Calcium and Parathyroid USMLE Step 1 Practice Question
A 52-year-old woman with a history of parathyroidectomy for primary hyperparathyroidism 8 years ago now presents with bone pain, elevated alkaline phosphatase, and hypercalcemia with an inappropriately high PTH level despite previous surgery. Serum calcium is 11.2 mg/dL and PTH is 189 pg/mL. Which of the following is the most likely diagnosis?
Answer choices
- ARecurrent primary hyperparathyroidism from parathyroid remnant hyperplasiaCorrect answer
- BVitamin D intoxication from excessive supplementation
- CTertiary hyperparathyroidism from prior secondary changes
- DHyperthyroidism increasing bone turnover and calcium mobilization
- EEctopic PTHrP secretion from an undiagnosed malignancy
- FMilk-alkali syndrome from excessive calcium and alkali intake
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