✅ MCQ: Vascular Access for Hemodialysis
1. What is the preferred type of vascular access for long-term hemodialysis?
A. Central venous catheter (CVC)
B. Tunneled dialysis catheter
C. Arteriovenous fistula (AVF)
D. Arteriovenous graft (AVG)
➡️ Answer: C. Arteriovenous fistula (AVF)
2. Which of the following is the most common complication of arteriovenous grafts?
A. Steal syndrome
B. Infection
C. Aneurysm
D. Hypotension
➡️ Answer: B. Infection
3. Which vein is most commonly used to create an AV fistula in the upper limb?
A. Cephalic vein
B. Basilic vein
C. Subclavian vein
D. Jugular vein
➡️ Answer: A. Cephalic vein
4. The earliest time AV fistula can be used after creation is usually:
A. 1–2 days
B. 1 week
C. 2–3 weeks
D. 6–8 weeks
➡️ Answer: D. 6–8 weeks
5. What is the purpose of the "thrill" assessment in an AV fistula?
A. To check blood pressure
B. To evaluate fistula flow
C. To assess edema
D. To detect clotting time
➡️ Answer: B. To evaluate fistula flow
6. Which of the following vascular access types has the highest risk of bloodstream infection?
A. AV fistula
B. AV graft
C. Tunneled CVC
D. Non-tunneled CVC
➡️ Answer: D. Non-tunneled CVC
7. What is a common cause of access failure in AV grafts?
A. Steal syndrome
B. Central vein stenosis
C. Thrombosis
D. Aneurysm rupture
➡️ Answer: C. Thrombosis
8. The term “steal syndrome” in vascular access refers to:
A. Blood diversion from the central circulation
B. Infection spreading to the bloodstream
C. Ischemia of the distal limb due to shunting of blood through AV access
D. Stealing of blood samples without permission
➡️ Answer: C. Ischemia of the distal limb due to shunting of blood through AV access
9. Which access is most suitable for emergency hemodialysis?
A. AV fistula
B. AV graft
C. Tunneled catheter
D. Non-tunneled central venous catheter
➡️ Answer: D. Non-tunneled central venous catheter
10. When examining a patient’s AV fistula, the absence of a bruit or thrill suggests:
A. Functional access
B. High-flow fistula
C. Thrombosis or access failure
D. Maturation of fistula
➡️ Answer: C. Thrombosis or access failure
11. The most important factor for AV fistula maturation is:
A. Patient age
B. Vein diameter and quality
C. Blood pressure
D. Type of dialysis machine
➡️ Answer: B. Vein diameter and quality
12. Which imaging modality is commonly used to assess vascular access patency?
A. X-ray
B. CT scan
C. Doppler ultrasound
D. MRI
➡️ Answer: C. Doppler ultrasound
13. Which of the following is NOT a benefit of AV fistula compared to other access types?
A. Lower infection rate
B. Better long-term patency
C. Immediate usability
D. Lower thrombosis rate
➡️ Answer: C. Immediate usability
14. Which sign would not typically suggest an infected dialysis catheter?
A. Fever
B. Redness around insertion site
C. Thrill at the insertion site
D. Pus or discharge
➡️ Answer: C. Thrill at the insertion site
15. What should be done if a fistula shows no thrill and has stopped working suddenly?
A. Start antibiotics
B. Continue dialysis as usual
C. Notify vascular surgeon and arrange imaging
D. Switch arms for cannulation
➡️ Answer: C. Notify vascular surgeon and arrange imaging
16. What is the primary reason for creating an AV fistula in the non-dominant arm?
A. Cosmetic reasons
B. It is closer to the heart
C. To preserve function in the dominant hand
D. Higher blood flow
➡️ Answer: C. To preserve function in the dominant hand
17. A patient with an AV graft complains of hand numbness and cold fingers. This may indicate:
A. Infection
B. Thrombosis
C. Steal syndrome
D. Hypocalcemia
➡️ Answer: C. Steal syndrome
18. How often should a dialysis access be assessed for thrill and bruit?
A. Monthly
B. Weekly
C. Before each dialysis session
D. Only during access creation
➡️ Answer: C. Before each dialysis session
19. Which of the following is most commonly used for temporary dialysis access?
A. Left subclavian catheter
B. Right internal jugular catheter
C. Femoral tunneled catheter
D. Subcutaneous port
➡️ Answer: B. Right internal jugular catheter
20. Which complication is more associated with subclavian vein catheterization?
A. Infection
B. Hematoma
C. Pneumothorax and central vein stenosis
D. Thrombosis
➡️ Answer: C. Pneumothorax and central vein stenosis
