Thread by @CPSolvers

#MedTwitter we wanted to share some of the pearls that came from our first virtual morning report yesterday.

We have another TODAY @ 12pm PST/3pm EST

Zoom link coming soon.

Here are yesterday's teaching points:

Hyperkalemia can lead to fatal arrhythmias.

Treatment includes 3 stages:
1. cardiac membrane stabilization (e.g., IV calcium gluconate)
2. shifting potassium (e.g., B2-agonists, insulin, bicarb)
3. eliminating excess potassium (e.g., loop diuretics, K-binding resins, dialysis)

Spontaneous tumor lysis syndrome (TLS) is rare, but can occur with aggressive tumors (e.g., leukemia, lymphoma, small cell cancer).

Electrolyte derangements in TLS include hyperphosphatemia, hyperkalemia, hyperuricemia, and hypocalcemia.

Treatment for TLS includes aggressive IV fluid resuscitation & uric acid lower therapy (e.g., allopurinol, rasburicase).

Rasburciase is expensive and often reserved for patients with marked hyperuricemia or high risk disease (e.g., DLBCL, AML, or T cell leukemias or lymphomas)

Rasburicase can cause hemolytic anemia in G6PD deficient patients.

Balancing the need to assess for G6PD deficiency against time delays inherent in testing remains a clinical challenge.

If considering the diagnosis of an aggressive lymphoma, excisional/core biopsy is preferred to a fine needle aspiration, given the rate of false negatives with FNA.

Let us know what else you learned from yesterday's virtual morning report and be sure to tune in today at 12pm PST/3pm EST for our next one!

See you soon!