Rhabdomyolysis — RACP Adult Medicine MCQ

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ModerateNephrologyRhabdomyolysisRACP Adult Medicine

A 25-year-old man collapses during a marathon. Urine dipstick is strongly positive for blood but microscopy shows no red blood cells. Serum CK is 85000 U/L. Serum is dark brown. What is the most likely urinalysis interpretation?

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Correct answer: B — Myoglobinuria

Dipstick positive for blood but absent RBCs on microscopy indicates myoglobinuria (or haemoglobinuria). Massively elevated CK (>50× ULN) after exertion confirms rhabdomyolysis. Myoglobin is a haem pigment detected by the dipstick peroxidase reaction. Management is aggressive IV normal saline to maintain urine output >200 mL/hr and prevent AKI from myoglobin-induced tubular injury.

Reference: eTG Nephrology – 2024 – Rhabdomyolysis; ACEM Guidelines