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A 62-year-old woman is referred to your clinic for evaluation of hypercalcemia.

A 62-year-old woman is referred to your clinic for evaluation of hypercalcemia. She has a history of hypertension and vitamin D deficiency. Her medications include hydrochlorothiazide and vitamin D supplements. Laboratory investigations are as follows:

Calcium: 2.72 mmol/L (↑)

Phosphate: 0.9 mmol/L (↓)

Parathyroid hormone (PTH): 0.9 pmol/L (↓)

25-hydroxy vitamin D: 80 nmol/L (normal)

Which one of the following is the best next step?

A.

Order 24-hour urine calcium

B.

Start calcitriol

C.

Refer for consideration of parathyroidectomy

D.

Switch to a different antihypertensive medication

E.

Order serum protein electrophoresis and urine for light chains

Medical Council of Canada MCCQE Summary

  • Vendor: Medical Council of Canada
  • Product: MCCQE
  • Update on: Mar 25, 2026
  • Questions: 348
Price: $52.5  $149.99
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