A 28-Year-Old Man With Wheezing: Osmosis USMLE Study Question of the Week

October 19, 2018

Answer: B. Azoospermia

Cystic fibrosis is an autosomal recessive genetic disorder that most commonly affects individuals of European descent. It is usually diagnosed using the quantitative pilocarpine iontophoresis test, also known as a sweat test. These individuals suffer from an absent or mutated copy of the cystic fibrosis transmembrane conductance regulator protein. Bronchiectasis, sinusitis, pancreatic insufficiency, male infertility, and cirrhosis are classically associated with cystic fibrosis.

Azoospermia and infertility are found in about 95% of males who survive cystic fibrosis to adulthood. Individuals with cystic fibrosis most commonly suffer from sinus and pulmonary complications, with recurrent infections with organisms like Staphylococcus aureus and Pseudomonas aeruginosa. Note that S aureus is the most common organism seen in individuals younger than 20 years and that P aeruginosa is most common organism seen in individuals older than 20 years.

Major Takeaway: Cystic fibrosis is classically associated with bronchiectasis, sinusitis, pancreatic insufficiency, and cirrhosis. About 95% of all males who survive cystic fibrosis to adulthood will have infertility secondary to azoospermia.

For more on cystic fibrosis, read here.

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