kidney - kallastro

[ArchivalUser]

A 54-year-old homeless man with a history of chronic alcoholism was admitted to the hospital after a fall. He was diagnosed with a hip fracture but was otherwise well. The repair of the fracture and his immediate postsurgery course were unremarkable. On day 4 of hospitalization, he developed myalgia and weakness. Laboratory evaluation revealed elevated serum creatinine, and urinalysis showed a large amount of blood and no red blood cells (RBCs). Which of the following laboratory tests will probably reveal the cause of his symptoms?
A. Serum haptoglobin
B. Serum lactate dehydrogenase (LDH)
C. Serum phosphate
D. Serum sodium

[ArchivalUser]

bbbb????

[ArchivalUser]

C.

[ArchivalUser]

C.

This patient probably has rhabdomyolysis resulting from hypophosphatemia. Refeeding syndrome occurs in chronically malnourished individuals who are suddenly challenged with a full, nutritionally necessary intake. During starvation, decreased carbohydrate intake reduces insulin secretion. The resultant catabolism of muscle and fat stores leads to intracellular phosphate loss. When nutritional intake resumes, insulin secretion rises, stimulating cellular uptake of phosphate, which can lead to severe hypophosphatemia, usually occurring within 4 days of the initiation of refeeding. Other signs and symptoms of refeeding syndrome are leukocyte dysfunction, respiratory and/or cardiac failure, hypotension, arrhythmias, seizures, coma, and sudden death. There is no evidence of hemolysis in this patient. Hyponatremia or hypernatremia generally does not lead to rhabdomyolysis.

[ArchivalUser]

"urinalysis showed a large amount of blood and no red blood cells (RBCs)"
What does this mean, can somebody probably explain this to me ?

[ArchivalUser]

yes, this urinalysis is very confirmatory of rhabdomyolysis

[ArchivalUser]

I think only Myoglobin is Seen in the urine

Maybe some can give a Better Explanation!