Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

What is a consequence of nucleic acid metabolism in the context of tumor lysis syndrome (TLS)?

1. Increased production of creatinine

2. Build-up of uric acid in renal tubules

3. Decreased renal blood flow

4. Inhibition of bone marrow function

The correct answer is: Build-up of uric acid in renal tubules

In the context of tumor lysis syndrome (TLS), the correct answer is related to the build-up of uric acid in renal tubules. Tumor lysis syndrome occurs after the rapid cell lysis of malignant cells, typically following chemotherapy or the treatment of aggressive cancers. When these cancer cells break down, they release a large amount of nucleic acids, which are subsequently metabolized to purines and then to uric acid. The metabolism of nucleic acids into uric acid leads to a significant increase in uric acid levels in the blood, a condition known as hyperuricemia. This excess uric acid can be deposited in the renal tubules, contributing to the risk of acute kidney injury. The deposition obstructs the renal tubules, which not only impairs their function but can also lead to further complications like nephropathy if not promptly managed. Other options relate to potential effects of TLS but do not directly address the specific consequence of nucleic acid metabolism. While increased creatinine could occur as a result of kidney dysfunction, and decreased renal blood flow may happen in critical situations, these are secondary effects and not direct consequences of the metabolism of nucleic acids leading to uric acid build-up. Inhibition of bone marrow function