RHABDOMYOLYSIS

Question 1

rhabdomyolysis

Answer 1

breakdown of muscle tissue leading to release of muscle fiber contents (myoglobin, creatine kinase, potassium, phosphate) into the bloodstream
- substances can be toxic to kidneys and lead to AKI (acute kidney injury)

Question 2

rhabdo–> AKI complication

Answer 2

AKI can turn into CKD–>dialysis—> needing transplant

Question 3

causes- traumatic and non traumatic

Answer 3

traumatic
- crush injuries (accidents, disasters)
- prolonged immobilization (after OD, srugery)

non traumatic
- drugs: statins, cocaine, heroin, amphetamines
- alcohol

Question 4

S/Sx

Answer 4

• muscle pain and swelling (thighs, shoulders, lower back)
• weakness
• DARK COLORED URINE
• dec urine output
• systemic sx (feveer, nausea, confusion)

Question 5

Dx markers
- labs

Answer 5

• serum CK >5000
• myoglobin in urine (pos blood on dipstick but no RBCs on microscopy)
• hyperkalemia
• hyperphospahtemia
• hypocalcemia
• elevated creatinine + BUN (if kindey injury present)

Question 6

management

Answer 6

• agressive IV fluids
• isotonic saline to maintain urine ouput/prevent kidney injury
• correct electrolyte imbalances (especially hyperkalemia)
• monitor for AKI
• dialysis in severe cases

Question 7

tx

Answer 7

tx underlying cause
- stop offending drugs, manage trauma, tx infx
- iv fluid, correct electrolyte imbalances, monitor for AKI

Question 8

complications

Answer 8

• AKI
• electrolyte imbalance
• compartment syndrome
• cardiac arrhythmias