Answer This Challenging Question About Lung Cancer & Hypercalcemia

Welcome to the next episode of The Reveal where we take you inside the mind of a test-taker to deconstruct and connect the dots of a board-style question so you can become a better student, transform how you learn, and excel not only on high-stakes exams, but also in your general medical knowledge. Let’s get started.

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A 56-year-old woman with a history of lung cancer presents to the emergency department with confusion, nausea, and vomiting. She is unable to provide much history due to her confusion. She is dehydrated and is oriented only to self. She is afebrile. Her renal function is normal. Her serum calcium level is 14 mg/dl. What is the most likely mechanism for her hypercalcemia?

A) Abnormal calcium clearance in the kidneys

B) Bony erosion due to metastases

C) Production of vitamin D analogues by the tumor

D) Secretion of parathyroid hormone related protein from the tumor

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