Question

question 21 (mandatory) (1 point)
a 17 - year - old female patient presents to your office complaining of extreme muscle soreness and swelling after an intense training session at her local gym. urinalysis reveals a dark brown tint to the urine. cbc reveals highly elevated levels of cpk, ldh and bun. what is the most likely diagnosis?
a) rhabdomyolysis
b) renal calculi
c) kidney infection
d) urinary tract infection
e) hepatitis

Explanation:

• Rhabdomyolysis is characterized by muscle breakdown. Intense exercise can cause it. When muscle cells break down, they release substances like CPK (creatine phosphokinase), LDH (lactate dehydrogenase) into the bloodstream, leading to elevated levels. Myoglobin (from muscle) can also be released and excreted in urine, giving it a dark - brown tint. BUN (blood urea nitrogen) can be elevated due to kidney stress from the released substances.
• Renal calculi (kidney stones) usually present with pain (colicky pain) during urination and may not have such a strong association with intense exercise - induced muscle symptoms and the specific lab changes (except in some cases of obstruction, but the muscle - related lab elevations are more indicative of rhabdomyolysis).
• Kidney infection (pyelonephritis) typically has symptoms like fever, flank pain, dysuria (painful urination), and may have leukocytes in urine (not the dark - brown urine from myoglobin and the specific muscle - enzyme elevations).
• Urinary tract infection (UTI) has symptoms like frequency, urgency, dysuria, and usually shows leukocytes, nitrites in urine (not the muscle - related findings here).
• Hepatitis is related to liver inflammation. Symptoms would be more related to the liver (e.g., jaundice, right upper quadrant pain, abnormal liver enzymes like AST, ALT rather than CPK, LDH in the context of intense exercise - induced muscle problems).

Answer:

A. Rhabdomyolysis