Immunity and immune deficiencies: first aid

Question 1

Cellular vs. humoral response to vaccines

Answer 1

cellular response usually seen with live attenuated vaccine

humoral response seen with inactivated vaccine

Question 2

What are examples of live vaccines?

Answer 2

measles, mumps, rubella, polio (Sabin), intranasal flu, varicella, yellow fever

Question 3

What are examples of killed vaccines?

Answer 3

hep A, salk polio vaccine, flu shot, rabies, DTaP

Question 4

Direct vs. indirect coombs

Answer 4

direct: detects abs that HAVE adhered to a pts RBCs (ie test Rh+ infant of an Rh- mom
Indirect: detect abs that CAN adhere to an RBC (ie. test Rh- mom for Rh+ abs)

Question 5

What is serum sickness?

Answer 5

type III hypersensitivity. immune complexes form to foreign proteins and are deposited in membranes, where they fix complement and cause tissue damage. usually caused by drug haptens. see fever, urticaria, arthralgias, proteinuria, and LAD 5-10 days post exposure

Question 6

What is Arthus rxn?

Answer 6

local subacute antibody mediated hypersensitivity. intradermal injection of the antigen induces antibodies, which form antigen-antibody complexes in the skin. this causes edema, necrosis, and activation of complement.

Question 7

What kinds of infections might you see in a patient who is T cell deficient?

Answer 7

bacterial sepsis, CMV, EBV, JCV, VZV, chonic resp and GI infections.
also may see Candida and PCP (pneumocystis pneumonia).

Question 8

What kinds of infections do you see in pts who are deficient in B cells?

Answer 8

encapsulated organism infections (SHiNE SKiS: strep pneumo, HiB, neisseria, E coli, Salmonella, Klebsiella pneumo, group B strep)
some enteroviral encephalitis, polio. May get Giardia (no IgA)

Question 9

What kinds of infections do you see in pts without granulocytes?

Answer 9

staph, burkholderia cepacia, serratia, nocardia, candida, aspergillus