Internal Medicine

63 year old lady with abdominal pain and mild confusion

Samuel Wilson on Jun 2, 2013

Ms. Moore, a 63 year old lady with hypertension and hyperlipidemia, presents to your office complaining of abdominal pain and mild confusion. She reports intermittent abdominal discomfort for the past two weeks. Her pain is not associated with meals and she reports minimal relief with antacids. She also notes mild confusion and disorientation over the past week, especially upon waking which is concerning for her. 

On further questioning, she reports progressively worsening fatigue and a 10 lb weight loss over the last six months. She also reports worsening of her chronic smoker’s cough over the past three months, with occasional hemoptysis. She has a 50 pack year history of smoking. She has experienced chronic dyspnea over the past several years, but notes that it has noticed increased dyspnea over the past several weeks. She denies any burning with urination but has noticed that she is going to the bathroom more frequently. She also reports occasional constipation which appears to be getting worse for her.

Given the history so far, what electrolyte abnormality is most typically associated with her symptoms?

Expand all answers
Hypermagnesemia
Incorrect, try again!
Hyperkalemia
Incorrect, try again!
Hypokalemia
Incorrect, try again!
Hypercalcemia
Correct. Symptoms of hypercalcemia include abdominal pain/nausea, bone pain, renal stones, polyuria, and confusion/somnolence. Ms. Moore is experiencing several of these symptoms which is concerning for hypercalcemia.
Hyponatremia
Incorrect, try again!

Ms. Moore, a 63 year old lady with hypertension and hyperlipidemia, presents to your office complaining of abdominal pain and mild confusion. She reports intermittent abdominal discomfort for the past two weeks. Her pain is not associated with meals and she reports minimal relief with antacids. She also notes mild confusion and disorientation over the past week, especially upon waking which is concerning for her. 

On further questioning, she reports progressively worsening fatigue and a 10 lb weight loss over the last six months. She also reports worsening of her chronic smoker’s cough over the past three months, with occasional hemoptysis. She has a 50 pack year history of smoking. She has experienced chronic dyspnea over the past several years, but notes that it has noticed increased dyspnea over the past several weeks. She denies any burning with urination but has noticed that she is going to the bathroom more frequently. She also reports occasional constipation which appears to be getting worse for her.

Given the history so far, what electrolyte abnormality is most typically associated with her symptoms?

Expand all answers
Hypermagnesemia
Incorrect, try again!
Hyperkalemia
Incorrect, try again!
Hypokalemia
Incorrect, try again!
Hypercalcemia
Correct. Symptoms of hypercalcemia include abdominal pain/nausea, bone pain, renal stones, polyuria, and confusion/somnolence. Ms. Moore is experiencing several of these symptoms which is concerning for hypercalcemia.
Hyponatremia
Incorrect, try again!

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