A 40 year old woman presents to her physician complaining of marked left flank pain that began the previous night. She reports that the pain is worse than that of childbirth. She also reports blood in her urine. She is very fatigued, and she feels more forgetful, which has worsened over the last year. There is no significant past medical history and is not currently taking medications. Family history is also unremarkable.Physical exam: Marked tenderness in left flank Calcium 11.1 mg/dL (normal 8.5-10.2 mg/dL) Albumin 3.8 (normal 3.5-4.8 g/dL) Intact PTH 162 pg/mL (normal 11-54 pg/mL) Renal function is normal Urinalysis- >50 RBCs/HPF Urine calcium 483mg/24hr (normal, 100 to 250/24hr)Questions— Answer in completed sentences. Defend and explain your answers.1. Which laboratory results are abnormal?2. What is the presumptive diagnosis for this patient? The differential diagnosis? WHY?3. What treatment is indicated for this disease?
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