Primary hyperparathyroidism Laboratory findings: triad (hallmark) immaging: is it necessary for dx of it?; use what to detect/locate parathyroid adenoma, if ultrasound and nuclear is negative and prior to neck surgery pts , have to be done for all pts with confirmed hyperparathyroidism, and determine amount of bone loss management: first line tx and second line tx for those who are not surgical candidates and asymptomatic