A patient with persistent hypercalcemia presents with stones, bones, groans, and psychiatric overtones. What are first-line treatments?

A patient with persistent hypercalcemia presents with stones, bones, groans, and psychiatric overtones. What are first-line treatments?

• A. Hydration with isotonic saline to promote calciuresis; consider calcitonin for rapid short-term reduction and bisphosphonates for longer-term control; evaluate for hyperparathyroidism.
• B. Loop diuretic therapy alone.
• C. Phosphate therapy.
• D. Vitamin D supplementation alone.

Answer: (A)