CYSTIC FIBROSIS Flashcards

1
Q

WHAT IS CYSTIC FIBROSIS ?

A

GENETIC DISORDER INHERITED IN AN AUTOSOMAL RECESSIVE MANNER.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

WHAT DOES AUTOSOMAL RECESSIVE INHERITANCE IN CYSTIC FIBROSIS LEAD TO?

A

FAULTY TRANSPORTATION OF CHLORIDE IONS ACROSS THE EPITHELIAL CELLS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

WHAT GENE IS ASSOCIATED WITH CYSTIC FIBROSIS ?

A

CHROMOSOME 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

WHAT ARE THE CYSTIC FIBROSIS CLASSIFICATIONS? (HOW MANY CLASSES ARE THERE?

A

THERE ARE SIX CLASSES OF THE DISEASE VARYING IN SEVERITY.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

OUT OF THE 6 CLASSES WHAT ARE THE MOST SEVERE?

A

1-3 IS THE MOST SEVERE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

WHAT ARE THE MILDER CLASSES OF CYSTIC FIBROSIS?

A

4-6 ARE THE MILDER PULMONARY DIASEASE.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PATHOPHYSIOLOGY OF CYSTIC FIBROSIS?

A

A MUTATION IN THE CFTR GENE CAUSES ABNORMAL CFTR PROTEIN EXPRESSION.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

WHAT ORGANS DOES CYSTIC FIBROSIS EFFECT?

A

HAS MULTIORGAN EFFECT INCLUDING THE AIRWAYS, DIGESTIVE TRACT AND REPRODUCTIVE ORGANS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

WHAT IS THE MOST COMMON MUTATION OF CYSTIC FIBROSIS ?

A

F508delCFTR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

WHERE DO MOST SIGNS AND SYMPTOMS OF CYSTIC FIBROSIS SHOW? (WHAT SYSTEM(s))

A

RESPIRATORY
GASTROINTESTINAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

WHAT ARE THE RESPIRATORY SYMPTOMS?

A

PERSISTENT COUGH OR WHEEZE
EXCESSIVE SPUTUM
RECURRENT OR SEVERE PNEUMONIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

WHAT IS THE MOST SUBTLE RESPIRATORY TRACT PRESENTATION OF CYSTIC FIBROSIS ?

A

CHRONIC SINUSITIS
NASAL POLYPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CAN PATIENTS WITH CYSTIC FIBROSIS EXPERIENCE DIGITAL CLUBBING AND IF SO WHEN WOULD THEY EXPERIENCE THIS?

A

MAY APPEAR EARLY IN THE ABSENCE OF SIGNIFICANT PULMONARY IMPAIRMENT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CAN PATIENTS WITH CYSTIC FIBROSIS GET A BARREL CHEST? WHAT ABOUT THE CRACKLES?

A

YES THEY CAN SUFFER WITH A BARREL CHEST AND PERSISTENT CRACKLES HOWEVER THIS TENDS TO COME MUCH LATER IN THE DISEASE.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

IS THE SEVERITY OF CYSTIC FIBROSIS VARIABLE ?

A

YES HIGHLY VARIABLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

WILL SIBLINGS WITH THE SAME CFTR MUTATION, ENVIRONMENT AND TREATMENT PLAN HAVE DIFFERENT CLINICAL OUTCOMES AND EXPERIENCES ?

A

YES THEY WILL HAVE DIFFERENT CLINICAL OUTCOMES AND EXPERIENCES AS THEIR COURSE OF ILLNESS CAN VARY SIGNIFICANTLY.

17
Q

WHAT AFFECTS DIFFERENCES IN CLINICAL SYMPTOMS AND WHAT DOES THIS CAUSE?

A

VARIATIONS IN HOW THE CFTR GENOTYPE IS EXPRESSED IN THE EPITHELIAL CELLS ACROSS VARIOUS ORGANS LEADS TO DIFFERENT CLINICAL SYMPTOMS WHICH AFFECTS THE PROGRESSION OF THE DISEASES AND THE SURVIVAL OF THE INDIVIDUAL.

18
Q

WHAT OTHER COMPLICATIONS ARE THERE WITH CYSTIC FIBROSIS (HINT- NUTRITION AND PANCREATIC).

A

ISSUES WITH NUTRITION
90% OF CHILDREN HAVE SOME FORM OF PANCREATIC INSUFFICIENCY.

19
Q

TREATMENTS FOR CYSTIC FIBROSIS

A

MONITORING GROWTH PARAMETERS.

CONTROLLING FAT MALABSORPTION

MAINTAINING ADEQUATE PROTEIN AND CALORIE INTAKE.

SUPPLEMENTATION WITH EXOGENOUS PANCREATIC ENZYMES.

20
Q

EVALUATION AND TREATMENT ???

A

HEEL PRICK TEST / BLOOD TEST

SWEAT TEST

21
Q

EVALUATION AND TREATMENT, WHAT ARE HEAL TEST AND BLOOD TEST LOOKING FOR?

A

IMMUNOREACTIVE TRYPSINOGEN

22
Q

EVALUATION AND TREATMENT, WHAT IS A SWEAT TEST LOOKING FOR?

A

REVEAL SWEAR CHLORIDE CONCENTRATION IN EXCESS OF 60mmol/L

23
Q

EVALUATION AND TREATMENT, WHAT WILL HEEL PRICK, BLOOD AND SWEAT TEST LEAD TO?

A

GENETIC TESTING.

24
Q

EVALUATION AND TREATMENT, WHAT DOES THIS GENETIC TESTING INVOLVE?

A

GENOTYPING FOR THE CFTR MUTATIONS.

25
Q

EVALUATION AND TREATMENT, WHAT DOES CYSTIC FIBROSIS TREATMETN PRIMARILY FOCUS ON?

A

PULMONARY HEALTH AND NUTRITION.

26
Q

EVALUATION AND TREATMENT, WHAT PULMONARY THERAPIES ARE THERE?

A

CHEST PHYSICAL THERAPY

HIGH-FREQUENCY CHEST WALL OSCILLATION VEST

POSITIVE EXPIRATION PRESSURE DEVICE (PEP).

27
Q

EVALUATION AND TREATMENT.
AEROSOL THERAPIES?

A

BRONCHODILATORS

DORNASE ALFA

HYPERTONIC SALINE

28
Q

EVALUATION AND TREATMENT

WHAT ELSE? (TO DO WITH AXB, ROUTES, PATHOGENS)

A

DIFFERENT AXB USED (AZITHROMYCIN)

DIFFERENT ADMINISTRATION ROUTES (ORAL, INHALED, IV)

DIFFERENT PATHOGENS CAN CAUSE INFLAMMATION (PSEUDOMONAS AERUGINOSA, S. AUREUS, BURKHOLDERIA CEPACIAN)

29
Q

EVALUATION AND TREATMENT

OTHER TREATMENTS?

A

IBUPROFEN

CORTICOSTEROIDS

ORAL CFTR MODULATORS (IVACAFTOR, KAFTRIO ETC).