A 42-year-old woman with parathyroid carcinoma presents with severe hypercalcemia. Vital signs show BP 158/92 mmHg, HR 108/min, RR 20/min, temp 37.2°C. Labs reveal serum calcium 14.2 mg/dL, phosphate 2.0 mg/dL, PTH 650 pg/mL, and creatinine 3.2 mg/dL consistent with acute kidney injury. Urinalysis shows no glycosuria. She develops nausea and confusion. Which medication should be AVOIDED in her acute management?
- A)Bisphosphonates
- B)Intravenous saline and loop diuretics
- C)Thiazide diureticsGABARITO
- D)Cinacalcet
- E)Calcitonin
Explicação
Thiazide diuretics should be avoided in acute severe hypercalcemia because they decrease urinary calcium excretion by enhancing proximal tubule calcium reabsorption. In hypercalcemic crisis with AKI, the goal is to promote renal calcium excretion through salin... Ver explicação completa e trilha adaptativa →