Nephrotube Dialysis Module Mini Exam (1)

10 Questions | By GawadNephroTubee | Last updated: Mar 20, 2022 | Total Attempts: 150

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Nephrotube Dialysis Module Mini Exam (1) - Quiz

10 MCQs20 minGood LuckGawad

Questions and Answers

1.

A 24-year-old woman with a long-standinghistory of lupus is diagnosed with heparininducedthrombocytopenia.Regarding alternatives to therapy, whichONE of the following therapies is the MOSTappropriate anticoagulation strategy?
- A.
  
  Enoxaparin
- B.
  
  Epoprostenol
- C.
  
  Tinzaparin
- D.
  
  Clopidogrel
- E.
  
  Heparinization of dialyzer with reversal
2.

A 60-yr-old man with ESRD because of multiplemyeloma complains of progressive backpain. Hb level last mo was 10.8 g/dl, at whichtime you had increased erythropoietin from10,000 IU two times weekly to 10,000 IU threetimes weekly administered subcutaneously.Now, you note Hb level of 8.2 g/dl and serumalbumin level of 2.2 g/dl. You consult hematology.They recommend therapy with dexamethasone,thalidomide, and cyclophosphamide.Free light chain concentration was 17,000 mg/L.Which ONE of the following therapies isMOST likely to result in effective reductionin free light chain until chemotherapy becomeseffective?
- A.
  
  Dialysis with a high-flux dialyzer, molecular cutoff 20 kD
- B.
  
  Plasma exchange with albumin replacement
- C.
  
  Dialysis with “super” flux dialyzer, molecular cutoff 10 KD
- D.
  
  Dialysis with high molecular weight cutoff dialyzer, molecular cutoff 45 kD
- E.
  
  Switch to peritoneal dialysis (PD)
3.

Protein-bound uremic solutes are poorly removedby current dialysis therapies. Recently,one such toxin, p-cresol, was associated withincreased mortality in dialysis patients.Which ONE of the following strategies isMOST likely to result in effective removalof protein-bound uremic solutes?
- A.
  
  Maintenance of residual renal function
- B.
  
  Switching to PD
- C.
  
  Hemodiafiltration
- D.
  
  Gut lavage with nonreabsorbable solutes
- E.
  
  High-flux dialysis
4.

Hemodiafiltration (HDF) combines both diffusion and convection. Which one of the following clinical benefits of HDF is FALSE?
- A.
  
  HDF removes middle molecules more efficiently than high-efficiency and high-flux dialysis
- B.
  
  Phosphate removal is much higher than high-efficiency and high-flux dialysis
- C.
  
  Removal of inflammatory cytokines is better or higher with HDF than high-efficiency and high-flux dialysis
- D.
  
  Preservation of residual renal function is much better with HDF than high-efficiency and high-flux dialysis
- E.
  
  Improvement in albumin and other markers of nutrition is better with HDF than high-efficiency and high-flux dialysis
5.

In your patient with CKD 4 (eGFR 22 mL/min), you plan to place a native arterio-venous (A-V) fistula. Which one ofthe following is the MOST preferred fistula for your patient?
- A.
  
  Radiocephalic fistula
- B.
  
  Brachiocephalic fistula
- C.
  
  Brachiobasilic transposition fistula
- D.
  
  A-V graft
- E.
  
  Any one of the above
6.

The above patient has radiocephalic fistula, and he comes to your office 4 weeks after fistula creation. Which one of thefollowing measurements suggests that the fistula is functioning properly and will be ready in 3 months forcannulation?
- A.
  
  Vein diameter 2 mm and access flow rate 300 mL/min
- B.
  
  Vein diameter 3 mm and access flow rate 400 mL/min
- C.
  
  Vein diameter 4 mm and access flow rate 450 mL/min
- D.
  
  Vein diameter 6 mm and access flow rate 600 mL/min
- E.
  
  Vein diameter 2.8 mm and access flow rate 350 mL/min
7.

A radiocephalic A-V access was created in your 60-year-old African American diabetic woman 4 weeks ago and iscurrently not maturing. Which one of the following variables is associated with failure of fistula maturation(primary failure) is CORRECT?
- A.
  
  Age > 65 years
- B.
  
  Coronary artery disease (CAD)
- C.
  
  Peripheral vascular disease (PVD)
- D.
  
  Hyperlipidemia
- E.
  
  All of the above
8.

You have been dialyzing a patient with a graft with a blood flow of 400–500 mL/min for 6 months without anycomplications. One day you get a call from your nurse that the venous pressure is high and she needs to reduce bloodflow to 300 mL/min, and the nurse suspects thrombosis of the graft. Which one of the following methods of vascularaccess surveillance would have prevented the thrombus of the graft?
- A.
  
  Measurement of monthly access flow
- B.
  
  Measurement of monthly static venous dialysis pressures
- C.
  
  Monthly duplex ultrasound
- D.
  
  Monthly physical examination by qualified personnel
- E.
  
  None of the above
9.

Your patient has a central venous catheter for HD, and the infection rate is much higher than an A-V graft. Infection ofthe catheter results from which one of the following sources of contamination is CORRECT?
- A.
  
  Catheter connectors
- B.
  
  Catheter lumen during dialysis
- C.
  
  Infused solutions
- D.
  
  Migration of patient’s skin flora into the cannulation site
- E.
  
  All of the above
10.

As medical director of a dialysis facility, you noticed that one of your colleague’s patients has consistently low eKt/V of1.1 despite a 4-h session 3 times a week on a high-flux dialyzer and a functioning A-V fistula. Which one of thefollowing factors can affect delivered Kt/V?
- A.
  
  A-V access recirculation
- B.
  
  Delivered blood and dialysate flow rates
- C.
  
  Treatment time
- D.
  
  Dialyzer KoA (mass transfer area coefficient)
- E.
  
  All of the above