In parathyroid crisis with sudden elevations of calcium over 16 mg /dl ; the treatment consist of -a) Intravenous vitamin Db) Parathyroidectomy for removal of adenomac) Thyrocalcitonind) Intravenous bicarbonatee) All of the above

**Core Concept**
The parathyroid crisis, also known as hyperparathyroidism crisis, is a life-threatening condition characterized by severely elevated serum calcium levels (>14 mg/dL) due to an overproduction of parathyroid hormone (PTH) by one or more parathyroid glands. The sudden elevation of calcium levels can lead to cardiac arrhythmias, renal failure, and other systemic complications.

**Why the Correct Answer is Right**
The treatment of parathyroid crisis involves measures to reduce serum calcium levels and manage the underlying cause. **Option B**, Parathyroidectomy for removal of adenoma, is the definitive treatment for hyperparathyroidism crisis. This surgical procedure involves the removal of the affected parathyroid gland(s) to correct the underlying hormonal imbalance. **Option C**, Thyrocalcitonin, also known as calcitonin, is a hormone that helps lower serum calcium levels by inhibiting osteoclast activity and promoting calcium deposition in bone. However, its role in acute management is limited.

**Why Each Wrong Option is Incorrect**
**Option A:** Intravenous vitamin D is not indicated in parathyroid crisis as it can further increase serum calcium levels.
**Option D:** Intravenous bicarbonate may help manage acidosis, but it is not a primary treatment for parathyroid crisis.
**Option E:** All of the above is incorrect as not all options are indicated in the treatment of parathyroid crisis.

**Clinical Pearl / High-Yield Fact**
In cases of parathyroid crisis, it's essential to monitor serum calcium levels closely and consider surgical intervention if levels remain elevated despite medical management.

**Correct Answer:** B. Parathyroidectomy for removal of adenoma.