Nephrotube Online Quiz - Ckd Mdb

9 Questions | Total Attempts: 98

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Nephrotube Online Quiz - Ckd Mdb

MCQsTime allowed: 25 minGood LuckMohammed Abdel Gawadwww. NephroTubeCNE. Com


Questions and Answers
  • 1. 
    Which ONE of the following statements about the use of calcium containing-phosphate binders (CCPB) is TRUE?
    • A. 

      Patients who develop hypercalcemia on CCPB tend to have low bone density, suggesting reduced capacity for bone to buffer calcium loads.

    • B. 

      Vascular calcification has been shown to occur only when patients are in positive calcium balance.

    • C. 

      Randomized control trials have shown that sevelamer hydrochloride is less likely to be associated with cardiovascular mortality than comparable phosphate control with CCPB.

    • D. 

      Extensive vascular calcification had been rarely seen before the advent of the use of CCPB.

  • 2. 
    Which ONE of the following statements BEST characterizes the effects of calcimimetic agent in modifying abnormalities in divalent ion metabolism in patients with renal failure?
    • A. 

      Calcimimetics effectively reduce intact parathyroid hormone (PTH) levels only when the value is less than 400 pg/ml.

    • B. 

      Calcimimetics tend to raise the serum PO4 levels in hemodialysis patients.

    • C. 

      Ca  PO4 product tends to slightly increase in patients receiving calcimimetics.

    • D. 

      Calcimimetics reduce intact PTH levels while concurrently reducing Ca  PO4 product.

  • 3. 
    A 54-yr-old Caucasian man presents with two large areas of skin necrosis on his left thigh. He has been treated with hemodialysis for the past 6 yr for chronic kidney disease secondary to polycystic kidney disease. He has received intermittent, small, oral doses of calcitriol but has developed hypercalcemia to 12.0 mg/dl. His physical examination is unremarkable except for moderate obesity and for intact pulses throughout his lower extremities. The necrotic areas of skin are superficial. Laboratory studies revealed: calcium, 9.6 mg/dl; phosphate, 5.6 mg/dl; immunoreactive parathyroid hormone, 100 pg/ml.Which ONE of the following choices BEST explains this clinical condition?
    • A. 

      Calciphylaxis associated with adynamic bone disease.

    • B. 

      Calciphylaxis with intermittent hyperphosphatemia.

    • C. 

      Calciphylaxis secondary to intermittent hyperparathyroidism.

    • D. 

      Vasculitis.

  • 4. 
    Which ONE of the following statements regarding the measurement of serum parathyroidhormone (PTH) in patients with chronic kidney disease is TRUE?
    • A. 

      The first-generation intact PTH assay measures both 1-84 and 7-84 moieties of PTH.

    • B. 

      The ratio of 1-84/7-84 more accurately predicts the histologic state of bone than the intact PTH assay.

    • C. 

      A low 7-84 moiety in the face of a low 1-84 moiety rules out low turnover bone disease.

    • D. 

      A low intact PTH in the face of a high 7-84 moiety indicates the presence of adynamic bone disease.

  • 5. 
    It is recommend to monitor serum levels of calcium, phosphorus, PTH, and alkaline phosphatase activity beginning in CKD
    • A. 

      Stage 1

    • B. 

      Stage 2

    • C. 

      Stage 3

    • D. 

      STage 4

  • 6. 
    In CKD stage 5, including 5D, it is recommended to monitor PTH level every:
    • A. 

      1-3 months

    • B. 

      3-6 months

    • C. 

      6-12 months

    • D. 

      Every 14 months

  • 7. 
    In patients with CKD stage 5D, recommended KDIOG dialysate calcium concentration between
    • A. 

      1.00 and 1.25 mmol/l

    • B. 

      1.25 and 1.50 mmol/l

    • C. 

      1.50 and 1.75 mmol/l

    • D. 

      None of the above

  • 8. 
    In patients with CKD stages 3–5D, we recommend that therapeutic decisions be based on a single laboratory value rather than on trends, taking into account all available CKD–MBD assessments
    • A. 

      True

    • B. 

      False

  • 9. 
    In patients with CKD stages 3–5D with evidence of CKD–MBD, BMD testing better not to be performed routinely, because BMD does not predict fracture risk as it does in the general population, and BMD does not predict the type of renal osteodystrophy
    • A. 

      True

    • B. 

      False

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