This page is dedicated to organizing various examples of standardized exam questions whose answer is rhabdomyolysis. While this may seem a odd practice, it is useful to see multiple examples of how rhabdomyolysis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 84 year old woman is brought to the hospital by paramedics after she was found on her apartment floor by her neighbor. The patient explains that she stripped and fell down last night while getting up to go to the bathroom and estimates that she was on the floor for 9 hours before being found. She denies having any health problems, and there is no evidence of trauma. Her vital signs are unremarkable and a physical exam is non-contributory. A urinalysis is performed and reported below.
- Specific gravity: 1.024
- Blood: 2+
- Protein: trace
- RBC: 0/hpf
- WBC: 0/hpf
- Nitrites: negative
What diagnosis is likely in this patient?
Explanation: patient on floor for hours + blood present on UA + no RBCs on UA = rhabdomyolysis
Question # 2
65-year-old male patient is hospitalized with tonic clonic seizures. He is a alcoholic who has had previous hospitalizations for withdrawal and alcohol related seizures. During his hospitalization his temperature is 98.9°F, blood pressure is 155/92 mm HG, his pulse is 108/min, and respirations are 14/min a physical exam is noncontributory. Lab results are shown below:
- Serum sodium: 141 mEq/L
- Serum potassium: 5.2 mEq/L
- Bicarbonate: 21 mEq/L
- BUN: 35 mg/dL
- Serum creatinine: 2.5 mg/dL
- Urine glucose: negative
- Urine keytones: trace
- Urine leukocyte esterase: negative
- Urine blood: large amount
A urine sediment microscope analysis shows 5 to 10 WBCs, 0-1 red blood cells, and some epithelial cells. What is the likely diagnosis and this patient.
Explanation: blood present on UA + no RBCs on UA = rhabdomyolysis
Question # 3
A 35-year-old man with passes through drug abuse is found by a friend on the floor of his apartment. There is a pool of urine around him. He’s confused he does not know where he is or his name or the date on your recent events. His blood pressure is 120/70 mmHg and his heart rate is 120/men. He is able to speak and move all of his extremities. His lab findings are as follows:
- Hemoglobin: 15.5 mgdL
- WBC: 13,00/mm³
- Platelets: 170,000/mm³
- CPK: 26,000 units/L
Patient’s urine talks screen is positive for cocaine and cannabinoids. What is the likely diagnosis?
Explanation: history of lying on the floor for a prolonged period of time + elevated CPK = rhabdomyolysis
Page Updated: 01.22.2017