Lysis of cells cause A/E –
Correct Answer: Hypercalcemia
Description: Hypercalcaemia, also spelled hypercalcemia, is a high calcium (Ca2+) level in the blood serum. The normal range is 2.1-2.6 mmol/L (8.8-10.7 mg/dL, 4.3-5.2 mEq/L), with levels greater than 2.6 mmol/L defined as hypercalcemia. Those with a mild increase that has developed slowly typically have no symptoms. In those with greater levels or rapid onset, symptoms may include abdominal pain, bone pain, confusion, depression, weakness, kidney stones or an abnormal hea rhythm including cardiac arrest The neuromuscular symptoms of hypercalcaemia are caused by a negative bathmotropic effect due to the increased interaction of calcium with sodium channels. Since calcium blocks sodium channels and inhibits depolarization of nerve and muscle fibers, increased calcium raises the threshold for depolarization. This results in diminished deep tendon reflexes (hyporeflexia), and skeletal muscle weakness. There is a general mnemonic for remembering the effects of hypercalcaemia: "stones, bones, groans, moans, thrones, and psychiatric oveones". Stones (kidney or biliary) (see calculus) Bones (bone pain) Groans (abdominal pain, nausea and vomiting) Moans (may complain about other non-specific symptoms) Thrones (polyuria) resulting in dehydration due to nephrogenic diabetes insipidus from nephrocalcinosis Muscle tone (hypotonicity, muscle weakness, hyporeflexia) Psychiatric oveones (Depression 30-40%, anxiety, cognitive dysfunction, insomnia, coma) Other symptoms include cardiac arrhythmias (especially in those taking digoxin), fatigue, nausea, vomiting (emesis), loss of appetite, abdominal pain, constipation, & paralytic ileus. If kidney impairment occurs as a result, manifestations can include increased urination, urination at night, and increased thrist.Psychiatric manifestation can include emotional instability, confusion, delirium, psychosis, and stupor.Limbus sign seen in eye due to hypercalcemia Ref Davidson 23rd edition pg 370
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