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Parathyroid level may be normal or high (in myeloma it would be low)
Stereotypical - elderly female with thirst and normal or high PTH - commonly due to solitary adenoma

Causes
80% solitary adenoma
15% hyperplasia
4% multiple adenoma
1% carcinoma

Features - bones, stones, abdo moans and psychic groans
polydipsia, polyuria
peptic ulceration, constipation, pancreatitis
bone pain / fracture
renal stones
depression 
HT

associations - HT and MEN 1 and 2 (multiple endocrine neoplasia)

Ix
raised Ca and low phosphate
PTH raised or normal
technetium MIBI subtraction scan if considering op
if cCa <3 - repeat bloods 6/12ly and do BMD scan

Rx 
Total parathyroidectomy