A patient with metastatic lung cancer has nausea, constipation and confusion. Measured calcium is 2.62 mmol/L, albumin 22 g/L and eGFR 48 mL/min.

Question

A patient with metastatic lung cancer has nausea, constipation and confusion. Measured calcium is 2.62 mmol/L, albumin 22 g/L and eGFR 48 mL/min. Goals favour reversal of a treatable cause. Using the Scottish correction formula, which interpretation and initial plan are most appropriate?

Accepted Answer

Corrected calcium is 3.02 mmol/L; rehydrate, then consider IV bisphosphonate after renal review

Answer

Corrected calcium is 3.02 mmol/L; prescribe a loop diuretic alone after assessing fluid status

Answer

Corrected calcium is 3.42 mmol/L; arrange immediate dialysis before attempting intravenous rehydration

Answer

Corrected calcium is 2.22 mmol/L; administer intravenous calcium and repeat serum measurements

Answer

Corrected calcium is 2.62 mmol/L; provide symptom control and avoid intravenous rehydration

Bilateral Pleurodesis Risk — SCE Palliative Medicine MCQ

A patient with metastatic lung cancer has nausea, constipation and confusion. Measured calcium is 2.62 mmol/L, albumin 22 g/L and eGFR 48 mL/min. Goals favour reversal of a treatable cause. Using the Scottish correction formula, which interpretation and initial plan are most appropriate?