rhabdomyolysis

Question 1

definition of rhabdomyolysis

Answer 1

rapid breakdown of skeletal muscles

Question 2

risk factors for rhabdomyolysis

Answer 2

statins, antipsychotic, SSRI, heavy metals, snake venom, alcohol

Question 3

rhabdomyolysis causes

Answer 3

extreme exercise, delirium tremens, prolonged seizures, crush, arterial thrombosis, DKA/hyperglycaemic hyperosmolar state, prolonged immobilisation, neoplastic malignant syndrome

Question 4

rhabdomyolysis pathophysis

Answer 4

cell damage -> fluid intake into muscle -> ATP depletion -> increases ca into cell -> breakdown of muscles -> neutrophils -> inflammation -> PO4, myoglobin, ck, uric acid release

kidney injury within 24 hours

uric acid forms kidney stones

myoglobin forms casts

acute tubular necrosis

Question 5

symptoms of rhabdomyolysis

Answer 5

muscle pain/tenderness, weakness, swelling, hypotension, dark brown urine, electrolyte disturbances

Question 6

investigations of rhabdomyolysis

Answer 6

Ck x5 normal range, 20000+ for kidney injury, increasd LDh, U+E, raised liver proteins, urine dip (blood+, no blood on microscopy), ECG

Question 7

treatment of rhabdomyolysis

Answer 7

IV fluid 12L over 24 hours, treat hyperkalaemia, dialysis, kidney function will recover

Question 8

complications of rhabdomyolysis

Answer 8

DIC, compartment syndrome, AKI, hyperkalaemia, hypercalcemia