Immune Responses to Virus II

Question 1

Primary purpose of vaccines is to induce

Answer 1

Populations of memory B and T cells that form rapid response to pathogen exposure.

Question 2

Describe anti-viral vaccines.

Answer 2

Question 3

Factors influencing the efficacy of anti-viral vaccines.

Answer 3

Question 4

Importance of measles vaccine

Answer 4

Question 5

Importance of Measles Vaccine

Answer 5

Question 6

Herd Immunity

Answer 6

Level of immunity in a population, which effectively prevents spread of disease.

Question 7

How does herd immunity help unimmunized individuals?

Answer 7

Herd immunity indirectly protects unimmunized individuals by decreasing pathogen load.

Question 8

Disappearance of a disease when immunization rates approach 100% (smallpox, polio) is due to

Answer 8

Herd Immunity

Question 9

What is herd immunity for newly emerging or bioterrorism agents?

Answer 9

Zero

Question 10

Why must children be at least one year old to receive measles immunization?

Answer 10

Interference with maternal antibodies

Question 11

Interference is more common with what type of vaccine?

Answer 11

Live attenuated

Question 12

Preformed antibody can interfere with immunization.

Answer 12

Question 13

Recommended routine viral vaccines

Answer 13

Question 14

What vaccines are important for elderly?

Answer 14

Varicella-Zoster after 60 yo

HBV after 60 yo, especially diabetics

Question 15

Candidates for viral immunization

Answer 15

Question 16

Attenuated vaccines can cause diseases in fetus b/c

Answer 16

They can cross placenta

Question 17

Vaccine Adverse Effects

Answer 17

Question 18

Which of the following is a standard component of the routine pediatric regimen of vaccines currently recommended by ACIP (US Advisory Committee on Immunization Pracitces)?

Answer 18

Rubella

Question 19

Which vaccine should not be administered to immunocompromised individuals?

Answer 19

MMR

Question 20

Which condition places a patient at greatest risk for severe viral infections?

Answer 20

Deficiency of IL-2R-gamma (gamma-c deficiency)

-Cause of SCID (deletion of adaptive immune system)

Il-2 is important for lymphocytes (B and T cells)

Question 21

Answer 21

Induction of serum antibodies and cytotoxic T cells

Parenteral Subcutaneous vaccine

Some value from inducing IgG antibodies (serum antibodies)

Final clearance of pathogen will be due to cytotoxic T cells

Best way to induce cytotoxic T cells is to have a replicating attenuating virus b/c antigen presentation through MHC-I is necessary (b/c antigen is internal/endogenous)

Endogenous antigen gets broken up/processed by proteosome, and transported to TAP by MHC-I to be expressed on cell surface

Question 22

Subunit vaccines (proteins) are not very effective at inducing T cell immunity b/c

Answer 22

They are endogenous antigens (cannot be expressed by MHC-I)

Question 23

Does innate immunity get boosted by vaccines?

Answer 23

No

Question 24

Induction of high levels of interferons and induction of NK cells are examples of

Answer 24

Innate immunity

Question 25

Neutralizing IgA antibodies are most likely induced by

Answer 25

Mucosal Vaccines

Question 26

Active immunization

Answer 26

Using an antigen to induce population of memory B and T cells.

Question 27

Pre-formed antibodies from to child from mother is an example of

Answer 27

Pre-formed antibodies

Question 28

Pts who take IVIG are benefitting from

Answer 28

Passive Immunity Pool of immunoglobins in IVIG contains a lot of antibodies (mostly IgG) against common pathogens Concentration for any one pathogen-specific antibody is low so adequate for preventative purposes in B-cell or antibody deficient patient

Question 29

If high levels of a specific antibody to a specific antigen is needed

Answer 29

Source from people with high titers for specific antibodies (pool and isolate immunoglobins)

Question 30

Virus immune globulins

Answer 30

Question 31

Examples of recommended pre and post exposure virus immunoglobulins

Answer 31

Question 32

Graft vs. Host Disease

Answer 32

One month after transplant Sunburn rash at onset Progression to blistering and decimation Hepatosplenomegaly

Question 33

Are viruses a problem in patients with phagocytic cell deficiencies?

Answer 33

No

Question 34

Are viral infections a problem in patients with complement deficiencies?

Answer 34

No

Question 35

Deficiencies of Cell-Mediated Immunity is equal to

Answer 35

T-cell deficiencies

Question 36

Antibody Deficiencies =

Answer 36

B cell deficiencies

Question 37

Highly lytic viruses are a problem with B cell deficiencies.

Answer 37

Influenza RSV Enteroviruses

Question 38

Latent/Persistent viruses are more of a problem in T cell deficiencies eg. Herpes Viruses (reactivation).

Answer 38

CMV HSV VZV EBV JC HCV

Question 39

Which virus is the most common concern during transplant immunosuppression?

Answer 39

CMV: We all carry it.

Question 40

Patients at risk for opportunistic viral infections.

Answer 40

Question 41

Sepsis is caused by

Answer 41

Overzealous immune response to infectious agents or products

Question 42

What is infectious agent for mononucleosis?

Answer 42

EBV

Question 43

Answer 43

CD8+ cytotoxic T cells elminating EBV infected B cells Splenomegaly caused by killing of B cells Enlarged tonsils and lymph nodes due to T cell proliferation Supportive Therapy for Mononucleosis

Question 44

Advanced rabies pt

Answer 44

Infection spread to CNS so vaccination (induce population of B and T cells) or immunoglobulin (lowers circulation of viral load) not appropriate Antibodies will not interfere with vaccine (unlike measles)

Question 45

Newborn T cell deficiency signs (eg. DiGeorge)

Answer 45

Mucosal candidiasis

Question 46

B cell deficiencies do not become apparent until

Answer 46

5-7 months old b/c maternal antibodies are gradually lost