An 85 year old man has a fall at home and is seen in the Emergency Department

An 85 year old man has a fall at home and is seen in the Emergency Department. He had incontinence of urine and had been lying on the floor all night. He had a myocardial infarction 8 years ago. He takes aspirin, atorvastatin and ramipril.

His pulse rate is 94 bpm and BP 106/76 mmHg.

Investigations:

  • White cell count 14.3 × 10⁹/L (3.0–11.0)
  • Urea 30.4 mmol/L (2.5–7.8)
  • Creatinine 158 micromol/L (60–120)
  • Creatinine kinase 11025 U/L (25–200)

ECG: Q waves in lead III.

Which is the most likely cause of his raised creatinine kinase?

  1. Acute kidney injury
  2. Acute myocardial infarction
  3. Dermatomyositis
  4. Rhabdomyolysis
  5. Urinary tract infection

D. Rhabdomyolysis

Explanation:

https://bestpractice.bmj.com/topics/en-gb/167