Which of the following is NOT a CHIMPS cause of hypercalcemia?

• A. Cancer
• B. Hyperparathyroidism
• C. Sarcoidosis
• D. Diabetes mellitus

Answer: (D)

Hypercalcemia is classically remembered through the CHIMPS framework, which groups the common mechanisms behind elevated calcium. C stands for cancer, where calcium can rise due to bone metastases or tumor secretion of PTH-related protein. H is for hyperparathyroidism, where excess parathyroid hormone drives calcium release from bone and increased renal reabsorption. I captures immobilization, since lack of mechanical use of bone accelerates bone resorption and calcium release. M refers to milk-alkali syndrome, a result of high calcium intake with alkali that raises calcium and can cause metabolic alkalosis. P stands for Paget disease in this mnemonic, reflecting high bone turnover that can elevate calcium in some cases. S is for sarcoidosis, a granulomatous disease where macrophages produce active vitamin D (calcitriol), increasing intestinal calcium absorption.

Diabetes mellitus does not fit these calcium-raising mechanisms, so it is not considered a CHIMPS cause of hypercalcemia.