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Tumor lysis syndrome — ABEM Board MCQ

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HardRenal/Metabolic emergenciesTumor lysis syndromeABEM Board

A 58-year-old man with lymphoma presents as triage level 2 two days after chemotherapy. Potassium is 6.4 mEq/L, phosphate is 8.2 mg/dL, calcium is 6.8 mg/dL, uric acid is 14 mg/dL, creatinine is 2.4 mg/dL, and ECG shows peaked T waves. Which of the following is the most appropriate imaging study?

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Correct answer: E — No imaging is required to diagnose the metabolic emergency

The constellation after chemotherapy indicates tumor lysis syndrome; management is metabolic stabilization, rasburicase or allopurinol as appropriate, fluids, and possible dialysis.

Reference: ASCO/NCCN tumor lysis guidance; ABEM EM Model