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Human Development > Immunisation > Flashcards

Immunisation Flashcards

1
Q

what caused the major fall in infant deaths in the 20th century

A

vaccination

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2
Q

who created vaccination

A

Edward Jenner

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3
Q

wha is an example of where vaccines can go wrong

A

1970s caused children to get side effect due to whooping cough vaccine not working properly

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4
Q

why do we have to be careful when giving a vaccine

A
  • usefulness of having protection versus immune system development
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5
Q

what vaccine is given at

  • two months old
  • three months old
  • four months old
  • 12 month old
A
  • diphtheria, tetanus, peruses, polio and haemophillus influenza type b, Meningitis type B, rotavirus, pneumococcal disease
  • dipeteris, teatusmus, peruses, polio and hib, meninggoal C and B, rota virus
  • diphtheria tetanus peruses polio hib, pneumococcal disease
  • hib B/Men C, pneumococcal disease, measles, mumps and rubella
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6
Q

name some vaccines that you have to have if you have certain diseases (targeted vaccines)

A

BCG – neonatal depending on risk level (area/family)

Hepatitis B – In first year if born to infected mother

Influenza/pertussis – Pregnant women

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7
Q

what are some diseases that would mean you have to have vaccines earlier

A

Chronic respiratory, heart, neurological conditions

Diabetes

Haemophilia

Immunosuppressed (either naturally or drug-induced)

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8
Q

when can you not give a vaccine (important)

A

Anaphylaxis to a previous dose

Immunosuppression – do not give live vaccine (MMR, BCG)- some vaccines are weakened form so it can still cause an immune reaction

Pregnancy (in some cases) don’t give rubella while pregnant

Postpone if acutely unwell

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9
Q

several live vaccines can be given…

A

Several live vaccines can be given concurrently but if spaced, minimal interval = 3 weeks

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10
Q

why is it hard to make vaccines for some diseases

A
  • in some diseases the pathogens infect and hide away having latent periods
  • these are the diseases that we have problems making vaccines for
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11
Q

describe Herd vaccination

A
  • this is when you vaccinate 85-90% of the population in order to prevent the spread of the disease and to protect the people that cannot be vaccinated for reasons such as being immunosuppressed
  • if a lower amount of the population is vaccinated then it spreads further through eh population
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12
Q

how effective are vaccines

A

Vaccines have been so effective that many diseases are no longer seen in “rich” countries

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13
Q

why do parents withhold vaccination

A

Some parents may elect to withhold vaccination for fear of side effects, judging risk of vaccine to be higher than the small risk of catching infection

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14
Q

what diseases are hard to prevent through herd immunity

A

Highly contagious infections like chicken pox, whooping cough and measles more difficult to prevent through herd immunity

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15
Q

what are the features of an effective vaccine

A 
safety 
protection 
longevity 
neutralising antibodies
protective T cells
practicality
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16
Q

describe the features of an effective vaccine

A

safety - the vaccine must not cause illness or death

protection - the vaccine must protect against exposure to the pathogen

longevity - the vaccine should give long lasting protection

neutralising antibodies - these must be induced to protect against pathogens such as polio, and many toxins and venoms

protective T cells - these must be induced to protect against pathogens such as TB

practicality - the vaccine must be cheap to produce and easy to administer

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17
Q

what are the reactions to vaccine administration

A

Anaphylactic reactions

Fever / febrile convulsion

Local reactions

Reversion of live vaccines to ‘wild type’

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18
Q

what are the problems of the vaccine when the pathogen is encountered

A

Vaccine ineffective

Heightened immune response to illness

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19
Q

what are the problems with vaccine and therefore the things that you must test

A
  • reactions to vaccine administration

- problems when the pathogen is encountered

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20
Q

what is passive immunisation

A
  • passive is when you receive antibodies

- an example would be the transfer of maternal antibodies from the mother to the baby

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21
Q

what is the difference between active and passive immunisation

A

passive involves receiving antibodies therefore the immune system is not activated whereas active is when you get some form of the disease thus the immune system is activated

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22
Q

name some types of active immunisation

A
  • inactivated vaccines
  • attenuated vaccines
  • recombinant peptide vaccines
  • DNA vaccines
  • therapeutic vaccines
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23
Q

describe how passive antibodies are made

A 
Injected killed pathogen 
Make ian immune response 
10 days layer 
Take serum that contains the antibodies 
Inject mouse 
Challegne with live pathogen 
Shows animal is protected
24
Q

what is passive immunisation used for

A

This type of immunisation is often given to counteract insect/animal venoms

25
Q

what serum is usually used for passive immunisation

A

horse

26
Q

what is the problem with passive immunisation and using horse serum

A

The immunisation effect lasts for as long as the antibody remains active – a few months at most

The patient makes an immune response against the serum (can cause “serum sickness”)

27
Q

passive immunisation does not..

A

give long lasting protection

28
Q

how is polio transmitted

A

Transmission: faecal – oral

29
Q

what is polio caused by

A

enterovirus 3 different strains

Incubation period 7-14 days

30
Q

what does polio have a high affinity for

A

nervous tissue

31
Q

what is the inactivate and active form of disease of polio

A

inactive - polio Salk - sugar lump

active- polio sabin

32
Q

describe polio Salk

A
  • polio virus is marinated in formalin
  • virus is unable to replicate thus it is deactivated
  • generates good humeral immunity
  • no chance of disease but has side effects
33
Q

describe polio sabin

A
  • a live weakend polio virus is generate
  • the virus can replicate but does not cause diseae
  • vaccine generates good humeral and cell mediated immunity
  • occasionally can get polio in patients
34
Q

why do we go inactivated, attenuated, inactivated in the case of polio

A

Injection - get rid of it the majority of it
Attenuated – stop spreading
Injected – prevent it coming back

35
Q

name some inactivated vaccines

A
  • DPT - Diphtheria, whooping cough, tetanus
  • polio
  • cholera
  • influenza
  • plague
36
Q

name some attenuated vaccines

A
  • MMR - measles, mumps and rubella
  • polio sabin
  • chicken pox
  • tuberculosis
  • influenza
  • yellow fever
  • rabies
37
Q

what is a difference between inactivated and attenuated

A
  • inactivated produces humeral immunity whereas attenuated produces humeral and cell mediated immunity
38
Q

when was MMR introduce

A

Introduced to the UK in 1988

39
Q

what are the side effects of MMR

A

malaise, fever, rash (at 1wk), febrile convulsions

40
Q

what are the illnesses of MMR

A

Acute illness

Immunosuppression e.g. steroids, AIDS

Another live vaccine within previous 3 weeks

Receipt of immunoglobulin within previous 3 months

Children who have an anaphylactic reaction to egg should be immunised and observed in hospital for 2 hours

41
Q

what is the cause and incubation period and pathogenesis of diphtheria

A

Notifiable illness caused by Corynebacterium diphtheria

Incubation period: 2-5 days

Pathogenesis: disease results from exotoxin-producing strains

42
Q

what are the cause and incubation period of pertuses

A

Cause: Bordetella pertussis

Incubation period: 7-10 days

43
Q

what are the adverse effects of pertusis vacciantion

A

Local: Redness and swelling

Systemic: Inconsolable screaming, high fever, hypotonic, seizures, anaphylaxis, bronchospasm

Encephalopathy (very rare, especially with new vaccine – 1.3/10 million

44
Q

what causes tetanus, wha tis its incubation period and who is it transferred

A

Notifiable illness caused by Clostridium tetani (a spore forming anaerobic gram positive bacillus)

Incubation period of 4-21 days (depending on inoculum)

Transmission: direct transfer of spores (e.g. from soil)

45
Q

what type of vaccine is tetanus

A

it is a toxoid

46
Q

describe HpB symptoms

A

Many cases are asymptomatic, 1-2% develop fulminant hepatic failure with high risk of mortali

47
Q

what are the two vaccines for HpB

A

Purified from human plasma – HBsAg

HBsAg produced in yeast cells by recombinant DNA technology

48
Q

how effective is HpB

A

Vaccine is 90% effective after a 3-dose series (but this decreases over 40 years of age)

Duration of protection is at least 3-5 years – booster if concentration Antibody <50 IU/I

49
Q

what type of pathogen is haemophilia influenzae type B

A

An encapsulated Gram negative bacterium which has been the major cause of bacterial meningitis and epiglottitis in infants and young children

50
Q

describe how many people effected by haemophilia influenzae type B

A

70% of cases occur in children <2 years of age

1 in 600 develop disease by 5 years of age

An estimated 65 deaths/year in the UK prior to vaccine

51
Q

describe the vaccine used for haemophilia influenzae type b

A

First vaccine consisted of purified polysaccharide PRP which was poorly immunogenic in children <2 years

We now have a conjugate vaccine (protein carrier) – highly protective

52
Q

how does a recombinant peptide vaccine work

A

Get the virus sequence the gneome of the virus
Find a gene molecular clone it
Put it into a yeast
Purify the viral protein
Get lots of the protin and then use it as a vaccine – need to use it as an adjuvant
Makes a regulatory response – will not respond to that, desntities it
Mix the protein with harmless bactria and makes immune response to bacteria

53
Q

describe benefits of adjuvants

A
  • activate dendritic cells
  • bias towards Th2 antibody response
  • stimulate mucosal immunity
  • bias towards TH1 cell mediated response
54
Q

describe how a DNA vaccine works

A
  • gene is isolated from pathogen
  • placed in a bacterial plasma
  • bacterial DNA acts as an adjuvant via TLR9
  • add cytokines and the plasmid is then injected into the muscle of a recpipenet
  • the animal is then protected
55
Q

where do you inject DNA vaccines

A

they are injected into the muscle of a recipient

56
Q

what is the future of vaccines

A
  • this will occur when the animal is already infected and cannot clear the infection
  • the sick animal is then vaccinated to boost the immune response and can now clear the infection

Human Development (28 decks)

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