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Rhabdomyolysis — SCE Acute Medicine MCQ

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ModerateAcute Renal and Metabolic EmergenciesRhabdomyolysisSCE Acute Medicine

A 36-year-old man is assessed on the acute medical unit. He was found after lying on the floor overnight. Creatine kinase is 42,000 IU/L, urine is dark and creatinine is rising. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: E — Give isotonic crystalloid boluses with frequent reassessment

Give isotonic crystalloid boluses with frequent reassessment is the best answer because rhabdomyolysis threatens AKI and needs aggressive but monitored isotonic fluid resuscitation. Give broad-spectrum intravenous antibiotics within one hour is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Monitor potassium, calcium and compartment syndrome in severe rhabdomyolysis.

Reference: NICE CKS; renal guidance