A 20-year-old woman is brought to the emergency department because of severe muscle soreness, nausea, and darkened urine for 2 days. The patient recently joined the military and was participating in rigorous training exercises in hot weather earlier in the day. She appears healthy. Her temperature is 37.0°C (98.6°F), pulse is 64/min, and blood pressure is 110/70 mm Hg. Cardiopulmonary examination shows no abnormalities. The abdomen is soft and nontender. There is diffuse muscle tenderness over the arms, legs, and back. Laboratory results are as follows: Which of the following urine microscopy findings is most likely to be seen in this patient?

Question

A 20-year-old woman is brought to the emergency department because of severe muscle soreness, nausea, and darkened urine for 2 days. The patient recently joined the military and was participating in rigorous training exercises in hot weather earlier in the day. She appears healthy. Her temperature is 37.0°C (98.6°F), pulse is 64/min, and blood pressure is 110/70 mm Hg. Cardiopulmonary examination shows no abnormalities. The abdomen is soft and nontender. There is diffuse muscle tenderness over the arms, legs, and back.  Laboratory results are as follows:  Which of the following urine microscopy findings is most likely to be seen in this patient?

Quizplus · Accepted Answer

Eductional Objective: Rhabdomyolysis usually presents with myalgia, proximal muscle weakness, and dark urine (myoglobinuria) in the setting of trauma, sepsis, or overexertion.  Kidney injury occurs due to heme pigment-mediated tubular injury, leading to acute tubular necrosis.  Urine microscopy typically reveals granular, muddy brown casts.

A 20-Year-Old Woman Is Brought to the Emergency Department Because