2: Oncological Emergencies - TLS Flashcards
What is tumour lysis syndrome
Metabolic abnormalities caused by rapid destruction of tumour cells - leads to renal failure
When is TLS most common
Following induction of chemotherapy for leukaemia and lymphoma
How long after chemotherapy does TLS symptoms manifest
Days
What scoring system is used for TLS
Cario-Bishop Scoring System
What does Cario-Bishop Scoring system state must be present
Two laboratory criteria present 3d before and 7d after chemotherapy
- Hyperphosphataemia (25% Increase)
- Hyperuraecaemia (25% Increase)
- Hyperkalaemia (25% Increase)
- Hypocalcaemia (25% decrease)
What are the 4 electrolyte abnormalities in TLS
- High Uric Acid
- High Potassium
- High Phosphate
- Low calcium
What is clinical TLS
Laboratory criteria and one of:
- Arrhythmias
- Seizures
- Increase serum creatinine (1.5 times limit)
What causes high potassium in TLS
Renal Failure
What does high potassium cause
Cardiac arrhythmias
What causes high phosphate in TLS
Tumour cells usually contain higher phosphate - rupture cause phosphate release
What does high phosphate cause
Binds with calcium and precipitates to cause:
- Renal damage
- Arrhythmias (heart)
- Gangrene (skin)
What cause high uric acid in TLS
- Renal failure
- Release uric acid used to make DNA
What does high uric acid cause
- Renal failure
What causes low calcium in TLS
Binds to phosphate
What does low calcium cause
Weakness
Tetancy
