28 year old male met with an accident and sustained severe crush injury. He is most likely develop aEUR’
**Core Concept**
Rhabdomyolysis is a condition that occurs due to direct muscle injury, leading to the breakdown of muscle tissue and release of myoglobin into the bloodstream. This can cause acute kidney injury (AKI) due to tubular obstruction and vasoconstriction.
**Why the Correct Answer is Right**
The severe crush injury causes extensive muscle damage, leading to the release of intracellular contents, including potassium, phosphate, and myoglobin. Myoglobin is particularly nephrotoxic, causing vasoconstriction and tubular obstruction, ultimately leading to AKI. This process is often exacerbated by factors such as dehydration, hyperkalemia, and acidosis. The kidneys are unable to filter the released myoglobin, leading to a decrease in glomerular filtration rate (GFR) and a subsequent rise in serum creatinine levels.
**Why Each Wrong Option is Incorrect**
**Option A:** Septic shock is a potential complication of severe crush injury due to potential infections, but it is not the most direct consequence of muscle damage.
**Option B:** Hypovolemic shock may occur due to blood loss, but it is not the primary concern in this scenario.
**Option C:** Neuropraxia may occur due to nerve compression, but it is not directly related to muscle damage.
**Clinical Pearl / High-Yield Fact**
Rhabdomyolysis can be prevented or minimized by early recognition and treatment of crush injuries, including fluid resuscitation and pain management.
**Correct Answer:** C. Rhabdomyolysis