BOF: 28
You are called to see a
60-year-old female on the oncology ward. She has breast cancer with bone
metastases. Her serum calcium level is 3.8 mmol/l.
Which of the following features
are likely to occur in this patient?
a)
Hyporeflexia on neurological examination
b)
Prolonged QT interval on the ECG
c)
Tachycardia
d)
Tall peaked T waves
e)
Diarrhoea
Answer:
a)
Hypercalcaemia may result in the following
features in relation to the CNS:
Personality changes, malaise,
headache, hallucinations, depression, irritability confusion, depressed
sensorium, unsteady gait, proximal muscle weakness, hyporeflexia
The ECG changes that may occur
are:
Shortened QT interval,
bradycardia, coving of ST-T wave, widened T wave
The features in relation to the
gastrointestinal system are:
Hypercalcaemia may cause
paralytic ileus, with resultant abdominal cramping, constipation, anorexia,
nausea, and vomiting.
Ectopic calcification may lead
to features of pancreatitis, with epigastric pain and vomiting.
Increased gastric acid
secretion may produce features of gastritis
Last Updated: 16/04/06
