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Long lie after fall — DGM MCQ

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HardFallsLong lie after fallDGM

An 86-year-old man is found on the floor after lying there overnight. He is thirsty and has hip pain but no fracture on X-ray. Urine dipstick is positive for blood but microscopy shows few red cells. Current medicines include ramipril and simvastatin. What is the most appropriate assessment?

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Correct answer: A — Check creatine kinase and renal function

A long lie can cause rhabdomyolysis, suggested by dipstick blood with few red cells, so creatine kinase and renal function should be checked. Podiatry alone misses systemic risk, delayed X-ray is unsafe, antibiotics need evidence of infection, and increasing statin may worsen muscle injury. After a long lie, complications of immobility can be more urgent than the fall mechanism.

Reference: BGS falls guidance; NICE NG249