Cystic Fibrosis 2 Flashcards
What are further issues with CF?
Fertility
Transplantation
What effect does CF have on the sexual function of men and woman?
No effect
What may CF do to puberty?
Cause it to occur later
How does CF affect fertility in men?
>95% are infertile
How does CF affect fertility in females?
They are fertile but poor nutrition may change that
What options are available for infertile males?
Adoption
Artificial insemination with donor sperm
Intra-cytoplasmic sperm injection (ICSI)
What is the success rate of artificial insemination with a donor sperm?
60-70% success rate
What is the waiting list for intra-cytoplasmic sperm injection (ICSI)?
4 months
What is the success rate of intra-cytoplasmic sperm injection (ICSI)?
25-30%
What does ICSI stand up for?
Inta-cytoplasmic sperm injection
How many attemps of ICSI is on the NHS?
3
What is the cost of ICSI treatment?
£3000-4000
What are the female fertility issues?
Major decisions (ethically and clinically)
Careful planning essential
Screening of partner
Counselling regarding long term impact of condition on family
Good communication with CF team
Optimum health (lung function and weight)
What is the main risk for mothers with CF?
Baby is born premature, where the mothers can do badly
What should be known about lung transplantation?
Last resort treatment
Not a miracle cure
Where are lung transplants for grampian people done?
Freeman Hospital, Newcastle
What kind of lung transplant is perfomed?
Double lung transplant
When are patients bad enough for a lung transplant?
FEV1 < 30% predicted
Lots of weight loss
Hypoxia at rest/desaturation on exercise
Hypercapnia
Recurrent worsening sepsis
Worsening quality of life
Where are patients for a lung transplant often seen first?
Satellite clinic in Edinburgh
What happens during the formal assessment for a lung transplant?
3 or 4 day admission
Must bring carer
Seen by multidiscipline team
Clinical investigations
Two way information sharing process
Multi-disciplinary meeting where the decision is made
What are potential outcomes of the initial assessment?
Active list
Passive list
Too well
Decision not to go onto list (by patient)
Decision not to go onto list (by team)
Too ill
What are 3 questions that you need to ask before doing a lung transplant?
Is the condition bad enough?
Is the rest of the body good enough?
Does the patient want this (prepared to take the gamble)?
What are absolute conta-indications to transplant?
Other organ failure
Malignancy within 5 years
Significant peripheral vascular disease
Drug, nicotinne, alcohol dependency
Active systemic infection
Microbiological issues
What are relative conta-indications for transplant?
Other organ dysfunction
Non-compliance
Steroids >20mg daily
Absence of recognised social support
Osteoporosis
Low BMI
Surgical risks (previous thoracic surgery)
What are some psychological issues for a lung transplant?
Hope
Fear
Guilt/conflict
Stress
What percentage of people who get double lung transplants survive 5 years?
61%
What percentage of people who get double lung transplants survive 10 years?
48%
