**Core Concept**
Hyperparathyroidism is a condition characterized by the overproduction of parathyroid hormone (PTH) by the parathyroid glands, leading to an imbalance in calcium and phosphate levels in the body. This imbalance can cause a range of symptoms, including osteoporosis, kidney stones, and neuromuscular symptoms.

**Why the Correct Answer is Right**
Hyperparathyroidism is often associated with an increase in serum calcium levels, which can lead to a decrease in serum phosphate levels. This decrease in phosphate levels can cause a range of symptoms, including neuromuscular symptoms such as muscle weakness, fatigue, and depression. Additionally, the increased calcium levels can lead to an increase in urinary excretion of calcium, which can cause kidney stones.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it is actually a common finding in hyperparathyroidism. Elevated serum calcium levels can cause an increase in urinary excretion of calcium, leading to kidney stones.
**Option B:** This option is incorrect because it is a classic symptom of hyperparathyroidism. The increased calcium levels can cause neuromuscular symptoms such as muscle weakness and fatigue.
**Option C:** This option is incorrect because it is a consequence of the increased calcium levels in hyperparathyroidism. The increased calcium levels can cause an increase in the excretion of calcium in the urine, leading to kidney stones.

**Clinical Pearl / High-Yield Fact**
It's essential to remember that hyperparathyroidism can cause a range of symptoms, including neuromuscular symptoms, kidney stones, and osteoporosis. A high level of suspicion should be maintained in patients with unexplained kidney stones, osteoporosis, or neuromuscular symptoms.

**Correct Answer: D.**