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BOF: 1

A 30-year-old female presents with fatigue, weight loss, red, painful tender nodules over her shins and breathlessness. The chest X-ray shows bilateral hilar lymphadenopathy. Investigations show that she has hypercalcaemia.

The cause of the hypercalcaemia is:

a)      Increased parathyroid hormone production in the lungs

b)      A high serum ACE causing increased hydroxylation of 25 hydroxycholecalciferol to 1,25 dihydroxycholecalciferol in the kidney

c)      Alpha hydroxylation of 25 hydroxycholecalciferol to 1, 25 dihydroxycholecalciferol by macrophages in the lung

d)      Lytic lesions in the bones

e)      Hyperventilation

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