BIOLOGY 2D03 Lecture Notes - Lecture 16: Sweat Test, Immunodeficiency, Elastase
19 Jun 2018
School
Department
Course
Professor
Environmental factors are most likely to be the cause here and further investigations
are not necessary
Investigations to consider:
o FBC/ serum ferritin – anaemia
o WCC – infection/ immune deficiency
o UE, scid-base, calcium, phosphate – renal failure, metabolic disorders,
William syndrome
o LFTs – liver disease/ metabolic disorders/ malabsoprtoin
o TFTs
o CRP – inflammation
o Immunoglobulins – immune deficiency
o IgA and TTG abs – coeliac
o Urine dip/ M+C – renal infection/ failure
o Stool M+C and elastase – gastroenteritis, parasites/ worms, pancreatic
insufficiency
o CXR and sweat test – CF
o Karyotype – Turner syndrome
Management
Education:
Dietary:
o Breastfeeding/ formula feeding is recommended up to 12 months and can be
continued up to 18 months
o Cow’s ilk should ot e used as a sustitute for reast/ forula feedig as
it is insufficient in Vitamin A, D and iron
o Itrodue ow’s ilk fro oths full fat util aged 5
o Consider usig follow o forula fro oths – higher in protein and
sodium than infant feed and is fortified with iron and vitamins
o Weening should start from 6 months (although many people start earlier)
Initially start with small quantities of pureed fruit, root vegetables and
rice
If weaning before 6 months avoid wheat, eggs and fish
o Aim for three meals and two snacks a day
o Increase number and variety of foods offered
o Increase energy density of usual foods (e.g. add cheese, margarine and
cream)
o Decrease fluid intake – particularly squash
Behavioural:
o Have meals at regular times; eaten with other family members
o Praise when food is eaten
o Gently encourage to eat but avoid conflict
o Never force feed
MDT:
JWH, JM, AJS
85
Document Summary
Environmental factors are most likely to be the cause here and further investigations are not necessary. Investigations to consider: fbc/ serum ferritin anaemia, wcc infection/ immune deficiency, ue, scid-base, calcium, phosphate renal failure, metabolic disorders, William syndrome: lfts liver disease/ metabolic disorders/ malabsoprtoin, tfts, crp inflammation. Iga and ttg abs coeliac: urine dip/ m+c renal infection/ failure, stool m+c and elastase gastroenteritis, parasites/ worms, pancreatic insufficiency, cxr and sweat test cf, karyotype turner syndrome. Initially start with small quantities of pureed fruit, root vegetables and rice. If weaning before 6 months avoid wheat, eggs and fish: aim for three meals and two snacks a day. Increase energy density of usual foods (e. g. add cheese, margarine and cream: decrease fluid intake particularly squash. Behavioural: have meals at regular times; eaten with other family members, praise when food is eaten, gently encourage to eat but avoid conflict, never force feed. Health visitor: carry out home visits, assess eating behaviour and provide support.
