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A patient found lying on the floor 13 hours ago is expected to have which lab value indicating a musculoskeletal complication?

  1. Elevated creatine kinase

  2. Decreased potassium level

  3. Decreased WBC

  4. Elevated GFR

The correct answer is: Elevated creatine kinase

Elevated creatine kinase (CK) is a significant indicator of muscle damage, particularly in cases where a patient has been immobile or lying on the floor for an extended period, such as 13 hours. When muscle tissue undergoes injury or necrosis, creatine kinase, an enzyme found in high concentrations in skeletal muscles, is released into the bloodstream. The higher the level of creatine kinase, the greater the extent of muscle damage may be. In this scenario, prolonged immobility can lead to conditions such as rhabdomyolysis, where muscle fibers break down and release CK as well as myoglobin into the circulation. This can occur due to pressure on muscle tissue from lying immobile, especially in individuals who may have various risk factors such as dehydration or certain underlying health conditions. Monitoring creatine kinase levels in such cases is crucial as elevated levels can help guide further investigations and management. It can also assist healthcare providers in identifying potential complications that may arise from muscle damage, such as acute kidney injury due to myoglobinuria.