Newly Diagnosed High-grade Non-hodgkin in Medicine / Internal Medicine — 45yo Man | Oncology | SMLE Q#16988

SMLE Question #16988

Medicine / Internal Medicine Oncology

Objective: OBJ-191

Last updated: February 2026
A 45-year-old man with newly diagnosed high-grade non-Hodgkin lymphoma is admitted for his first cycle of combination chemotherapy. Within 24 hours, he develops generalized muscle weakness, palpitations, and nausea. Laboratory studies show acute metabolic derangements after starting chemotherapy, and tumor lysis syndrome is suspected. Which laboratory abnormality is most directly responsible for his acute neuromuscular and cardiac symptoms?

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