American Board of Internal Medicine (ABIM) Certification Practice Exam

Rasburicase is primarily used in which condition?

1. Fibromyalgia

2. Tumor lysis syndrome with acute kidney injury

3. Chronic renal failure

4. Infection treatment

The correct answer is: Tumor lysis syndrome with acute kidney injury

Rasburicase is an enzyme that plays a crucial role in the management of tumor lysis syndrome (TLS), particularly when acute kidney injury is present. TLS occurs when there is a rapid breakdown of cancer cells, often due to chemotherapy, leading to the release of large amounts of uric acid into the bloodstream. This can result in hyperuricemia, which can subsequently cause acute kidney injury due to the precipitation of uric acid crystals in the renal tubules. Rasburicase helps by converting uric acid into allantoin, a more soluble compound that can be more easily excreted by the kidneys. This is particularly important in patients at risk for or presenting with acute kidney injury related to TLS, as reducing uric acid levels can help alleviate renal damage and improve kidney function. Thus, its primary indication in this context is directly related to preventing or treating the complications stemming from TLS, especially when it has progressed to include acute kidney injury.