case 38

A 70-year-old-woman is brought to the emergency departement with right flank
pain, nausea, vomiting, and blood in her urine. she has no fever or urinary tract symptoms. she has recurrent kidney stones, vague abdominal pain, muscle weakness, and atrophy. on examination, she is in moderate distress secondary to her flank pain. she appears thin and fragile. other than right back pain, her physical examination is normal. urinalysis reveals large amounts of blood but no signs of infection. an intravenous pylogram (IVP) is performed and revelas nomerous kidney stones. a metabolic panel shows an extremely elevated calcium level. futher workup demonstrates that the patient has hyperparathyroidsm from a parathyroid (PTH) adenoma.
-how does PTH increase instestinal calcium absortion
-what effect do elevated levels of PTH  have on renal phosphate rebasoption
-what are three factors that increase the activity of 1α-hydroxylase in kidney