Hypercalcemia is a topic covered in the 5-Minute Emergency Consult.

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  • Severity depends on serum calcium level and rate of increase
  • 0.1–1% of patients on routine screening
  • Most cases mild (<12 mg/dL) and asymptomatic
  • Hypercalcemic crisis, usually >14 mg/dL, causes serious signs and symptoms
  • Calcium in bloodstream in 3 forms:
    • Ionized: 45%
    • Bound to protein (primarily albumin): 40%
    • Bound to other anions: 15%
  • Ionized calcium—only physiologically active form


  • Primary hyperparathyroidism
  • Malignancy
  • Miscellaneous

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