Weakness!

• 43 M @ with fatigue and met lung ca
• started on immunotherapy po
• CC nausea, dyspnea, sudden in onset
• fluid overloaded, ++ weak, cannot get out of bed
• What are some cannot miss diagnoses?

You order some labs

• K+ 7
• Ca 2.0
• PO 2.2
• Cr 310
• Uric acid 500
• DIAGNOSIS?

TUMOUR LYSIS

RISK FACTORS

• large tumour burden
• high LDH
• ALL, Burkitt
• consider diagnosis in fast growing tumours (eg. HCC, testicular, small cell lung, breast)
• MAY NOT ALWAYS BE BLOOD CANCER**

management

• hydration +/- diuretics
• metabolic correction
• address renal failure
• specifics: hyperK, allopurinol/rasburicase, consideration of dialysis (GOC), phosphate binders, calcium