Cystic Fibrosis & Pneumonia Flashcards
What is cystic fibrosis vs normal lungs?
Affects the functioning of the body’s exocrine glands - respiratory and digestive systems.
Normally cystic fibrosis transmembrane conductance regulator protein transports chloride across the membrane.
In CF pts, this transporter protein has a mutation causing it to lack phenylalanine.
Overall, decreased chloride out of the epithelium lining of mucous glands and goblet cells causes chloride retention. This causes an increase in sodium reabsorption. This increases the viscosity of mucus making breathing very difficult.
What is the cause of CF?
Genetic
What are the symptoms of CF - both resp & reproductive?
Resp -
Thick, sticky mucus accumulates in lungs, plugging bronchi and making breathing difficult.
Bouts of severe coughing
End in resp failure
In males - make sterile
In female - irregular periods but still fertile
What are the gastric effects in CF?
Thick mucus interfere with passage of digestive enzymes - chronic pancreatitis - poor digestion & malabsorption
Diabetes
DIOS - distal intestinal obstruction syndrom
What are the goals of treatment in CF?
What are some treatments?
Prevent & control infections that occur in the lungs
Remove & loosen mucus from lungs
Treat & prevent intestinal blockage
Physiotherapy - improve expectoration
Nutritious high-calorie diet - counteract malnutrition
Counselling & support
How do you diagnose CF?
High sodium levels in sweat
Eventually finger clubbing
Newborn screening test - potentially in heel prick
What are treatments of CF?
Antibiotics that are effective against Ps.aeruginosa and staph. aureus
Begin with ciprofloxacin - resistance occurs rapidly
IV ceftazidime - Hospital
Nebulised Tobramycin
Colistimethate sodium
What is pneumonia?
Inflammation of lung tissue. Inflammation of alveoli causing them to fill with liquid. Normally begins in the upper resp tract and develops in the lower tract
Inflitration of macrophages and neutrophils causing release of cytokines
What bacteria/virus are responsible for pneumonia?
RSV
Step.Pneumoniae
Hae.Influenzae
What treatment can help the pancreas in CF?
Pancreatic Enzyme Replacement Therapy - PERT
What are common symptoms of Pneumonia?
Complications?
Symptoms - cough, pain, difficulty breathing & fever
Complications -
Respiratory failure - insufficient o2 being brought into lungs due to alveoli being filled with fluid
Septicaemia - huge release of cytokines result in cell death
What are the 2 classifications of pneumonia?
CAP & HAP
Community acquired Pneumonia
Primary - initial infection is caused by exposure to bacteria/ virus ( s.aureus, s.pneumoniae, rsv)
Secondary - due to complication of another condition ie COPD
Hospital acquired Pneumonia -
Nosocomial Pneumonia - contracted 48-72hrs following admission
Normally associated with other microoganisms
MRSA
Ventilator-associated pneumonia
What does a CURB-65 score of +3 mean?
SEVERE CAP
CURB-65 score of 0-1?
Non-severe
For severe pneumonia what are treatment options?
Hospital
Oxygen
IV Antibiotics
Ventilation if particularly bad
