Rhabdomyolysis Flashcards
How does rhabdomyolysis present?
Presentation is classically with myalgia, weakness and brown urine (due to myoglobinuria).
How is rhabdomyolysis diagnosed?
Intracellular contents of muscle cells are released, including creatine kinase, myoglobin and potassium. This can cause acute tubular necrosis
Which contents are released in rhabdomyolysis?
Intracellular contents of muscle cells are released, including creatine kinase, myoglobin and potassium. This can cause acute tubular necoriss
What are the causes of rhabdomyolysis
Thyroid storm
Diabetic ketoacidosis
Prolonged immobilisation
Crush injuries
Severe burns
Electric shock
Prolonged seizures
Compartment syndrome
Heatstroke
Delirium tremens form alcohol withdrawal
Which rugs cause rhabdomyolysis?
Statins
Fibrates
Neuroleptic malignant syndrome
Ecstasy
Cocaine
What are the signs of rhabdomyolysis on examination?
Tender and swollen muscles (often disproportionate to the injury sustained)
Altered mental state - agitation, delirium
Oliguria or anuria
What will the Rhine dipstick finding be for rhabdomyolysis?
Falsely positive for blood due to myoglobinuria
What will the electrolyte change be?
Metabolic acidosis
Hyperkalemia
Hypocalcaemia with calcium deposits in necrotic muscle tissue that can progress -> hypercalcaemia
How long should muscle biopsy take after rhabdomyolysis?
At least one month
Which drug worsens the effects of statins?
Clarithromycin
How much must creatinine rise to be considered rhabdomyolysis?
At least 5 times
