Introduction An increase in serum calcium level Mechanisms and pathophysiology dietary causes calcium ingestion (milk-alkali syndrome) hypervitaminosis D hypervitaminosis A pharmacologic causes thiazides login to view 2 more bullets malignancy-associated causes Paget's disease login to view 2 more bullets squamous cell cancer of the lung login to view 1 more bullet multiple myeloma login to view 1 more bullet sarcoidosis granulomatous macrophages produce 1α-hydroxylase which produces high amounts of 1,25 vitamin D hyperparathyroid genetic causes familial hypocalciuric hypercalcemia login to view 5 more bullets other causes hyperthyroid Addison's disease Zollinger-Ellison syndrome Presentation Symptoms CNS confusion stupor weakness gastrointestinal constipation anorexia nausea vomiting kidney polyuria kidney stones polydipsia Physical exam weakness decreased/absent reflexes EKG shortened QTc interval Treatment Conservative hydration saline diuresis Pharmacologic loop diuretics bisphosphonates mithramycin calcitonin galium nitrate Other dialysis