Lung Defenses

Question 1

name 3 anatomic host defenses

Answer 1

upper airway (nose), epiglottis, epithelial tight junctions

Question 2

example of defect in upper airway defense

Answer 2

endotracheal tube

Question 3

example of defect in epiglottis/larynx

Answer 3

esophageal reflux/aspiration

Question 4

example of defect in epithelial tight junctions

Answer 4

acid aspiration

Question 5

what is the primary mechanical lung defense?

Answer 5

mucociliary and cough clearance

Question 6

give two examples of how mucociliary and cough clearance can go wrong

Answer 6

PCD, CF

Question 7

of PCD and CF, which one does not impair cough clearance?

Answer 7

PCD

Question 8

purpose of nasal turbinates

Answer 8

warm/humidify, set up turbulent airflow so that particles deposit along upper airway rather than entering lungs

Question 9

a defect in which type of cilia causes Fifth’s disease

Answer 9

non-motile cilia (primary/sensory)

Question 10

what stimulates cilia

Answer 10

neurohumoral and mechanical stimulation

Question 11

a defect in embryonic nodal cilia can cause?

Answer 11

sinus inversus totalis or heterotaxy

Question 12

thoraco-abdominal asymmetry (heterotaxy) is associated with what other condition?

Answer 12

congenital heart disease (so they miss the PCD)

Question 13

name proximal immune defenses (bronchus, submucosal glands)?

Answer 13

IgA, defensins (lysozyme, lactoferrin)

Question 14

IgA deficiency is likely a marker of deficiencies of?

Answer 14

IgG-2/4

Question 15

which is more likely to cause chronic respiratory infection: IgA or IgG deficiency

Answer 15

IgG

Question 16

name secondary defense mechanism throughout the lungs

Answer 16

neutrophils

Question 17

name distal immune defenses (near alveoli)

Answer 17

alveolar macrophages, IgG

Question 18

how are macrophages activated?

Answer 18

through T cell recognition and lymphokine recruitment/activation of macrophage

Question 19

how does the body defend against neutrophil elastase?

Answer 19

alpha1-antitrypsin (anti-protease)

Question 20

alpha-1-antitrypsin deficiency results in?

Answer 20

emphysema

Question 21

predictors of lung function in CF

Answer 21

genetic mutations and environment (50% genetic contribution)

Question 22

what do regulatory domains in CF tell us?

Answer 22

help us understand why the disease is mild or severe

Question 23

the importance of individual components of lung defense is recognized by?

Answer 23

in vivo mutational analysis