This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
[{'content': 'A 60 year old male patient exhibits excessive sleepiness, slowing of movements, mild depression and proximal muscle weakness. Serology shows normal  blood calcium and increased creatinine with reduced creatinine clearance. The patient has had joint swellings and  abdominal discomfort for several months . what is most likely diagnosis \nSelect and explain. \nA. Hypermagnesemia, B. Hepatolenticular degeneration, C. Hyperparathyroidism, D. Akinetic mutism', 'role': 'user'}, {'content': 'Answer: C \nExplanation: The appearance of pseudogout in elderly patients should raise the probability of hyperparathyroidism. Blood calcium levels may be normal when checked , but parathyroid hormone levels will be elevated.', 'role': 'assistant'}]