PAEA Surgery End Of Rotation (EOR) Practice Exam

Prolonged immobilization can lead to which condition?

1. Hyponatremia

2. Hypernatremia

3. Hypokalemia

4. Hypercalcemia

The correct answer is: Hypercalcemia

Prolonged immobilization is associated with the development of hypercalcemia, primarily due to the increased release of calcium from the bones into the bloodstream as a result of decreased mechanical loading and physical activity. When the body is immobilized for extended periods, there is a reduction in weight-bearing activities, which normally stimulate bone formation and inhibit bone resorption. Consequently, the balance shifts towards bone resorption, leading to an elevated level of calcium in the serum. In addition, immobilization can cause an increase in osteoclastic activity (the cells responsible for bone resorption), leading to further calcium release. Hypercalcemia may manifest with symptoms such as lethargy, confusion, muscle weakness, and gastrointestinal disturbances, making it a significant concern in patients who are immobilized for long-term. Other conditions mentioned, such as hyponatremia, hypernatremia, and hypokalemia, are typically related to fluid and electrolyte imbalances or renal function rather than the direct effects of immobilization. While these conditions can occur in various clinical scenarios, they are not primarily associated with immobilization itself. Thus, the proper understanding of the physiological consequences of prolonged immobilization links it directly to hypercalcemia.