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Primary hyperparathyroidism — ABFM Board MCQ

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HardEndocrine/MetabolicPrimary hyperparathyroidismABFM Board

A 48-year-old woman has serum calcium 11.4 mg/dL on two tests, phosphate is low, PTH is elevated, and 25-hydroxyvitamin D is sufficient. She has recurrent kidney stones. Which of the following is the most likely diagnosis?

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Correct answer: E — Primary hyperparathyroidism

Hypercalcemia with inappropriately elevated PTH and low phosphate is consistent with primary hyperparathyroidism. Kidney stones are a classic complication and support referral for parathyroidectomy evaluation.

Reference: Endocrine Society/AAES Primary Hyperparathyroidism Guidance