Self-Test Questions for Accreditation

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The Basis of the Acute Phase of Verotoxin-Induced HUS: Molecular risk factors

Presented by Clifford A. Lingwood, Ph.D.

1) Which of the following increase cell sensitivity to verotoxin?

a.TNFalpha,

b. TGFbeta

c. alpha interferon

d. IL4

e. LPS

f. IL1beta

g. VEGF

2 ) Which of the following statements are correct?

a. Gb3 is made in the Golgi

b. Gb3 is present in platelets

c. Gb3 binds cytosolic kinases

d. Gb3 makes cells drug resistant

e. Gb3 induces B cell differentiation

f. Renal Gb3 is elevated in HIV

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Plasma Exchange in the Treatment of Thrombotic Thombocytopenic Purpura/Hemolytic Uremic Syndrome with Long Term Follow Up and Prognosis

Presented by Gail Rock, MD

3) Of the following, which method for treating TTP/HUS has received the best results?

a) Plasma exchange with plasma exchange (PE) with fresh frozen plasma

b) Plasma infusion

c) Cryosupernatant Plasm

4) True or False: If high molecular weight multimers of von Willebrand factor (vWF) contribute to the progress of TTP/HUS; cryosupernatant plasma which is relatively deficient in vWF multimers, might be of some benefit to patients.

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Escherichia coli O157:H7 of the GI Tract: Complications Beyond Diarrhea

Presented by Phillip I. Tarr, MD

Questions:

5) An 8 year old boy had E. coli O157:H7 infection, without HUS. He comes to you 6 months later with abdominal pain that is predominantly umbilical. Each of the following diagnostic measures is appropriate as the first test to order except:

a. Barium enema

b. Abdominal x-ray (without barium)

c. Diagnostic trial of lactose withdrawal

d. Fructose based breath hydrogen test

6) A 3 year old girl is discharged from hospital after having had E. coli O1157:H7 associated HUS. Her parents tell you that she has a persistently distended abdomen, seems to be in pain, and has partial relief of symptoms after passing bowel movements, which seem uncomfortable. Do you:

a. Suggest a stool softener

b. Perform an abdominal ultrasound

c. Obtain a stool culture

d. Perform a barium enema

7) A 3 year old girl is discharged from hospital after having had E. coli O1157:H7 associated HUS. Her parents tell you that she has a persistent loose stools. She has had a negative culture for E. coli O157:H7 and has been cleared to return to day care. However, her loose stools are frequent, and even wake her at night.

The best test to perform is:

a. Stool culture for other enteric pathogens

b. Barium enema

c. Stool for C. difficile toxin, by cytotoxicity assay

d. Stool for parasite examination

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Diabetes and HUS

Presented by Richard Mauseth, MD

8) What are three times when diabetes onset is more prevalent in HUS?

a. Acute-onset/dialysis, transient, growth

b. Puberty, Time of Transplant-stress/immunosuppress

c. Increasing weight gain, illness

d. All of the above.

9) What are three symptoms of diabetes?

a. Increased urination, increased thirst, weight loss

b. Fatigue/decreased energy, poor healing, numbness/tingling

c. Increased energy, good healing, weight gain

d. Both a and b.

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Longterm Renal Outcomes of Diarrhea-Associated HUS

Presented by John Brandt, MD

10) Which tests are most useful in assessing long term renal health following HUS (choose all that apply)?

a) Hematuria (Blood in the urine)

b) Proteinuria (protein in the urine)

c) Glomerular Filtration rate

d) Blood Creatinine level

e) Blood pressure

11) Approximately what percentage of children have NO evidence of renal damage / sequelae on long term follow-up?

a) 5%

b) 20%

c) 45%

d) 65%

e) 90%

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Long-term Consequences of HUS: the ENCHLOSE Network

Presented by Piero Ruggenenti, MD

12) Why may post HUS chronic nephropathy have a progressive course to end stage renal failure?

13) How may ACE Inhibitors limit or prevent progression of post HUS chronic nephropathies?

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Hemolytic Uræmic Syndrome: The 'eart of the matter

Presented by Garry Cornel MB, BS, FRCS (C)

14) Cardiac involvement in HUS is due to:

a) Fluid and electrolyte balance.

b) Hypertension.

c) Thrombotic microangiopathy.

d) Toxic myocarditis

e) All or any of the above.

15) True or False: There are no long term effects on the heart of HUS.

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Neuropsychological Sequelae of HUS: A Positive Outcome

Presented by Elaine Orrbine

16) In the many tests administered to children for potential neuropsychological sequelae, which were the only two tests to show any differences:

a) WIAT and WRMT-R

b) Peabody, Stanford-Binet

c) Wechsler, the Swanson, Nolan and Pelham checklist (SNAP)

d) Woodcock and TOWL-2

17) True or False: For this study, which was conducted with children who had no evidence of neurological impairment at the time of discharge from hospital after their acute HUS episode, there was no increase in the risk of clinically important central nervous system sequelae when patients were compared with carefully matched controls.

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Answers

1. a, e, and f.

2. a, b, and f.

3. c

4. True

5. a

6. d

7. c

8. d

9. d

10. b, c, and e

11. c

12.

13.

14. e

15. False

16. a

17. True