28 year old male met with an accident and sustained severe crush injury. He is most likely develop –
**Core Concept**
Rhabdomyolysis is a syndrome that occurs due to the breakdown of skeletal muscle tissue, leading to the release of myoglobin into the bloodstream. This can cause damage to the kidneys and other organs.
**Why the Correct Answer is Right**
In the setting of a severe crush injury, the affected muscles undergo necrosis, releasing large amounts of myoglobin into the bloodstream. This can lead to acute kidney injury, as the myoglobin binds to Tamm-Horsfall protein in the renal tubules, causing obstruction and subsequent renal failure. The condition is often accompanied by hyperkalemia, hypocalcemia, and an elevated creatine kinase level.
**Why Each Wrong Option is Incorrect**
**Option A:** Myocardial infarction is not a direct consequence of crush injury, although it may occur in the context of other traumatic injuries or pre-existing cardiac conditions.
**Option B:** Septic shock is a possible complication of crush injury, but it is not the most direct or common consequence.
**Option C:** Acute respiratory distress syndrome (ARDS) can occur in the setting of trauma, but it is not as directly related to crush injury as rhabdomyolysis.
**Clinical Pearl / High-Yield Fact**
In the context of crush injury, it is essential to monitor serum creatine kinase levels, urine myoglobin, and renal function to diagnose and manage rhabdomyolysis promptly.
**Correct Answer: D. Rhabdomyolysis**