Sample interview questions: How do you approach the challenges of managing infections in patients with end-stage renal disease (ESRD) undergoing dialysis?
Sample answer:
Challenges in Infectious Disease Management in Patients with End-Stage Dialysis (ESRD)
- Immunosuppression: ESRD patients have impaired immune function due to dialysis, increasing their susceptibility to infections.
- Vascular Access: Dialysis catheters and fistulas provide a direct route for bacterial entry, posing a significant risk for bloodstream infections.
- Dialysis-Related Infections: Contamination of dialysis equipment and fluids can lead to bloodstream, peritoneal, and urinary tract infections.
- Multidrug Resistance: Patients with ESRD often have prolonged antibiotic use, which can contribute to the development of multidrug-resistant bacteria.
- Drug Interactions: Medications used to manage ESRD, such as erythropoietin and iron supplements, can interact with antibiotics.
- Diminished Renal Clearance: Impaired renal function reduces the clearance of antibiotics, requiring dosage adjustments to avoid toxicity.
- Peritoneal Dialysis: This modality of dialysis is associated with a higher risk of peritonitis due to direct access to the peritoneal cavity.
Approach to Challenges
- Early Diagnosis and Treatment: Prompt identification and initiation of appropriate antimicrobial therapy is crucial to prevent infection-related complications.
- Infect… Read full answer
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