A 46-year-old man with bulky Burkitt lymphoma starts chemotherapy. Twelve hours later potassium is 6.3 mmol/L, phosphate is 2.6 mmol/L, calcium is

Question

A 46-year-old man with bulky Burkitt lymphoma starts chemotherapy. Twelve hours later potassium is 6.3 mmol/L, phosphate is 2.6 mmol/L, calcium is 1.82 mmol/L, urate is 890 micromol/L and creatinine has doubled. ECG shows peaked T waves. What is the most appropriate management?

Accepted Answer

Aggressive intravenous hydration, rasburicase, hyperkalemia treatment and urgent nephrology involvement

Answer

Allopurinol alone after acute kidney injury is established

Answer

Calcium replacement as the main treatment for asymptomatic hypocalcemia

Answer

Fluid restriction to prevent pulmonary edema

Answer

Delay chemotherapy-related management until urate returns

Tumour lysis syndrome — RCPSC IM MCQ

A 46-year-old man with bulky Burkitt lymphoma starts chemotherapy. Twelve hours later potassium is 6.3 mmol/L, phosphate is 2.6 mmol/L, calcium is 1.82 mmol/L, urate is 890 micromol/L and creatinine has doubled. ECG shows peaked T waves. What is the most appropriate management?