In a patient with kidney stones, hypercalcemia, and mental confusion, which condition should be evaluated?

The condition that should be evaluated in a patient presenting with kidney stones, hypercalcemia, and mental confusion is hyperparathyroidism. This condition is characterized by an overproduction of parathyroid hormone (PTH), which leads to elevated levels of calcium in the blood (hypercalcemia). The excess calcium can contribute to the formation of kidney stones, as high calcium levels in the urine promote stone formation. Additionally, hyperparathyroidism can cause neurological symptoms, such as confusion, due to the effects of high calcium levels on the brain and nervous system.

In contrast, other conditions listed such as Cushing's syndrome and Conn's syndrome primarily involve excess cortisol and aldosterone, respectively, which do not typically lead to hypercalcemia or kidney stones as prominent features. Addison's disease, characterized by adrenal insufficiency, is more associated with low blood sodium and high potassium levels, rather than the hypercalcemia seen in hyperparathyroidism. Thus, the clinical presentation strongly points to hyperparathyroidism as the condition that requires evaluation.