Key Points
- Confirm diagnosis early with highest-yield tests (e.g., MRV for CVST, CTA for mesenteric ischemia).
- Dose-and-route precision for high-risk medications; monitor for adverse effects.
- Explicit ICU criteria and consultation triggers.
Clinical Synopsis & Reasoning
Muscle breakdown with CK elevation causes electrolyte derangements and AKI. Treat with early, high-volume isotonic fluids, correct hyperkalemia, and consider urine alkalinization in select cases; avoid nephrotoxins and monitor urine output/CK trends.
Treatment Strategy & Disposition
Stabilize airway/breathing/circulation; initiate guideline-concordant first-line therapy; tailor escalation or de-escalation to clinical response and objective metrics; define clear disposition criteria (e.g., ICU triggers, ward acceptability, outpatient safety).
Epidemiology / Risk Factors
- Risk varies by comorbidity and precipitating factors
Investigations
| Test | Role / Rationale | Typical Findings | Notes |
|---|---|---|---|
| CBC | Anemia/leukocytosis | Context-specific | Trend with therapy |
| BMP | Electrolytes/renal | Derangements common | Renal dosing |
| Condition-specific imaging | See topic | Diagnostic hallmark | Do not delay when red flags present |
Pharmacology
| Medication | Mechanism | Onset | Role in Therapy | Limitations |
|---|---|---|---|---|
| Normal saline | Crystalloid | Immediate | Initial high-volume hydration | Avoid volume overload |
| Bicarbonate infusion (selected) | Alkalinization | Hours | Consider if severe acidosis/myoglobinuria | Monitor pH/K+ |
| Insulin/dextrose ± albuterol | Shift K+ | Minutes | Hyperkalemia management | Hypoglycemia risk |
Prognosis / Complications
- Outcome depends on timeliness of diagnosis and definitive therapy
Patient Education / Counseling
- Explain red flags, adherence, and follow-up plan
References
- Authoritative guideline/review; see internal bibliography — Link