Certified Hemodialysis Technologist/Technician Exam Medications and Pharmacology in Dialysis 2 — Questions and Answers
Question 1: Which medication is used to reverse heparin anticoagulation in cases of bleeding during hemodialysis?
- Vitamin K
- Protamine sulfate (Correct answer)
- Fresh frozen plasma
- Tranexamic acid
Correct answer: Protamine sulfate
Protamine sulfate binds and neutralizes heparin, rapidly reversing its anticoagulant effect.
Question 2: Cinacalcet (Sensipar) is used in dialysis patients to treat which condition?
- Anemia
- Secondary hyperparathyroidism (Correct answer)
- Hypertension
- Metabolic acidosis
Correct answer: Secondary hyperparathyroidism
Cinacalcet is a calcimimetic that sensitizes the calcium-sensing receptor on parathyroid cells, suppressing PTH secretion in secondary hyperparathyroidism.
Question 3: Which active form of vitamin D is most commonly prescribed to dialysis patients?
- Ergocalciferol (D2)
- Cholecalciferol (D3)
- Calcitriol (1,25-dihydroxyvitamin D) (Correct answer)
- 25-hydroxyvitamin D
Correct answer: Calcitriol (1,25-dihydroxyvitamin D)
Calcitriol is the active form of vitamin D prescribed to dialysis patients because failed kidneys cannot perform the final hydroxylation step.
Question 4: What is the primary concern when administering EPO (erythropoietin) to a dialysis patient with uncontrolled hypertension?
- EPO lowers blood pressure dangerously
- EPO can further increase blood pressure and risk of stroke (Correct answer)
- EPO is ineffective in hypertensive patients
- EPO depletes iron stores faster in hypertension
Correct answer: EPO can further increase blood pressure and risk of stroke
ESA therapy can raise blood pressure and increase stroke risk, requiring blood pressure control before and during ESA administration.
Question 5: A dialysis patient taking calcium carbonate as a phosphate binder should be instructed to take it:
- On an empty stomach 1 hour before meals
- With meals to bind dietary phosphate (Correct answer)
- At bedtime
- After dialysis sessions only
Correct answer: With meals to bind dietary phosphate
Calcium carbonate must be taken with meals to bind phosphate from food in the GI tract before it can be absorbed.
Question 6: Which electrolyte imbalance is most commonly treated with sodium bicarbonate supplementation in dialysis patients?
- Hyperkalemia
- Hypercalcemia
- Metabolic acidosis (Correct answer)
- Hyperphosphatemia
Correct answer: Metabolic acidosis
Dialysis patients frequently develop metabolic acidosis due to inability to excrete acid, treated with bicarbonate in dialysate or oral supplementation.
Certified Hemodialysis Technologist/Technician Exam Medications and Pharmacology in Dialysis 2
Which medication is used to reverse heparin anticoagulation in cases of bleeding during hemodialysis?