Al-Mehdi Rhabdomyolysis

Question 1

skeletal muscle breakdown due to trauma or ATP depletion

Answer 1

Rhabdomyolysis

Question 2

5-10% of all acute kidney injury is due to this

Answer 2

rhabdomyolysis

Question 3

what is released from rhabdomyocytes that causes acute kidney injury

Answer 3

myoglobin

Question 4

K+ release from rhabdomyocytes causes

Answer 4

hyperkalemia

Question 5

Ca2+ uptake into rhabdomyocytes causes

Answer 5

hypocalcemia

Question 6

myalgia, tenderness, and muscle weakness are what features of rhabdomyolysis

Answer 6

local

Question 7

tea-colored urine is what feature of rhabdomyolysis

Answer 7

systemic

Question 8

specific pathology of rhabdomyolysis that leads to small amount of urine

Answer 8

Oliguria

Question 9

sign of severe rhabdomyolysis that leads to uremic encephalopathy which lead to mental status changes

Answer 9

hyperuricemia

Question 10

occurs in muscle groups (fascia); trauma releases fluid from cell; sensory abnormalities due to nerve compression

Answer 10

compartment syndrome

Question 11

main labs of rhabdomyolysis (3)

Answer 11

increased CK-MM
increased creatinine
acidosis

Question 12

main sign of rhabdomyolysis

Answer 12

myoglobinuria

Question 13

what 3 things does elevated CK entail

Answer 13

Rhabdomyolysis, myocardial infarction, and muscular dystrophy

Question 14

can lead to cardiac arrest, peaked T waves on ECGs, muscle paralysis

Answer 14

hyperkalemic periodic paralysis

Question 15

to treat hyperkalemic periodic paralysis

Answer 15

calcium gluconate (reduces firing)
albuterol and insulin (increases Na/K ATPase to put K back in cell)

Question 16

painless total body muscle weakness; mutation in L-type VGCC, increase in epi and insulin which brings K in cell

Answer 16

hypokalemic periodic paralysis

Question 17

to treat hypokalemic periodic paralysis

Answer 17

PO K+

Question 18

most specific test to do for rhabdomyolysis but its cost expensive and not readily available

Answer 18

myoglobin testing

Question 19

these two things contain heme (blood)

Answer 19

myoglobin and hemoglobin

Question 20

pink serum + urine positive for heme (blood)

Answer 20

hemolysis

Question 21

serum NOT pink + urine positive for heme (blood)

Answer 21

rhabdomyolysis

Question 22

proximal tubular necrosis and distal tubule obstruction cause

Answer 22

acute kidney failure

Question 23

will BUN levels increase or decrease in rhabdomyolysis

Answer 23

decrease

Question 24

neutral charge small molecule: (filtered or not)

Answer 24

all filtered

Question 25

positive charge small molecule like myoglobin: (filtered or not)

Answer 25

all filtered

Question 26

positive charge large molecule: (filtered or no)

Answer 26

some filtered

Question 27

negative charge large molecule: (filtered or no)

Answer 27

barely filtered

Question 28

main isoform of creatine kinase in skeletal muscle

Answer 28

CK-MM

Question 29

most sensitive test to confirm rhabdomyolysis

Answer 29

CK-MM

Question 30

myopathy and hepatitis are side effects of what drug for rhabdomyolysis

Answer 30

statins

Question 31

only statin that doesn't have SE of myopathy and hepatitis for rhabdomyolysis

Answer 31

Pravastatin

Question 32

a statin and its inhibitor like grapefruit juice can lead to what

Answer 32

rhabdomyolysis

Question 33

1st line of treatment for rhabdomyolysis that filters proximal tubule

Answer 33

normal saline

Question 34

2 things used to alkalinize urine and protect distal tubule

Answer 34

NaCHO3 (sodium bicarbonate) + acetazolamide

Question 35

number in mM that is a threat of cardiac arrest

Answer 35

>8.5

Question 36

hyperkalemia lowers or brings resting potential up

Answer 36

brings it up (will depolarize membrane)

Question 37

lowers threshold to be closer to resting potential and increases firing

Answer 37

hypocalcemia

Question 38

raises threshold and makes it harder to depolarize cell

Answer 38

hypercalcemia

Question 39

treatment of hyperkalemia that does not affect plasma K+ levels

Answer 39

calcium gluconate

Question 40

what increases K+ excretion

Answer 40

dialysis

Question 41

what brings K+ back into the cell, lowering serum K+ levels

Answer 41

albuterol and insulin

Question 42

to treat hypocalcemia

Answer 42

diuresis (fluid + diuretics)

Question 43

what NOT to treat hypocalcemia with

Answer 43

Ca2+