PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the suggested treatment for myoglobinuria?

1. IV fluids and pain management

2. Hydration with IV fluids, alkalization of urine, and Mannitol diuresis

3. Antibiotics and anti-inflammatories

4. Hemodialysis

The correct answer is: Hydration with IV fluids, alkalization of urine, and Mannitol diuresis

Myoglobinuria typically occurs when there is muscle injury that leads to the release of myoglobin into the bloodstream, which then gets filtered through the kidneys and can cause renal damage. The suggested treatment focuses on the prevention of kidney damage and alleviating the symptoms associated with myoglobinuria. The use of hydration with intravenous fluids is crucial as it helps maintain adequate urine output and dilutes the nephrotoxic myoglobin, reducing the risk of acute kidney injury. Alkalization of urine is beneficial because it can help decrease the precipitation of myoglobin in the renal tubules, which might otherwise lead to obstruction and further renal damage. Mannitol is an osmotic diuretic that promotes urine flow and can help in flushing out myoglobin from the kidneys, further protecting renal function during acute episodes. While IV fluids and pain management are important components in treating myoglobinuria, they do not address the need for urine alkalization and the potential protective effects of Mannitol. Antibiotics and anti-inflammatories are generally not indicated unless there is an underlying infection or inflammation causing the muscle injury, and hemodialysis is reserved for cases of severe renal failure that do not respond to other treatments. Thus, the comprehensive approach of hydration, alkalization, and Mann