skip to main content

Rhabdomyolysis after long lie in frailty — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMedicine in the elderlyRhabdomyolysis after long lie in frailtySCE Acute Medicine

An 88-year-old man is found on the floor after an estimated 18-hour long lie. He is frail, confused and dehydrated; CK is 18,600 U/L, creatinine is 214 micromol/L and potassium is 5.7 mmol/L. Urine dip is positive for blood with few red cells on microscopy. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Give intravenous crystalloid with close monitoring of potassium, renal function and fluid status

The raised CK, AKI and dipstick pattern indicate rhabdomyolysis after a long lie, requiring prompt intravenous fluid while monitoring for hyperkalaemia and overload. Diuretics before rehydration are not the primary treatment. A fall assessment is needed, but the immediate medical risk is pigment nephropathy and electrolyte disturbance.

Reference: NICE NG148 acute kidney injury; NICE falls guidance