A 26 year old farmer complains of a persistent dry cough and vague abdominal pain. On inspection he is noted to be slightly pale but otherwise healthy.

Question Number 0468

Question:
A 26 year old farmer complains of a persistent dry cough and vague abdominal pain. On inspection he is noted to be slightly pale but otherwise healthy. On examination the lungs are clear. A chest X-ray reveals bilateral hilar adenopathy. An abdominal XRay reveals minor bilateral renal calcification. initial investigations demonstrate a mild anemia and hypercalcemia. Further investogations reveal that the PTH and urinary cAMP are suppressed while the serum level of 1,25(OH)2 D is elevated. The hypercalcemia in this patient is likely to be secondary to

a) bronchial carcinoma
b) breast metastases
c) William's syndrome
d) Sarcoidosis
e) primary hyperparathyroidism


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