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APA
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Health, Medicine, Nursing
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Coursework
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English (U.S.)
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Topic:

Diagnosis, Pathophysiology, and Complications of Rhabdomyolysis

Coursework Instructions:

Answer all of the following questions for your discussion response.
A 28-year-old woman was admitted to the general internal medicine service with a 3-day history of malaise and cough that progressed to include myalgia, generalized weakness, and dark-colored urine. Three days before admission, she had an abrupt onset of a dry nonproductive cough, malaise, and anorexia that resulted in a prolonged period of fasting. On the second day of the illness, she awoke with diffuse muscle pain and progressive weakness, culminating in an inability to walk. She subsequently noted dark urine and presented to the emergency department, leading to this admission. She had no recent trauma, exercise, rash, joint pain, or foreign travel. She was taking a multivitamin supplement but no prescription medication.
At presentation, she was mildly distressed but oriented. Her vital signs were within normal limits, apart from mild tachycardia (heart rate, 104 beats/min). Physical examination revealed grade 3/5 limb muscle strength, although testing was associated with obvious discomfort. Muscle bulk and tone, tendon reflexes, and sensation were normal. Notably, there was no rash, and cardiorespiratory examination yielded unremarkable findings. Initial chest radiography revealed a left lower lobe infiltrate most consistent with pneumonia. Urinalysis was strongly positive for hemoglobin. Initial laboratory analysis (reference ranges provided parenthetically) revealed that her creatine kinase (CK) level was markedly elevated at 118,342 U/L (38-176 U/L).
What is the most appropriate next step to confirm the diagnosis of rhabdomyolysis in this patient? Provide an explanation for your answer.
What is the most likely etiology of this patient's recurrent rhabdomyolysis?
Rhabdomyolysis is a rapid breakdown of muscle. Detail the pathophysiology behind rhabdomyolysis.
What are the possible complications of rhabdomyolysis?
Which medications may cause rhabdomyolysis?

Coursework Sample Content Preview:

Week 13 DQ 1
Student’s Name
University Affiliation
Professor’s Name
Course Title
Due Date
Week 13 DQ 1: Rhabdomyolysis
Confirming Rhabdomyolysis Diagnosis
To confirm the diagnosis of rhabdomyolysis, a blood test is necessary to distinguish which component of the enzyme creatine kinase (CK) is elevated. The enzyme exists in three major isoenzymes: CK-MB, CK-MM, and CK-BB, where CK-BB is the fraction in the brain. CK-MB is present in the heart muscle, while CK-MM is in the skeletal muscle. Rhabdomyolysis involves the breakdown of the skeletal muscle, which causes the release of myoglobin into the blood. Therefore, detection of the enzyme CK-MM confirms the injury of the skeletal muscle.
Etiology of the Recurrent Rhabdomyolysis
The patient’s recurrent rhabdomyolysis is likely caused by excessive intake of vitamin B6 from the multivitamin supplement she was taking. When vitamin B6 is taken in high doses, it causes neuropathy resulting in pain and numbness in the lower limbs.
Pathophysiology behind Rhabdomyolysis
Breakdown of muscles releases extracellular calcium ions into the intracellular space, causing myosin and actin to interact. This interaction results in fiber necrosis and muscle i...
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