Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Calcium level
23%
13/57
Lead level
11%
6/57
Phosphate level
4%
2/57
Potassium level
51%
29/57
TSH level
Select Answer to see Preferred Response
This patient is presenting with confusion, constipation, and increased urination which is likely caused by hypercalcemia (possibly from malignancy or hyperparathyroidism though more diagnostic testing would be needed). Clinical symptoms associated with hypercalcemia include fractures, nephrolithiasis, vomiting, constipation, and altered mental status. These symptoms are typically summarized as "bones (fractures and pain), stones (nephrolithiasis), groans (vomiting and constipation), and psychic overtones (altered mental status)." There are many possible etiologies of hypercalcemia including malignancy, familial hypocalciuric hypercalcemia, and hyperparathyroidism. The treatment of hypercalcemia is first to give IV fluids. Subsequent treatments can include calcitonin and bisphosphonates (for long-term management). The underlying etiology should be elucidated and treated as well. Incorrect Answers: Answer 2: Lead level could be used to elucidate a diagnosis of lead poisoning which may present with confusion, constipation, and irritability in an adult. This is a less common diagnosis (without a key exposure such as working in a battery factory) and would not explain this patient's dilute urine. Answer 3: Phosphate level could elucidate a diagnosis of hypophosphatemia which may occur in refeeding syndrome or hyperparathyroidism and presents with weakness, muscle/bone pain, confusion, and possibly rhabdomyolysis. Answer 4: Potassium level could work up a diagnosis of hyperkalemia which could cause peaked T waves and QRS widening on ECG that could lead to cardiac arrest. Hypokalemia can also present with non-specific changes on physical exam including weakness. Answer 5: TSH level could elucidate a diagnosis of hypothyroidism which would present with depression, fatigue, weight gain, and constipation. Though there is significant overlap with hypercalcemia, this patient's dilute urine and weight loss suggest hypercalcemia as a more likely etiology. Bullet Summary: Hypercalcemia can present with confusion, abdominal pain, constipation, and profuse urination.
4.1
(8)
Please Login to add comment