skip to main content

Familial hypocalciuric hypercalcaemia — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCalcium/BoneFamilial hypocalciuric hypercalcaemiaSCE Endocrinology

A 63-year-old woman has thiazide-treated hypertension and repeated calcium 2.72 mmol/L. PTH is 8.4 pmol/L and urinary calcium:creatinine clearance ratio is 0.004. Her mother had mild hypercalcaemia but no renal stones. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Familial hypocalciuric hypercalcaemia

Familial hypocalciuric hypercalcaemia is best because familial mild hypercalcaemia with inappropriately normal PTH and very low urinary calcium suggests FHH. The alternatives are less appropriate because primary hyperparathyroidism usually has higher urinary calcium; tertiary disease follows CKD; sarcoidosis and malignancy suppress PTH. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: NICE CKS Hypercalcaemia; Society for Endocrinology