Term
| What are the four classifications of immunity stimulation? Give examples of each? |
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Definition
-Can be natural/artificial & passive/active
-Natural passive; IgG from mother
-Natural active; recovery from infection
-Artificial passive; antivenom, antitoxin, human Ig, etc.
-Artificial active; vaccines |
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Term
| What the risks of passive immunotherapy (3)? Give a special case when patients are at risk? |
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Definition
-Passive is used typically after exposure has occurred
Risks;
1. Antibodies from other species can generate IgE, and cause systemic anaphylaxis (type I HSRs)
2. Antibodies from other species can generate IgG, leading to complex formation (type III HSRs)
3. Even human antibodies can elicit anti allotype rxns when given in series
-Patients with selective IgA def. (1:700 in pop) can develop reactions to infused IgA (haven't seen IgA before) |
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Term
| Run through the 10 immunizations that are typically given from birth to age 6? |
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Definition
1. HepB
2. RV (Rotavirus)
3. DTaP (Diphtheria, tetanus, pertussis)
4. HiB (Haemophilus influenzae type b)
5. PCV (Pneumococcal vaccine)
6. IPV (Inactivated poliovirus)
7. Influenza
8. MMR (mumps, measles, rubella)
9. Varicella
10. HepA
Mnemonic;
He Remembered Doing His PIIM Vaccinations Hatefully |
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Term
| What immunizations (4) are given after age 7 and when? |
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Definition
-Tdap; age 11-12 and then as needed (every 5 to 10 yrs)
-HPV; 3 doses at age 11-12
-MCV (meningiococcal vaccine); once at age 11-12 (given as early as age 2-6 if high-risk)
-Flu Shot; yearly
Mnemonic;
Totally Hate My Immunizations |
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Term
| Which immunizations are usually given 4 or more times? What type are they? When are they given? Why so many times? |
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Definition
-There are 5 (3th thu 7th of the 10 childhood vaccines)
-DTaP, Hib, PCV, IPV, Influenza
None of them are live;
-DTap is toxoid (2,4,6,16,+every 5-10 years)
-PCV & Hib are capsular
-IPV is killed (2,4,12, & year 4-6)
-Influenza is killed (yearly)
-For the most part, they are given at 2, 4, 6, & 12 months (note exceptions listed above)
-Generally, these all are less effective in generating memory and thus must be given multiple times and early |
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Term
| Which childhood immunizations are given three times? What are their types? When are they given? Why are they given 3 times? |
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Definition
-HepB and RV are both generally given three times
-HepB; component (through DNA recombination)
-RV; live (attenuated)
-HepB; 0, 1-2, & 12 (earliest given immunization)
-RV; 2, 4, 6
-We give RV earlier than the other live viruses, so we have to boost it a bit more
-Hep B is capsular and given early, so we have to boost it
-Note that anything given before 12 mo. will have trouble generating a cellular response because of maternal IgG |
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Term
| What are the live childhood vaccines? How many times are they given and when and why? |
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Definition
-MMR, Varicella, & RV (not Hep A!)
-The MMR and varicella are given at 12-15 months (along w the HepA) then boosted again before school (around 5-6yrs), but this is probably not necessary
-They are given after one year of age to avoid blocking of cellular response by maternal IgG
-They are live, so they generate a strong cellular response without need for repeated inoculations (RV given early, so repeated) |
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Term
| What are the four bacterial vaccines we give (4)? What types are they? |
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Definition
-DTP/DTaP
-Hib (yes, it is a bac)
-PCV/PPV(adult version)
-MCV
-The DTaP is toxoid, the rest are capsular |
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Term
| What are the positives and negatives of live viral vaccines? How does this compare to the killed and component viral vaccines? |
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Definition
-Can revert to pathogenic form
-Can't be given to the immunocompromised and pregnant
-Are susceptible to contamination with other viruses
-Requires special storage
-Has the best results generating strong cellular and humoral responses
-Component has no risks and generates some CMI
-Killed has contamination risk and generates little CMI (but strong HMI) |
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Term
| List the killed vaccines? |
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Definition
Mnemonic; Rest In Peace Always
-Rabies
-Influenza
-Polio
-A Hepatitis |
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Term
| List the live viral vaccinations? Who can't we give these to? |
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Definition
Mneumonic; Mrr. V.Z. Mapsy
-Mumps
-Rotavirus
-Rubella
-Varicella - Zoster
-Measles
-Adenovirus (not attenuated, given GI)
-Polio (no longer given live in US)
-Small Pox
-Yellow Fever
-Can't give to pregnant or immunocompromised
-Note, we typically give these after 1 year of age so they are not canceled by maternal IgG (except RV) |
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Term
| Which vaccines can we not give to patients with egg allergies? |
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Definition
-Influenza (egg wh-I-te)
-MMR (MMembrane)
-Yellow Fever (Yolk) |
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Term
| What are the two component vaccines? How do we make them? |
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Definition
-HepB & HPV
-We use DNA recombinant technology (gene insertion into yeast cells, having them produce the immunogen) |
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Term
| What Ig is far below normal levels in 1 year old child? How is this partially supplemented? What Ig must we use for diagnostics when under one year of age? What does the timing of Ig mean for immunocompromised children? |
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Definition
-IgA is only at 20% normal at year 1 (reason for higher instance of mucosal infections)
-Colostrum (first milk) has lots of IgA
-Use IgM for diagnostics when younger than 1 (IgG could be mothers or the babies, we can't know for sure)
-Immunocompromised children will not become ill until maternal IgG is low (almost gone around month 6) |
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Term
| What is special about the Hib vaccine? What about the other two capsular types, how do they elicit memory? |
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Definition
-It uses a polysaccharide, but conjugated to a carrier protein in order to elicit a cellular response (T cells need protein)
-The pneumonia and meningitis shots given later in life rely on presence of preexisting reactive cells |
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Term
| As far as microbiology is concerned, when do we use live vs. killed preparations of viruses for vaccination? |
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Definition
-Naked capsid; okay to use killed
-Enveloped; need to use live |
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Term
| What are the four effects adjuvants can have? What are examples of compounds eliciting these effects? |
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Definition
1. Prolonging antigen persistence (aluminum potassium sulfate)
2. Enhancing costimulatory signals (muramyl dipeptide)
3. Inducing granuloma formation (knot under skin)
4. Inducing nonspecific lymphocyte proliferation (LPS, synthetic polyribonucleotides) |
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Term
| If a bacteria is killed and injected along with the capsular polysaccharide of what we want immunity to, what is the bacteria serving as? |
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Definition
| -An adjuvant; it is just there to increase swelling and immune response |
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Term
| The following are a few for Lima... ugh. |
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Definition
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Term
| Give a few examples of intracellular bacteria and diseases? |
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Definition
-Mycobacterium leprae - Leprosy
-Plasmodium falciparum - Malaria
-Leishmania donovani - Leishmaniasis (causes sores, from sandfly bite) |
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Term
| As a reminder, what molecules activate NK cells? |
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Definition
| -IFNs and IL-12, both from macs |
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Term
Give the type of vaccine for the following;
Paratyphoid fever?
Typhus fever?
Cholera?
Plague?
TB?
Typhoid fever? |
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Definition
-Paratyphoid fever; Killed
-Typhus fever; Killed
-Cholera; Killed or cell extract
-Plague; Killed or cell extract
-TB; Attenuated bovine strain
-Typhoid fever; Attenuated |
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Term
| What is the top 3 killers that we don't have vaccines for? |
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Definition
1. Respiratory diseases (3.9 mil)
2. HIV (2.7 mil)
3. Diarrhea (1.8 mil)
-TB is a close 4th at 1.6 |
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Term
| What is the difference between the Sabin and Salk Polio vaccines? |
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Definition
-The Sabin is live, Salk is killed (it's sulking bc it's dead)
-Remember, polio is the P in Mrr. V.Z. Mapsy, but it is no longer given live in the U.S. because we have eradicated polio and live vaccines hold risk of reintroduction |
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Term
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Definition
-Immuno-stimulating complexes
-Basically they are detergents that help deliver the antigen directly into cytosol, stimulating MHC I presentation via the endogenous pathway |
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