---
title: A 57-year-old woman with metastatic breast cancer
description: It's Metastatic Breast Cancer Quiz Time with Med-Challenger!
---

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# [A 57-year-old woman with metastatic breast cancer](https://challengercme.com/blog/a-57-year-old-woman-with-metastatic-breast-cancer-was-found-to-be-very-lethargic-and-sleepy)

 Written by [Med-Challenger](https://challengercme.com/blog/author/med-challenger) | Feb 6, 2025 2:30:00 PM

A 57-year-old woman with a 4-year history of metastatic breast cancer was found by her family to be very lethargic and sleepy. She had previously been acting strangely and complaining of nausea, constipation, abdominal pain, and constant thirst.

An ECG shows:

What is the most important initial step in the emergency treatment of this patient’s likely acute problem?

- Mithramycin 25 micrograms/kg every 4 to 5 days
- Calcitonin 4-8 IU/kg body weight
- Saline fluid bolus
- Prednisone 60-80 mg/day

 

This question appears in [Med-Challenger Emergency Medicine Review with CME](https://challengercme.com/emergency-medicine-exam-review-cme-course)

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