Further Issues in Cystic Fibrosis

Question 1

What staff are included in the multidisciplinary team for CF treatment?

Answer 1

Also includes

• Diabetic Team
• GI team
• Community Nurses
• Genetics staff
• Nutrition Nurse

GP

• X-Ray Staff
• Obstetricians
• Gynaecologists

Question 2

What is the effect of CF on sexual function?

Answer 2

• CF has no effect on sexual function in men or women
• Puberty may occur later

Question 3

What is the effect of CF on fertility?

Answer 3

• CF does affect fertility in men – > 95% males infertile – blocked/absence vas deferens
• Females are fertile although poor nutritional state may affect chances of conception

Question 4

What is the technique where the sperm is injected direectly into the egg?

Answer 4

Intracytoplasmic sperm injection technique

Question 5

How many attempts of ICSI are offered on NHS?

Answer 5

3

Question 6

When are patients offered a lung transplant?

Answer 6

When the FEV1 is less than 30% predicted

Massive weight loss

Hypoxia at rest / de-saturation on exercise

Hypercapnia

Recurrent worsening sepsis

Worsening quality of life

Question 7

What are absolute contra-indications to transplant?

Answer 7

Other organ failure

Malignancy within the last 5 years

Significant peripheral vascular disease

Drug, nicotine, alcohol dependancy

Active systemic infection

Microbiological issues (M. abscessus)

Question 8

What are the relative contraindications?

Answer 8

• Other organ dysfunction
• Non-compliance
• Steroids >20mg daily
• Absence of recognised social support
• Osteoporosis
• Low BMI - 18 or above needed
• Surgical risks (previous thoracic surgery)

Question 9

What are the pschosocial issues attached to a lung transplant?

Answer 9

Hope

Fear - •risks, no lungs in time, infection means suspension from the waiting list

Guilt/conflict - •someone had to die in order for them to receive the lungs

Stress

Question 10

Freeman Hospital Lung Transplant Statistics (2015)

Answer 10