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1. In which tumor type is tumor lysis syndrome most common?

A. Acute myeloid leukemia (white blood cell count <25 000) B. Any hematological cancer C. Chronic myelogenous leukemia D. Large bulky, rapidly growing disease

2. When do clinically important symptoms of patients with tumor lysis syndrome most often appear after initiation of therapy?

A. Within 1 hour B. More than 10 days C. 2 to 3 days D. 7 to 10 days

3. In the study by Cortes et al of adult patients receiving rasburicase, allopurinol, or both agents for patients with established tumor lysis syndrome, which drug(s) provided superior reduction of hyperuricemia?

A. Allopurinol alone B. Rasburicase alone C. Combination rasburicase and allopurinol D. Rasburicase alone and combination rasburicase and allopurinol were equally superior to allopurinol alone

4. SF is a 42-year-old man who is receiving induction chemotherapy (cytarabine and daunorubicin) treatment for acute myeloid leukemia. On the third day of his second cycle, he notes that his heart occasionally speeds up or “skips” a beat. His pre-therapy and current laboratory measures are (respectively): uric acid, 7.2 mg/dL and 16.6 mg/dL; potassium, 5.4 mEq/L and 6.2 mEq/L; phosphorus, 4 mg/dL and 8 mg/dL; and calcium, 7.6 mg/dL and 6.9 mg/dL. Which of the following would you recommend for SF?

A. Maintain hydration and administer sodium polystyrene sulfonate (15 g by mouth, 1–4 times daily) with a laxative to reduce potassium levels B. Maintain oral hydration and rasburicase since SF does not have established TLS C. Administer intravenous hydration and 40 mg furosemide D. Initiate hemodialysis to reduce electrolyte imbalance

5. Which of the following is a direct effect of hyperphosphatemia?

A. Hypocalcemia B. Oliguria C. Urine alkalization D. Tetany

6. CF is a 40-year-old woman with metastatic EGFR-positive non-small cell lung cancer (primary mass recurrence 2 cm³, 3 new nodules 0.5–1.0 cm³ each) initiating afatinib therapy. Her laboratory values are 12.5 mg/dL uric acid, 1 mEq/L potassium, 3.6 mg/dL phosphorus, and 8 mg/dL calcium. Which of the following prophylaxis treatments would you recommend for CF?

A. Oral hydration (2 L/D) alone B. Oral hydration (2 L/D) + allopurinol C. Oral hydration (2 L/D) + rasburicase D. Oral hydration (2 L/D) + potassium citrate

7. Which of the following potential effects of therapy should pharmacists discuss with patients as an indication the patient may be experiencing early stages of tumor lysis syndrome?

A. Decreased urine output B. Tingling in the fingers and hands C. Sleepiness or drowsiness D. Shortness of breath

8. Which adverse reaction associated with allopurinol use would necessitate discontinuation of allopurinol?

A. Urticaria B. Nausea or vomiting C. Skin rash D. Hypoxemia

9. Which of the following is an immediate concern in a patient experiencing tumor lysis syndrome?

A. Hyperkalemia B. Hyponatremia C. Hypophosphatemia D. Hypercalcemia

10. Which of the following puts a patient at high risk for tumor lysis syndrome?

A. Hypotension B. Small primary tumor C. Receiving allopurinol D. Slow tumor growth

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. In which tumor type is tumor lysis syndrome most common?

2. When do clinically important symptoms of patients with tumor lysis syndrome most often appear after initiation of therapy?

3. In the study by Cortes et al of adult patients receiving rasburicase, allopurinol, or both agents for patients with established tumor lysis syndrome, which drug(s) provided superior reduction of hyperuricemia?

5. Which of the following is a direct effect of hyperphosphatemia?

7. Which of the following potential effects of therapy should pharmacists discuss with patients as an indication the patient may be experiencing early stages of tumor lysis syndrome?

8. Which adverse reaction associated with allopurinol use would necessitate discontinuation of allopurinol?

9. Which of the following is an immediate concern in a patient experiencing tumor lysis syndrome?

10. Which of the following puts a patient at high risk for tumor lysis syndrome?

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. In which tumor type is tumor lysis syndrome most common?

2. When do clinically important symptoms of patients with tumor lysis syndrome most often appear after initiation of therapy?

3. In the study by Cortes et al of adult patients receiving rasburicase, allopurinol, or both agents for patients with established tumor lysis syndrome, which drug(s) provided superior reduction of hyperuricemia?

5. Which of the following is a direct effect of hyperphosphatemia?

7. Which of the following potential effects of therapy should pharmacists discuss with patients as an indication the patient may be experiencing early stages of tumor lysis syndrome?

8. Which adverse reaction associated with allopurinol use would necessitate discontinuation of allopurinol?

9. Which of the following is an immediate concern in a patient experiencing tumor lysis syndrome?

10. Which of the following puts a patient at high risk for tumor lysis syndrome?

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