Question 26.1

College answer

Syllabus topic/section:

2.1.9 Endocrine Intensive Care / Diabetes Mellitus: L1

Discussion:  

Generally, candidates answered this question adequately, although there was an expectation of a higher standard of answer given this very common therapy and clinical scenario. Candidates are reminded that according to the glossary, “Discuss” should include information about key principles, potential controversies and any relevant advantages and disadvantages in the answer.

Discussion

a)

These are:

1. Citrate pre blood pump fluid set
2. Access pressure sensor
3. Filter
4. Return pressure sensor
5. Calcium replacement syringe driver
6. Bubble trap deaerator
7. Dialysate
8. Effluent

b)

 It would be nice to give "information about key principles, potential controversies and any relevant advantages and disadvantages" here, but this "discuss" answer is worth two marks, and at maximum handwriting speed (~20-25 words/min) the headings themselves take up 10% of the word count. It would end up having to look something like this:

• Improve access
  • Improves duration of effective dialysis
  • Requires another site of access
• Increase blood flow rate
  • Improvement in efficiency will be max at ~200ml/min
  • Depends on good access
• Increase predilution fluid
  • Reduces efficiency of small solute clearance
  • Increases elution of urea from red cells

This is 45 words in total.