امرأة عمرها ٦٠ سنة عندها حصوات كلى متكررة، وآلام عظام، وإمساك، وتعب، واكتئاب. الكالسيوم مرتفع وهرمون الغدة جار الدرقية مرتفع. ما الأرجح؟

A 60-year-old woman has recurrent kidney stones, bone pain, constipation, fatigue and low mood. Calcium and PTH are both high. What is most likely?

1. Mild vitamin D deficiency
2. Hypothyroidism
3. Addison’s disease
4. Primary hyperparathyroidism

Answer: D) Primary hyperparathyroidism. High calcium with high PTH indicates primary hyperparathyroidism, usually from an adenoma: stones, bones, abdominal groans and psychiatric moans. Treatment is often surgical, with hydration.