Review Question - QID 210700

A 55-year-old man presents to the emergency department for fever and altered mental status. The patient was found by his wife in his chair at home. She noticed he responded incoherently to her questions. He has a past medical history of pancreatitis and alcohol abuse and is currently in a rehabilitation program. He has known esophageal varices. His temperature is 103°F (39.4°C), blood pressure is 127/68 mmHg, pulse is 120/min, respirations are 12/min, and oxygen saturation is 98% on room air. Laboratory values are obtained and shown below.

Serum:
Na+: 139 mEq/L
Cl-: 100 mEq/L
K+: 4.3 mEq/L
HCO3-: 25 mEq/L
BUN: 29 mg/dL
Glucose: 99 mg/dL
Creatinine: 1.5 mg/dL
Ca2+: 7.2 mg/dL
AST: 12 U/L
ALT: 10 U/L
1,25 dihydroxycholecalciferol: 50 nmol/L

Further laboratory studies are pending. Physical exam notes a diffusely distended and tender abdomen. This patient's hypocalcemia is most likely to lead to which of the following?