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Primary Hyperparathyroidism

D: Primary Hyperparathyroidism
C: elevated/ intact PTH, chloride / phosphate > 33:1, low level of Ca in urine, mild metabolic acidosis, hypercalcemia, hypohphosphatemia
C: hypercalcemia, hypophosphatemia, metabolic acidosis b/c PTH inhibits phos & bicarb reabs in the renal tubule, k. stones, pud, pancreatitis, gout, psych, htn, lvh, 10% lifespan decrease
T: surgery

met. acidosis - increased HCO3- excretion causes more Cl- to be reabsorbed with Na+ to maintain electroneutrality
hypercalcemia - maignancy + hyperparathyroidism (most common in ambulatory setting - 50-60%) account for 90% - weakness + constipation + fatigue