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TLS Hyperkalaemia — SCE Medical Oncology MCQ

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EasyOncological EmergenciesTLS HyperkalaemiaSCE Medical Oncology

A 65-year-old man with cancer develops tumour lysis syndrome after starting chemotherapy. His uric acid is 680 µmol/L, potassium 6.8, phosphate 3.2, calcium 1.7. Which electrolyte abnormality is the most immediately life-threatening?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Hyperkalaemia — cardiac arrhythmia risk; requires immediate ECG, IV calcium gluconate (cardioprotective), insulin-dextrose, and urgent potassium reduction

TLS: hyperkalaemia is the most immediately life-threatening abnormality (cardiac arrest from arrhythmia). Immediate management: ECG, IV calcium gluconate (stabilise myocardium), insulin-dextrose (shift K intracellular), salbutamol nebuliser, calcium resonium. Concurrent: rasburicase for uric acid, aggressive hydration, avoid calcium supplementation for hypocalcaemia (phosphate-calcium precipitation risk).

Reference: ESMO Oncological Emergencies; Cairo et al Br J Haematol 2010; NICE