In CF management, pancreatic enzymes are given with meals and a diet high in protein and calories.

• A. Enzymes with meals and snacks; high protein, high calorie
• B. Enzymes only with breakfast; low fat
• C. No enzymes; fat-restricted diet
• D. Enzymes after meals; normal calories

Answer: (A)

In cystic fibrosis with pancreatic insufficiency, replacing pancreatic enzymes is essential to digest fats, proteins, and carbohydrates. These enzymes should be taken with every meal and with snacks so digestion occurs as nutrients pass through the digestive tract. Alongside this, the diet is intentionally high in protein and calories to support growth and prevent weight loss from malabsorption.

The best choice reflects both practices: enzymes with meals and snacks, plus a high-protein, high-calorie diet. It’s not limited to breakfast or taken only after meals, and it doesn’t omit enzymes or restrict fats, which would worsen malabsorption and poor growth.