This includes the commonest underlying diagnosis: primary hyperparathyroidism, and all other causes of hypercalcaemia.
To diagnose hypercalcaemia a detailed and full general examination is mandatory in the initial assessment of all patients. Particular attention should be made of the neck, lymph nodes, and gastrointestinal system to seek underlying causes of hypercalcaemia.
Examination of the chest may reveal signs of sarcoidosis, tuberculosis or malignancy.
Prior to considering surgery, thorough cardiac assessment and fitness for anaesthetic should also be assessed.
Seeking underlying malignancy.
Seeking underlying malignancy as well as thyroid and parathyroid anatomy.
Seeking evidence of underlying renal disease or haematuria.
Seeking underlying thyrotoxicosis.
Increased pigmentation or postural hypotension may indicate underlying Addison's disease.