A 61-year-old woman has calcium 11.2 mg/dL on two tests. Phosphate is low, creatinine is normal, and parathyroid hormone is elevated. She has

Question

A 61-year-old woman has calcium 11.2 mg/dL on two tests. Phosphate is low, creatinine is normal, and parathyroid hormone is elevated. She has constipation and a history of calcium kidney stones. Which of the following is the most appropriate at this time?

Accepted Answer

Refer for parathyroidectomy evaluation

Answer

Observe without follow-up despite stones

Answer

Start thiazide therapy

Answer

Give loop diuretics as definitive outpatient therapy

Answer

Treat with vitamin D megadoses alone

Hypercalcemia primary hyperparathyroidism — USMLE Step 3 MCQ

A 61-year-old woman has calcium 11.2 mg/dL on two tests. Phosphate is low, creatinine is normal, and parathyroid hormone is elevated. She has constipation and a history of calcium kidney stones. Which of the following is the most appropriate at this time?