A 52-year-old man with high-grade lymphoma starts chemotherapy and 24 hours later becomes oliguric. Potassium is 6.8 mmol/L, phosphate 2.5 mmol/L,

Question

A 52-year-old man with high-grade lymphoma starts chemotherapy and 24 hours later becomes oliguric. Potassium is 6.8 mmol/L, phosphate 2.5 mmol/L, calcium 1.82 mmol/L, urate 890 micromol/L and creatinine has doubled. ECG shows peaked T waves. What is the most appropriate next step in management?

Accepted Answer

Treat hyperkalaemia immediately and involve haematology and renal teams for tumour lysis syndrome

Answer

Delay treatment until urate crystal analysis is available

Answer

Give calcium supplements as the first priority

Answer

Restrict fluids and avoid renal discussion

Answer

Start allopurinol alone and review in the morning

Tumour lysis syndrome with life-threatening hyperkalaemia — SCE Acute Medicine MCQ

A 52-year-old man with high-grade lymphoma starts chemotherapy and 24 hours later becomes oliguric. Potassium is 6.8 mmol/L, phosphate 2.5 mmol/L, calcium 1.82 mmol/L, urate 890 micromol/L and creatinine has doubled. ECG shows peaked T waves. What is the most appropriate next step in management?