Extraneous information for Pediatric Oncology

Question 1

When cancer cells lyse they release (3 things), which are metabolized into ______ - which can induce acute ______ injury through crystal formation but also through vasocosntriction of this organ, impaired autoregulation, etc.

Answer 1

potassium, phosphorus, nucleic acids

uric acid

kidney

Question 2

_________ can cause _________, leading to neuromuscular irritability (tetany), dysrhythmias and seizures, and can form crystals in various organs.

Answer 2

hyperphosphatemia –> secondary hypocalcemia

Question 3

TLS also releases ______ that cause a systemic inflammatory response syndrome and often mulit-organ failure

Answer 3

cytokines

Question 4

All patients at risk for TLS should receive what?

Answer 4

IV hydration to improve renal perfusion, glomerular filtration and minimize acidosis and oligouria

Question 5

What kind of hydration is given to TLS patients?

Answer 5

Hyperhydration by IV (2500-3000 mL per square meter per day in highest risk patients)

Question 6

What drug is used for TLS to promote urine ouput?

Answer 6

Furosemide

Question 7

Low risk patients for TLS can be treated with what?

high risk?

Answer 7

Low risk - allopurinol and IV fluids

high risk - rasburicase

Question 8

What is the key factor to monitor for patients at risk for TLS?

Answer 8

Urine output