immunisation + prophylaxis

Question 1

types of adaptive immuity

Answer 1

natural: passive (maternal), active (infection)
artificial: passive (antibody transfer), active (immunisation)

Question 2

types of vaccines

Answer 2

live attenuated
inactivated (killed)
detoxified toxin
subunit of micro-organism (purified microbial products or recombinant)

Question 3

ex. of live attenuated vaccines

Answer 3

measles, mumps, rubella (MMR) 
BCG
varicella-zoster virus
smallpox
yellow fever

Question 4

ex. of inactivated (killed) vaccines

Answer 4

polio (in combined vaccine D/T/P/hib) 
hep A
cholera
rabies 
japanese encephalitis 
influenza

Question 5

how are toxins detoxified

Answer 5

toxin treated with formalin –> toxoid

e.g. diptheria, tetanus

Question 6

ex. of subunit vaccines

Answer 6

pertussis
heamophilus influenzae b 
meningococcus (group c) 
pneumococcus 
typhoid

Question 7

recombinant vaccines

Answer 7

e.g. hepatitis B

DNA segment coding for HBsAg –> removed, purified + mixed w plasmids –> inserted into yeasts –> fermented –> HBsAg produced

Question 8

‘6 in 1’ vaccine: infanrix hexa

D
T
aP
IPV
Hib
HBV

Answer 8

D: purified ditheria toxoid 
T: purified tetanus toxoid 
aP: purified Bordetella pertussis
IPV: inactivated polio virus 
Hib: purified component of haemophilus influenzae b 
HBV: hepatitis B rDNA

Question 9

target for herd immunity

Answer 9

90-95% coverage

Question 10

immunisations for special patient and occupational groups

Answer 10

BCG
influenza
pneumococcal 
hepatitis B 
varicella zoster (chickenpox) 
herpes-zozster (shingles)

Question 11

who gets BCG

Answer 11

• some infants (areas UK higher incidence and if parents/grandparents from country higher incidence)
• children at school who have risk factors
• immigrants from high prevalence country
• contacts of resp TB pts
• healthcare workers

Question 12

indications to receive influenza vaccine

Answer 12

age >65yrs
nursing home residents
some healthcare workers 
immunodeficient 
immunosuppression 
asplenia/hypopslenism
chronic liver/renal/cardiac/lung disease
DM 
coeliac
preg women

Question 13

indications for pneumococcal vaccine

Answer 13

immunodeficient
immunosuppressed
sickle cell 
chronic liver, renal, cardiac, lung disease
DM 
coeliac

Question 14

human normal immunoglobulins

Answer 14

contains antibodies against hepatitis A, rubella, measles

used in immunoglobulin deficiencies

used in some autoimmune disorders e.g. myasthenia gravis

Question 15

disease specific immunoglobulin and examples

Answer 15

post-exposure

• hepatitis B Ig
• tetanus anti-toxin Ig
• varicella zoster Ig
• diphtheria anti-toxin Ig
• botulinum anti-toxin Ig

Question 16

risk assessment for traveller immunisation + prophylaxis

Answer 16

health of traveller
prev immunisation + prophylaxis 
area visiting 
duration of visit 
accomodation
activities
remote areas
recent outbreak

Question 17

general measures travellers can take

Answer 17

care w food/water
hand washing 
suburn/sunstroke 
altitude road traffic accidents
safer sex
mosquitos: bed nets, sprays, cover up

Question 18

common immunisations for travellers

Answer 18

tetanus 
polio
typhoid 
hep A
yellow fever
cholera

Question 19

immunisations for travellers in specific circumstances

Answer 19

meningococcal A, C, W, Y 
rabies
diphtheria 
japanese B encephalitis
tick borne encephalitis

Question 20

ABCD of malaria prevention

Answer 20

Aware of risk
Bite prevention
Chemoprophylaxis
Diagnosis and treatment

Question 21

type of vaccine: MMR

Answer 21

live attenuated

Question 22

type of vaccine: BCG

Answer 22

live attenuated

Question 23

type of vaccine: polio

Answer 23

inactivated

Question 24

type of vaccine: hep a

Answer 24

inactivated

Question 25

type of vaccine: Hib

Answer 25

subunit

Question 26

type of vaccine: diptheria

Answer 26

detoxified

Question 27

type of vaccine: tetanus

Answer 27

detoxified

Question 28

type of vaccine: hep b

Answer 28

recombinant