Which of the following lists reflects the plasma/serum changes seen in suspected primary hyperparathyroidism?

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Multiple Choice

Which of the following lists reflects the plasma/serum changes seen in suspected primary hyperparathyroidism?

In primary hyperparathyroidism, excess parathyroid hormone drives a pattern of high calcium, low phosphate, and increased bone turnover. PTH raises serum calcium through bone resorption, increasing renal calcium reabsorption, and promoting activation of vitamin D to boost gut calcium absorption. It also causes the kidneys to waste phosphate, lowering serum phosphate. The bone turnover stimulated by PTH often elevates alkaline phosphatase levels. So the expected plasma/serum profile is PTH elevated, calcium elevated, phosphate reduced, and ALP elevated. That matches the pattern where PTH is increased, Ca is increased, PHOS is decreased, and ALP is increased. The other patterns would not fit this mechanistic combination of hypercalcemia with phosphate wasting and increased bone turnover.

In primary hyperparathyroidism, excess parathyroid hormone drives a pattern of high calcium, low phosphate, and increased bone turnover. PTH raises serum calcium through bone resorption, increasing renal calcium reabsorption, and promoting activation of vitamin D to boost gut calcium absorption. It also causes the kidneys to waste phosphate, lowering serum phosphate. The bone turnover stimulated by PTH often elevates alkaline phosphatase levels. So the expected plasma/serum profile is PTH elevated, calcium elevated, phosphate reduced, and ALP elevated. That matches the pattern where PTH is increased, Ca is increased, PHOS is decreased, and ALP is increased. The other patterns would not fit this mechanistic combination of hypercalcemia with phosphate wasting and increased bone turnover.

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