B5-092 Dialysis

Question 1

accumulation in blood of nitrogenous end products

Answer 1

azotemia

Question 2

symptom complex resulting from failure to excrete nitrogenous end products

Answer 2

uremia

Question 3

90% of patients with a GFR <30 are

Answer 3

anemic

appears at beginning of GFR stage 4

Question 4

treatment for anemia due to CKD may require […] iron

(administration method)

Answer 4

IV

Question 5

mineral and bone disorder is often evident in what stage of CKD?

Answer 5

3

Question 6

most important symptom of CKD-MBD

Answer 6

vascular calcification

Question 7

calcium deposits in small vessels of dermis

Answer 7

calciphylaxis

Question 8

important player in the “trade-off” hypothesis of CKD-MBD

causes the increase in PTH

Answer 8

FGF23

Question 9

most important cause of volume overload in CKD

Answer 9

sodium retention

Question 10

diet for CKD

Answer 10

• low sodium
• low potassium
• low phosphorus
• fluid restriction
• protein restriction

Question 11

meds for CKD

Answer 11

• phosphate binders
• calcitriol
• antihypertensives
• ESA
• treatment for renal disease
• treatment for comorbid conditions

Question 12

indications for dialysis

Answer 12

• uremic pericarditis
• uremic encephalopathy
• severe bleeding with uremia
• fluid overload refractory to diuretics
• refractory metabolic disturbances
• refractory HTN

Question 13

most common cause of death in CKD

Answer 13

heart disease

Question 14

does kidney transplant or dialysis offer a better quality of life for CKD patients?

Answer 14

kidney transplant

Question 15

if a patient had cancer and is currently in remission, and in need of kidney transplant, are they eligible?

Answer 15

yes after certain wait time depending on type of cancer

Question 16

low bone density due to hormonal changes or calcium or vitamin D deficiency

Answer 16

osteoporosis

Question 17

• occurs with a relatively suppressed PTH and alkaline phosphate levels
• associated with significant vascular calcifications

Answer 17

adynamic bone disease

Question 18

defect of both low turnover and abnormal mineralization of bone

Answer 18

osteomalacia

Question 19

why was osteomalacia more common in the past?

Answer 19

nephrologists used aluminum-based phoshorus binders

aluminum toxicity causes osteomalacia

Question 20

class bone disease associated with renal failure

Answer 20

osteitis fibrosa

Question 21

associated with increased bone turnover and elevated PTH and alkaline phosphatase

Answer 21

osteitis fibrosa

Question 22

glucocorticoid therapy for primary renal disorder or renal transplant can lead to CKD patients developing

Answer 22

osteoporosis

Question 23

bone disease in CKD with elements of both low and high bone turnover

Answer 23

uremic osteodystrophy

Question 24

is osteoporosis typically caused by ESKD?

Answer 24

no

Question 25

does increasing the frequency of dialysis improve survival or hospitalizations?

Answer 25

no

Question 26

most likely positive outcome from increasing dialysis

Answer 26

improved blood pressure control | fluid removal

Question 27

conservative management of ESKD has a [...] shorter median survivial

Answer 27

2 year

Question 28

patients who choose [...] are more likely to die at home or in hospice and have lower rates of hospitilization overall

Answer 28

conservative management

Question 29

individuals who chose [...] maintain QOL over those who chose RRT

Answer 29

conservative management

Question 30

patients who chose [...] have shorter survival but fewer hospitalizations

Answer 30

conservative management

Question 31

mortality and hbA1c have a [...] relationship

Answer 31

U shaped

Question 32

both high and low hemoglobin A1c are associated with

Answer 32

higher levels of mortality

Question 33

lowest mortality in ESKD is seen in patients with a hemoglobin A1c of

Answer 33

7-8%

Question 34

what should be done for a patient with persistent severe secondary hyperparathyroidism and four-gland hyperplasia who has not responded to medical therapy

Answer 34

subtotal parathyroidectomy

Question 35

persistent PTH following kidney transplant with values above [...] increase all-cause mortality and risk of graft loss

Answer 35

65

Question 36

elevated PTH causes [...] wasting

Answer 36

postassium

Question 37

what procedure is required for evaluation prior to kidney transplant?

Answer 37

urethrocystoscopy with bladder capacity

Question 38

[...] before kidney transplant is critical to prevent complications after transplant

Answer 38

urological assessent

Question 39

many kidney transplant candidates have received dialysis for many years and have long periods of oliguria or anuria. This may result in

Answer 39

bladder dysfunction/atrophy | urethrocystoscopy prior to transplant to evaluate

Question 40

patients who urinate greater than [...] ml/d likely do not need urethrocystoscopy prior to transplantation

Answer 40

300

Question 41

patients with <100 ml bladder capacity should receive treatment for [...] prior to transplantation

Answer 41

improving bladder capacity

Question 42

patients with a history of **invasive** bladder cancer must wait [...] after successful treatment to be eligible for kidney transplant

Answer 42

2 years | superficial bladder cancer does not require waiting

Question 43

patients who receive education and guidance from a multidisciplinary approach are more likely to choose

Answer 43

home-based modality

Question 44

kidney transplants for a [....] donor are associated with longevity and fewer comorbidities

Answer 44

living