Respiratory Short Case Flashcards
What are the respiratory complications of Cystic Fibrosis?
Respiratory:
- PHT = 6 month median survival;
- PTX (75% 3 year mortality)
What are the nutrition/gastrointestinal complications of Cystic Fibrosis?
Nutritional:
- Malabsorption/malnutrition (macronutrient and vitamins ADEK)
Gastrointestinal:
- Chronic liver disease +/‐ portal hypertension
- Meconium ileus
- DIOS (Distal Intestinal Obstruction Syndrome)
- Hernia (from coughing)
- Rectal prolapse (usually in first few years of life)
What are the endocrine and haematological complications of Cystic Fibrosis
Endocrine:
- CFRD (CF related diabetes)
- Pubertal delay (30%)
- Poor bone mass accrual
Anaemia:
- Chronic disease, variceal bleeds/poor clotting function, thrombocytopenia from hypersplenism, haemoptysis
- Mental state
What are the complications of CF treatment
Complications of treatment:
- Steroids
- Aminoglycosides: hearing
- Ciprofloxacin: skin sensitivity, tendinopathy, arthralgia
- Immunosuppression with organ transplantation
- Complications of vascular access
What are the main non-CF differentials for bronchiectasis
Tests in CF:
- CXR and lung function tests,
- sputum MCS
Major differentials include non‐CF causes of bronchiectasis, in particular:
- Immunodeficiency
- Ciliary dyskinesia including Kartegener’s syndrome
- Chronic inhaled foreign body
- Indigenous/Maori background
What relevant positives do you look for on exam for CF?
- INSPECTION
a. Iatrogenic = long-line or port, sputum cup, PEG,
b. Cough at the outset
c. Cushingoid = steroids for ABPA
d. Stigmata of chronic liver disease - HANDS
a. Finger-prick marks – diabetes - HEAD/FACE
a. Polyps - CHEST
a. Bilateral crackles +/- evidence of pulmonary hypertension/ cor pulmonale
b. MUST check apex beat – PCD key differential diagnosis
c. Wheeze = may indicate ABPA - ABDOMEN
a. PEG
b. Scars – meconium ileus/ DIOS
c. Hepatomegaly/ ptosis
d. Portal hypertension
e. Insulin injection sites - LOWER LIMB
a. Muscle bulk - ADDITIONAL
a. Pubertal status
