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Year 1: Respiratory System > 9. Lung Infection > Flashcards

9. Lung Infection Flashcards

1
Q

What are the defences of the lung?

A

Mechanical, local and systemic

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2
Q

Give examples of mechanical defence?

A

Pathogens sticking to mucus or the epithelium acting as a barrier

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3
Q

Give examples of local defences?

A

BALT - samples antigens and produces antibodies
Neutrophils - mobilise from the circulation
Antimicrobial substances in secretions

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4
Q

What are the cilia surrounded by?

A

Periciliary fluid - watery

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5
Q

What floats on top of the cilia?

A

Mucus - sticky gel like

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6
Q

What is the rate at which cilium beats at?

A

15 times a second

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7
Q

Describe the movement of the cilium?

A

The backwards and forwards movement is different. When moving forward the cilium engages the mucus when it is vertical. It is withdrawn in a curved fashion within the periciliary fluid back to the start

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8
Q

What part of the cilia engages with the mucus?

A

Little claws

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9
Q

What rhythm does the cilia beat in?

A

metachronal rhythm

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10
Q

What is the arrangement of microtubules in cilium?

A

9+2 pattern with the 9 microtubules pairs on the outside with dynein arms

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11
Q

What are the dynein arms for?

A

They have ATPase which provides energy to move the microtubules up and down each other. It makes the cilia bend

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12
Q

What is the function of the central tubule?

A

It used as an axis to move against

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13
Q

What can problems with the host defence systems be?

A

congenital or acquired

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14
Q

What are the two most common acquired defects of the mucociliary system?

A

Cigarette smoking

Viral infection

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15
Q

What cigarette smoke do to the mucociliary system?

A

It destroys the cilia - makes you more prone to infection. Tight junctions begin to fall apart

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16
Q

How long does it take for cilia to regrow, restoring the mucociliary system?

A

6 weeks

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17
Q

What are compound cilia?

A

Groups of cilia which are useless - no function. This occurs when cilia grows back abnormally

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18
Q

What is the risk being infected by a virus?

A

It puts you at risk from a bacterial infection as well

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19
Q

What could be the reason of an acute and overwhelming syndrome?

A

Very virulent bug or disorder of the host defence

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20
Q

What could be the reason for recurrent-acute, slow to resolve syndrome?

A

Bronchial, pneumonic or abnormalities in host defence

21
Q

Define dextrocardia and what does it suggest?

A

It is an abnormality where the heart lies on the right side. Suggests some sort of ciliary abnormality

22
Q

People born with cilia that do not work have a heart on a random side of the body. Why?

A

This is because the microtubules are used to guide cells around during embryological development. So if the microtubules didn’t guide the cardiac cells to the right place then the cilia which are made up of microtubules won’t work.

23
Q

What structural defects will mean that the cilia doesn’t work?

A

1) No outer dynein arms

Dynein arm defects

24
Q

How do you identify defective cilia?

A

1) Biopsies - use a microscope to look at beating

2) Biochemical marker - look for reduced levels of NO

25
Q

What bacteria is the most common cause of bronchitis and sinusitis?

A

Haemophilus influenzae

26
Q

How do bacteria attach to the epithelial surface?

A

With hair like fimbriae which act as anchors. They then divide and form a colony

27
Q

How do bacteria avoid clearance from airways?

A

1) Exoproducts that impair mucociliary clearance - disorganise ciliary beat, damage epithelium
2) Enzymes - breakdown local immunoglobulins
3) Exoproducts - impair neutrophil, macrophage and lymphocyte function
4) Adherence - increased epithelial damage and tight junction separation
5) Avoid immune surveillance

28
Q

What is pneumonia?

A

Inflammatory condition of the lung affecting primarily the alveoli. The alveoli can be filled with pus

29
Q

List the clinical features of pneumonia

A

Cough, sputum, fever, dyspnoea, pleural pain, headache

30
Q

Why is there stabbing pleuritic chest pain in pneumonia?

A

When inflammation starts to affect the pain fibres on the surface of the lung

31
Q

What is the most common cause of bacterial pneumonia

A

Streptococcus pneumoniae

32
Q

How does streptococcus pneumonia cause inflammation?

A

Produces pneumolycin which punches holes in cells killing them. Has a negatively charged polysaccharide capsule which makes it more virulent

33
Q

Define gas trapping

A

Air trapped when airways have collapsed - results in high RV. This is caused by lost of elasticity in to the lungs

34
Q

What kind phlegm do people with bronchiectasis have?

A

Greeny phlegm

35
Q

What are typical bronchiectactic airways?

A

Damaged airways which have fallen apart and are much bigger than they should be

36
Q

What is bronchiectasis

A

Bronchiectasis is a disease in which there is permanent enlargement of parts of the airways of the lung

37
Q

How is excess phlegm removed in brochiectatic patients?

A

physiotheraphy

38
Q

What does the removal of phlegm help with?

A

Reduction of inflammation because then the neutrophils dont have a stimulus to move in

39
Q

List the causes of chronic bronchial sepsis?

A

1) Congenital
2) Mechanical obstruction
3) Inflammatory pneumonitis
4) Fibrosis
5) Postinfective
6) Immunological
7) Imparied mucocillary clearance
8) Immune deficiency

40
Q

What is the cycle of chronic inflammation

A

Microbial infection -> inflammation -> tissue damage -> Impaired lung defences ->

More infection = more inflammation

41
Q

What is damage caused by inflammation based upon?

A

Protease anti-protease balance

42
Q

Give an example of an anti-protease?

A

Alpha 1 antitrypsin

43
Q

What is function of an anti-protease?

A

They neutralise proteases preventing damage to the body

44
Q

Describe what happens in chronic inflammation in terms of proteases and anti-proteases?

A

In chronic inflammation there are so many neutrophils so much protease is released that it overwhelms the anti-proteases. The free proteases then cause damage

45
Q

What effect does protease have on the epithelium?

A

It breaks down the epithelial surface causing damage

46
Q

What are the risks of have damaged areas of epithelium?

A

They become more susceptible to infection

47
Q

How does bronchiectasis affect the bronchial wall?

A

Patients with bronchiectasis have chronic inflammation resulting in high levels of neutrophils which digest the elastin

48
Q

What could be the reason for daily purulent sputum only temporarily responding to antibiotic?

A

Abnormality in host defenses

49
Q

What are the common complaints for patients with bronchiectasis?

A

Daily sputum production
Recurrent respiratory infections
Breathlessness
Fatigue

Year 1: Respiratory System (19 decks)

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