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A 23 year old woman presents to her physician for a routine physical examination. Her lab tests are normal except elevated calcium level (13 mg/dL). She is healthy, exercises regularly, doesn't smoke or drink alcohol. She has no history of renal or digestive symptoms. Further evaluation shows decreased 24-hour calcium in urine (60 mg). Her mother was diagnosed with hyperparathyroidism and had a neck surgery. Her calcium serum level didn't improve and stayed high after surgery.
What is the most likely diagnosis?
A- Primary hyperparathyroidism
B- Secondary hyperparathyroidism
C- Familial benign hypocalciuric hypercalcemia
D- Milk alkali syndrome
E- Medullary carcinoma of thyroid gland
Answer: http://medical-usmle.com/?p=752
 
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