<prompt> A 10 year old child presents with fever since 24 hours. History reveals 3 episodes of chest infection and passage of bulky, foul smelling stools. The most probable diagnosis is-Cystic FibrosisMaple Syrup urine DiseaseBilirubin Congugation DefectCriggler Najar Syndrome  <response>: Ans. is a i.e., Cystic fibrosis Recurrent chest infection in a child with evidence of exocrine pancreatic insufficiency bulky, foul smelling stool suggest a diagnosis of cystic fibrosis. Most patients with CF present in childhood. Approx 18 of patients present within the first 24 hr of life with gastrointestinal obstruction, termed Meconium ileus. Other systems dysfunctions are not present at birth, they may manifest within the first year or two of life including respiratory tract system.1Lungs and sinus disease Sinusitis Pulmonary hypertension - can cause heart failure Bronchiactasis Allergic bronchopulmonary aspergillosis Nasal polyps Lower respiratory tract infection Chronic lung disease 2GIT, Liver and pancreas Meconium ileus Rectal prolapse Malabsorption Pancreatitis Constipation Intussusception Meconium peritonitis Bile duct obstruction and biliary cirrhosis3Endocrine and growth Diabetes Osteoporosis Poor growth4Infertility In men due to absence of vas deference In women due to thick cervical mucus. 