Thakker, DKulkarni, AHegde, A V.2023-06-172023-06-172023-05Thakker D, Kulkarni A, Hegde AV.. A Diagnostic Journey. Journal of the Association of Physicians of India. 2023 May; 71(5): 90-910004 – 5772http://imsear.searo.who.int/handle/123456789/216397We describe the case of a patient who came with features suggestive of diabetic ketoacidosis. On further evaluation of DKA, we found that it was caused by acute pancreatitis. This acute pancreatitis was found to be caused by hypercalcemia, which was in turn due to primary hyperparathyroidism. Imaging studies done for hyperparathyroidism revealed a thyroid nodule which later turned out to be malignant. This patient was also incidentally found to have hypertrophic obstructive cardiomyopathy.Journal ArticleIndiaStudent, DNB MedicineDrNB Endocrinology Student, DNB MedicineConsultant, Head of Department, Department of Critical Care Medicine, P. D. Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra, India