HeMe #4 | Page 35

What are the signs and symptoms of CF? In lungs- incessant coughing, low exercise tolerance, copious phlegm production, difficulties in breathing, coughing up blood, fungal and bacterial infections in respiratory tract. In GIT- meconium ileus in newborns, rectal prolapse, pancreatitis, frequent greasy, bulky stools, constipation. Other signs and symptoms- poor growth and weight gain, salty tasting skin, clubbing of their fingers and toes, amenorrhea, azoospermia, teratospermia What are the causes? It is due to mutation in the gene cystic fibrosis transmembrane conductance regulator (CFTR). Commonest mutation is deletion of three nucleotides that results in a loss of the amino acid phenylalanine at the 508th position on the protein. What are the investigation methods? Genetic tests newborn screening sweat testing prenatal testing for parents and fetus, What are the laboratory results in CF? Raised blood concentration of immunoreactive trypsinogen. Abnormal amounts of sodium and chloride. What are the differential diagnoses? Aspergillosis, bronchiectasis, bronchiolitis, asthma, pediatric celiac disease, short stature, sinusitis. What are the medications to treat CF? Gene therapy, frequent airway clearance, bronchodilator treatments, chest physical therapy and postural drainage, increased doses of mucolytics, antibiotics like oral fluoroquinolones, pancreatic enzyme supplements, multivitamins, anti inflammatory drugs. What kind of nutrition & supplements are good for patients with CF? High energy and high fat diet is recommended. Additionally fat soluble vitamins, and minerals are given. Regular exercises help CF patients to gain their physical fitness. Especially canoe paddling improves respiratory muscles work more efficient.