A 45-year-old man is evaluated for persistent cough and progressive dyspnea on exertion. The patient has no medical issues but has been exposed to large quantities of coal dust while working as a miner for the past 15 years. Chest imaging reveals small, nodular opacities in the upper lobes. Lung biopsy shows fine carbon particles within the patient's respiratory bronchioles and alveolar ducts. Which of the following mechanisms is most directly responsible for clearing the foreign particles from this patient's respiratory tract?

Question

A 45-year-old man is evaluated for persistent cough and progressive dyspnea on exertion.  The patient has no medical issues but has been exposed to large quantities of coal dust while working as a miner for the past 15 years.  Chest imaging reveals small, nodular opacities in the upper lobes.  Lung biopsy shows fine carbon particles within the patient's respiratory bronchioles and alveolar ducts.  Which of the following mechanisms is most directly responsible for clearing the foreign particles from this patient's respiratory tract?

Quizplus · Accepted Answer

Eductional Objective: The pneumoconioses are diseases resulting from the inhalation of fine dust particles that reach the respiratory bronchioles and alveoli.  Particles that lodge in this region are normally cleared by alveolar macrophages.  High particulate burden can cause the excessive release of cytokines from macrophages, resulting in progressive pulmonary fibrosis.

A 45-Year-Old Man Is Evaluated for Persistent Cough and Progressive