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Tumour lysis syndrome — SCE Acute Medicine MCQ

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ModerateAcute Renal and Metabolic EmergenciesTumour lysis syndromeSCE Acute Medicine

A 59-year-old man is assessed on the acute medical unit. He has high-grade lymphoma and develops AKI after chemotherapy. Potassium, phosphate and urate are high, while calcium is low. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: A — Tumour lysis syndrome

Tumour lysis syndrome is the best answer because the electrolyte pattern after cytotoxic treatment is characteristic of tumour lysis syndrome. Hyperosmolar hyperglycaemic state is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Rasburicase is considered for high-risk or established hyperuricaemic TLS.

Reference: https://b-s-h.org.uk/guidelines#acute-medicine-order-49-1