SAQ 1200 – Soldier with myalgia, dark urine and abnormal blood results

A 28-year-old soldier from the army barracks is transferred to your hospital. He feels lethargic, has generalised myalgia and has passed dark urine. On arrival he is alert, HR 100/min, BP 128/70, RR 20/min and temperature 37.5 degrees C.

His initial results are shown below.

Test	Result	Reference range
Na	130 mmol/L	135-145
K	6.5 mmol/L	3.5-4.5
Cl	95 mmol/L	95-110
Urea	15 mmol/L	2.9-7.1
Creatinine	320 umol/L	45-90
Bilirubin	20 mmol/L	0-25
ALP	110 U/L	30-110
GGT	25 U/L	0-30
ALT	100 U/L	<45
AST	510 U/L	<45
WCC	20 x 10^9/L	3-11
Hb	150 g/L	115-165
Platelets	400 x 10^9/L	150-450

What is the most likely diagnosis? Indicate your reasons.

(Marked out of 2.0)

/ 2

What other investigations would you do?

(Marked out of 2.0)

/ 2

What is your initial management of this patient?

(Marked out of 3.0)

/ 3

What are the management options for the acute kidney injury?

(Marked out of 3.0)

/ 3

Total Score: 0 / 10

Percentage: 0%