A&P Basics                BIOL 2404                  Case Study: Respiratory          Dr. Weis

Metroplex Clinic                                                        Referral Report

A 10 year old boy was presented for muscular weakness, twitching, wheezing and a dry nonproductive cough. Vomiting and loose foul smelling fatty pale stools were previously reported along with poor growth and weight gain.  Pancreatic insufficiency had been diagnosed and cystic fibrosis was suspected.

Physical exam revealed cyanosis with clubbing of the fingers and toes. Tachypnea with dyspnea were also noted.  

Chest radiographs, arterial blood gases, and pulmonary function tests were ordered.

Assessment:

Posteroanterior and Lateral chest films indicated bronchial dilation with peribronchial thickening. Bronchiectasis with parenchymal scarring was evident in the superior lobes.

Blood gases revealed a respiratory acidosis. There were decreases in VC and TV.

Diagnosis:       CF

Plan:

High protein, low fat diet with vitamin supplementation

Nebulizer and postural drainage of mucopurulent secretions

Breathing exercises and oxygen therapy as needed

Chemistry panel to retest liver and pancreatic enzymes