Challenge Your Exam Readiness With Our Free AOCNP Practice Questions

Tumor lysis syndrome (TLS) risk is high with Burkitt lymphoma due to rapid cell turnover. Laboratory abnormalities here (hyperuricemia, hyperkalemia, hyperphosphatemia, rising creatinine) with oliguria indicate evolving TLS. Immediate management includes vigorous IV hydration to enhance renal clearance, rasburicase to rapidly degrade uric acid (preferred over allopurinol in high-risk or established TLS), strict electrolyte control (treat hyperkalemia, manage hyperphosphatemia with binders, avoid nephrotoxic agents), and continuous cardiac/telemetry monitoring. Avoid potassium and phosphate in IV fluids and diet. Allopurinol (Option A) prevents new uric acid formation but does not reduce existing levels promptly. Hemodialysis (Option C) is reserved for refractory electrolyte disturbances, persistent acidosis/uremia, or fluid overload despite optimal medical therapy. Fluid restriction (Option D) is inappropriate; careful hydration with monitoring of urine output and diuretics as needed is standard. Initiate cytoreduction once stabilized, and use established TLS criteria (Cairo-Bishop) to guide diagnosis and severity grading.