AV Fistula BP Arm — ORE Part 1 MCQ

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EasyHuman Disease & Dental ManagementAV Fistula BP ArmORE Part 1

A patient on chronic haemodialysis has an AV fistula in the left arm. Blood pressure during a dental emergency needs to be monitored. Which arm should be used?

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Reveal the answer and explanation

Correct answer: D — Right arm (the arm without the AV fistula)

Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as D · D = shown as E

The correct answer is A. Blood pressure measurement must never be performed on the arm with the AV fistula because the occlusive cuff interrupts blood flow through the fistula, risking thrombosis and loss of this vital dialysis access. The contralateral (non-fistula) arm must always be used. Distractors fail because: (B) directly contradicts established practice; (C) creates a false equivalence—measurement on the fistula arm is harmful; (D) is incorrect—BP monitoring is essential in dialysis patients, just not on the fistula arm; (E), while theoretically possible, is unnecessarily inconvenient when the other arm is available and is not standard practice.

Reference: Cambridge University Hospitals NHS Foundation Trust. Arterio Venous Fistula (AVF) as an access for haemodialysis. Patient information. https://www.cuh.nhs.uk/patient-information/arterio-venous-fistula-avf-as-an-access-for-haemodialysis/