Physical examination of patients with hypercalcemia is usually unremarkable. Patients may have physical findings due to severe hypercalcemia and other complications.

• Physical examination of patients with hypercalcemia is usually unremarkable.^[1]
• Patients may have physical findings due to severe hypercalcemia and other complication.^[2]

• Patients with hypercalcaemia usually appear well.

• High blood pressure due to hypercalcemia and renal failure

• Persistent itching may be present due to renal failure

• Band keratopathy (calcium precipitation in a horizontal band across the cornea in the palpebral aperture); may lead to vision impairment

• Dyspnea due to fluid overload form renal failure

• Palpitations due to arrhythmias
• Chest pain due to fluid overload form renal failure
• Rales and S3 due to fluid overload form renal failure

• Nausea and vomiting
• Anorexia
• Fecal impaction (from constipation)
• Epigastric pain and tenderness due to development of pancreatitis
• Flank pain and tenderness due to nephrolithiasis

• Alteration in urinary habits
• Volume depletion
• Signs of renal failure

• Patient is usually oriented to persons, place, and time.
• Patients with severe hypercalcemia and other complications may have:
  • Anxiety
  • Fatigue and weakness due to renal failure
  • Lethargy
  • Sleep disturbances
  • Muscle twitch and cramps
  • Signs of depression
  • Confusion
  • Memory disturbances
  • Hypotonia
  • Hyporeflexia
  • Paresis
  • Coma

• Swelling of feet and ankles due to renal failure
• Arthralgia due to bone resorption