MCQs on renal dialysis

By | May 13, 2024

1. Which of the following is not a type of renal dialysis?
A) Hemodialysis
B) Peritoneal dialysis
C) Renal transplantation
D) Conservative management

2. Hemodialysis access is usually achieved through:
A) Arteriovenous fistula
B) Peritoneal catheter
C) Renal vein catheterization
D) Renal artery bypass

3. All of the following are indications for initiation of dialysis EXCEPT:
A) Uremia
B) Hyperkalemia
C) Fluid overload
D) GFR >20 ml/min

4. During hemodialysis, which of the following gets removed from blood?
A) Urea
B) Creatinine
C) Potassium
D) All of the above

5. Hemodialysis membranes are classified based on their:
A) Porosity
B) Surface area
C) Composition
D) All of the above

6. During peritoneal dialysis, the peritoneal cavity is filled with:
A) Blood from the dialysis machine
B) Dialysate fluid
C) Saline solution
D) Plasma

7. Peritonitis is a common complication of which type of dialysis?
A) Hemodialysis
B) Kidney transplant
C) Conservative management
D) Peritoneal dialysis

8. Dialysate contains high levels of which electrolyte to help remove excess potassium from blood during hemodialysis?
A) Sodium
B) Potassium
C) Calcium
D) Bicarbonate

9. Stable urea reduction ratio during hemodialysis indicates:
A) Adequacy of dialysis
B) Residual renal function
C) High potassium levels
D) Metabolic acidosis

10. Creatinine clearance is the gold standard test used to evaluate adequacy of which type of dialysis?
A) Hemodialysis
B) Peritoneal dialysis
C) Kidney transplant
D) Conservative management

11. Hemodialysis is contraindicated in patients with:
A) Infection
B) Cardiac instability
C) Significant bleeding disorders
D) All of the above

12. High molecular weight solutes are cleared more rapidly by which type of dialysis membrane?
A) Cellulose
B) Polysulfone
C) Cuprophane
D) All are equal

13. During peritoneal dialysis, spent dialysate is drained from the peritoneal cavity via:
A) Arteriovenous fistula
B) Renal vein
C) Abdominal wall catheter
D) Nephrostomy tube

14. Peritoneal equilibrium test is done to assess:
A) Residual kidney function
B) Peritoneal membrane transport characteristics
C) Adequacy of dialysis
D) Vascular access function

15. Erythropoietin stimulating agents are given to correct which condition during dialysis?
A) Hyperphosphatemia
B) Anemia
C) Hyperkalemia
D) Metabolic acidosis

16. Dialysate calcium concentration is usually higher than serum calcium concentration during hemodialysis to:
A) Correct hypocalcemia
B) Avoid calcium mobilization from bone
C) Prevent muscle cramping
D) All of the above

17. Sodium modeling is a technique used during hemodialysis to:
A) Prevent hyponatremia
B) Correct hypernatremia
C) Slow the rate of ultrafiltration
D) Increase potassium removal

18. Recombinant erythropoietin reduces requirements for which component of blood during dialysis?
A) Platelets
B) Fresh frozen plasma
C) Packed red blood cells
D) Cryoprecipitate

19. Intraperitoneal bleeding during peritoneal dialysis initially presents as:
A) Abdominal pain
B) Cloudy dialysate
C) Hypotension
D) Anemia

20. The Kt/V is a parameter used to quantify adequacy of which type of dialysis?
A) Hemodialysis
B) Peritoneal dialysis
C) Kidney transplant
D) Conservative management

21. Essential hypertension is best treated in dialysis patients by controlling which of the following?
A) Pre-dialysis weight gain
B) Inter-dialytic weight gain
C) Use of ACE inhibitors
D) Strict fluid restriction

22. For a patient with peritoneal dialysis catheter, exit site infection presents as:
A) Cloudy dialysate fluid
B) Abdominal pain
C) Fever
D) Erythema and purulent discharge at catheter exit site

23. A patient develops muscle cramps during hemodialysis. Which of the following interventions would be best?
A) Increase dialysate potassium
B) Decrease dialysate calcium
C) Reduce blood flow rate
D) Increase anticoagulation

24. Cinacalcet is a calcimimetic drug used to treat which abnormality associated with dialysis?
A) Hyperphosphatemia
B) Secondary hyperparathyroidism
C) Metabolic acidosis
D) Anemia

25. Patients on peritoneal dialysis can develop encapsulating peritoneal sclerosis, which is caused by:
A) Bacterial peritonitis
B) Chemical peritonitis
C) Fungal peritonitis
D) Viral peritonitis

26. For a patient with new hemodialysis access, the access flow should be at least:
A) 300 ml/min
B) 500 ml/min
C) 1000 ml/min
D) 1500 ml/min

27. Inadequate dialysis for patient on hemodialysis results in accumulation of which solute?
A) Creatinine
C) Potassium
D) Bicarbonate

28. Intraperitoneal bleed during peritoneal dialysis results in:
A) Cloudy dialysate fluid
B) Abdominal pain
C) Hypotension
D) Anemia

29. Important blood tests monitored during hemodialysis include all EXCEPT:
B) Serum bicarbonate
C) Serum calcium
D) Serum albumin

30. The membrane used for kidney replacement in hemodialysis must be able to:
A) Allow passage of large solutes
B) Prevent passage of middle molecules
C) Remove only urea and creatinine
D) Have high selectivity for potassium

31. Recurrence of original kidney disease is the main cause of graft loss after:
A) Hemodialysis
B) Kidney transplant
C) Peritoneal dialysis
D) Conservative management

32. Match the following dialysis modality with its property:

1. Conservatve management
2. Peritoneal dialysis
3. Hemodialysis

A. Uses patient’s peritoneum as dialyzing membrane
B. Artificial kidney machine used
C. Aiming to delay dialysis without it

A) 1C, 2A, 3B
B) 1C, 2B, 3A
C) 2A, 1C, 3B
D) 1C, 3B, 2A

33. A patient has intolerance to hemodialysis due to recurrent hypotension. The best alternative modality would be:
A) Conservative management
B) Peritoneal dialysis
C) Kidney transplant
D) Increase dialysate sodium

34. Sodium modeling during hemodialysis involves:
A) Gradual decrease in dialysate sodium over treatment
B) Gradual increase in dialysate sodium over treatment
C) Maintaining constant dialysate sodium
D) Cyclic changes in dialysate sodium

35. Coombs positive hemolytic anemia may occur as a complication of which type of dialysis access?
A) Arteriovenous graft
B) Arteriovenous fistula
C) Tunneled cuffed catheter
D) Peritoneal catheter

36. A patient develops catheter-related bloodstream infection on peritoneal dialysis. Next best step is:
A) Add antibiotics to dialysate
B) Remove catheter and start hemodialysis
C) Give IV antibiotics and continue PD
D) Stop all dialysis and treat medically

37. Clinical assessment of the arteriovenous fistula includes checking for:
A) Turgor
B) Bruits
C) Capillary refill
D) All of the above

38. A patient developed sudden onset of severe abdominal pain and peritonitis during peritoneal dialysis exchange. Next immediate step should be:
A) Send dialysate fluid for culture
B) Stop peritoneal dialysis
C) Give intraperitoneal antibiotics
D) Start hemodialysis urgently

39. Syndrome of inadequate dialysis includes all of the following EXCEPT:
A) Pruritus
B) Muscle cramps
C) Hyperkalemia
D) Metabolic alkalosis