CCTC LATEST 2026 EXAMINERS SET QUESTIONS
AND ANSWERS SURE A+
✔✔Bladder Drainage (BD) post pancreas transplant - ✔✔Easier to monitor for rejection
with urine amylase, may cause dehydration and cystitis. Direct monitoring of graft
exocrine function, easier to perform biopsy, less invasive if complications arise.
✔✔Disadvantages of Bladder Drainage (BD) post pancreas transplant -
✔✔Dehydration, cystitis, UTIs, metabolic acidosis, urine leak, hematuria, 35% go on to
need enteric conversion, pancreatitis
✔✔Patients with anastomotic leak post pancreas transplant may present with what? -
✔✔Elevated serum amylase levels
✔✔C-peptide normal range - ✔✔0.8-3.1
✔✔What is a sign of late rejection post pancreas transplant? - ✔✔Hyperglycemia
✔✔Patients with chronic pancreas rejection can present with what? - ✔✔Progressive
need for insulin
✔✔In pancreas transplant recipients temperature elevations may indicate what? -
✔✔Infection, pancreatitis, acute rejection
,✔✔Cvp range post pancreas transplant - ✔✔5-10
✔✔When should you notify transplant team in regards to urine output s/p pancreas
transplant - ✔✔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 - ✔✔Pancreas
graft is "low blood flow" organ higher potential for graft thrombosis
✔✔Which rejection is more common in PTA patients? - ✔✔Acute happens earlier and
more frequent
✔✔Pancreatic graft function monitored by which labs? - ✔✔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? -
✔✔Vascular thrombosis of graft, (US COMMONLY ORDERED TO RULE OUT
THROMBOSIS)
✔✔Serum amylase may be elevated 48-96hrs post pancreas tx due to what? -
✔✔Damage to the organ during cold ischemic preservation, manipulation of the organ
during recovery,
✔✔What can cause elevated serum amylase after pancreas tx - ✔✔Anastomoses leak,
venous thrombosis, subsequent to transplant biopsy
✔✔Decreased amylase in BD drain pancreas recipient can be caused by what? -
✔✔Indicative of graft rejection
✔✔What is a way to monitor for organ rejection in BD pancreas transplant recipients -
✔✔An 8 hour urine collection
✔✔Amylase levels 1500- 7000 IU/hr within a few days after pancreas transplant
indicate what? - ✔✔Good initial graft function
✔✔Clinical indications of vascular thrombosis in pancreas transplant recipients -
✔✔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 - ✔✔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 - ✔✔Fever, elevated WBC ,
n& v, abdominal pain, elevated serum amylase abd creatinine
✔✔How is pancreas rejection diagnosed (procedure) - ✔✔Pancreas allograft biopsy
✔✔Diagnoses leading to end stage lung disease in children - ✔✔Alveolar proteinosis,
bronchiectasis, bronchopulmonary dysplasia, cystic fibrosis, interstitial lung disease,
pulmonary hypertension
✔✔End stage heart disease diagnoses in children - ✔✔Congenital heart disease such
as hypoplastic left heart syndrome, cardiomyopathies, cardiac tumors
✔✔Kidney placement in infants and small children - ✔✔Kidney placed intraperitoneally,
donor vessels anastomosed directly to aorta and IVC, following reperfusion donor ureter
is anastomosed to the bladder
✔✔KDPI - ✔✔Score can help predict how a particular donor kidney is expected to
perform
✔✔Kidney placement > 3 years old - ✔✔Donor kidney implanted in an extra peritoneal
position, donor vessels anastomosed to iliac vessels
✔✔Calculation of child's BSA - ✔✔Hgt x wgt/3600
✔✔END STAGE LIVER DISEASE DIAGNOSES IN CHILDREN - ✔✔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 - ✔✔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*
✔✔Tacrolimus (Prograf) - ✔✔Do not take before lab draw, taken bid, side effects
include HTN, dyslipidemia, headache, diarrhea, nausea, tremor, hair loss (alopecia),
hyperglycemia, changes in kidney function(nephrotoxic), adrenal insufficiency, DM
*tac toxicity-tremors, especially in hands, leukoencephalopathy- mental status changes
stop dc n
Med
✔✔Autotransplant - ✔✔Donation to self
AND ANSWERS SURE A+
✔✔Bladder Drainage (BD) post pancreas transplant - ✔✔Easier to monitor for rejection
with urine amylase, may cause dehydration and cystitis. Direct monitoring of graft
exocrine function, easier to perform biopsy, less invasive if complications arise.
✔✔Disadvantages of Bladder Drainage (BD) post pancreas transplant -
✔✔Dehydration, cystitis, UTIs, metabolic acidosis, urine leak, hematuria, 35% go on to
need enteric conversion, pancreatitis
✔✔Patients with anastomotic leak post pancreas transplant may present with what? -
✔✔Elevated serum amylase levels
✔✔C-peptide normal range - ✔✔0.8-3.1
✔✔What is a sign of late rejection post pancreas transplant? - ✔✔Hyperglycemia
✔✔Patients with chronic pancreas rejection can present with what? - ✔✔Progressive
need for insulin
✔✔In pancreas transplant recipients temperature elevations may indicate what? -
✔✔Infection, pancreatitis, acute rejection
,✔✔Cvp range post pancreas transplant - ✔✔5-10
✔✔When should you notify transplant team in regards to urine output s/p pancreas
transplant - ✔✔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 - ✔✔Pancreas
graft is "low blood flow" organ higher potential for graft thrombosis
✔✔Which rejection is more common in PTA patients? - ✔✔Acute happens earlier and
more frequent
✔✔Pancreatic graft function monitored by which labs? - ✔✔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? -
✔✔Vascular thrombosis of graft, (US COMMONLY ORDERED TO RULE OUT
THROMBOSIS)
✔✔Serum amylase may be elevated 48-96hrs post pancreas tx due to what? -
✔✔Damage to the organ during cold ischemic preservation, manipulation of the organ
during recovery,
✔✔What can cause elevated serum amylase after pancreas tx - ✔✔Anastomoses leak,
venous thrombosis, subsequent to transplant biopsy
✔✔Decreased amylase in BD drain pancreas recipient can be caused by what? -
✔✔Indicative of graft rejection
✔✔What is a way to monitor for organ rejection in BD pancreas transplant recipients -
✔✔An 8 hour urine collection
✔✔Amylase levels 1500- 7000 IU/hr within a few days after pancreas transplant
indicate what? - ✔✔Good initial graft function
✔✔Clinical indications of vascular thrombosis in pancreas transplant recipients -
✔✔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 - ✔✔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 - ✔✔Fever, elevated WBC ,
n& v, abdominal pain, elevated serum amylase abd creatinine
✔✔How is pancreas rejection diagnosed (procedure) - ✔✔Pancreas allograft biopsy
✔✔Diagnoses leading to end stage lung disease in children - ✔✔Alveolar proteinosis,
bronchiectasis, bronchopulmonary dysplasia, cystic fibrosis, interstitial lung disease,
pulmonary hypertension
✔✔End stage heart disease diagnoses in children - ✔✔Congenital heart disease such
as hypoplastic left heart syndrome, cardiomyopathies, cardiac tumors
✔✔Kidney placement in infants and small children - ✔✔Kidney placed intraperitoneally,
donor vessels anastomosed directly to aorta and IVC, following reperfusion donor ureter
is anastomosed to the bladder
✔✔KDPI - ✔✔Score can help predict how a particular donor kidney is expected to
perform
✔✔Kidney placement > 3 years old - ✔✔Donor kidney implanted in an extra peritoneal
position, donor vessels anastomosed to iliac vessels
✔✔Calculation of child's BSA - ✔✔Hgt x wgt/3600
✔✔END STAGE LIVER DISEASE DIAGNOSES IN CHILDREN - ✔✔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 - ✔✔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*
✔✔Tacrolimus (Prograf) - ✔✔Do not take before lab draw, taken bid, side effects
include HTN, dyslipidemia, headache, diarrhea, nausea, tremor, hair loss (alopecia),
hyperglycemia, changes in kidney function(nephrotoxic), adrenal insufficiency, DM
*tac toxicity-tremors, especially in hands, leukoencephalopathy- mental status changes
stop dc n
Med
✔✔Autotransplant - ✔✔Donation to self
