<prompt> Lysis of cells cause AE -HyperuricemiaHypercalcemiaHyper phosphatemiaHyperkalemia.  <response>: Hypercalcaemia, also spelled hypercalcemia, is a high calcium Ca2 level in the blood serum. The normal range is 2.1-2.6 mmolL 8.8-10.7 mgdL, 4.3-5.2 mEqL, with levels greater than 2.6 mmolL defined as hypercalcemia. Those with a mild increase that has developed slowly typically have no symptoms. In those with greater levels or rapid onset, symptoms may include abdominal pain, bone pain, confusion, depression, weakness, kidney stones or an abnormal hea rhythm including cardiac arrest The neuromuscular symptoms of hypercalcaemia are caused by a negative bathmotropic effect due to the increased interaction of calcium with sodium channels. Since calcium blocks sodium channels and inhibits depolarization of nerve and muscle fibers, increased calcium raises the threshold for depolarization. This results in diminished deep tendon reflexes hyporeflexia, and skeletal muscle weakness. There is a general mnemonic for remembering the effects of hypercalcaemia: stones, bones, groans, moans, thrones, and psychiatric oveones. Stones kidney or biliary see calculus Bones bone pain Groans abdominal pain, nausea and vomiting Moans may complain about other non-specific symptoms Thrones polyuria resulting in dehydration due to nephrogenic diabetes insipidus from nephrocalcinosis Muscle tone hypotonicity, muscle weakness, hyporeflexia Psychiatric oveones Depression 30-40, anxiety, cognitive dysfunction, insomnia, coma Other symptoms include cardiac arrhythmias especially in those taking digoxin, fatigue, nausea, vomiting emesis, loss of appetite, abdominal pain, constipation, paralytic ileus. If kidney impairment occurs as a result, manifestations can include increased urination, urination at night, and increased thrist.Psychiatric manifestation can include emotional instability, confusion, delirium, psychosis, and stupor.Limbus sign seen in eye due to hypercalcemia Ref Davidson 23rd edition pg 370 