calcium levels

136.Calcium level falls to normal after cortisone administration in all of the following except:
a) Primary hyperparathyroidism
b) Vitamin D overdose
c) Adisonian crisis
d) Sarcoidosis
e) Hypercalcemia of infancy

ref CMDT- (hyperparathyroidism, sarcoidosis topic)

1) Vit D overdose- a brief course of glucocorticoids may be necessary if hypercalcemia is severe.

2) Adisons ds- corticosteroids are the main treatment. (no need for thinking!!)

3) Sarcoidosis- indications for treatment with oral steroids include constitutional symptoms, hypercalcemia, iritis, arthritis, cns invol, cardiac invol,granulomatous hep,pulmonary lesions. ( so, hypercal is there in this list!!)

4) Hypercalcemia of infancy- regardind this i could only find that it has excellent prognosis and hypercalcemia here does not respond to parathyroid removal surgery.

5) Primary hyperparathyroidism- CMDT clearly mentions that Glucocorticoid therapy is ineffective for treating hypercalcemia in hyperparathyroidism.
treatment is- Bisphosphonates, Mithramycin, parathyroidectomy.

so, the answer is PRIMARY HYPERTHYROIDISM.