Nephrotube Dialysis Module Mini Exam (1)

10 Questions | 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