Cystic Fibrosis Flashcards

1
Q

What is cystic fibrosis?

A

Autosomal recessive condition
Mutation in CFTR gene on chromosome 7
Results in defective chloride channels

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2
Q

What is the result of defective chloride channels?

A

Defective chloride secretion and increased sodium absorption across airway epithelium

Changes in composition of airway surface liquid

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3
Q

CF Lungs are predisposed to?

A

Chronic infections and bronchiectasis

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4
Q

What are neonatal features?

A

Failure to thrive
Meconium ileus
Rectal prolapse

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5
Q

What is meconium ileum?

A

bowel obstruction that occurs when the meconium in a child’s intestine is even thicker and stickier than normal meconium

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6
Q

What is rectal prolapse?

A

mucosal or full-thickness layer of rectal tissue protrudes through the anal orifice

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7
Q

How many people carry the gene for CF?

A

1 in 24/25

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8
Q

Because CFTR is an ATP-activated channel feedback loop from other chloride channels and a negative effect on sodium entry causes?

A

Dryness in the lumen

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9
Q

What are children & young adult features of CF?

A
Cough
Wheeze
Recurrent infections 
Bronchiectasis
Pneumothorax
Haemoptysis
Respiratory failure 
Cor Pulmonale
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10
Q

CF causes pancreatic insufficiency leading to?

A
Diabetes mellitus
Steatorrhea
Distal intestinal obstruction syndrome (equivalent of meconium ileum) 
Gallstones
Cirrhosis
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11
Q

What are other features of CF in adults (other than respiratory and GI)?

A
Male infertility 
Osteoporosis
Arthritis
Vasculitis 
Nasal polyps 
Sinusitis
hypertrophic pulmonary osteoarthropathy
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12
Q

What are clinical signs of CF?

A

Cyanosis
Finger clubbing
Bilateral coarse crackles

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13
Q

How can CF be diagnosed?

A
Sweat test
Genetic screening 
Faecal elastase
FBC, U&E, LFT
Vitamin levels
Glucose tolerance test
Sputum culture 
CXR 
USS
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14
Q

What is a positive result for a sweat test?

A

Sodium and chloride >60 mmol/L (chloride usually > sodium)

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15
Q

What does faecal elastase test for?

A

Exocrine pancreatic dysfunction

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16
Q

How do you treat CF?

A
Physio - postural drainage 
Oxygen (non-invasive - for advanced)
Antibiotics for exacerbation and prophylaxis
?Mucolytics
Bronchodilators 
Pancreatic lipase replacement 
Fat-soluble vitamin supplements
Ursodeoxycholic acid for impaired liver function
?liver transplant
17
Q

What are fat-soluble vitamins?

A

Vit. A, D, E, K

18
Q

In exacerbation management; what is the guideline for antibiotics?

A

Always give 2 to reduce resistance

19
Q

Which oral antibiotics are given for CF exacerbation?

A
Augmentin
Fluclox
Minocycline 
Septrin
Flusidin
Ciprofloxacin
20
Q

Which iv abx are given for pseudomonas?

A
Tazocin
Ceftazidine
Tobramicine
Meropnem
Colistin
21
Q

Which iv abx should be given for Staph aureus?

A

Flucloxacillin

Trigecycline

22
Q

Which iv abx should be given for cepacia?

A

Temacillin

23
Q

Which infections are common in CF?

A

Pseudomonas aeruginosa
Staph aureus
Haemophilus influenza
Cepacia

24
Q

What is Ivacaftor?

A

CFTR potentiator

25
Q

What is action of Ivacaftor?

A

Improves chloride flow