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Medgeeks Clinical Review Podcast

Dec 20, 2018

The next patient on your list is a 35 year old male with a past medical history of IV drug and alcohol abuse. He's been sober for the last 7 years. 

He presents to the ER after a mechanical fall at home. The nursing triage notes states the patient was in his normal state of health, until about two days prior.

He may have hit his head, but is unsure. The patient had a loss of consciousness. No neurological deficits. The day after his fall, he's experienced decreased urine output, despite increasing his water intake.

The urine that was seen was noted to be brown.

Labs were notable for

  • BUN of 63 mg/dL
  • Creatinine of 8 mg/dl. His last creatinine from a wellness visit was .8 mg/dl.
  • Potassium 6.8 mEq/L. EKG is normal sinus rhythm.
  • CK: 40,000
  • AST: 1066
  • ALT: 450
  • Urine analysis was positive for blood, but negative for RBCs. 

What would you do next?

We'll walk you every step of the way!


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