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Primary hyperparathyroidism — MCCQE Part 1 MCQ

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HardRenal StonesPrimary hyperparathyroidismMCCQE Part 1

A 45-year-old woman has recurrent calcium oxalate kidney stones. 24-hour urine: hypercalciuria, high calcium, low citrate. PTH elevated, calcium 2.85 mmol/L, phosphate low. Most likely underlying cause?

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Correct answer: E — Primary hyperparathyroidism

Recurrent Ca stones + hypercalcaemia + elevated PTH + hypophosphataemia = primary hyperparathyroidism. Parathyroid adenoma in 85%. Surgery (parathyroidectomy) curative. Localisation with sestamibi scan.

Reference: Endocrine Society / Canadian Guidelines