function Question (qname, type, qstring, response, corrects, explan, ifcorrect,ifwrong,ifnull, img) {this.qname=qname; this.type=type; this.qstring=qstring; this.response=response; this.corrects=corrects; this.explan=explan; this.ifcorrect=ifcorrect; this.ifwrong=ifwrong; this.ifnull=ifnull; this.img=img; } resp=new Array("all","I and II","II and III","I and V ","IV and V") corr=new Array("0","0","0","0","1") quest001 = new Question( "Question 1", 0, "
Interactions of the dialysis membrane with components of blood may induce an inflammatory response and long-term clinical sequelae that are in part determined by the degree of membrane biocompatibility. Which statement(s) is/are correct?


I. Several dialysis membranes induce inflammatory reactions that are reflected e. g. by enhanced phagocyte oxidative metabolism, transcription and receptor expression of cytokines, and activation of natural killer cells or lymphocytes.


II. The most direct consequence of complement and leukocyte activation is leukocytosis.


III. The strongest and/or most rapid activation of the complement and leukocyte systems has been demonstrated with synthetic membranes.


IV. Cell proliferation but not apoptosis may be induced by blood-membrane contact.


V. The type of inflammatory response induced by complement-activating membranes might affect clinical outcome. ", resp, corr, "", 1, 0, 0, ""); resp=new Array("III","III and IV","I and II","II","II and V") corr=new Array("0","0","0","0","1") quest002 = new Question( "Question 2", 0, "
When blood encounters the hemodialysis membrane, several reactions are triggered. Which statement(s) is/are correct?


I. Differences among membranes in their capacity to induce inflammatory responses are only caused by the membrane's ability to remove and/or adsorb inflammatory agents.


II. Chronic use of complement-activating membranes affects long-term leukocyte responses.


III. Cuprophan adsorbs large amounts of ß2-microglobulin, C5a and C3a.


IV. Very strong adsorption of erythropoietin occurs with AN69 membranes and this adsorption has a relevant influence on the erythropoietin plasma concentration.


V. Several membranes with low systemic complement-activating capacity adsorb components with pathophysiologic potential, e. g. ß2-microglobulin is adsorbed by polysulfone, AN69, polyamide, polymethylmethacrylate (PMMA) and polycarbonate.
", resp, corr, "", 1, 0, 0, ""); resp=new Array("I","I and II","I, II, IV, V","I, IV, V","all") corr=new Array("0","0","0","1","0") quest003 = new Question( "Question 3", 0, "
Dialyzer reactions refer to all of the abnormal sequelae resulting from the interaction between blood constituents and the hemodialysis membrane. Which statement(s) is/are correct?


I. The use of dialyzers and tubings sterilized with ethylene oxide (ETO) should be avoided, especially in patients showing otherwise unexplained signs of anaphylactoid reaction, eosinophilia or elevated IgE.


II. The combination of dialysis with AN69 membranes and medical treatment with both ACE-inhibitors and angiotensin receptor II antagonists must be avoided because of the possibility of severe haemodynamic reactions.


III. Anaphylcatoid reactions are more prominent with plate dialyzers than with hollow fibre dialyzers.


IV. The plasticizer phthalate anhydride and the sterilant formaldeyhyde can induce anaphylactoid reactions or specific antibody responses.


V. Phthalates have been implicated in chemically induced polycystic kidney diseases. ", resp, corr, "", 1, 0, 0, ""); resp=new Array("all","I, II, III, IV","I, II, III, V","I, III, IV, V","II") corr=new Array("0","0","0","1","0") quest004 = new Question( "Question 4", 0, "
The release of fragments from the dialyzer circuit should be prevented. Which statement(s) is/are correct?


I. The fragments of dialysis system materials that are released in the circulation of dialysis patients may contain silicone, polyvinylchloride (PVC), polyurethrane or any other polymer used for the assembly of dialysis circuits.


II. Very recently, di-(2-ethylhexyl)-phthalate has become available as an alternative plasticizer for PVC.


III. Platicizer release can be reduced by the coating of the inner wall of the tubings, e. g. with PVC-ethylen vinylacetate or PVC-polyurethane.


IV. Fragments may be sequestered in the liver and the spleen, inducing hepatic dysfunction and enhanced blood cell destruction.


V. Gamma irradiation for sterilization of plastic materials may result in the release of cytotoxic compounds, which can be reduced by adequate pre-rinsing. ", resp, corr, "", 1, 0, 0, ""); resp=new Array("all","I and II","I, II, III","II and IV","II, III, V") corr=new Array("0","0","0","0","1") quest005 = new Question( "Question 5", 0, "
The biocompatibility of the dialyzer membranes has clinical consequences. Which statement(s) is/are correct?


I. To achieve an improved clinical outcome regarding morbidity and mortality, the use of small pore/low-flux biocompatible dialyzers should be preferred.


II. Several studies point to a relation between the application of unmodified cellulose dialyzers and increased mortality.


III. The use of complement activating membranes has an acute negative impact on pulmonary function and perfusion.


IV. Repeated intrapulmonary release of proteases and free radicals induces pulmonary fibrosis in haemodialysis patients.


V. Some studies suggest that cardiovascular morbidity and/or mortality might be increased when complement-activating membranes are applied. ", resp, corr, "", 1, 0, 0, ""); resp=new Array("I and II","I, II, IV","all","II, IV","II, V") corr=new Array("0","0","0","1","0") quest006 = new Question( "Question 6", 0, "
The nutritional status is influenced by hemodialysis. Which statement(s) is/are correct?


I. Direct and indirect parameters of nutritional status are affected by dialysis with complement-activating dialyzers. Negatively affected are albumin, pre-albumin and body-weight, positively affected is insulin-like growth factor-I


II. Dialysis with complement-activating dialyzers leads to net protein breakdown.


III. The switch of patients with hypoalbuminaemia from a socalled “bioincompatible” to a more biocompatible membrane is followed by a further decrease in serum albumin.


IV. The application of complement activating membranes has a negative impact on lipid profiles.


V. The amino acid loss into the dialysate is greater when using high-flux membranes than low-flux membranes. This could be demonstrated if the results were normalized for the greater surfaces and flows of a high-flux membrane.", resp, corr, "", 1, 0, 0, ""); resp=new Array("all","I, II, III","I, III, IV","I, III, V","II and III") corr=new Array("0","0","0","1","0") quest007 = new Question( "Question 7", 0, "
Several further organ systems are influenced by the biocompatibility of dialyzer membranes. Which statement(s) is/are correct?


I. Oxidative stress during haemodialysis with complement-activating membranes has been correlated with increased malondialdehyde and inversely correlated with glutathione peroxidase and erythrocyte dismutase activity.


II. Haemodialyis patients are characterized by an increased risk of atheromatosis and atherosclerosis but these problems usually develop only after more than 10 years of dialysis.


III. Vitamin-E-substituted cellulosic dialyzer membranes might allow to preserve blood anti-oxidative capacity.


IV. Development of clinical symptoms of ß2-m amyloidosis seems to be most prominent on high-flux biocompatible membranes and lowest on low-flux socalled “bioincompatible” membranes.


V. ß2-m can be modified by advanced glycation. AGE-ß2-m induces more potent biological inflammatory reactions than native ß2-m.", resp, corr, "", 1, 0, 0, ""); resp=new Array("I","II","II,IV, V","II, III","III, V") corr=new Array("0","0","0","1","0") quest008 = new Question( "Question 8", 0, "
Which statement(s) is/are correct? Shear stress related problems:


I. can be prevented by the use of small diameter needles.


II. can be avoided by the prevention of highly negative arterial pressure alarms (exceeding 150 mm Hg).


III. can induce haemolysis, platelet activation, platelet fragmentation, inhibition of platelet aggregability.


IV. can be avoided in a single needle setting.


V. include increases of the leukocyte chemotactic capacity and the oxidative burst response of macrophages.", resp, corr, "", 1, 0, 0, ""); questions = new Array ( quest001,quest002,quest003,quest004,quest005,quest006,quest007,quest008) function doQuestion(quest) { var numdo; var numord=eval(quest+1); var i=-1, ii, type, myname, gadget; type=questions[quest].type; numdo=type>=3?1:questions[quest].response.length; document.write("\n") document.write("
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You have made the following errors

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"+uno+"
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";}} winr=window.open('','wapres', 'titlebar=1,location=0,directories=0,menubar=1,toolbar=0,scrollbars=1,resizable=1,status=1') winr.document.write("Results
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"+fill((now.getMonth()+1),2)+"/"+fill(now.getDate(),2)+"/"+now.getYear()+"  "+fill(now.getHours(),2)+":"+fill(now.getMinutes(),2)+"

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You have made "+errori+" error."); else winr.document.write("

Congratulations, you haven't made any errors

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") printest=(((navigator.appName=='Netscape') && (navigator.appVersion.charAt(0)>='4')) || (testIE5plus() == true))? 'print()': 'alert("This button can be used with Netscape Navigator 4 or Microsoft Internet Explorer 5 only. If you want to print with other browsers, please select the Print command in the File menu.")' winr.document.write("    ") winr.document.write("
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Created and managed with SmartLite WebQuiz

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