Which of the following is a recognized treatment for complications of cystic fibrosis?

Which of the following is a recognized treatment for complications of cystic fibrosis?

A) DNAase to assist in reinflating collapsed lung segments.
B) Rectal pull-through and anastamosis for rectal prolapse.
C) Pancreatic transplant for diabetes mellitus.
D) Nebulised tobramycin for pseudomonas colonisation of the lower respiratory tract.
E) Hypotonic saline drinks for hypernatraemic dehydration.

Answer:
D: Nebulised tobramycin for pseudomonas colonisation of the lower respiratory tract.

Discussion:
Human recombinant DNAase given as a single daily aerosol seems to improve pulmonary function, decrease the frequency of chest exacerbations, and promotes a sense of well-being in patients with mild to moderate disease with purulent secretions. This may be because, in the inflamed airway, the nuclei from dead cells accounts for much of the viscidity of secretions.

Rectal prolapse is usually idiopathic, occurring between 1 and 5 years. Intestinal parasites, malnutrition, acute diarrhoea, ulcerative colitis, pertussis, Ehler's Danlos Syndrome, meningocele, cystic fibrosis, and chronic constipation can also predispose to it. Following defecation the prolapse usually resolves spontaneously, or through manual reinsertion by the patient or parent.

Nebulised tobramycin or gentamicin may be given when airway pathogens are resistant to oral antibiotics, or where infection is difficult to control at home.

Hypernatramic dehydration should be treated in the usual way.