Further Issues in Cystic Fibrosis Flashcards
What effect does CF have on sexual function?
No effect
How does puberty differ in patients with CF compared to those who do not have CF?
May occur later
How does CF affect the fertility of men?
-Most males infertile due to blocked/absence of vas deferens
How does CF affect the fertility of women?
- Females are fertile
- Poor nutritional state may affect chances of conception
What is the main option available for men with fertility issues?
Intra-cytoplasmic sperm injection
What happens in ICSI?
Intracytoplasmic sperm injection technique where a sperm is place directly into the egg
What issues must be addressed before a female becomes pregnant?
- Major ethical and clinical decisions
- Careful planning
- Screening of partner
- Counselling re long term impact of condition on family
- Good communication with CF team
- Optimum health including lung function and weight
When does the greatest risk for mother and child occur?
If the baby is born prematurely
If a lung transplant is performed, why must it be a double lung transplant?
So that one lung does not deteriorate the condition of the other
When are patients ‘bad’ enough to be considered for double lung transplant?
- FEV1 <30% predicted
- Weight loss
- Hypoxia at rest/ de-saturation on exercise
- Hypercapnia
- Recurrent worsening sepsis
- Worsening quality of life
What is usually the first assessment for transplant a patient undergoes?
Initial assessment in a satellite clinic in Edinburgh
What happens at the more formal assessment in Newcastle?
- 3 or 4 day admission
- Must bring a carer
- Seen by multi-disciplinary team
- Undergo clinical investigations
- Two-way information sharing process
- Decision is made at multi-disciplinary team meeting
What are the different outcomes of transplant assessments?
- Active list
- Passive list
- Too well
- Decision not to go on list made by patient
- Decision not to go on list made by team
- Too ill
What are the 3 essential questions when it comes to transplant?
- Is the condition bad enough?
- Is the rest of the body good enough?
- Does the patient want this?
What absolute contra-indications to transplant are there?
- Other organ failure
- Malignancy within 5 years
- Significant peripheral vascular disease
- Drug, nicotine, alcohol dependency
- Active systemic infection
- Microbial issues
