skip to main content

Tumour lysis syndrome after lymphoma chemotherapy — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardCancer and Palliative Care and HaematologyTumour lysis syndrome after lymphoma chemotherapySCE Acute Medicine

A 57-year-old man with high-grade lymphoma starts chemotherapy and becomes oliguric after 36 hours. Potassium is 6.4 mmol/L, phosphate 2.4 mmol/L, corrected calcium 1.82 mmol/L, urate 980 micromol/L and creatinine has doubled. What is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: B — Tumour lysis syndrome

The combination of hyperkalaemia, hyperphosphataemia, hypocalcaemia, hyperuricaemia and AKI after chemotherapy is tumour lysis syndrome. Milk-alkali and primary hyperparathyroidism cause hypercalcaemia rather than hypocalcaemia. Rhabdomyolysis may cause hyperkalaemia and AKI but does not explain the classic phosphate-urate-calcium pattern. Early recognition matters because rasburicase and renal support may be needed urgently.

Reference: BCSH tumour lysis syndrome guideline, BNF