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RHABDOMYOLYSIS • Characterized by skeletal muscle breakdown & necrosis. • Elevated Creatine kinase (CK) hallmark of rhabdomyolysis. • Defined based
Creatine kinase (CK ... Defined based on CK ... • Half-life of CK ... peaks in 3 days, & normalizes ... and cefdinir #CK
INR Chart - International Normalized Ratio #INR #International #Normalized #Ratio #Range #Laboratory
International Normalized ... International #Normalized
Creatine kinase (CK) is an intracellular enzyme present in skeletal muscle, myocardium & brain; smaller amounts
Creatine kinase (CK ... CK may increase ... creatine kinase (CK ... CK functions as ... first 3 days, and normalizes
Myositis and Myopathies Polymyositis • Progressive, symmetric muscle weakness • Elevated CK, +Anti-Jo, +Anti-Mi2 Dermatomyositis
weakness • Elevated CK ... rash • Elevated CK ... Elevated ESR, Normal CK ... mildly elevated CK ... Myopathies #myopathy #differential
Creatine Kinase - Causes of Elevated CK Levels Acute CK Elevation (Pain > Weakness): • RHABDOMYOLYSIS
Causes of Elevated CK ... Levels Acute CK ... ASYMPTOMATIC: Macro CK ... Kinase #Elevated #CK ... #differential #
Inflammatory Myopathies Dermatomyositis • Onset: Subacute • Pattern: Proximal • CK: Up to 50X ULN • Autoantibodies:
: Proximal • CK ... : Proximal • CK ... : Proximal • CK ... and distal • CK ... Inflammatory #Myopathies #differential
Mixing Study • Clotting tests can be abnormal due to either a clotting factor deficiency, or
Clotting test normalizes ... test does not normalize
Myositis and Myopathies #ESR #CK #Differential diagnosis of myopathy #Inflammatory #myopathies #Dermatomyositis #muscle weakness #Polymyositis #Inclusion body myositis #Polymyalgia rheumatica #Fibromyalgia #Hypothyroid myopathy #Muscle stiffness #Drug-induced
Myopathies #ESR #CK ... #Differential diagnosis
Systemic Lupus Erythematosus (SLE): Musculoskeletal Manifestations • Immune Complex Deposition - Arthralgia, Arthritis
Weakness, Normal CK ... Weakness, Incr CK ... therapy), Normal CK
COMMONLY ENCOUNTERED MEDICATIONS THAT INCREASE OR DECREASE WARFARIN’S INTERNATIONAL NORMALIZED RATIO (INR) #Pharmacology #Warfarin #Medications #Interactions #INR
INTERNATIONAL NORMALIZED
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