American Board of Pathology (ABPath) 2025 – 400 Free Practice Questions to Pass the Exam

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What is the leading cause of primary hyperparathyroidism?

Parathyroid hyperplasia

Parathyroid adenoma

The leading cause of primary hyperparathyroidism is parathyroid adenoma. This benign tumor of the parathyroid gland results in excessive secretion of parathyroid hormone (PTH), which in turn raises serum calcium levels by increasing renal tubular reabsorption of calcium, enhancing intestinal absorption of calcium, and mobilizing calcium from bones. The majority of primary hyperparathyroidism cases are indeed attributable to these adenomas, making them the most common etiology.

Other causes of primary hyperparathyroidism include parathyroid hyperplasia and malignancy; however, these are less common than adenomas. Chronic kidney disease can lead to secondary or tertiary hyperparathyroidism, where increased PTH secretion occurs as a compensatory mechanism due to low calcium levels, but it is not a cause of primary hyperparathyroidism.

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Malignancy

Chronic kidney disease

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