Diet Counselling in ESRD

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✅ MCQs – Diet Counselling in ESRD (Hemodialysis Focus)

1. The main goal of dietary counseling in ESRD patients on dialysis is to:
A. Promote weight gain
B. Prevent muscle cramps
C. Maintain nutritional status and reduce uremic complications
D. Reduce protein intake to zero
➡️ Answer: C. Maintain nutritional status and reduce uremic complications

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2. Protein recommendation for a stable hemodialysis patient is approximately:
A. 0.6 g/kg/day
B. 0.8 g/kg/day
C. 1.2 g/kg/day
D. 2.0 g/kg/day
➡️ Answer: C. 1.2 g/kg/day

(Higher due to protein loss during dialysis)

3. Which of the following nutrients should be restricted in ESRD patients?
A. Vitamin C
B. Iron
C. Potassium and phosphorus
D. Fiber
➡️ Answer: C. Potassium and phosphorus

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4. Which of the following foods is high in potassium and usually avoided in ESRD diet?
A. White rice
B. Apples
C. Bananas
D. Chicken breast

➡️ Answer: C. Bananas 

5. Hyperphosphatemia in ESRD patients can lead to:
A. Hair loss
B. Bone disease and vascular calcification
C. Low blood pressure
D. Vitamin C deficiency
➡️ Answer: B. Bone disease and vascular calcification

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6. Sodium restriction in ESRD helps in controlling:
A. Blood sugar
B. Fluid overload and hypertension
C. Anemia
D. Bone loss
➡️ Answer: B. Fluid overload and hypertension

7. A food label indicates 400 mg of sodium per serving. For ESRD patients, this is considered:
A. Low sodium
B. High sodium
C. Moderate sodium
D. Safe for daily intake
➡️ Answer: B. High sodium

(Low sodium foods typically have <140 mg per serving)

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8. The daily fluid intake for a patient on hemodialysis is generally restricted to:
A. 1.5–2.0 L/day
B. 500 mL + urine output
C. 3.0–4.0 L/day
D. No fluid restriction
➡️ Answer: B. 500 mL + urine output

9. Which food is safe for a renal diet (low in potassium and phosphorus)?
A. Avocado
B. Watermelon
C. Cauliflower
D. Sweet potatoes
➡️ Answer: C. Cauliflower

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10. Which of the following is a common nutrition-related complication in ESRD?
A. Hyperglycemia
B. Protein-energy wasting (PEW)
C. Obesity
D. Iron overload
➡️ Answer: B. Protein-energy wasting (PEW)

✅ MCQs – Diet Counselling in ESRD (Set 2)

11. Which phosphate binder is commonly prescribed to control phosphorus levels in ESRD patients?
A. Furosemide
B. Sevelamer
C. Calcium gluconate
D. Sodium bicarbonate
➡️ Answer: B. Sevelamer

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12. Which of the following fruits is considered low in potassium and suitable in moderation for ESRD patients?
A. Orange
B. Banana
C. Apple
D. Mango
➡️ Answer: C. Apple

13. Why are high-phosphorus foods like nuts and cola discouraged in ESRD?
A. They raise potassium levels
B. They increase blood sugar
C. They can worsen secondary hyperparathyroidism
D. They are high in sodium
➡️ Answer: C. They can worsen secondary hyperparathyroidism

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14. Which symptom is commonly associated with fluid overload in dialysis patients?
A. Hypotension
B. Shortness of breath
C. Constipation
D. Joint pain
➡️ Answer: B. Shortness of breath

15. ESRD patients are advised to avoid processed and canned foods because they are often:
A. High in vitamins
B. High in sodium and phosphorus additives
C. Contaminated
D. Hard to digest
➡️ Answer: B. High in sodium and phosphorus additives

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16. A dialysis patient is advised to increase protein intake. Which of the following is a high biological value protein source?
A. Beans
B. Tofu
C. Egg white
D. Brown rice
➡️ Answer: C. Egg white

(High biological value = easily absorbed and utilized proteins)

17. What is the recommended energy intake (calories) for a stable adult ESRD patient on hemodialysis?
A. 15–20 kcal/kg/day
B. 20–25 kcal/kg/day
C. 25–35 kcal/kg/day
D. >40 kcal/kg/day
➡️ Answer: C. 25–35 kcal/kg/day

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18. A common reason for anorexia in ESRD patients is:
A. Depression
B. Uremic toxins
C. Medication side effects
D. All of the above

➡️ Answer: D. All of the above

19. Which micronutrient may require supplementation in dialysis due to losses during treatment?
A. Iron
B. Vitamin B12
C. Vitamin C
D. Water-soluble vitamins (B complex, C)
➡️ Answer: D. Water-soluble vitamins (B complex, C)

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20. Which of the following is true regarding potassium restriction in ESRD patients?
A. Cooking vegetables does not reduce potassium
B. Leaching vegetables in water helps reduce potassium content
C. All fruits are safe in unlimited amounts
D. Low potassium intake causes anemia

➡️ Answer: B. Leaching vegetables in water helps reduce potassium content 

Eat Right to Feel Right On Dialysis.Part 2

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Eat Right to Feel Right on Dialysis – MCQs

1. Why is nutrition especially important for patients on dialysis?
A. It helps them gain weight quickly
B. It helps manage blood pressure only
C. It supports energy levels, maintains muscle, and reduces complications
D. It helps stop dialysis permanently
✅ Correct answer: C

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2. Which nutrient should be limited in a dialysis patient’s diet due to risk of hyperkalemia?
A. Calcium
B. Potassium
C. Iron
D. Fiber
✅ Correct answer: B

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3. High phosphorus levels in dialysis patients can lead to:
A. Hair loss
B. Stronger bones
C. Itchy skin and bone disease
D. Weight gain
✅ Correct answer: C

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4. Which food is high in potassium and usually limited in a dialysis diet?
A. Apple
B. Cabbage
C. Banana
D. White rice
✅ Correct answer: C

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5. Why is protein intake increased in dialysis patients compared to healthy individuals?
A. Protein causes less waste
B. Protein helps lower phosphorus
C. Dialysis removes protein waste; more is needed to prevent muscle loss
D. High protein lowers blood sugar
✅ Correct answer: C

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6. What is the recommended protein source for a dialysis patient?
A. Processed meats
B. Red beans
C. Eggs and lean meats
D. Ice cream
✅ Correct answer: C

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7. Fluid intake for dialysis patients should be:
A. Unlimited
B. Based on thirst only
C. Limited to prevent fluid overload and swelling
D. Reduced only on non-dialysis days
✅ Correct answer: C

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8. A common sign of excess fluid intake in a dialysis patient is:
A. Fever
B. Hair loss
C. Swollen legs, high blood pressure, and shortness of breath
D. Low urine output only
✅ Correct answer: C

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9. Which of the following is a low phosphorus food?
A. Cheese
B. Nuts
C. Chicken breast
D. Cola drinks
✅ Correct answer: C

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10. Why should dialysis patients avoid salt (sodium) in large amounts?
A. It causes nausea
B. It increases urine production
C. It can cause high blood pressure and fluid retention
D. It prevents phosphate absorption
✅ Correct answer: C

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11. Which of the following foods is typically high in phosphorus and should be limited?
A. Chicken breast
B. Soft drinks with phosphates (e.g., cola)
C. Apples
D. Cucumber
✅ Correct answer: B

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12. Why should dialysis patients limit dairy intake?
A. It’s high in fat only
B. It can increase fluid loss
C. It contains high amounts of phosphorus and potassium
D. It lowers iron absorption
✅ Correct answer: C

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13. What type of bread is usually better for a dialysis diet?
A. Whole grain bread
B. Bran bread
C. White bread
D. Multigrain bread
✅ Correct answer: C
(White bread has less phosphorus and potassium than whole grain or bran breads.)

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14. What is a safe fruit choice for dialysis patients watching potassium intake?
A. Orange
B. Banana
C. Grapes
D. Mango
✅ Correct answer: C

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15. A dialysis patient should choose which of the following snacks?
A. Salted peanuts
B. Potato chips
C. Unsalted popcorn
D. Dried apricots
✅ Correct answer: C

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16. Which of these is a hidden source of phosphorus in processed foods?
A. Baking soda
B. Phosphate additives (e.g., sodium phosphate)
C. Cornstarch
D. Vinegar
✅ Correct answer: B

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17. How can dialysis patients reduce potassium in vegetables like potatoes or carrots?
A. Fry them
B. Steam them
C. Soak and double-boil (leaching)
D. Add salt
✅ Correct answer: C

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18. Which vitamin is often supplemented in dialysis patients due to losses during treatment?
A. Vitamin A
B. Vitamin C
C. Vitamin D and B-complex
D. Vitamin K
✅ Correct answer: C

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19. Which food is a high-protein, low-phosphorus option suitable for dialysis?
A. Sardines
B. Skinless chicken breast
C. Cheese
D. Lentils
✅ Correct answer: B

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20. What is one tip to help dialysis patients control thirst?
A. Eat salty snacks
B. Sip fluids slowly and use ice chips
C. Avoid all fluids
D. Drink large amounts in the morning only
✅ Correct answer: B

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21. What happens if a dialysis patient regularly eats foods high in potassium?
A. They get more energy
B. It can cause dangerous heart rhythm problems
C. It helps cleanse the kidneys
D. It improves appetite
✅ Correct answer: B

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22. A patient on dialysis complains of fatigue. Which of the following dietary factors might be contributing?
A. Low potassium intake
B. Excessive protein
C. Poor fluid restriction
D. Low protein or iron intake
✅ Correct answer: D

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23. Which cooking method can help reduce phosphorus and potassium content in food?
A. Deep frying
B. Grilling
C. Double boiling or leaching
D. Baking
✅ Correct answer: C

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24. A good breakfast option for a dialysis patient would be:
A. Bran cereal with milk and bananas
B. White bread toast with egg and apple slices
C. Yogurt and orange juice
D. Peanut butter on multigrain toast
✅ Correct answer: B

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25. Which of the following is a low-sodium seasoning option?
A. Soy sauce
B. Table salt
C. Lemon juice and fresh herbs
D. Salted margarine
✅ Correct answer: C

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26. Phosphate binders are prescribed to dialysis patients to:
A. Increase appetite
B. Help remove excess potassium
C. Prevent phosphorus from being absorbed from food
D. Improve digestion
✅ Correct answer: C

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27. A dialysis patient is following their diet well but still has high phosphorus. What might be the reason?
A. Skipping phosphate binders during meals
B. Low protein intake
C. Drinking too much water
D. Eating too little potassium
✅ Correct answer: A

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28. When should phosphate binders be taken?
A. On an empty stomach
B. At bedtime only
C. Right before or with meals
D. After dialysis sessions
✅ Correct answer: C

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29. Which of the following is not recommended as a regular beverage for dialysis patients?
A. Water (in limited amount)
B. Apple juice
C. Orange juice
D. Black coffee (in moderation)
✅ Correct answer: C

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30. Why is it important to control phosphorus levels in dialysis patients?
A. To prevent diabetes
B. To avoid kidney stones
C. To prevent weak bones and heart problems
D. To help increase potassium
✅ Correct answer: C

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Eat Right to Feel Right On Dialysis.Part 1

Full Text:click here

31. A dialysis patient asks if they can eat bananas daily. Your best response is:
A. “Yes, they are great for energy.”
B. “Only in moderation—bananas are high in potassium.”
C. “Only if taken with extra salt.”
D. “Yes, but only on dialysis days.”
✅ Correct answer: B

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32. A patient is gaining 3 kg between dialysis sessions. What dietary advice is most appropriate?
A. Increase protein intake
B. Decrease potassium-rich foods
C. Limit sodium and fluid intake
D. Eat more carbohydrates
✅ Correct answer: C

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33. During a nutrition counseling session, a patient asks if they can drink cola daily. What is your advice?
A. “Yes, it has no fat.”
B. “No, cola contains added phosphorus.”
C. “Only if you have high blood pressure.”
D. “Yes, but dilute it with water.”
✅ Correct answer: B

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34. A dialysis patient frequently eats processed meats. What complication are they at increased risk for?
A. Low potassium
B. Hypotension
C. High sodium and phosphorus levels
D. Dehydration
✅ Correct answer: C

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35. A vegetarian dialysis patient is losing weight and muscle. What is the best protein advice?
A. “Avoid protein to reduce waste.”
B. “Add high-biological-value protein like eggs and dairy if possible.”
C. “Rely only on fruits and vegetables.”
D. “Switch to high-fat foods.”
✅ Correct answer: B

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36. A dialysis patient reports constant itching. Lab tests show high phosphorus. What’s the next best action?
A. Stop dialysis temporarily
B. Reduce potassium intake
C. Review diet and phosphate binder compliance
D. Drink more fluids
✅ Correct answer: C

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37. A patient asks if they can eat oranges and drink orange juice daily. What is your answer?
A. “Yes, it's healthy and hydrating.”
B. “No, both are high in potassium and should be limited.”
C. “Yes, if you take phosphate binders.”
D. “Only after dialysis sessions.”
✅ Correct answer: B

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38. You observe a patient skipping meals due to poor appetite. Which recommendation is best?
A. “Skip meals until you feel hungry.”
B. “Eat small, protein-rich snacks throughout the day.”
C. “Eat sugary snacks to boost energy.”
D. “Reduce protein intake until appetite improves.”
✅ Correct answer: B

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39. A dialysis patient is constipated due to fluid and fiber restrictions. What is a suitable advice?
A. “Eat bananas and drink more juice.”
B. “Increase fiber with allowed fruits and use stool softeners if needed.”
C. “Take laxatives daily.”
D. “Stop phosphate binders.”
✅ Correct answer: B

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40. A patient asks why fluid must be restricted even when not feeling thirsty. You respond:
A. “Because your kidneys still make urine.”
B. “Because dialysis removes all fluid.”
C. “Because fluid can build up between sessions, causing heart and lung strain.”
D. “Because fluids make you sleepy.”
✅ Correct answer: C

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41. True or False: All fruits are safe to eat in large quantities on dialysis.
A. True
B. False
✅ Correct answer: B

Many fruits (e.g., bananas, oranges, avocados) are high in potassium and must be limited.

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42. True or False: Dialysis patients need less protein to avoid waste buildup.
A. True
B. False
✅ Correct answer: B

They actually need more protein to replace what is lost during dialysis.

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43. Which of the following statements is a myth?
A. “Too much sodium can cause fluid retention.”
B. “Processed foods may contain hidden phosphorus.”
C. “You can drink as much fluid as you want because dialysis will remove it.”
D. “High-protein foods help prevent muscle loss.”
✅ Correct answer: C

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44. True or False: Drinking cola and soft drinks with phosphate additives can increase phosphorus levels.
A. True
B. False
✅ Correct answer: A

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45. Which of the following is not a good practice for dialysis patients?
A. Reading food labels for sodium and phosphorus content
B. Taking phosphate binders with meals
C. Drinking more than 1.5–2 L fluid per day regardless of advice
D. Asking the dietitian before changing the diet
✅ Correct answer: C

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46. True or False: Eating salty foods can increase thirst and fluid overload.
A. True
B. False
✅ Correct answer: A

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47. Which of the following food combinations is not dialysis-friendly?
A. White rice + chicken + apple
B. Boiled potatoes + fried fish + grapes
C. Baked egg + toast + green beans
D. Pasta + lean beef + cabbage
✅ Correct answer: B

Potatoes and fried foods can be high in potassium and fat.

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48. True or False: All dairy products are safe and encouraged on a dialysis diet.
A. True
B. False
✅ Correct answer: B

Many dairy products are high in phosphorus and potassium and must be limited.

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49. A patient says, “I avoid all protein to keep my kidneys from working too hard.” Your response should be:
A. “That's good, keep it up.”
B. “Actually, you need more protein to stay strong during dialysis.”
C. “Try to avoid carbohydrates instead.”
D. “Drink more fluids instead.”
✅ Correct answer: B

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50. True or False: Eggs, lean meats, and some fish are good protein sources for dialysis patients.
A. True
B. False
✅ Correct answer: A

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51. A dialysis patient wants to replace high-potassium bananas in their smoothie. What’s a better option?
A. Avocado
B. Apple
C. Mango
D. Orange
✅ Correct answer: B

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52. Which nutrient is most often restricted in dialysis patients due to risk of mineral imbalance?
A. Iron
B. Calcium
C. Phosphorus
D. Vitamin B12
✅ Correct answer: C

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53. When reading food labels, which ingredient should dialysis patients watch for as a hidden phosphorus additive?
A. Potassium chloride
B. Calcium carbonate
C. Sodium phosphate
D. Ascorbic acid
✅ Correct answer: C

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54. A good lunch choice for a dialysis patient would be:
A. Grilled chicken sandwich on white bread, cucumber slices, and water
B. Ham sandwich on whole grain bread, orange juice
C. Fried fish with mashed potatoes and coleslaw
D. Cheese pizza with tomato sauce
✅ Correct answer: A

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55. A patient is asking about herbal supplements. What’s the correct advice?
A. All herbal products are safe
B. Herbal supplements are natural and don’t affect dialysis
C. Some herbs can interfere with medications or harm kidneys—always consult your care team
D. Herbs are only dangerous when taken in large amounts
✅ Correct answer: C

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56. Which dessert is best suited for a dialysis patient with potassium restriction?
A. Chocolate pudding
B. Ice cream with nuts
C. Apple pie (small slice)
D. Banana split
✅ Correct answer: C

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57. Dialysis patients are advised to limit whole grains and bran products because they are:
A. Too high in sugar
B. Too high in phosphorus and potassium
C. Low in fiber
D. Difficult to digest
✅ Correct answer: B

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58. What type of fat is healthiest for dialysis patients to use in cooking?
A. Butter
B. Lard
C. Trans fat
D. Olive oil or canola oil
✅ Correct answer: D

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59. Which food item would best increase protein intake without adding too much phosphorus?
A. Egg white
B. Peanut butter
C. Cheese
D. Lentils
✅ Correct answer: A

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60. If a dialysis patient insists on drinking milk, what’s the best strategy?
A. Allow unlimited intake
B. Suggest a low-phosphorus milk alternative and monitor potassium
C. Encourage milk with every meal
D. Replace milk with cola
✅ Correct answer: B

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