A 67-year-old man with metastatic squamous cell carcinoma of the lung presents with constipation, abdominal pain, polyuria, and confusion. Vital signs: BP 148/92 mmHg, HR 102 bpm, RR 18, Temp 37.2°C, SpO2 98% on room air. Laboratory studies show serum calcium 13.9 mg/dL, phosphate 2.2 mg/dL, and albumin 3.8 g/dL. Serum PTH is suppressed. Which symptom cluster best characterizes this electrolyte disorder?

1. A)Hyperreflexia, clonus, agitation, and hyperthermia
2. B)Tetany, seizures, prolonged QT, and laryngospasm
3. C)Headache, confusion, coma, and seizures from water intoxication
4. D)Bradycardia, hyporeflexia, respiratory depression, and flushing
5. E)Stones, bones, groans, thrones, and psychiatric overtonesGABARITO