8th September 2020

A 72-year-old retired banker presents with profound muscle weakness, bone pain, polyuria and polydipsia

A 72-year-old retired banker presents with profound muscle weakness, bone pain, polyuria and polydipsia. He is a current smoker and has suffered from COPD for the past 15 years. He has noticed considerable weight loss in the past month but no other symptoms of note. His regular medications include a salbutamol inhaler and prednisolone. On examination, there is no visible atrophy; however, there is a marked decrease in power across all four limbs. Respiratory examination reveals monomorphic wheeze and finger clubbing. Chest X-ray reveals an irregular nodule and biopsy results reveal a squamous cell carcinoma. A paraneoplastic syndrome is suspected.

Levels of which hormone is most likely to be elevated?

Select the SINGLE most appropriate option from the list below. Select ONE option only.