A patient with abdominal pain and constipation has elevated calcium levels. What physical exam finding is most likely?

The scenario describes a patient with abdominal pain, constipation, and elevated calcium levels, which suggests hypercalcemia. Hypercalcemia can lead to several symptoms, including muscle weakness.

Decreased muscle strength in the extremities is particularly relevant because hypercalcemia can interfere with neuromuscular transmission, leading to muscle weakness or fatigue. This occurs due to the effect of elevated calcium on the neuromuscular junction and the muscle fibers themselves. Patients might report a feeling of weakness in their arms and legs, and this can be observed during a physical examination as diminished strength when testing muscle groups.

The other options relate to specific physical exam findings not typically associated with hypercalcemia. For instance, carpal spasm is indicative of hypocalcemia and reflects increased neuromuscular excitability due to low calcium levels. Contraction of facial muscles when tapping the facial nerve, known as Chvostek sign, is also associated with hypocalcemia, where the body has heightened neuromuscular irritability. Lower extremity edema may be caused by various other conditions but is not directly linked to elevated calcium levels in the way that decreased muscle strength is.

Thus, the most likely physical exam finding in a patient with hypercalcemia is decreased muscle