PTH and Familial adenomatous polyposis: A 22-year-old male with a history of vitamin D deficiency and family history of familial adenomatous polyposis (FAP) presented to the emergency department with intermittent upper extremity muscular twitching and was found to have elevated serum calcium (15.4 mg/dL [3.85 mmol/L]; reference range [RR], 8.4-10.2 mg/dL [2.1-2.6 mmol/L]) alongside elevated intact PTH (463 pg/mL [49.1 pmol/L]; RR, 22.4-88.2 pg/mL [2.40-9.40 pmol/L]) and mild prerenal azotemia.