A 69 yo smoker presents with a dry cough, dyspnea, vague chest pain and 10 pounds weight loss over 2 months. The chest x-ray reveals a 4 cm irregular lesion. While being worked up an ECG is done -shown below. Based on this preliminary H & P, what is the next study of choice?
a. Urinary cortisol levels
b. Holter monitor
c. Electrophysiologic study
d. Electrolytes
e. Renal function
f. Echocardiogram
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The main ECG abnormality seen with hypercalcemia is shortening of the QT interval
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In severe hypercalcemia, Osborn waves (J waves BLUE arrows) may be seen
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Ventricular irritability and VF arrest has been reported with extreme hypercalcemia
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Hypercalcemia is one of the most frequently encountered paraneoplastic syndromes, occurring in 20–30% of patients with cancer. Historically, hypercalcemia has been associated mainly with squamous cell carcinoma of the bronchus, carcinoma of the breast and multiple myeloma
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