Cystic Fibrosis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Defect of the cystic fibrosis transmembrane conductance regulator (CFTR)
  • CFTR functions as an ATP-regulated chloride channel that regulates the activity of chloride and sodium channels on the cell surface:
    • Abnormal electrolyte transport in exocrine glands and secretory epithelia
    • Decreased exocrine pancreatic function with malabsorption
    • Thickened mucus, recurrent pulmonary infections, and progressive obstructive damage to the lungs
    • Recurrent sinus disease
  • Occurs in 1:3,600 live births in White population, 1:29,000 in African American population; 1:6,500 in Hispanic population
  • 30% of cases diagnosed by newborn screening
  • 75% cases diagnosed in the 1st 2 yr of life
  • ∼30,000 children and young adults in US have CF.
  • Median life expectancy in US about 40 yr.
  • 40% of CF patients are older than 18 yr.
  • 10 million Americans are unknown, asymptomatic carriers of the defective gene.
  • 16% of lung transplants in US due to CF

Risk Factors

Genetics
Recessively inherited genetic disease, involving the CFTR gene on the long arm of chromosome 7:
  • Different mutations; variable phenotypes.
  • Classic disease: Homozygous DF508 mutation.
  • Most common lethal genetic disease in US

Etiology

Common organisms in patients with pneumonia; often multiple drug resistance:
  • Staphylococcus aureus:
    • MSSA/MRSA
  • Pseudomonas aeruginosa:
    • Prevalence increases with age; >70% of adults are chronically infected.
  • Haemophilus influenzae
  • Stenotrophomonas maltophilia
  • Burkholderia cepacia:
    • Prevalence 3%
    • Associated with rapid clinical deterioration
  • Achromobacter xylosoxidans
  • Mycobacteria (nontuberculous):
    • Mycobacterium avium complex, Mycobacterium abscessus
  • Aspergillus

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Citation

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TY - ELEC T1 - Cystic Fibrosis ID - 307111 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307111/all/Cystic_Fibrosis ER -