مريض بالساركويد الرئوي، وتحاليله تظهر كالسيوم ٣٫٠ ملمول/لتر، ويشتكي عطشاً وكثرة تبول. ما التفسير؟

A client with pulmonary sarcoidosis has calcium 3.0 mmol/L with thirst and polyuria. What is the explanation?

1. Hypocalcaemia from malabsorption
2. A normal finding in sarcoidosis needing no follow-up
3. Hypercalcaemia from granulomas activating vitamin D
4. New diabetes from steroids

Answer: C) Hypercalcaemia from granulomas activating vitamin D. Sarcoid granulomas convert vitamin D to its active form, increasing calcium absorption. Clients avoid unsupervised vitamin D and calcium supplements, keep hydrated, and may need steroids.