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A 9-year-old girl being treated with combination chemotherapy for acute lymphoblastic leukemia (ALL) is noted to have increased levels of blood urea nitrogen (BUN) and creatinine on day 4 of treatment. The patient is immediately started on intravenous normal saline. An ECG is ordered which demonstrates prolonged QT intervals. For confirmation of the diagnosis, several laboratory tests, including a complete metabolic profile, are ordered. Which of the following laboratory abnormalities result from this patient's condition?Ask StudybuddyGroup of answer choicesDecreased calcium, increased phosphate, decreased uric acid, decreased potassiumDecreased calcium, decreased phosphate, increased uric acid, increased potassiumDecreased calcium, increased phosphate, increased uric acid, increased potassiumIncreased calcium, increased phosphate, increased potassium, increased uric acid

Question

A 9-year-old girl being treated with combination chemotherapy for acute lymphoblastic leukemia (ALL) is noted to have increased levels of blood urea nitrogen (BUN) and creatinine on day 4 of treatment. The patient is immediately started on intravenous normal saline. An ECG is ordered which demonstrates prolonged QT intervals. For confirmation of the diagnosis, several laboratory tests, including a complete metabolic profile, are ordered. Which of the following laboratory abnormalities result from this patient's condition?Ask StudybuddyGroup of answer choicesDecreased calcium, increased phosphate, decreased uric acid, decreased potassiumDecreased calcium, decreased phosphate, increased uric acid, increased potassiumDecreased calcium, increased phosphate, increased uric acid, increased potassiumIncreased calcium, increased phosphate, increased potassium, increased uric acid

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Solution

The patient's condition, which is likely tumor lysis syndrome (TLS), is characterized by rapid release of intracellular components into the bloodstream following the lysis of malignant cells. This can occur spontaneously but is often precipitated by cytotoxic therapy, as in this patient. The intracellular components released include potassium, phosphate, and nucleic acids, which are metabolically converted to uric acid in the liver.

Therefore, the laboratory abnormalities that result from this patient's condition would be: Decreased calcium (due to precipitation with increased phosphate), increased phosphate, increased uric acid (from the breakdown of nucleic acids), and increased potassium (from the intracellular component). So, the correct answer is: Decreased calcium, increased phosphate, increased uric acid, increased potassium.

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