Rhabdomyolysis

Question 1

What is the pathology of Rhabdomyolysis

Answer 1

Skeletal muscle breakdown releases myoglobin and potassium into blood
Myoglobin precipitates at the glomerulus = renal obstruction, nephrotoxicity and AKI

Question 2

What are the causes of Rhabdomyolysis

Answer 2

Trauma (immobilisation, burns, seizures)
Ischemia (embolism and surgery)
Toxins (statins, ecstasy)
Strenuous exercise

Question 3

What are the fetaures of Rhabdomyolysis (RAM)

Answer 3

R- Red urine
A- AKI (10hrs after pain)
M-Muscle pain/swelling

Question 4

What is the most reliable investigation for muscle damage

Answer 4

Creatinine Kinase (5 fold increase from baseline= rhabdomyolysis)

Question 5

What other investigations suggest Rhabdomyolysis

Answer 5

Raised LDH
Hyperkalemia
Hyperphosphatemia
Hyperuricemia
Hypocalcemia

Question 6

Is a urine dipstick a good indicator of Rhabdomyolysis

Answer 6

It will falsely be positive for blood but this is myoglobinuria (red brown urine)

Question 7

What is the management for Rhabdomyolysis

Answer 7

IV fluids and treatment for Hyperkalemia