<prompt> Which of the following is seen in tumor lysis syndrome?HypokalmiaHyponatremiaHypercalcemiaNone  <response>: Tumor lysis syndrome TLS is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia and is caused by the destruction of a large num of rapidly proliferating neoplastic cells. Acidosis may also develop. Acute renal failure occ frequently. TLS is most often associated with the treatment of Burkitts lymphoma, acute lymphoblas leukemia, and other rapidly proliferating lymphomas, but it also may be seen with chro leukemias and, rarely, with solid tumor. TLS usually occurs during or sholy 1-5 days af: chemotherapy Treatment: Recognition of risk and prevention are the most impoant steps in the management of this syndrome. The standard preventive approach consists of allopurinol, urinary alkalinization, and aggressive hydration. Intravenous allopurinol may be given in patients who cannot tolerate oral therapy. Rasburicase recombinant urate oxidase can be effective where uric acid levels cant be reduced by standard methods. Indications of hemodialysis in TLS: Serum K 6 mEq1 Serum creatinine 10 mgdl Serum phosphate 10 mgdl or increasingv Symptomatic hypocalcemia. 