Acute Rhabdomyolysis Case 1
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Question 1 of 5
1. Question
You are the ST4 in an emergency department one summer weekend that coincides with a local 10k run.
A 25-year-old female who collapsed is brought in to the department:
- She is awake and alert
- Her ECG trace shows a sinus tachycardia at a rate of 108 with no other changes evident. She has no chest pains
- She complains of severe muscle pain and discomfort in her lower limbs
- She is clinically dehydrated
- The remainder of her observations are within normal limits
You assess her airway, breathing and circulation and establish circulatory access. What questions should you be asking early on in your history taking?
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Question 2 of 5
2. Question
At this stage what conditions specific to this scenario would be included in your differential diagnosis?
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Question 3 of 5
3. Question
The patient’s temperature is within normal limits and it is not particularly warm outside. What tests are you going to request?
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Question 4 of 5
4. Question
We have established the tests that are required at this stage. What is each of the tests looking for?
Sort elements
- Urea and Electrolytes (U and E)
- Blood glucose level (BM stick)
- Urine dipstick/microscopy
- CK and troponin T
- Full blood count (FBC)
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Renal function, sodium and potassium level
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Exclude hypoglycaemia/coexistent DKA
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Suspicion of rhabdomyolysis and myoglobin in the urine
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Confirm muscle damage, suspicion of rhabdomyolysis and exclude myocardial infarction
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Exclude anaemia, establish baseline white cell count (WCC) and platelet count
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Question 5 of 5
5. Question
What would be your management plan with the patient?
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