This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Kidney, Subject name: Medicine
Which of the following finding shall be seen in patient with hyper-parathyroidism? 
Select and explain. 
A. Hypophosphatemia, B. Hyperphosphatemia, C. Hypermagnesemia, D. Hypo magnesemia
A: Hypophosphatemia
Answer: A: Hypophosphatemia 
Explanation: Ans. (a) Hypophosphatemia* Vitamin D deficiency will lead to Hypocalcemia. This will result in secondary increase in PTH.* This PTH will now act on proximal convoluted tubule to cause loss of phosphate. The increased bone turnover will cause increase in serum alkaline phosphate.* Important calcium/phosphate and SAP fluctuations which are asked ( especially those in bold)ConditionRicketsHyperparathyroidismOsteoporosisPaget diseaseChronic renal failureSerum calciumLessIncreasedNormalNormalLessSerum hosphateLessLessNormalNormalIncreasedSAPIncreasedIncreasedNormalDisproportionate IncreasedIncreasedPTHIncreasingIncreasednormalnormalIncreased