| Post Name | Lab Assistant (Dialysis) - Medical Education |
|---|---|
| Question Paper Code | 082/2024/OL |
| Category Code | 581/2023 |
| Date of Test | 9 July 2024 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
All the following are functions of kidneys except
Answer
C. Production of microglobulin
2
All the following statements are correct regarding anatomy of kidney and urinary tract except
Answer
D. Prostate gland is situated on the top of urinary bladder
3
Regarding water balance all the following statements are correct except
Answer
A. Total body water is 40% of body weight
4
Identify the correct statement regarding AKI
Answer
C. Acute rise in S. creatinine of ā„ 0.3 z observed over 48 hrs
5
All the following are indicators for dialysis in chronic kidney disease except
Answer
B. Chronic kidney disease stage IV
6
All the following statements regarding temporary venous catheters are correct except
Answer
D. Venous catheters have high URR
7
Identify the wrong statement regarding subclavian access
Answer
D. Better than left jugular access
8
All the statements regarding anticoagulation in dialysis are correct except
Answer
D. Heparin based catheter lock solution are better than citrate based solution in preventing infection
9
Identify the wrong statement regarding access imaging
Answer
B. Incidence of nephrogenic systemic ļ¬brosis has increased with the use of new contrast agents for MRA
10
All the following statements regarding AV access canulation are correct except
Answer
C. Buttonhole method is used in AV graft canulation
11
All the following statements regarding exit site infection of permanent catheter are true except
Answer
C. If blood culture are positive a course of antibiotics given and catheter retained
12
All the statements regarding catheter related blood stream infects are correct except
Answer
D. Taking a blood sample from dialysis circuit is not a substitute for peripheral blood sample
13
Identify the incorrect statement regarding antibiotic lock solution
Answer
A. To treat bacteremia antibiotic lock is used without systemic antibiotics
14
All the following statements regarding catheter dysfunction are correct except
Answer
D. Failure to deliver blood ļ¬ow of atleast 200 m/mt at a pre pump pressure less negative than -250 mn of Hg
15
All the following are risk factors for development of central venous stenosis except
Answer
D. Silicone catheter
16
All the following are the factors favouring clotting of the extra corporeal circuit except
Answer
D. low haematocrit
17
All are the complications of Heparin therapy except
Answer
A. Hypernatremia
18
All the following statements are correct regarding Heparin induced thrombocytopenia except
Answer
D. Low molecular wt heparin is used in the treatment of HIT
19
All the following statements regarding citrate as anticoagulant are current except
Answer
C. Blood ļ¬ow rates have to be kept very high
20
All the following are newer anticoagulants except
Answer
D. Dalteparin
21
A 50 year old woman is received in the Haemodialysis unit. She has been treated with thrice weekly Haemodialysis via Left Brachiocephalic ļ¬stula for the last 5 years. Over the past 2 months, she reports prolonged bleeding when needles are removed, often upto 40 to 50 minutes, despite continuous pressure. Examination of the AVF revealed a strong thrill with no collapse visible on raising the arm. What is the most likely cause of this prolonged bleeding?
Answer
D. Venous outļ¬ow stenosis of the AVF
22
The sensitivity of the blood leak monitor in the hemodialysis circuit is between
Answer
A. 0.25 to 0.35 ml of blood per litre of dialysate
23
Balancing chamber is for
Answer
D. For ultraļ¬ltration
24
The temperature of the dialysate when exceeds 45 degree celcius, the important complication which can develop include
Answer
B. Sudden cardiac arrest
25
Acetate intolerance manifests as
Answer
B. Hypotension
26
Heparin is infused into
Answer
B. Post pump pre dialyser segment
27
Causes of low arterial pressure alarminclude all of the following except
Answer
D. Unclamping of saline infusion line
28
Identify the true statement about phosphate in dialysis
Answer
A. Normally absent in dialysis solution
29
For optimum dialysis the ratio of blood ļ¬ow to dialysate ļ¬ow should be
Answer
B. 1:2
30
Degassing is performed by exposing the heated water to
Answer
C. Negative pressure
31
45 yrs old lady with diabetes and end stage kidney disease has been on regular Haemodialysis for the last 5 years. Her BP is often uncontrolled often, 180/100 mmHg and has always leg edema and facial puļ¬ness. Her interdialytic weight gain is 4-5 Kg. She is currently on 4 hour sessions of hemodialysis, 3 times per week, with a blood ļ¬ow rate of 350. She is speciļ¬cally asking for change of dialysers, to improve her edema and long term mortality. What should be ideal for her?
Answer
A. Dialyser with KuF>20ml/h/mmHg
32
Priming volume of most dialysers is usually within the range of
Answer
A. 60 to 120 ml
33
Molecular Weight (MW) of creatinine
Answer
A. 113
34
Heat sterilisation involves the used of
Answer
C. Heated water at 105 degree C
35
Maximum reduction in total cell volume of dialyser acceptable for reuse is
Answer
A. 20%
36
76 years old man with end stage kidney disease, diabetes and hypertension, has been undergoing haemodialysis for the last 3 years. His regimen is 4 hours session 3 times weekly with a blood ļ¬ow of 300 ml/minute. His dialyser speciļ¬cations are as follows Speciļ¬cation Result Dialyser material Acrylonitrile (AN69) Surface area 1.2 sq.m KuF 10ml/hr/mmHg Beta2 microglobulin clearance 16 ml/mt Method of sterilisation Chemical He was recently seen by his cardiologist and was started on Ramipril (ACE-I) and aspirin daily. Today a few minutes after the start of the dialysis, he developed swelling of conjunctiva, lips and bronchospasmand hypotension. Dialysis was stopped and he was resuscitated successfully and admitted to ICU for further management What is the most appropriate plan for his dialysis after discharge?
Answer
C. Switch to a polycarbamate dialyser
37
A 30 year old man on haemodialysis for the last 2 years through AV ļ¬stula, with previous sessions have all been without any complications. Suddenly, the machine started alarmingand the haemodialysis circuit started jerking with the movement of the blood pump. You notice that arterial pressure has become more negative than before. Based on the structure of the haemodialysis circuit, what is the most likely problem causing this alarm
Answer
C. Kink in arterial line between needle and the blood pump
38
45 years old man on thrice weekly maintenance Haemodialysis for the last 3 years, without any known complications. Today pt collapsed after dialysis and is being resuscitated. He was drowsy, BP 90/60 mmHg, pulse 55 beats/mt and is sweating with cold and clammy extremities. The technicians noticed a brown discolouration of blood in the venous line and his pottassium is 6.6 mEq/l What is the most likely cause for his clinical presentation?
Answer
A. Acute hemolysis
39
A protein from the blood of horseshoe crab is used for detecting which contaminant in the water treatment system?
Answer
D. Endotoxin
40
Empty Bed Contact time of carbon in carbon ļ¬lter must be atleast
Answer
A. 10 mts
41
Unit of KT/V, which is used to calculate adequacy of dialysis is
Answer
D. Dimensionless
42
Minimally adequate dose of hemodialysis given 3 times per week to patients excluding residual kidney function [RKF] is
Answer
A. spKt/V of 1.2 per dialysis
43
In hemodialysis which is false regarding dialysis adequacy?
Answer
A. Equilibrated Kt/V (eKt/V) is always higher than spKt/V
44
In blood circuit of hemodialysis apparatus, which of the following statement is/are true?
Answer
C. Outļ¬ow blood line contain venous drip chamber and air detector
45
Which of the statement is/are true about conductivity?
Answer
D. All of the following
46
Which of the statement is false about central venous access in hemodialysis?
Answer
C. Use of subclavian site is associated with less incidence of insertion related complications
47
All of the following are immediate complication of central venous catheterization except
Answer
B. Central venous stenosis
48
Which among the following is/are the complications of catheter related blood stream infections
Answer
D. All of the following
49
Ultrapure dialysis solution contain
Answer
C. Bacteria level <0.1 cfu/ml, endotoxin level <0.03
50
Causes of intradialytic hypotension include all except
Answer
C. Low dialysis solution temperature
51
Treatment resistant muscle cramps during dialysis is usually due to
Answer
C. Hypomagnesemia
52
Which among the following is false about headache during hemodialysis?
Answer
D. Acetaminophen is contraindicated for the treatment
53
Which among the following is true about dialyzer reaction?
Answer
B. Type A reactions in the past were due to hypersensitivity reactions to ethylene oxide
54
Dedicated dialysis machine is recommended for the dialysis of
Answer
A. Hepatitis B positive patients
55
Vaccination schedule for hepatitis B in CKD patients is
Answer
C. 0, 1, 2, 6 Months
56
Reason for choosing incentre over home based HD include
Answer
D. All of the following
57
Daily hemodialysis (DHD) is indicated in all of the following conditions except
Answer
D. Patient with bleeding manifestations
58
Following statement is false about home hemodialysis
Answer
B. Rope ladder technique is the preferred mode of cannulation
59
Safety measures for prevention of morbidity when lines are disconnect in home hemodialysis include
Answer
D. all of the above
60
NxStage System 1 device is used in
Answer
A. Home hemodilaysis
61
All are true except
Answer
A. Parietal peritoneum accounts for about 80% of the total peritoneal surface area
62
Transport processes involved in peritoneal dialysis are all except
Answer
C. Conduction
63
Aquaporins in the endothelial cell membrane transport which of the following
Answer
B. Water only
64
According to the three pore model, large pores are with a radius of
Answer
B. 20-40 nm
65
Aquaporins are
Answer
C. Ultrapores
66
A standardised Peritoneal Equilibration Test (PET) uses
Answer
A. 2.5%, 2.0 L dextrose solution
67
Standard PD solutions contain all except
Answer
D. Potassium
68
Causes of ļ¬uid overloaded in PD patients include
Answer
D. All of the above
69
All may suggest peritonitis, except
Answer
C. Peritoneal ļ¬uid cell count of 50/mcL
70
Most common agent causing peritonitis in CAPD is
Answer
B. Gram positive bacteria
71
Preferred mode of initial treatment in CAPD peritonitis is
Answer
C. Intra peritoneal antimicrobials
72
Most common sign of peritonitis is
Answer
D. Cloudy peritoneal ļ¬uid
73
All are relative contraindications for Peritoneal Dialysis except
Answer
A. Heart failure
74
Which is usually not a complication of CAPD?
Answer
D. Hypoglycemia
75
Dialysis can be a good option for all except
Answer
Question Cancelled
76
Which of the following is not an advantage of hemodiaļ¬ltration compared to hemodialysis?
Answer
B. higher inļ¬ammatory proļ¬le
77
All of the following are advantages of predilution HDF except
Answer
B. high solute clearance and removal of small, middle and high molecular weight solutes than post dilution HDF
78
Which of the following is not a preferable characteristic of high-ļ¬ux hemodiaļ¬lter
Answer
B. internal ļ¬bre diameter < 200 micrometers
79
Computerised medical records helps in ensuring the following except
Answer
A. Assess the dry weight of the patient
80
Hemodialysis software helps in
Answer
C. treatment of chronic kidney disease
81
What is the KDIGO recommendation regarding choice of anticoagulation in CRRT in AKI?
Answer
B. Regional citrate anticoagulation
82
What is the recommendation regarding the delivered dose of CRRT in AKI?
Answer
A. 20 to 25 ml/kg/hour
83
All of the following are conditions were CRRT is preferred over intermittent hemodialysis except
Answer
D. Drug overdose
84
All of the following are advantages of CRRT except
Answer
D. rapid correction of azotemia, electrolyte and acid base disturbances.
85
To avoid overconcentration of rbcs and protein and fouling of dialyzer membranes, it is recommended to keep the ļ¬ltration fraction in CRRT below
Answer
A. 25%
86
All of the following are complications of regional citrate anticoagulation except?
Answer
D. Hyponatremia
87
All of the following are true regarding regional citrate anticoagulation except?
Answer
C. citrate toxicity is likely if the ratio of total serum calcium to ionised calcium is less than 2.5
88
According to AAMI standards, ultrapure dialysate characteristics are?
Answer
C. 0.1 CFU and 0.03 IU endotoxin
89
All of the following are true regarding SLED except?
Answer
C. Replacement solution is required
90
All of the following are true in case of preļ¬lter dilution in HDF except?
Answer
D. Increases urea clearance upto 20%
91
50 year old man presented with congestive heart failure and ļ¬uid overload. He has progressive breathlessness despite medical management. His renal function tests and electrolytes are normal. Which of the following extracorporeal therapy is ideal for his treatment?
Answer
B. SCUF
92
All of the following are advantages of SLED except?
Answer
D. Excellent middle molecule clearance
93
All of the following are true regarding hemodiaļ¬ltration except?
Answer
D. There is reduced loss of albumin
94
Poisons with molecular weight of 10,000 to 40,000 Da and are less than 80% protein bound are better removed by which of the following extracorporeal therapy?
Answer
B. Hemodiaļ¬ltration
95
Criteria for consideration of hemoperfusion in a case of poisoning include all the following except?
Answer
D. intoxication with drugs that can be removed rapidly by endogenous elimination by liver or kidney
96
All of the following are factors that determine dialyzability of a poison except?
Answer
D. Chemical stability
97
Intermittent hemodialysis is not eļ¬ective in the management of which of the following drug overdose?
Answer
D. Digoxin
98
All of the following are true regarding Hemoperfusion except?
Answer
B. Heparin requirement is less than conventional hemodialysis
99
All of the following are complications of Hemoperfusion except?
Answer
D. hyperglycemia
100
Hemodialysis is indicated in the treatment of which of the following poisonings?
Answer
A. Lithium
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