A 21-Year-Old Man Is Brought to the Emergency Department Due

A 21-year-old man is brought to the emergency department due to diffuse muscle aches and weakness.  He has also noticed darkening of his urine.  The patient recently joined the military and was participating in rigorous training exercises in hot weather earlier in the day.  He has no significant medical conditions and takes no medications.  Medical evaluation and laboratory testing performed prior to military enlistment showed no abnormalities.  Temperature is 36.7 C (98 F) , blood pressure is 100/60 mm Hg, pulse is 105/min, and respirations are 16/min.  Physical examination shows dry mucous membranes and muscle tenderness over the bilateral thighs and calves.  Laboratory results are as follows: Which of the following urine microscopy findings is most likely to be seen in this patient?

A) Dysmorphic red blood cells
B) Eosinophils
C) Granular casts
D) Isomorphic red blood cells
E) Polymorphonuclear leukocytes
F) Red blood cell casts

Correct Answer:

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