Section One: Multi-Choice Questions (15 marks)

Question 1

What is dialysis, and what are the two forms of it?

Answer 1

Dialysis is the mechanical blood filtration and reabsorption used in pts with acute kidney failure or end-stage renal failure.

1. Haemodialysis - Pt’s blood moves from an implanted shunt in an artery into a machine where it exchanges waste, fluids and electrolytes. Once this is complete the pt’s blood is returned to them via vein.
2. Peritoneal Dialysis - A catheter with an entry and exit point is implanted into the peritoneal cavity. Dialysing fluid is instilled into the cavity and drains from cavity via gravity into a container

Question 2

What are the cons of haemodialysis?

Answer 2

• Shunt may become infected
• Blood clots may form
• Blood vessels involved in shunt may become sclerosed or damaged.
• Increased risk of HEP B & C, or HIV if precautions are not followed.

Question 3

What are the cons of peritoneal dialysis?

Answer 3

• time consuming
• requires loose clothing to accommodate fluid bag
• risk of infection resulting in peritonitis

Question 4

Define chronotropic, inotropic, dromotropic and lusitropic.

Answer 4

Chronotropic: increases the heart rate

Inotropic: increase for of contraction

Dromotropic: increase the rate of conduction through the AV node

Lusitropic: increases the relaxation of the myocardium during diastole.

Question 5

Define the difference between ventilation, perfusion and diffusion.

Answer 5

Ventilation: movement of air in and out of the lungs
Perfusion: circulation of blood through the lung tissue
Diffusion: process of gas exchange at the alveoli

Question 6

What instrument is used to inspect the eye?

Answer 6

Opthalmoscope

Question 7

What instrument is used to inspect the inner ear?

Answer 7

Otoscope

Question 8

What is a sphygmoanometer?

Answer 8

BP cuff

Question 9

What are the normal ranges for: Respiratory Rate, Pulse, BP, Temp

Answer 9

RR: 12-24 breaths per minute
PR: 60-100 bpm
BP: 120/80
Temp: 36.4 - 37.2 C

Question 10

What do crackles in the lung sounds typically sound like and what may the indicate?

Answer 10

High-pitches, discontinuous sounds typically heard during the end of inspiration O

Indication of fluid in the lungs - pulmonary oedema or pneumonia.

Question 11

What kind of sound is a wheeze when listening to the chest, and what is it an indication of?

Answer 11

A continuous high pitched musical noise, louder during expiration.

Can be caused by asthma, constrictive diseases or congestive heart failure.

If it occurs localised, suspect a foreign body obstruction, tumour or mucous plug.

Question 12

What type of sound is a Ronchi chest sound and what doe it indicate?

Answer 12

A continuous, low pitched, rumbling sound on expiration.

Caused from air passage through obstructed airways from thick secretions muscular spasm, new tissue growth or external pressure collapsing the airway.

Question 13

What does a stridor chest sound sound like and what may it indicate?

Answer 13

Crowing type sound, typically on inspiration and can be heard without the aid of instrument.

Indicates narrowing or obstruction of the larynx or trachea - may be caused by epiglottitis, viral croup, anaphylaxis, foreign body aspiration.