18th February 2025

A patient with metastatic colorectal cancer was admitted to the oncology ward 5 days ago with malignant hypercalcaemia

A patient with metastatic colorectal cancer was admitted to the oncology ward 5 days ago with malignant hypercalcaemia. She was treated with IV fluids and IV zoledronic acid, after which her calcium levels normalised. She has no allergies. She is complaining of new numbness around her mouth after being administered her fourth dose of amoxicillin for a UTI.

Observations as follows: HR 72 bpm, BP 125/69, RR 18, oxygen saturations 96% on room air, temperature 36.2 degrees.

There is no mouth swelling or tongue swelling or wheeze. She appears comfortable. However, whilst you are measuring her blood pressure, you notice spasming of her hand muscles.

What is the most likely diagnosis?

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