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Medicine yr1 > RESP-lung defence > Flashcards

RESP-lung defence Flashcards

1
Q

what is the mucociliary escalator?

A

the structures that waft pathogens/foreign bodies out of the large airways

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2
Q

what is the mucociliary escalator made up of?

A
  • lined by respiratory epithelium
  • cilia
  • ASL
  • gel layer
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3
Q

which type of epithelium lines the large airways of the respiratory system?

A

pseudostratified ciliated columnar epithelium (+ goblet cells)

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4
Q

what is the role of cilia?

A

beat in a coordinated manner to push pathogens out of lungs (sol layer)

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5
Q

what is the role of ASL in the mucociliary escalator?

A

combined with cilia to make up sol layer of mucociliary escalator

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6
Q

what is the role of gel layer in the mucociliary escalator?

A

contains mucins (glycopeptides) which make up mucous

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7
Q

how does the mucociliary escalator work?

A

cilia wafts pathogens which travel and stick inside mucous up to throat, where they can be coughed out or swallowed and destroyed by stomach acid

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8
Q

at what height must the sol layer remain at?

A

same height as cilia->7um

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9
Q

what happens of the sol layer is too thick?

A

cilia won’t reach top of liquid to push pathogens along

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10
Q

what happens of the sol layer is too thin?

A

cilia squashed –> unable to beat all together

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11
Q

how is the height of the ASL maintained?

A

through Na+ transport

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12
Q

what is the response to too much water in the ASL?

A
  1. ENaC transports Na+ out of ASL and into epithelial cell. The Na+ is then removed on the basolateral side by an Na+/K+ pump Via blood
  2. Water follows
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13
Q

what is the response to too little water in the ASL?

A
  1. CFTR channels downregulate ENaC channels prevents Na+ (and water) leaving ASL
  2. CFTR channels also pump Cl- ions out of epithelial
    cell into ASL – this attracts water
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14
Q

what type of condition is CF?

A

Autosomal recessive condition

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15
Q

what causes CF?

A

-Mutated CFTR channel

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16
Q

what is the result of mutated CFTR channel in CF?

A
  • NO downregulation of ENaC and Cl- ions cannot be pumped into ASL to attract water
  • ENaC now moves Na+ and water out of ASL uninhibited –> thick, stagnant mucous that houses pathogens in an ideal reproductive environment
  • Cilia cannot reach top of sol layer-also cannot move efficiently inside thick mucous
17
Q

name the 3 types of immune defence in the airways.

A
  • innate defences (alveolar macrophage which phagocytose pathogens)
  • adaptive defences (immunoglobulins)
  • mucociliary escalator = physical defence
18
Q

what is the most common pathogen seen in CF?

A

pseudomonas aeruginosa (gram negative)

19
Q

what occurs in CF once the airways are infected?

A

-airways carry out an intense inflammatory neutrophil-mediated immune response

20
Q

what occurs do to leukocytes getting trapped in the mucus in CF?

A
  • leukocytes trapped in thick mucus begin to destroy the airways
  • begins a downward spiral of cytokines, proteases and even chondrolysis (break down of cartilage)
21
Q

what is the result of the inflammation in the airways seen in CF pateints?

A
  • does a lot of damage to the person’s airways, and people with cystic fibrosis have very scarred airways
  • long-term result is bronchiectasis and repeated infections-eventually, respiratory failure
22
Q

what is the role of IgA in lung defence?

A

Primarily functions through blocking adhesion + airway secretions

23
Q

where is IgA found?

A

in circulation

24
Q

what is the role of IgG in lung defence?

A

-Primarily functions through opsonisation

25
Q

where is IgG found?

A

in circulation

26
Q

which immune response is IgG typically involved in?

A

-typically involved in secondary immune response

27
Q

what is the role of IgE in lung defence?

A
  • essential for parasitic infections & important in allergy

- When pollen inhaled-activates APCs then T Helper Cells-activates B Cells to produce IgE

28
Q

which receptors does IgE bind to and what does this cause?

A

-IgE binds to Fc receptors on mast cells-causes degranulation of mast cells

29
Q

where is IgE found?

A

in mucosal membranes

30
Q

how is asthma caused?

A
  • some of the molecules released upon degranulation can sometimes be in excess and cause asthma
  • stimulates mucus secretion, smooth muscle contraction and increases vascular permeability
31
Q

the optimum height of airway surface liquid for efficient. mucociliary clearance is:

A-27 um
B-50 um
C-10 um
D-7 um
E-107um
A

D

32
Q

which of the following organisms commonly causes respiratory tract infections in patients with CF?

A-vibrio cholerae
B-dermatophytes
C-pseudomonas aeruginosa
D-strongloides stercoralis
E-treponema pallidum
A

C

Medicine yr1 (55 decks)

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