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CEL Online - Supporting Complex Care: Cystic Fibrosis

Date of Release

Period of Validity
2/1/2017 - 2/1/2020

After reviewing the course information below, there will be a link to register for the activity.

Educational Need
The goal of this series of presentations will include review of the common methods for airway clearance which are available during an impatient admission for Cystic Fibrosis (CF) exacerbation. The importance of active patient engagement in choosing a method and participating in airway clearance. The important role that exercise plays in airway clearance and overall health in Cystic Fibrosis. And a demonstration of some of the airway clearance techniques with an actual CF patient. 

At the conclusion of this activity, participants should be able to:

  • Describe the basic genetics and pathophysiology of Cystic Fibrosis
  • Identify the pulmonary and non-pulmonary manifestations of Cystic Fibrosis
  • Explain the principles of treatment as an outpatient and be able to describe the common medications used in Cystic Fibrosis
  • Explain the basic definition of a pulmonary exacerbation and describe the three main treatment goals during an inpatient admission: treat infection, address airway obstruction, and to improve nutritional status of the patient
  • Identify what needs to be monitored during an admission and recognize possible complications during an admission
  • Describe the rationale for obtaining sputum cultures for identification and sensitivity testing in CF patients 
  • Explain the microbiology of Cystic Fibrosis and list several of the bacteria which are considered pathogenic in Cystic Fibrosis
  • List several of the antibiotics used, understand the rationale for choosing them and be able to understand their dosing and monitoring
  • Recognize some of the less typical organisms seen on sputum culture and recognize which of those need special discussion with the CF team
  • Describe the importance of nutrition and the role that pancreatic insufficiency plays in the nutritional status of CF patients
  • Identify the dosing/timing of pancreatic enzymes and how to monitor for effectiveness
  • Recognize that diabetes is common in CF, understand the difference in pathophysiology and treatment compared to other forms of diabetes and recognize the importance of glycemic control during a CF pulmonary exacerbation
  • Explain the GI manifestations in Cystic Fibrosis from constipation to DIOS (distal ileal obstruction syndrome)
  • List some of the potential common “complications” during an inpatient admission
  • Explain the implications of and recognize the signs/symptoms of a serious episode of hemoptysis and describe the management options
  • Recognize when DIOS needs to be considered and understand how it is diagnosed and treated
  • Describe the role of non-invasive ventilation in some patients with Cystic Fibrosis
  • List the common methods for airway clearance which are available during an inpatient admission and understand the importance of active patient engagement in choosing and participating in airway clearance
  • Explain the role that exercise plays in airway clearance and overall health in Cystic Fibrosis
  • Observe some of the airway clearance techniques, be able to try them and watch airway clearance being done on a CF patient 

Bibliographic Sources to Allow for Further Study

  • Airway Clearance: J Peds 1983; 103: 538
  • Nebulized Tobi: NEJM 1998; 340: 23
  • Azithromycin: JAMA 2003; 290: 1749
  • Pulmozyme: NEJM 1994; 331: 637
  • Hypertonic saline: NEJM 2006; 354: 3

The University of Rochester School of Medicine & Dentistry is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians.

The University of Rochester School of Medicine and Dentistry designates this enduring material for a maximum of 3.0 AMA PRA Category Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity

Planning Committee and Author/Speaker Declarations
The ACCME Standards of Commercial Support require that presentations be free of commercial bias and that any information regarding commercial products/services be based on scientific methods generally accepted by the medical community. All of the planning committee members (listed here) have declared that they have no financial interests or relationships to disclose:

*Donna Germuga, RRT

*Tiffany Pulcino, MD, MPH

*Jane Tuttle, PhD, APRN, BC, FNP, CPNP

The following authors/speakers have disclosed financial interests/arrangements or affiliations with organizations that could be perceived as real or apparent conflict of interest in the context of the subject of their presentation(s).  Only the current arrangements/interests are included:

Steven Scofield, MD:

Speaker declared no financial interest or relationship exists.

Caitlin Casey: 

Speaker declared no financial interest or relationship exists.

No commercial funds have been received to support this educational activity.

Contact Information
For questions regarding certification or credit reports:
University of Rochester Medical Center
Center for Experiential Learning
Phone: (585) 275-7666

Registration Fees:



Criteria for Successful Completion of this Activity Include:

  • Register for the course
  • Review all course materials
  • Completion of  the self-assessment / program evaluation*

*The self-assessment / program evaluation must be completed in one sitting.


  • Will be available for download immediately following completion of the program evaluation.
  • Participants must download and save or print certificates before exiting the course.
  • Please remember to send a copy of your certificate to your credentialing office and to keep a copy for your records.

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