Symptomatic Hyperparathyroidism?

An early form of primary hyperparathyroidism and surgery is indicated that the patient is symptomatic. So this patient is normal calciumic and has hyper parathyroidism. They may, the calcium may just be on the upper end and normal there, but they have an abnormally elevated PTH - phosphate trashing hormone. You're going to have the hyperchloremic metabolic acidosis due to the PTH effect on the bicarb excretion in the kidney. And then we beat this into the ground.