Milk-alkali syndrome
Path	·       Excessive intake of calcium & absorbable alkali ·       Renal vasoconstriction & decreased GFR ·       Renal loss of sodium & water, reabsorption of bicarbonate
S/S	N/V Constipation Polyuria/Polydipsia Neuropsychiatric
Dx	⤴️ Ca Metabolic alkalosis AKI ❌ PTH
Tx	IVF D/C Causative agent

	Tx of Hypercalcemia
Severe >14	Immediate ·       IVF + calcitonin ·       Avoid loop diuretics unless volume overload (heart failure) exists Long-term: Bisphosphonate
Sxic
Moderate	Usually no immediate treatment required unless sx If Sxic → Bisphosphonate
Asx / Mild <12	·       No immediate treatment required ·       Avoid thiazide diuretics, lithium, volume depletion & prolonged bed rest

	Acute Hypocalcemia
Causes	·       Neck surgery (parathyroidectomy) ·       Pancreatitis / Sepsis ·       Tumor Lysis syndrome ·       Acute alkalosis ·       Chelation: blood transfusion (Citrate), ·       EDTA, foscarnet
Clx	Muscle cramps Chvostek & Trousseau signs Paresthesias Hyperreflexia (⤴️  DTR) / Tetany SZ
Tx	IV calcium gluconate/chloride