AFRAN Monthly Quiz - February 2022 - English Version
Quiz developed by:
Mohammed Abdel Gawad (Egypt), NZANA Victorine (Cameroon), Yannick Nlandu (Democratic republic of congo)

Find our previous quizzes at https://afran.org/quiz/
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Q1- A 50-year-old woman presented with a 4-week history of intermittent pain and numbness in her left hand. She had noticed that her hand became pale at times, particularly in the cold. She had started haemodialysis via a left brachial fistula 2 months previously. The symptoms in her left hand were worse during dialysis.Pain and fine-touch sensation were reduced in the thumb and first two fingers of her left hand.What is the most likely diagnosis? *
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Q2- A 71-year-old woman had been having haemodialysis for 16 years. She complained of stiffness and diffuse pain bilaterally in her shoulders and elbows. The pain was worse at night and after dialysis. Her fistula had recently been bleeding for longer than usual after removal of the dialysis needles. She dialysed with a low-flux biocompatible dialyser through a left radiocephalic AVF with a blood flow rate of 380 mL/min.On examination, she had reduced rotation in her shoulders.Investigations (pre-dialysis):serum corrected calcium 2.4 mmol/L (2.20–2.60)serum phosphate 2.3 mmol/L (0.80–1.45)serum total protein 63 g/L (61–76)serum albumin 30 g/L (37–49)serum alkaline phosphatase 125 U/L (45–105)serum CRP 21 mg/L (<10)plasma parathyroid hormone 48.0 pmol/L (0.9–5.4)What is the most likely explanation for her symptoms?
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