6: Pulmonary Defense Mechanisms

Question 1

Biggest goal of removal mechanisms of irritants in the lungs

Answer 1

Minimize inflammation

Question 2

Cough reflex: five steps

Answer 2

1. Deep inspiration
2. Trapping of air by shutting it off by glottis
3. Initiation of expiration, raising intrathoracic pressure
4. Buildup of pressure
5. Sudden release of trapped air at high pressure

Question 3

Three things that happen in a chronic inflammatory response

Answer 3

1. Infiltration of T cells and M1 macrophages
2. Mucus hypersecretion
3. Tissue remodeling -> fibrosis

Question 4

3 Chronic asthma airway remodeling mechanism

Answer 4

1. Leukotrienes -> bronchospasms, vascular permeability, mucus
2. Prostaglandins -> bronchospasms, vasodilation
3. SM and fibroblast recruitment -> deposition of collagen in submucosa

Question 5

Three major cells in asthma vs four in COPS

Answer 5

Asthma: mast cells, Th2 cells, eosinophils
COPD: alveolar macrophages, CD8 cells, neutrophils, Th17 cells

Question 6

Three major cytokines in COPD released by Th17 cells

Answer 6

IL-8, IL-17, IL-22

Question 7

What does physical damage in ventilator-associated lung injury cause?

Answer 7

Over-inflation and mechanical stress

Question 8

Bio damage (three examples) in ventilator-associated lung injury

Answer 8

1. Hyper-oxidation
2. Free radicals
3. Neutrophil influx and NETosis -> platelet/clot formation

Question 9

How does vaping-associated lung injury present?

Answer 9

ARDS with bilateral infiltrates on CXR with absence of infection

Question 10

Underlying cause of vaping-associated lung injury

Answer 10

Lipoid PNA

Question 11

Lipoid PNA

Answer 11

PNA cased by inhalation of lipids

Question 12

Oils that can cause lipoid PNA

Answer 12

Vitamin E, vicks, castor oil, olive oil, essential oils

Question 13

Treatment of lipoid PNA

Answer 13

Supportive case, steroids, antimicrobials for secondary complication