He was a young man who came in with a fracture due in part from his rip-roaring uncontrolled secondary hyperparathyroidism, which had actually progressed to tertiary hyperparathyroidism. We treated his hypercalcemia, got him a parathyroidectomy and then watched in horror as his hypercalcemia switched to hypocalcemia as part of a wicked case of Hungry Bone Syndrome. To cap it off he developed acute symptomatic hypocalcemia after meeting Alonzo Mourning.
On that one admission, in one patient my team got to see and study:
- Renal osteodystrophy with skeletal complications
- Diagnosis and management of Hypercalcemia
- Diagnosis and management of tertiary hyperparathyroidism
- Diagnosis of Hungry Bone Syndrome
- Management of severe hypocalcemia
- Relationship of ionized calcium to pH
Again I provided the resident with a booklet and did the lecture Seder Style. This was the best use of that style yet.
Calcium Case Report