Simplicity in Complexity VMR - October 10, 2026 - Weakness & Slurred Speech

Work up altered mental status by separating neurological from metabolic causes. For hypercalcemia, ask whether it is PTH-mediated and think PTHrP. Myeloma rarely causes hepatosplenomegaly, while marginal zone lymphoma can. MYC positivity points to a high-grade lymphoma such as DLBCL or Burkitt.