A 23 year old woman presents to her physician for a routine physical examination. Her lab tests are normal except an 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 evaluatin shows decreased 24-hour calcium in urine (60 mg). Her motner 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 hypocalcuric hypercalcemia D- Milk alkali syndrome E- Medullary carcinoma of thyroid gland http://medical-usmle.com/?p=752
