What's going on, I'm here for med geeks? So today we got a quick one. I want to go over

tumor lysis syndrome. Not a common one that you'll see, however, definitely an emergency

when it walks through the door.

I recently actually admitted a patient with tumor lysis syndrome to the ICU which was a very interesting case

because it was spontaneous and not following chemotherapy treatment.

So I figured it was an appropriate time to go over a case, break it down by the intro ideology

clinical presentation diagnosis and management.

So let us begin. So you have a 76 year old male with

a past medical history of recent diagnosis of non-Hodgkin's lymphoma.

Starting on chemo regimen five days ago, presents with generalized weakness,

common nausea, comma vomiting, no urine output over the past 24 hours and

abnormal labs from his outpatient, which included a sodium of 136, potassium 7.2,

cratineen 3.8, baseline cratineum 1.0, phosphorus of 8.3, calcium 6.8, uric acid, 16, and the eKG that was done in the office

showed peak T-waves. So, what's going on? Well Well your patient has hypercalemia, hyperphosphatemia,

hypocalcemia, hyper uresemia, olig. I. So not good things. So let's figure out how we're going to treat it.

So introduction. Tumor lysis syndrome is, essentially it's a rapid malignant cell turnover and lysis from therapy which will release these

intracellular contents and lead to these severe electrolyte derangements.

So labs you're going to see are your hypercalemia, hyperphosphatemia, hypocalcemia from the

phosphate binding the calcium and then hyperurisemia from the nucleic acids that are released into the cells and then converted

over. These derangements, these are going to lead to acute renal failure, cardiac arrhythmia,

and then potentially death.

These patients are very sick and can turn at any moment.

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