Term
| Definition of chronic lung disease |
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Definition
| Inflammation of the airways, lung and pleura caused by micro-organisms persisting for more than 8 weeks |
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Term
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Definition
Extremely common
Why so common?
200 m2 surface area
500 ml per breath, 15 breaths per min
0.5x15x60x24x365=59 million litres air per year
Unlike skin, disigned for permeability
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Term
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Definition
Bacterial
Mycobacterial
Fungal
Viral
Miscellaneous
So billions of organisms, acting over a large surface area.
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Term
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Definition
Structural
Innate
Inflammatory
Specific immunity
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Term
| Structural Defenses (1)
Nasopharyngeal airway |
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Definition
1. Warms
2. Absorbs noxious gases
3. Impacts
- hair trap particles 5-10 microns
- shape, "U" bend 2 microns
4. Mucociliary escalator (septum and turbinates)
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Term
| Structural Defenses (2)
Lower airways |
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Definition
Complex, lined by at least 50 types of cells
Mucociliary escalator
Sectretions
- Fe binding, lactoferrin
- Enzymes, lysozyme
- Antiproteases (ATT)
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Term
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Definition
Resident macrophages
NK cells
Complement (C3, MAC etc)
Surfactant (+ Macrophages, + chemotaxis, + agglutination etc)
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Term
| Describe the inflammatory response... |
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Definition
Resident macrophages lining alveolar capillary.
Phagocytose most organisms
When large bacterial load or
particularly virulent organism, the macrophages release chemokines
(IL-8, TNF-alpha, C5 etc)
These cause + recruitment of NK into lung (backup)
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Term
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Definition
Antibodies, IgA: B-lymphocytes
Cell mediated immunity
- Dendritic cells (APC) made in BM
- Migrate to lung, through
interstitium, alveolar septae,
bronchial epithelium
- Clonal expansion of APCs of T-lymphocytes
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Term
| Chronic Lung Infection occurs when... |
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Definition
(++) Ogranism virulence
- Impermeable capsule
- New peptidoglycan
- Preoteases to IgA
- Hijack cellular machinery
- Antibiotic use, resitance
(--) Host defense
- Structural
- Innate immunity
- Inflammatory responses
- Specific immunity
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Term
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Definition
D: multisystem disorder
I: 1 in 2800 Caucasians
A: DF508, CFTR -> Na+ and Cl- loss -> very thick mucous secretions
S: M=F
G: Western
A: Screening, childhood
P:Lung, bowel, reproductive system
M:Lung bronchiectasis, multiple infections, FEV1, Liver: fatty infiltration, Bones: osteoporosis, GIT: malabsorption, pancreas, constipation (ileus)
M: S
P: Antibiotics (Pseudomonas/ S. aureus), Supplements, Complications, Transplant (lung/liver) Death = 30 years
Note Pseudomonas and S. aureus in lung is not expected.
Flucloxacillin.
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