CF Flashcards

0
Q

Major clinical signs? Percent of CFTR function for each?

A

10%cbavd
4% airway prob and sweat
<1% pancreatic insufficiency

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1
Q

Frequency of CF carriers in caucasians?

A

1/30

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2
Q

Where exactly is the CF gene?

A

7q

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3
Q
Class I: 
what is affected? 
Mutation?
Result?
Frequency?
A
  • Transcription
  • missense, frame shift, splice
  • no protein is produced
  • 5-10%
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4
Q
Class II:
what is affected? 
Mutation?
Result?
Frequency?
A
  • Post-transcription
  • missense
  • degraded and does not reach membrane (F508)
  • 85%
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5
Q
Class III:
what is affected? 
Mutation?
Result?
Frequency?
A
  • Activation
  • Missense
  • ATP/cAMP regulation disfunction (G551D)
  • 2-4%
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6
Q
Class IV:
what is affected? 
Mutation?
Result?
Frequency?
A
  • Decreased conductance
  • Missense
  • Less Cl- transport; R117H
  • 2%
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7
Q
Class V:
what is affected? 
Mutation?
Result?
Frequency?
A
  • Processing defect
  • Missense
  • Less protein at PM
  • 1%
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8
Q

Severity of phenotype in R117H?

A
Poly-T tract (5T, 7T, 9T): shorter tail is more severe
TG tract (11TG, 12TG, 13TG): longer tail is more severe
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9
Q

Structure of CFTR?

A
ATP binding cassette (ABC)
- 2 membrane spanning domains 
- 2 ATP binding cassettes (nucleotide binding domains NBD)
- 1 regulatory domain
(made in ER, sugar chain added in golgi)
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10
Q

CFTR channel opening process?

A

cAMP PKA phosphoryates regulatory domain
ATP binding to NBD1 –> transient open
ATP binding to NBD2 –> stabilize open

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11
Q

What does bicarb have to do with pancreatic insufficienccy?

A

CF decreased bicarb production from from pancreatic acinar cells –> lowered pH –> blocks duct

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12
Q

CF Newborn screen process

A
  1. IRT (immunoreactive trypsinogen) - elevated
  2. 4% –> 42 mutation gene testing
  3. confirm with blood test and sweat Cl- test (>60 mmol/L; nrml 40)
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13
Q

Only cure for CF?

A

Kalydeco (lvacaftor)

  • G551D (Class III)
  • binds and opens gate
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14
Q

What is a normal sweat Cl level? CF?

A

40mmol/L

>60

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15
Q

What is a normal sweat Cl level? CF?

A

40mmol/L

>60