Rhabdomyolysis and Crush Injury – Board-Style Questions

What this deck covers

Rhabdomyolysis and crush injury in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Blood, but no red cells
2. The number that settles it
3. Sore calves after the flu
4. While he is still trapped
5. The moment he is freed
6. What the chart should show
7. A low result nobody corrects
8. Two things that are not added
9. Sedated, and the leg is tight
10. The third time this year
11. It eases if he keeps going
12. Three litres, and still dry
13. Rigid on the table
14. A tablet added last week
15. Kidney numbers on day two
16. When to ease off the drip
17. What he takes home with him
18. Planning the summer camp

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Bleeding from the kidney itself, with the cells destroyed by dilute urine, A creatine kinase many times above the upper limit of normal, Guillain-Barre syndrome, in its early and predominantly painful phase, Fluid is given only if the urine darkens after rescue, Potassium washed out of the crushed muscle as the blood returns to it, A central venous pressure held between eight and twelve millimetres of mercury, It is corrected slowly by mouth over the first week of her admission, Both of them, since each acts on a different part of the same problem, The pressure inside the compartment is measured, since he cannot report the pain, A muscular dystrophy, which is beginning to show itself at this age, Cramps in the first minutes of each run, He was dehydrated before the wall fell, and that deficit is still being replaced, Dantrolene with active cooling, and the volatile agent stopped, The chest infection itself, which has inflamed his muscle directly.

Clinical pearls from this deck

• Positive for blood with no cells means pigment.
• Creatine kinase confirms it and can be followed.
• Sore calves after influenza with a high enzyme.
• Run the fluid before the weight comes off.
• Reperfusion sends the potassium straight to the heart.
• Titrate the fluid against the urine, hour by hour.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all emergency and critical care case decks · pediatric reference values.