cystic fibrosis Flashcards

1
Q

what is CF

A

an inherited autosmal receive disease, the result of a gene mutation- single gene defect on chromosomes 7- responsible for encoding the CF membrane conductive regulator, a transmembrane protein involved in ion transport called cystic fibrosis transmembrane regulating protein (CFTR). this defect leads to a compromise ion transport- it impairs transport of chloride ions, and also addicts levels of sodium and water in cells

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2
Q

what does CF affect

A

affects several organs causing ducts to become obstructed with mucus-inflammation and replacement of damaged cells within CT (scarring)

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3
Q

what does the CFTR protein do

A

this is a channel protein, it controls the flow of water and chloride ions between membranes. when the structure is changed, passage molecules and ions is blocked. the most common pathology of CF. there are over 1500 mutations of the CFTR gene that produce different variations of CFTR protein- treatment=difficult

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4
Q

defect in CFTR results in- respiratory disease

A

abnormally concentrated fluid in the lungs, leads to vicious secretion in the airways, due to dehydrated airway mucous is not cleared, which predisposes patients to disease and infection- scarring lungs

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5
Q

defect in CFTR results in- high sodium sweat

A

chloride ions not absorbed leading to prevention of sodium absorption- low blood salt level- limit recognition of thirst= dehydration

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6
Q

defect in CFTR results in- pancreas insufficiency

A

production of enzymes is normal but abnormal ion transport leads to stagnation in pancreatic duct- causes diabetes later in life

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7
Q

defect in CFTR results in- billiary disease

A

abnormal ion transport reduces water movement in the lumen resulting in concentrated bile which can damage walls of lumen- damage to bowel

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8
Q

defect in CFTR results in- infertility

A

male CF patients are often infertile due to absence of vas deferences prevent transport of sperm from testes to the urethra

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9
Q

defect in CFTR results in- cirrhosis of the liver

A

due to abnormality in ion transport

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10
Q

defect in CFTR results in- gastrointestinal disease

A

intraluminal water deficiency causes problems with bowel movement

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11
Q

defect in CFTR results in- what can they all be related to

A

all of these can be related to a lack of Na+, CL- or water diffusion problems

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12
Q

prevalence

A

1 in 25 caucasians carries the gene, 2 carries have a 1 in 4 chance of having an affected baby and 1 in 2 chance that their baby will be carrier. affects more than 10.4k people in UK, 1 in 2.5 babies are born with CF, claims 2-3 lives per week, identified in early life now- higher survival rate

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13
Q

diagnosis- genetic testing

A

if someone has a history of CF in their family, a partner with CF, or a child with the condition, they may have carrier testing. a simple mouthwash of blood test can be determine if someone is a carrier of the faulty gene that causes CF.

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14
Q

diagnosis- heel prick test

A

since 2003 in Scotland and 2007 in ukm all babies born have been screened for CF using heel prick test. as a result most children are diagnosed with CF shortly after birth

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15
Q

diagnosis- sweat test

A

done for babies suspected to have CF, it is performed as part of a follow up process to screening. in people with CF there is a problem in the transport of chloride across the cell membranes, which results in higher concentrations of chloride in the sweat. the test measures this concentration and is done by collecting a small amount of sweat from the arm/leg

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16
Q

symptoms at birth

A

roughly 10% of babies are born with serious bowl obstruction that requires surgery (meconium lees). this is a thick, black substance normally passed out within a day or 2. however for babies this is too thick and causes bowel blockages. some babies show signs of jaundice (build up of bilirubin in the blood and body tissues) which are yellowing of the kin, eyes and mucous membrane

17
Q

common symptoms- lungs

A

persistent cough, coughing fits, inflammation of lungs- wheezing, SOB, difficulties breathing, recurring chest/lung infection, cross infection- lonely disease, impaired diaphragm from enlarged liver

18
Q

common symptoms- digestive system and MSK system

A

large smelly stools- digestive enzymes not produced properly- excess fat and protein, malnutrition/ poor weight gain/ stunted growth
MSK- inspiratory muscle atrophy, weakness/ atrophy in anti-gravity muscles such as gastroc, kyphosis of the spine resulting in neck and back pain

19
Q

common symptoms- other

A

diabetes, sinusitis, nasal polyps- fleshy swelling that grow from the lining of the nose, arthritis, infertility, liver failure, urinary insentience, delayed puberty.

20
Q

treatment- medication

A

bronchodilators, hypertonic saline nebs, antibiotics, mucolytic, steroids, routine vaccinations, digestive enzymes

21
Q

treatment- other

A

dietary advice, education, exercise, physio- PD postural drainage, percussion, ACBY, AD, adjuncts, mobilisation/exercise, suction, lung transplant- doesn’t cure all symptoms, psychological support

22
Q

prognosis

A

no cure or prevention, currently 50% of people with CF live past 40, lung complications are the normally cause of death in CF, specific quality of life depends on species protein mutation and environmental and development factors