibuprofen for back pain
Examination: No organomegaly or lymphadenopathy
FBC: Hb 78g/L but otherwise fairly normal.
Blood film: some rouleaux but otherwise fairly unremarkable.
Coombs test negative
Ferritin, B12 and folate normal
What is on your list of differentials for hypercalcaemia?
Why is hypercalcaemia an emergency?
How do you manage hypercalcaemia?