Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

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What can happen as a consequence of phosphorus binding with calcium in TLS?

  1. Hypocalcemia

  2. Hypercalcemia

  3. Acidosis

  4. Blood clotting

The correct answer is: Hypocalcemia

In the context of tumor lysis syndrome (TLS), phosphorus binding with calcium can lead to hypocalcemia. This occurs because when phosphorus levels rise rapidly due to the breakdown of tumor cells, it can result in the formation of calcium phosphate, which precipitates and effectively reduces the concentration of free calcium in the bloodstream. As a consequence, the serum calcium levels drop, resulting in hypocalcemia. Hypocalcemia can have significant clinical implications, including muscle cramps, tetany, and cardiac arrhythmias. Monitoring calcium levels and managing them appropriately is crucial in patients experiencing TLS to prevent complications associated with low calcium levels. Understanding the mechanism of phosphorus-calcium interaction in TLS is essential for effective management in oncology patients.

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