Q; Tumor lysis syndrome may cause all except? (Choose one)

A) Hyperkalemia

B) Hyperphosphatemia

C) Hypercalcemia

D) Hyperuricemia

E) Lactic acidosis

Answer:  C

Tumor lysis syndrome cause Hypocalcemia. Because of the hyperphosphatemia, calcium is precipitated to form calcium phosphate, leading to hypocalcemia. Hypocalcemia may lead to tetany, seizures etc.

Patients about to receive chemotherapy for a cancer with a high cell turnover rate, like lymphomas and leukemias, should receive prophylactic allopurinol as well as IV hydration to target urine output > 2.5 L/day. Rasburicase is an alternative to allopurinol. Alkalization of the urine is controversial and has shown no difference.