Mnemonic for Hypercalcemia

Serum calcium is tightly regulated by various factors which act in a coordinated manner to keep calcium levels in the normal range. A simple mnemonic for recalling both the causes and treatment of hypercalcemia is “BLACK-RHINOS”

Hypercalcemia Memory Aid. The Black Rhino (Created by OpenAI DALLE2)

Hypercalcemia Memory Aid. The Black Rhino (Created by OpenAI DALLE2)

The causes of hypercalcemia (RHINOS)

  • R Renal insufficiency (secondary and tertiary hyperparathyroidism)
  • H Hyperparathyroidism (primary hyperparathyroidism either sporadic or part of MEN syndrome)
  • I Immobilisation and iatrogenic (overdosage of calcium, vitamin D, thiazide diuretic exposure)
  • N Neoplasms (bone metastasis, primary bone cancer and paraneoplastic syndromes. Due to the production of cytokines and PTHrp etc)
  • O Other endocrinopathies (thyrotoxicosis and Addison’s disease)
  • S Sarcoidosis and other granulomatous conditions

The treatment of hypercalcemia (BLACK)

An excellent way of remembering the treatment options for hypercalcemia  requires the recollection of the mnemonic “BLACK RHINO”.

  • B : Bisphosphonates
  • L : Liquids (referring to normal saline)
  • A : Aquaretics (medications that induce fluid loss e.g. Furosemide)
  • C : Calcitonin
  • K : OsteoKlast inhibitors (Denosumab)

A collection of other highly effective hormone (endocrinology) mnemonics to help you remember essential clinical pearls can be found here.

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About the Author MyEndoConsult

The MyEndoconsult Team. A group of physicians dedicated to endocrinology and internal medicine education.

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