Step 1: Pseudohypoparathyroidism means the body looks like it lacks PTH effect, but the gland is fine. The defect is end-organ resistance to PTH, classically from a G protein (GNAS) defect in the receptor pathway.
Step 2: Because target tissues cannot respond to PTH, calcium stays low and phosphate stays high, just like true hypoparathyroidism. So decreased serum calcium (B) and increased serum phosphate (C) are both true.
Step 3: The key difference from true hypoparathyroidism is the PTH level. Since the resistance keeps calcium low, the parathyroid glands are continuously stimulated and pump out more hormone. So serum PTH is increased, not decreased. Option A is therefore the false statement.
Step 4: Type 1a pseudohypoparathyroidism shows the physical features of Albright hereditary osteodystrophy: short stature, round face, short fourth and fifth metacarpals, and obesity. So option D is true.
Step 5: The untrue statement is decreased serum PTH; it is actually high.
Correct option: A.