B) Rhabdomyolysis.

This condition is often seen after falls. Statins (such as simvastatin) are also common culprits and should be held. These patients may often have muscle aches (myalgias), tea colored urine, acute renal failure, elevated liver enzymes, and an elevated CK. Generally with Rhabdo you will see a CK that is 3-5+ times the norm. CK levels generally increase “12 hrs of muscle injury and peak in 24-36 hours” (emedicine ref #1). Aggressive fluid hydration and renal consult are generally a common course of treatment. Rule of thumb: if patient comes in with ARF+ fall look at the CK level. It is often seen after seizures as well. Rhabdo is often missed in the ER and early admission. Rock star status for sure if you catch it when others haven’t 😊

#1. Medscape

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