CCTN review Exam Questions with
Correct Solutions
Patients with anastomotic leak post pancreas transplant may present with what? - ANSWER
Elevated serum amylase levels
C-peptide normal range - ANSWER 0.8-3.1
What is a sign of late rejection post pancreas transplant? - ANSWER Hyperglycemia
Patients with chronic pancreas rejection can present with what? - ANSWER Progressive need
for insulin
In pancreas transplant recipients temperature elevations may indicate what? - ANSWER
Infection, pancreatitis, acute rejection
Cvp range post pancreas transplant - ANSWER 5-10
When should you notify transplant team in regards to urine output s/p pancreas transplant -
ANSWER Urine output <50 and >200 ml/hr in the first 24hrs post tx
Why is it important for adequate perfusion of graft post pancreas tx - ANSWER Pancreas graft is
"low blood flow" organ higher potential for graft thrombosis
Which rejection is more common in PTA patients? - ANSWER Acute happens earlier and more
frequent
,Pancreatic graft function monitored by which labs? - ANSWER Serum glucose, serum
amylase and serum lipase concentrations, glycosylated hgb, fasting C-peptide
What can an acute spike in glucose level early postop pancreas tx indicate? - ANSWER Vascular
thrombosis of graft, (US COMMONLY ORDERED TO RULE OUT THROMBOSIS)
Serum amylase may be elevated 48-96hrs post pancreas tx due to what? - ANSWER Damage to
the organ during cold ischemic preservation, manipulation of the organ during recovery,
What can cause elevated serum amylase after pancreas tx - ANSWER Anastomoses leak, venous
thrombosis, subsequent to transplant biopsy
Decreased amylase in BD drain pancreas recipient can be caused by what? - ANSWER Indicative
of graft rejection
What is a way to monitor for organ rejection in BD pancreas transplant recipients - ANSWER
An 8 hour urine collection
Amylase levels 1500- 7000 IU/hr within a few days after pancreas transplant indicate what?
- ANSWER Good initial graft function
Clinical indications of vascular thrombosis in pancreas transplant recipients - ANSWER Abrupt
rise in glucose, sharp rise in serum amylase or lipase, tenderness or pain over graft site in BD
recipients: massive hematuria, decrease or absence of urine amylase levels,
Pancreatitis symptoms - ANSWER Low grade temp, elevated serum amylase and lipase( these
may be elevated first 2-3 days after tx) decreased urine amylase, graft tenderness, abdominal
pain, n&v, endocrine secretory capacity ( insulin secretion) often only mildly impaired
ED pancreas tx anastomotic leak patients present with - ANSWER Fever, elevated WBC , n&
v, abdominal pain, elevated serum amylase abd creatinine
, How is pancreas rejection diagnosed (procedure) - ANSWER Pancreas allograft biopsy
Diagnoses leading to end stage lung disease in children - ANSWER Alveolar proteinosis,
bronchiectasis, bronchopulmonary dysplasia, cystic fibrosis, interstitial lung disease,
pulmonary hypertension
End stage heart disease diagnoses in children - ANSWER Congenital heart disease such as
hypoplastic left heart syndrome, cardiomyopathies, cardiac tumors
Kidney placement in infants and small children - ANSWER Kidney placed intraperitoneally,
donor vessels anastomosed directly to aorta and IVC, following reperfusion donor ureter is
anastomosed to the bladder
KDPI - ANSWER Score can help predict how a particular donor kidney is expected to perform
Kidney placement > 3 years old - ANSWER Donor kidney implanted in an extra
peritoneal position, donor vessels anastomosed to iliac vessels
Calculation of child's BSA - ANSWER Hgt x wgt/3600
END STAGE LIVER DISEASE DIAGNOSES IN CHILDREN - ANSWER Biliary Atresia, Alpha 1
Antitrypsin deficiency, Wilson's disease, alagilles syndrome, acute liver failure, viral hepatitis,
glycogen storage disease, liver tumor(hepatoblastoma)
end-stage renal disease (ESRD) diagnoses in children - ANSWER Renal
dysplasia/hypoplasia/aplasia, obstructive uropathy, focal segmental glomerulosclerosis(FSGS),
reflux pyelonephritis, henoch-schonlein purpura, bilateral wilm's tumor
*younger child congenital more common, older child FSGS more common*
Correct Solutions
Patients with anastomotic leak post pancreas transplant may present with what? - ANSWER
Elevated serum amylase levels
C-peptide normal range - ANSWER 0.8-3.1
What is a sign of late rejection post pancreas transplant? - ANSWER Hyperglycemia
Patients with chronic pancreas rejection can present with what? - ANSWER Progressive need
for insulin
In pancreas transplant recipients temperature elevations may indicate what? - ANSWER
Infection, pancreatitis, acute rejection
Cvp range post pancreas transplant - ANSWER 5-10
When should you notify transplant team in regards to urine output s/p pancreas transplant -
ANSWER Urine output <50 and >200 ml/hr in the first 24hrs post tx
Why is it important for adequate perfusion of graft post pancreas tx - ANSWER Pancreas graft is
"low blood flow" organ higher potential for graft thrombosis
Which rejection is more common in PTA patients? - ANSWER Acute happens earlier and more
frequent
,Pancreatic graft function monitored by which labs? - ANSWER Serum glucose, serum
amylase and serum lipase concentrations, glycosylated hgb, fasting C-peptide
What can an acute spike in glucose level early postop pancreas tx indicate? - ANSWER Vascular
thrombosis of graft, (US COMMONLY ORDERED TO RULE OUT THROMBOSIS)
Serum amylase may be elevated 48-96hrs post pancreas tx due to what? - ANSWER Damage to
the organ during cold ischemic preservation, manipulation of the organ during recovery,
What can cause elevated serum amylase after pancreas tx - ANSWER Anastomoses leak, venous
thrombosis, subsequent to transplant biopsy
Decreased amylase in BD drain pancreas recipient can be caused by what? - ANSWER Indicative
of graft rejection
What is a way to monitor for organ rejection in BD pancreas transplant recipients - ANSWER
An 8 hour urine collection
Amylase levels 1500- 7000 IU/hr within a few days after pancreas transplant indicate what?
- ANSWER Good initial graft function
Clinical indications of vascular thrombosis in pancreas transplant recipients - ANSWER Abrupt
rise in glucose, sharp rise in serum amylase or lipase, tenderness or pain over graft site in BD
recipients: massive hematuria, decrease or absence of urine amylase levels,
Pancreatitis symptoms - ANSWER Low grade temp, elevated serum amylase and lipase( these
may be elevated first 2-3 days after tx) decreased urine amylase, graft tenderness, abdominal
pain, n&v, endocrine secretory capacity ( insulin secretion) often only mildly impaired
ED pancreas tx anastomotic leak patients present with - ANSWER Fever, elevated WBC , n&
v, abdominal pain, elevated serum amylase abd creatinine
, How is pancreas rejection diagnosed (procedure) - ANSWER Pancreas allograft biopsy
Diagnoses leading to end stage lung disease in children - ANSWER Alveolar proteinosis,
bronchiectasis, bronchopulmonary dysplasia, cystic fibrosis, interstitial lung disease,
pulmonary hypertension
End stage heart disease diagnoses in children - ANSWER Congenital heart disease such as
hypoplastic left heart syndrome, cardiomyopathies, cardiac tumors
Kidney placement in infants and small children - ANSWER Kidney placed intraperitoneally,
donor vessels anastomosed directly to aorta and IVC, following reperfusion donor ureter is
anastomosed to the bladder
KDPI - ANSWER Score can help predict how a particular donor kidney is expected to perform
Kidney placement > 3 years old - ANSWER Donor kidney implanted in an extra
peritoneal position, donor vessels anastomosed to iliac vessels
Calculation of child's BSA - ANSWER Hgt x wgt/3600
END STAGE LIVER DISEASE DIAGNOSES IN CHILDREN - ANSWER Biliary Atresia, Alpha 1
Antitrypsin deficiency, Wilson's disease, alagilles syndrome, acute liver failure, viral hepatitis,
glycogen storage disease, liver tumor(hepatoblastoma)
end-stage renal disease (ESRD) diagnoses in children - ANSWER Renal
dysplasia/hypoplasia/aplasia, obstructive uropathy, focal segmental glomerulosclerosis(FSGS),
reflux pyelonephritis, henoch-schonlein purpura, bilateral wilm's tumor
*younger child congenital more common, older child FSGS more common*
