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Hypercalcaemia from primary hyperparathyroidism — SCE Rheumatology MCQ

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ModerateMetabolic bone diseaseHypercalcaemia from primary hyperparathyroidismSCE Rheumatology

A 64-year-old woman has symptomatic hypercalcaemia with recurrent renal stones. Examination shows examination is unremarkable. Investigations show calcium is 3.05 mmol/L and PTH is raised. What is the most appropriate management?

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Correct answer: C — Refer for parathyroidectomy assessment

Refer for parathyroidectomy assessment is the most appropriate management because it addresses the underlying metabolic bone risk. The alternatives either do not prevent fracture, treat a different disease, or delay necessary intervention. Fracture prevention should begin promptly after fragility fracture or high-risk glucocorticoid exposure.

Reference: NOGG osteoporosis guideline; NICE CG146; BNF