VM149

Booklet Question 149

A previously-well 65 year old female has been steadily losing weight for a year. She tells you that she noticed a breast lump a few months ago but has ignored it. She has recently started complaining of nausea and vomiting, as well as abdominal pain. She complains of tiredness and says her ‘arthritis has got worse’. She is not on any medications. Blood tests today reveal a calcium level of 3.5. What would be the most appropriate next step?

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