PTH-dependent: Primary hyperparathyroidism due to parathyroid adenoma or hyperplasia.
PTH-independent: malignancy (MM, Breast Ca., Lung Ca.) Granulomatous Dz (Sarcoidosis, TB), thyrotoxicosis, AI, pheochromocytoma, medications(esp. thiazides and lithium), Vit D intoxication, milk-alkali syndrome,FHH, immobilization, advanced liver dz, post-renal transplant, HIV/AIDS
Bisphosphonates (inhibit osteoclast activity)
Cinacalcet(binds to calcium-sensing receptor on Chief Cells in parathyroid gland and increases sensitivity to extracellular calcium)
Pt. w/ PTH dependent hypercalcemia +/- PTH-independent causes such as advanced liver dz., immobilization.
Further w/u P
Hydration started, consider treatment w/ bisphosphonates/cinacalcet in future.