Rhabdomyolysis
Medgeeks with Andrew Reid
Medgeeks
4.8 • 997 Ratings
🗓️ 20 December 2018
⏱️ 8 minutes
🧾️ Download transcript
Summary
The next patient on your list is a 35 year old male with a past medical history of IV drug and alcohol abuse. He's been sober for the last 7 years.
He presents to the ER after a mechanical fall at home. The nursing triage notes states the patient was in his normal state of health, until about two days prior.
He may have hit his head, but is unsure. The patient had a loss of consciousness. No neurological deficits. The day after his fall, he's experienced decreased urine output, despite increasing his water intake.
The urine that was seen was noted to be brown.
Labs were notable for
- BUN of 63 mg/dL
- Creatinine of 8 mg/dl. His last creatinine from a wellness visit was .8 mg/dl.
- Potassium 6.8 mEq/L. EKG is normal sinus rhythm.
- CK: 40,000
- AST: 1066
- ALT: 450
- Urine analysis was positive for blood, but negative for RBCs.
What would you do next?
We'll walk you every step of the way!
-
Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine.
This looks different to everyone, which is why we take such a personalized approach.
Whether you want to ...
- Stop taking your work home
- Have the skillset to work autonomously
- Improve your work life balance
https://medgeeks.co/about-us
-
Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates:
-
This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.
Transcript
Click on a timestamp to play from that location
| 0:00.0 | Team what's up more back sack here for med geeks so today let's do a case so in next patient on your list is a 35 year old male with the past medical history of IV drug and alcohol abuse. So over for the past seven years |
| 0:14.6 | presents to the ER after a mechanical fall at home. Nursing Trias notes state the patient |
| 0:20.9 | was in his normal state of health until two days prior to |
| 0:24.4 | arrival to the ER. He suffered a mechanical fall, may have hit his head |
| 0:28.6 | unsure loss of consciousness, currently no neurodeficits. The day after his fall, he experienced minimal urine output |
| 0:36.4 | to sprite increasing his water intake, and his urine was the color of like a brownish. |
| 0:44.0 | So on chart review, the patient was a-fabrile. |
| 0:47.0 | Heart rate 94 BP was 156 over 77, |
| 0:51.0 | and his oxygen saturation were 98% on room air. |
| 0:55.0 | Initial labs remarkable for BUN Coratine of 63 over 8. |
| 1:00.0 | Last Coratine one year ago from outpatient wellness visits was 0.8. |
| 1:05.0 | Has a normal bicarb. K 6.8 EKG was normal sinus rhythm without changes such as peak T waves, ST depression, A.V. blocks, |
| 1:16.4 | QT shortening, no QRS widening, or no loss of P wave. |
| 1:20.8 | Remaining electrolytes were normal, |
| 1:22.5 | CK was 40,000, AST 1066, ALT 450, |
| 1:29.2 | ALKFOS was normal, H&H normal, UA was positive for blood but negative for RBCs. |
| 1:38.8 | So in your head what do you think? |
| 1:41.4 | So I'll give you a second. Just to recap the lab so we have an |
| 1:46.4 | elevated crayotte to 8 a k elevated to 6.8 no EKG changes, |
| 1:53.6 | CK's up to 40,000, LFTs are also up, |
| 1:58.4 | Alkvos normal, and then UA was positive for for blood but negative for RBCs. |
| 2:05.0 | So I'd be thinking we have a young patient with a mechanical fall. |
... |
Please login to see the full transcript.
Disclaimer: The podcast and artwork embedded on this page are from Medgeeks, and are the property of its owner and not affiliated with or endorsed by Tapesearch.
Generated transcripts are the property of Medgeeks and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.
Copyright © Tapesearch 2026.