A 20-Year-Old Man Is Found to Have an Elevated Calcium

A 20-year-old man is found to have an elevated calcium level on pre-employment screening blood tests.  He feels well and has no polyuria, polydipsia, or constipation.  His medical history is unremarkable.  He takes no prescription medications, although he has been consuming "protein shakes and vitamin supplements" in preparation for running a marathon.  The patient does not use tobacco, alcohol, or illicit drugs.  Temperature is 37 C (98.6 F) , blood pressure is 110/70 mm Hg, and pulse is 82/min.  Physical examination is unremarkable.  Laboratory results are as follows: Which of the following conditions is most consistent with this patient's findings?

A) Familial hypocalciuric hypercalcemia
B) Multiple myeloma
C) Primary hyperparathyroidism
D) Renal cell carcinoma
E) Sarcoidosis
F) Vitamin D toxicity

Correct Answer:

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