GU/Nephrology - Acute Renal Disorders QUESTIONS AND CORRECT DETAILED ANSWERS WITH COMPLETE SOLUTIONS | GRADED A+

GU/Nephrology - Acute Renal Disorders


1. What are causes of rhabdomyolysis?: - crush injuries to muscle


- prolonged immobility
- severe dehydration
- seizures
- substance abuse (cocaine, meth)
- Medications (STATINS) -> MUSCLE ACHES
- Muscle pathology (polymyositis)

2. What occurs with rhabdomyolysis?: 1. Acute skeletal muscle necrosis


2. Myoglobinuria and INCREASED creatine kinase levels

3. What is a common complication of rhabdomyolysis and how does this occur?-


: Excess myoglobin leads to tubular obstruction and intrarenal vasoconstriction (DIRECT RENAL TOXICITY), which causes


ATN


4. When combining statins with which medications does the risk of rhabdomy-


olysis increase?: - drugs that inhibit cytochrome P450 (protease inhibitors, erythromycin/clarithromycin, itra-




,conazole, diltiazem, verapamil)

- concurrent use of niacin & fibrate-containing therapy


5. Which disease states increase the risk of rhabdomyolysis when used with


statins?: - kidney/liver disease


- DM
- hypothyroidism

6. Describe the presentation of rhabdomyolysis?: - Myalgias


- Weakness
- DARK URINE (cola-colored)


ASYMPTOMATIC is COMMON

7. How is rhabdomyolysis diagnosed?: 1. Serum creatine kinase exceeds 16,000-50,000 IU/L


2. UA is POSITIVE for "blood" due to detection of MYOGLOBIN but NO RBCs on microscopy
3. ELEVATION of AST/ALT/LDH (found in muscle)

8. What is the MC electrolyte derangement with rhabdomyolysis?: MC electrolyte


derangement is HYPERKALEMIA





, 9. What are other possible electrolyte derangements with rhabdomyolysis?: -


hyperphosphatemia