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Medical Studies 1 > 7.3 Mechanisms of Lung Inflammation > Flashcards

7.3 Mechanisms of Lung Inflammation Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the four broad classes of substances/factors that can damage the lungs

A
  • Microbes
  • Foreign bodies
  • Cell stress
  • Allergens
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2
Q

Give some examples of types of extracellular microbes that can damage the lungs

A
  • Bacteria
  • Fungi
  • Parasites
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3
Q

Give some examples of types of intracellular microbes that can damage the lungs

A
  • Viruses
  • Tuberculosis
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4
Q

A pathogen has breached the epithelial lining of the lungs. What are the types of cells that will try and defend the body, and are they adaptive or innate?

A

Cells such as
- Dendritic cells
- Phagocytes
- NK cells

Will come into action. They are innate.

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5
Q

What are defensins? Where in the barrier of the respiratory system are they located?

A

They are proteins located in the mucous layer of the respiratory tract. Their role is to attack and neutralise pathogens within the mucus layer

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6
Q

Which histological layer of the respiratory tissue do innate immune cells reside in?

A

Lamina propria

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7
Q

How do phagocytes call for backup from the adaptive immune system?

A

By secreting cytokines

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8
Q

What type(s) of innate lymphoid cells are involved in infective inflammation?

A

Type 1 and 3

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9
Q

What type(s) of innate lymphoid cells are involved in allergy?

A

Type 2

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10
Q

What are the four main pillars of innate immunity of the lungs?

A
  • Phagocytes
  • Dendritic cells
  • Innate lymphoid cells
  • Cytokines
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11
Q

How can pathogens evade the immune system of the lungs in individuals with intact immunity?

A
  • Adherence to epithelial cells (in the case of viruses: adhering and replicating)
  • Toxin release (impairs cilia function)
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12
Q

Describe three mechanisms by which respiratory immune defenses can be compromised

A
  • Defective mucus (such as in CF)
  • Damaged cilia (such as in smokers)
  • Defects in immune cells (such as in HIV)
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13
Q

Outline the defences of the respiratory systyem against infection (total overview)

A
  • Barrier: epithelial cells, with mucus and defensins in the mucus. Cilia escalate trapped pathogens up to be coughed out or swallowed
  • Innate: in lamina propria, we have dendritic cells, phagocytes, innate lymphoid cells and cytokines
  • Adaptive: B and T cells as usual
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14
Q

Broadly, what type of receptor to innate immune cells rely on to detect extracellular and intracellular pathogens?

A

Pattern recognition receptors

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15
Q

What pro-inflammatory cytokines do innate immune cells release upon recognition of a threat

A
  • IL-6
  • TNF alpha
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16
Q

How can acute lung inflammation lead to oedema

A
  • Release of inflammatory mediators
  • Vasodilation and increased vascular permeability of nearby capillaries
  • Fluid leaks into capillaries
17
Q

What is it called when fluid acutely leaks into the alveoli?

A

Acute respiratory distress syndrome

18
Q

How is acute lung inflammation resolved after it has served its purpose?

A
  • Cells have short half lives, and most naturally die
  • Some macrophages stick around and remove alveolar debris
  • Lymphatics reabsorb fluid
  • Macrophages also release TNF beta to stimulate fibroblast activity (in severe cases)
  • Type 2 pneumocytes proliferate to restore alveolar lining
19
Q

Describe the cellular response to intracellular pathogens such as tuberculosis. How does this lead to granuloma formation?

A
  • Pathogen is within phagocytes such as macrophages
  • CD4+ T cells secrete inflammatory mediators that cause macrophages to releases reactive nitrogen intermediates and kill the pathogen
  • CD8+ T cells then kill the macrophages
  • Granuloma forms around necrotic cell; innermost layer is epithelial cells, surrounded by B and T cells
20
Q

How can tuberculosis lead to type 4 hypersensitibity?

A
  • After granuloma formation, T cell activity remains elevated
  • Over time, this leads to a type 4 hypersensitivity reaction as a consequence of primary infection
21
Q

In healthy respiratory surfaces, what is the pH range of mucus? Why?

A
  • 5.5-6.7 (somewhat acidic)
  • This creates an environment that is not conducive to bacterial growth
22
Q

What are pattern recognition receptors, what is the name of the substances they detect, and what are these substances?

A
  • Pattern recognition receptors detect Pathogen-Associated Molecular Patterns (PAMPs)
  • PAMPs are nucleic acids that signal some form of infection (non-specific)
23
Q

What are the two kinds of pattern recognition receptors?

A
  • Toll Like Receptors (TLR)
  • Cytosolic receptors
24
Q

How can PRRs differentiate native mRNA from pathogen mRNA?

A

Our mRNA: methyl group at 5’ end
Foreign: no methyl cap

25
Q

In what instances would cytosolic receptors interpret cytoplasmic dsRNA as a PAMP?

A
  • All of them
  • That doesn’t usually happen
26
Q

Under what instances would cytosolic receptors interpret dsDNA in the cytoplasm as a PAMP

A
  • Every instance
  • This does not usually occur
27
Q

Are extracellular TLRs often used to detect viral infections?

A
  • no
  • Viruses are intracellular pathogens; thus, we usually rely on endosomal TLRs to detect viral infection
28
Q

At which point in DNA is it usually methylated?

A

CpG (Cytosine phosphate Guanine)

29
Q

Name a condition which can be result in inherited mechanical compromise of the immune system

A

Cystic fibrosis

30
Q

List some acquired conditions/substances that can lead to mechanical compromise of the respiratory immune system

A
  • COPD
  • Ethanol
  • Tobacco smoke
31
Q

What is the main cause of disorders of phagocytosis?

A

Neutropaenia (death of neutrophils)

32
Q

What characterises disorders of humoral immunity?

A
  • Decreased antibody levels
  • Inability to form new antibodies
33
Q

What two types of drugs can cause disorders of humoral immunity?

A
  • Corticosteroid therapy
  • Antimetabolite use
34
Q

What diseases can cause disorders of cellular immunity?

A
  • Hodgkin’s disease
  • HIV/AIDS
35
Q

Which age group is most susceptible to pneumonia?

A

Children under the age of 5

36
Q
A

Medical Studies 1 (90 decks)

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