Lung

Question 1

describe the pathology of primary ciliary dyskinesia

Answer 1

when cilia are not working properly, mucus starts to build up and leads to destruction of lung area

Question 2

what is the function of goblet cells?

Answer 2

produce mucine

Question 3

describe the pathology of goblet cells –> cystic fibrosis

Answer 3

chloride ions cannot pass through causing sticky mucus to build up blocking the airway resulting in widening of the bronchi and destruction of the lung area

Question 4

what is the function of neuro-endocrine cells?

Answer 4

important in lung development

Question 5

name 3 reasons why the basement membrane could be thickened

Answer 5

1. asthma
2. COPD
3. inflammation

Question 6

name the 4 functions of club cells

Answer 6

1. modulation of inflammation by cytokines/peptides
2. metabolism of inhaled toxic compounds
3. stem cell for cilitated/mucinous cells
4. production of surfactant

Question 7

why does the epithelium of the alveoli flatten?

Answer 7

for efficient gas extraction

Question 8

what is the function of parietal and visceral pleura?

Answer 8

they are close to each other but not connected for expanding the lung

Question 9

name 4 factors of the pulmonary defence

Answer 9

1. clearing mechanism (sneeze, cough)
2. mucociliary apparatus
3. phagocytic and bactericidal action
4. edema, congestion

Question 10

name 3 examples of each viral/ bacterial/ fungal/ parasitic pneumonia

Answer 10

viral; CMV, influenza A, EBV
bacterial; S. aureus, S. pneumonia, Tuberculosis
fungal; cryptococcus, mucormycosis, aspergillosis
parasitic; ascaris, echinococcosis, malaria

Question 11

name 3 patterns of each viral/bacterial/fungal/parasitic pneumonia

Answer 11

viral; interstitial - lymphocyte, diffuse alveolar damage (DAD), viral inclusion
bacterial; necrosis, granuloma, interstitial
fungal; irregular hyphi, necrosis, inflammation
parasitic; fibrosis, eosinophils, abscess

Question 12

give examples of viral/ bacterial/ fungal stains

Answer 12

viral; IHC/ISH
bacterial; gram, PAS, Ziehl-Neelsen (tuberculosis)
fungal; PAS(D), Grocott, IHC

Question 13

what is sarcoidosis?

Answer 13

a granulomatous disorder of unknown cause affecting multiple organs (lung, skin, eyes, liver, heart)

Question 14

name 3 treatments for sarcoidosis

Answer 14

1. abatacept; CLTA-Ig
2. JAK inhibition
3. glucocorticoids

Question 15

name the cells involved in sarcoidosis

Answer 15

• granulomas
• Th1- driven disease (IFNy)
• Th17 (IL-17A)
• double trouble; reduced CTLA-4 expression on Th17 (enhanced pro-inflammatory activity) and Tregs (decreased anti-inflammatory activity)

Question 16

name the 4 symptoms of asthma

Answer 16

• shortness of breath
• chest tightness or pain
• wheezing when exhaling
• chronic inflammation of the airways, involving immune cells and structural cells in the lung

Question 17

name 2 treatments for asthma

Answer 17

1. corticosteroids
2. bronchodilators (B2-agonists)

Question 18

name 6 key triggers for asthma

Answer 18

1. mould
2. pets
3. cleaning chemicals
4. cigarette smoke
5. fragrance
6. dust mites

Question 19

name the characteristics for T2 low and high asthma

Answer 19

Low; neutrophilic inflammation, non-allergic, late onset, involving IFNy and IL17 (Th1 and Th17)
High; eosinophilic inflammation, allergic, childhood onset, involving type II cytokines (Th2; IL4/5/9/13 and ILC-2) , associated with allergen-specific IgE

Question 20

what is the role of the type 2 cytokines in asthma?

Answer 20

IL-4; promotes Th2 cell differentiation and biosynthesis of IgE
IL-5; recruit eosinophils
IL-9; induce mast cell accumulation
IL-13; airway hyperresponsiveness, mucus overproduction and bronchial structural changes

Question 21

what is the role of ILC-2 in asthma?

Answer 21

increase in ILC-2 = increase in cytokine production

Question 22

how can viral infections trigger an asthma exacerbations?

Answer 22

activation of CD8+ T cell, production of type-1 cytokines (IFNy), suppression of type-2 inflammation

Question 23

describe the CD8+ T cell plasticity in asthma

Answer 23

Tc1 (IFNy) turn into Tc2 (IL-5/13) contributing to asthma exacerbations