CCHT Interpretation of Common Laboratory Values 3

Question 1

Which of the following serum calcium levels in a dialysis patient would most urgently require immediate notification of the physician?

Accepted Answer

11.9 mg/dL

Answer

9.2 mg/dL

Answer

8.4 mg/dL

Answer

10.2 mg/dL

Question 2

What does the albumin level in a dialysis patient primarily reflect?

Accepted Answer

Nutritional status and inflammation

Answer

Adequacy of dialysis delivery

Answer

Hydration status and fluid balance

Answer

Renal osteodystrophy severity

Question 3

A dialysis patient's hemoglobin is 8.2 g/dL and the reticulocyte count is low. What is the most likely cause of this finding?

Accepted Answer

Decreased erythropoiesis due to inadequate ESA dose or functional iron deficiency

Answer

Iron deficiency anemia from blood loss

Answer

Functional iron deficiency with adequate erythropoietin response

Answer

Hemolytic anemia from dialysis membrane reaction

Question 4

What is the significance of a BUN:creatinine ratio greater than 20:1 in a dialysis patient?

Accepted Answer

It suggests a catabolic state, gastrointestinal bleeding, or high dietary protein intake

Answer

It indicates excellent dialysis adequacy with efficient urea removal

Answer

It is a normal finding in all stable dialysis patients

Answer

It indicates the patient is anuric and all nitrogen waste is dialysis-dependent

Question 5

In a hemodialysis patient, which combination of laboratory findings is most consistent with iron deficiency anemia?

Accepted Answer

Low ferritin (<100 ng/mL), low TSAT (<20%), low hemoglobin, low MCV

Answer

High ferritin, high transferrin saturation (TSAT), low hemoglobin

Answer

Normal ferritin, normal TSAT, low hemoglobin, normal MCV

Answer

Low ferritin, high TSAT, normal hemoglobin

Question 6

A hemodialysis patient's pre-dialysis labs show sodium of 136 mEq/L, but the patient reports drinking 3 liters of fluid since their last treatment. How does this help interpret their fluid status?

Accepted Answer

The high fluid intake relative to sodium suggests dilutional hyponatremia is developing or the patient has significant interdialytic fluid gain

Answer

The normal sodium confirms the patient is not volume overloaded

Answer

Sodium does not help assess fluid status—use weight instead

Answer

Normal sodium indicates that dietary sodium restriction is unnecessary