Which of the following is not a feature of hypercalcemia?
Correct Answer: Diarrhea
Description: <p>Hypercalcemia can be a manifestation of a serious illness such as malignancy or can be detected coincidentally by laboratory testing in a patient with no obvious illness. The number between detection of hypercalcemia and death, especially without vigorous treatment, is often <6 months. Accordingly, if an asymptomatic individual has had hypercalcemia or some manifestation of hypercalcemia such as kidney stones for >1 or 2 years, it is unlikely that malignancy is the cause.Hypercalcemia from any cause can result in fatigue, depression, mental confusion, anorexia, nausea, vomiting, constipation, reversible renal tubular defects, increased urination, a sho QT interval in the electrocardiogram, and, in some patients, cardiac arrhythmias. There is a variable relation from one patient to the next between the severity of hypercalcemia and the symptoms. Generally, symptoms are more common at calcium levels >2.9-3 mmol/L (11.5-12 mg/dL), but some patients, even at this level, are asymptomatic. When the calcium level is >3.2 mmol/L (13 mg/dL), calcification in kidneys, skin, vessels, lungs, hea, and stomach occurs and renal insufficiency may develop, paicularly if blood phosphate levels are normal or elevated due to impaired renal function. Severe hypercalcemia, usually defined as >=3.7-4.5 mmol/L (15-18 mg/dL), can be a medical emergency; coma and cardiac arrest can occur.(harrison 18 pg 3100)</p>
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