Twenty-four hours after chemotherapy for bulky high-grade lymphoma, a patient has potassium 6.9 mmol/L with broad QRS complexes, phosphate 2.6

Question

Twenty-four hours after chemotherapy for bulky high-grade lymphoma, a patient has potassium 6.9 mmol/L with broad QRS complexes, phosphate 2.6 mmol/L, corrected calcium 1.72 mmol/L, urate 910 micromol/L and oliguric AKI. What is the best immediate management bundle?

Accepted Answer

Immediate hyperkalaemia protocol with ECG monitoring, intravenous hydration, rasburicase and early renal-support planning

Answer

ECG monitoring, insulin-dextrose and loop diuresis, avoiding urate-lowering treatment during AKI

Answer

ECG monitoring, intravenous hydration and allopurinol, with urate reassessment after six hours

Answer

Intravenous calcium, insulin-dextrose and ECG monitoring, deferring rasburicase until potassium normalises

Answer

Intravenous hydration, rasburicase and phosphate replacement, monitoring potassium without immediate drug treatment

Tumour Lysis Syndrome — SCE Medical Oncology MCQ

Twenty-four hours after chemotherapy for bulky high-grade lymphoma, a patient has potassium 6.9 mmol/L with broad QRS complexes, phosphate 2.6 mmol/L, corrected calcium 1.72 mmol/L, urate 910 micromol/L and oliguric AKI. What is the best immediate management bundle?