A
B
C
D
E
100

According to Joachim and Tang's publications, post-transplant mortality is lower with?

A.     PD

B.     HD


A.     PD

100

How many Kilos of Glucose exposure are reduced per year when substituting a 3.86% bag with a 2L Extraneal bag?

A.        8

B.      19

C.      28

D,      30

C.      28


100

Which treatment has been shown to improve early-stage survival outcomes for patients?


A.      PD

B.      HD

C.      there is no difference

A.      PD

100

Where can information related to Extraneal and glucose monitors be found:


A.      www.glucousesafety.com

B.      www.extranealsafety.com

C.      www.baxtersafety.com

D.      www.icodextrinesafety.com

100

Extraneal has been shown?


A.      To reduce infusion pain

B.      To improve patient survival

B.      to improve patient survival

200

What is the Potassium % In PD Fluid? 

  • Zero %
200

Advanced PD Solutions are important because they can impact:


A.      Patient comfort & well-being

B.      Ultrafiltration capacity

C.      Peritonitis incidence and severity

D.      Time on Therapy

E.      B, C & D

F.      All of the above

F.      All of the above

200

Patients treated with PD have 85% less risk of RKF loss than those with HD (Moist LM et al. Journal of American Society of Nephrology 2000)


  • True
  • False
  • False
    PD has a 65% lower risk of RKF loss than HD. 
200

Sharesource is the most clinically proven RPM technology in the market that enables an efficient approach to delivering effective PD away from the clinic:


  • True
  • False
  • True
200

The use of Extraneal has been associated with ?


A.      Lower risk of death in diabetic patients Vs those who are not using icodextrin

B.      Higher risk of death in diabetic patients Vs those who are not using icodextrin

C.      No difference in risk of death

A.      Lower risk of death in diabetic patients Vs those who are not using icodextrin

300

Each 250mL increase in daily urine volume is associated with a 36% decrease in relative risk (RR) of death and 5L per week greater residual GFR decreases the risk of mortality by 12%:


  • True
  • False
  • True



Reference 

Preservation of Residual Kidney Function in Hemodialysis Patients: Reviving an Old Concept for Contemporary Practice

300

In the Australian study by Johnson DW et al., patients with refractory fluid overload transitioning from PD to HD were given one Extraneal exchange. On average, this intervention extended their time on PD by how many years?


A.     1,63 years

B.     1,21 years

C.     0,51 years

D.     0,92 years

B.     1,21 years

300
  • In Sharesource, to increase adoption and maximize utilization, it is key to coach/guide your clinics on: (choose all that apply)


A.       Staff responsible for Sharesource

B.       Which patients to put on Sharesource

C.       Which flag rules and parameters to use

D.       Level of monitoring of Sharesource

E.       All Above

E.       All Above

300

The drop-out rate is:


A.      The number of patients who dropped out during the year (Excluding transplants in some countries) divided by the number at risk per year

B.      The number of patients who drop out of therapy the first 3 months on PD (Excluding transplants in some countries)






A.      The number of patients who dropped out during the year (Excluding transplants in some countries) divided by the number at risk per year

300

In Sharesource, it is recommended that all flags, both high and low priority are enabled with the tightest thresholds chosen to ensure all possible issues are flagged.


  • True
    It is best practice to follow this protocol
  • False
    It is best to set up a customized system and protocols for flag escalations that work for that specific clinic
  • False
    It is best to set up a customized system and protocols for flag escalations that work for that specific clinic
400

When deciding on renal replacement treatment, if there is a proper implementation of a shared decision-making process, what is the approximate percentage of the Patients who will choose PD?


A.      20% of patients choose PD

B.      30% of patients choose PD

C.      50% of patients choose PD

D.      65% of patients choose PD

C.      50% of patients choose PD

400

What percentage of patients drop out of PD due to inadequate dialysis?


A.      22%

B.      28%

C.      25%

D.      18%

D.      18%

400

What is the percentage (%) of CKD patients who are medically and psychosocially eligible for PD?


A.       78%

B.       72%

C.       69%

D.       81%

A.       78%

400

What are the current major claims for Sharesource, with supportive evidence:    
(select all that apply):


A.      Improves visibility to patient adherence patterns with the use of APD with Sharesource.

B.      Decreased Hospitalization rate with the use of APD with Sharesource.

C.      Decreased Time On Theropy of APD Patiernts that use RPM technology.

D.      Increase pre-emptive consults with the use of APD with Sharesource versus APD without Sharesource.

A.      Improves visibility to patient adherence patterns with the use of APD with Sharesource.

B.      Decreased Hospitalization rate with the use of APD with Sharesource.

D.      Increase pre-emptive consults with the use of APD with Sharesource versus APD without Sharesource.

400

What is the calcium level in Extraneal? 

1,75

500

Mr. S had a catheter inserted 4 weeks ago and has been on PD for 2 weeks. He is presenting to you for an exit site review, once you remove the dressing you notice a certain amount of discharge around the catheter site, what are your actions?


Game

1-Score the exit site

2-Swab the exit site

3-Follow pathway to prescribe treatment (Exit site dressing, Exit site Management)

4-Date for reviewing the exit site, 

5-Record the infection rate

500

Mr. X is a 50-year-old man, who has been recovering from an exit site infection. 

He has nearly finished his course of antibiotics and has mentioned he feels his tummy is a little tender.

On examination, you find inflammation along the catheter pathway.

Game, what is your plan for care?

1-Look, Feel & Record

2-Ultrasound examination – a positive finding with sonolucent peri catheter fluid collection

3-Start effective antibiotics and regular monitoring of the site

4-Adjusting treatment to both clinical and microbiological results

5-Monitoring culture after primary cure

500

A PD patient on APD,  came to the ER complaining of a cloudy Effluent bag & abdominal pain with fever.

Game
What is the expected diagnosis and the protocol?


1- Clinical Assessment.

2- Sampling & Culture-taking.

3- Rapid Flushing to reduce the pain.

4- Start antibiotics.

5- Adjust the treatment as per the Sample & Culture result.


500



                  YOU WIN




                   Open Discussion 





Mr. A is a 61-year-old man with ESRD secondary to diabetes.

He started APD 2 days ago and he complains of a negative ultrafiltration alarm in APD, he is feeling abdomen discomfort with abnormal swelling on his abdomen right side


1- What is your first action?

2- How can you confirm the diagnosis?

3- What is the next step in managing this pt?



1- What is your first action?

     

  • Inspection of the swelling.
  • Use of twin bag to drain any effluent
  • Roll out increasing of IPP


2- How can you confirm the diagnosis?

  • CT scan Peritoneal graph
  • Fill the abdomen with PD Solution mixed with Dye then arrange to make an abdominal CT scan.

3- What is the next step in managing this pt?

  • Avoid IIPP
  • Avoid Constipation
  • Treat cough
  • Proper fill volume
  • Proper Icodextrin volume.
  • Consider APD instead of CAPD.
  • If it happened due to a surgical insertion procedure, consider refining the insertion skills.
  •  Hold PD for (1-4 Weeks).
  • If the patient will not be tolerated: then consider having HD access.


500

What was the first Advanced Fluid released?

A.       Extraneal

B.       Physioneal

C.       Nutrineal


C.       Nutrineal
Was released in 1993

B.       Physioneal
Was released in 1996

A.       Extraneal
Was released in 1997

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