This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Nephropathy, Subject name: Pediatrics
Child presents with Pathological fracture, Renal stone and Psychiatric symptoms. Most probable diagnosis is? 
Select and explain. 
A. Renal tubular acidosis, B. Hyperparathyroidism, C. Polycystic kidney disease, D. CRF
B: Hyperparathyroidism
Answer: B: Hyperparathyroidism 
Explanation: Ans. (b) HyperparathyroidismRenal Tubular acidosisRTA 1 can present with Nephrocalcinosis and renal rickets but pathological fractures and psychiatric symptoms are not seenHyperpar- athyroidismThe increased bone resorption explains pathological fracture. Hypercalcemia leads to deposition of calcium in the kidney parenchyma. Psychiatric symptoms are seen in hyperparathyroidism.Polycystic kidneysPresents with CRF with cystic kidneysCRFCan have pathological fracture due toOsteitis Cystica Fibrosa due to secondaryHyperparathyroidism.