رجل عمره ٣٠ سنة في الأسبوع الأول بعد تمرين رياضي عنيف جداً، يشتكي آلاماً شديدة في العضلات وضعفاً، وبوله صار بلون الشاي. البوتاسيوم ٦٫١، وإنزيم العضلات CK مرتفع جداً. الضغط ١٢٨/٨٠. ما الأرجح وما أهم علاج؟

A 30-year-old after extremely strenuous exercise has severe muscle pain and weakness, and his urine is tea-coloured. K 6.1, CK very high, BP 128/80. What is likely and what is the key treatment?

1. Hepatitis; reduce fatty food
2. Ordinary muscle strain; rest at home
3. Kidney stone; analgesia without tests
4. Rhabdomyolysis; IV fluids

Answer: D) Rhabdomyolysis; IV fluids. Severe myalgia, dark urine and very high CK after exertion indicate rhabdomyolysis, risking kidney failure and hyperkalaemia; aggressive IV fluids with urine, electrolyte and cardiac monitoring are needed.