Which of the following are recommended for management of tumour lysis syndrome? 1. Urinary alkalinization 2. Intravenous fluids 3. Rasburicase 4. Febuxostat Select the correct answer using the code given below.
Tumor Lysis Syndrome Management Recommendations
Tumor Lysis Syndrome (TLS) is a critical condition characterized by the rapid release of intracellular components into the bloodstream following chemotherapy or radiation treatment. Effective management focuses on preventing and treating metabolic abnormalities.
The key management strategies include:
- Intravenous fluids (2): Aggressive hydration with intravenous fluids is fundamental. It helps maintain adequate urine output (aiming for > 0.5-1 mL/kg/hr), promotes the excretion of uric acid and other metabolic byproducts, and helps prevent acute kidney injury.
- Rasburicase (3): This is a recombinant urate oxidase enzyme. It effectively catalyzes the conversion of uric acid into allantoin, a much more water-soluble compound that is readily excreted by the kidneys. It is particularly useful for rapid reduction of significantly elevated uric acid levels.
- Febuxostat (4): This is a non-purine selective inhibitor of xanthine oxidase. By inhibiting this enzyme, it reduces the production of uric acid. It serves as an alternative or adjunct to other therapies for managing hyperuricemia.
Urinary alkalinization (1), while historically used, is generally *not* recommended in current practice guidelines. The risk of calcium phosphate precipitation within the renal tubules, potentially leading to nephrotoxicity, outweighs the benefits for preventing urate nephropathy, especially when other effective measures like hydration and specific medications are available.
Therefore, the recommended management strategies from the list are intravenous fluids, rasburicase, and febuxostat.
The correct option includes items 2, 3, and 4.
Important Questions from General Clinical Conditions
- In which of the following SA node dysfunction conditions, permanent pacing may NOT be required?
1. Beta blocker drugs
2. Narcotic drugs
3. Iatrogenic-Post RT/Surgery
4. Hypothyroidism
5. Sick sinus syndrome
6. Raised Intracranial tension
Select the correct answer using the code given below. - Consider the following statements regarding Weight Loss:
1. 4.5 kg over 6-12 months
2. 10 kg over 6-12 months
3. More than 5% over 6-12 months
4. More than 10% over 6-12 months
Which of the above constitute significant or clinically important weight loss? - The ‘Y' descent in JVP waveform represents:
- While distinguishing a venous pulsation from the arterial pulsation in neck, which of the following is NOT correct?
- Regardless of the infectious agent, the most characteristic symptom of infectious esophagitis is:
