A 28-year-old woman was found to have stage IV Burkitt"s lymphoma. Her renal function was normal and a staging CT scan had shown no abnormality of the renal tract. Three days later, when she was about to start chemotherapy, she developed a temperature of 39.0°C with rigors and was treated with imipenem. Investigations (the following day):

\begin{array}{ll}\text { serum sodium } & 138 \mathrm{mmol} / \mathrm{L}(137-144) \\\text { serum potassium } & 6.2 \mathrm{mmol} / \mathrm{L}(3.5-4.9) \\\text { serum creatinine } & 215 \mu \mathrm{mol} / \mathrm{L}(60-110) \\\text { serum corrected calcium } & 1.60 \mathrm{mmol} / \mathrm{L}(2.20-2.60) \\\text { serum phosphate } & 1.52 \mathrm{mmol} / \mathrm{L}(0.8-1.4) \\\text { serum lactate dehydrogenase } & 1238 \mathrm{U} / \mathrm{L}(10-250) \\\text { serum urate } & 0.69 \mathrm{mmol} / \mathrm{L}(0.19-0.36)\end{array}

What is the most likely cause of the renal impairment?
A)imipenem toxicity
B)intravenous contrast toxicity
C)kidney infiltration
D)septic shock
E)tumor lysis syndrome

Malignant Melanoma:-

Multiple Choice

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