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MBBS - Year 1 > Immunology - Viral Diseases > Flashcards

Immunology - Viral Diseases Flashcards

1
Q

Immunisation

A

The process whereby a susceptible individual is rendered immune to an infection
Can be passive or active
Aims of immunisation can range from eradication to preventing symptoms

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2
Q

Passive immunisation

A

Transfer of pre-formed antibodies to a susceptible individual giving temporary protection from infection

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3
Q

Natural, passive immunisation

A

Mother to baby via the placenta and breast milk

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4
Q

Diseases requiring normal immunoglobulins - passive immunisation

A

Hep A

Measles

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5
Q

Diseases requiring spp immunoglobulins - passive immunisation

A

Hep B
Rabies
Varicella Zoster
Tetanus

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6
Q

Diseases requiring monoclonal immunoglobulins - passive immunisation

A

RSV

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7
Q

Molecules used in active immunisation

A 
Live attenuated
Inactivated whole cell 
Toxoid 
Subunit 
Polysaccharides 
Conjugated polysaccharide
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8
Q

Live attenuated vaccines

A

Traditionally generated by serial passage in tissue culture

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9
Q

Examples of live attenuated vaccines

A 
TB (BCG)
Measles 
Mumps
Rubella
Varicella Zoster
Rotavirus
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10
Q

Pros of live attenuated vaccines

A

Replicates in recipients = excellent immune response

More closely resembles natural infection = mucosal immunity as appropriate

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11
Q

Cons of live attenuated vaccines

A

Potential for reversion
Potential for sustained vaccine strain infection
Not suitable for all

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12
Q

Inactivated whole cell vaccines

A

Pathogen killed by chemical or physical processes

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13
Q

Examples of inactivated whole cell vaccines

A

Inactivated polio (Salk)
Hep A
Rabies

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14
Q

Toxoid vaccine

A

Inactivated toxin

Toxins chemically treated to eliminate toxicity whilst maintaining immunogenicity e.g. w/ formaldehyde

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15
Q

Examples of toxoid vaccines

A

Diphtheria

Tetanus

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16
Q

Types of subunit vaccines

A

Recombinant proteins

Chemically purified

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17
Q

Subunit vaccines - recombinant proteins

A

Spp viral protein produced in a heterologous expression system

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18
Q

Recombinant proteins examples

A

Hep B

Papillomavirus

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19
Q

Subunit vaccines - chemically purified

A

Certain components of a pathogen are purified for use in a vaccine

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20
Q

Examples of chemically purified subunit vaccines

A

Acellular pertussis

Influenza

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21
Q

Polysaccharide vaccines

A

Purified bacterial polysaccharide

T cell independent and poorly immunogenic in young children

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22
Q

Examples of polysaccharide vaccines

A

Some meningococcal vaccines
Some pneumococcal vaccines
Salmonella

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23
Q

Conjugated polysaccharide vaccines

A

Purified bacterial polysaccharide linked to a protein

24
Q

Examples of conjugated polysaccharides

A

H. influenzae
Pneumococcal
Meningococcal

25
Q

Adjuvants

A

Agents that stimulate the immune system

Thought to sequester antigen and cause infl

26
Q

Commonly used adjuvants

A

Aluminium phospahte

Aluminium hydroxide

27
Q

Pre exposure vaccines in adults

A

65 yrs of age - pneumococcal polysaccharide vaccines
65 yrs of age - annual influenza vaccine
70 yrs of age - varicella zoster (shingles)

28
Q

Pre exposure vaccines in pregnant women

A

Influenza vaccine in any trimester prior to start of flu season
Pertussis vaccine from 16 weeks’ gestation

29
Q

Childhood vaccines at 2 months

A

Diphtheria/ tetanus/ pertussis/ polio/ haemophilus/ hep B
Meningococcal B
Rotavirus

30
Q

Childhood vaccines at 3 months

A

Diphtheria/ tetanus/ pertussis/ polio/ haemophilus/ hep B
Rotavirus
Pneumococcal conjugate

31
Q

Childhood vaccines at 4 months

A

Diphtheria/ tetanus/ pertussis/ polio/ haemophilus/ hep B

Meningococcal B

32
Q

Childhood vaccines at 12-13 months

A

Haemophilus/ meningococcal C conjugate
Meningococcal B
Pneumococcal conjugate
MMR

33
Q

Childhood vaccines at 2 years

A

Influenza - annually to age 16 (in process of being rolled out)

34
Q

Childhood vaccines at 3yr 4 months

A

Diphtheria/ tetanus/ pertussis/ polio

MMR

35
Q

Childhood vaccines at 12-13 yrs

A

Papillomavirus (2 doses 6 months apart)

36
Q

Childhood vaccines at 14 years

A

Tetanus/ diphtheria/ polio

Meningococcal ACWY conjugate

37
Q

Post-exposure vaccines

A

Ig and some vaccines can be given after exposure to reduce the chance of an individual developing a disease of reducing disease severity

38
Q

Examples of post-exposure vaccines

A

Wounds at risk of tetanus - spp Ig
Potential rabies exposure - course of vaccine +/- -spp Ig
Unvaccinated contact w/ confirmed measles case - vaccine, in contraindicated - consider normal Ig

39
Q

Adverse effects to immunisations

A

Related to either immunogenicity or other component of the vaccine
Most commonly local reactions - pain, swelling and redness
General systemic effects - fever, headaches and malaise

40
Q

Examples of adverse effects to immunisations

A

Yellow fever - encephalitis
Rubella - thrombocytopenia
BCG - osteitis
Rotavirus - potential increased risk of intussusception

41
Q

Contraindications considerations for immunisations

A

Hx of anaphylaxis to previous vaccine/ vaccine component
Immunosupression
Pregnancy

42
Q

When may an immunisation need to be deferred

A

Acutely unwell
Other vaccines given recently
Ig therapy

43
Q

Immunisation failure

A

Primary vaccine failure

Secondary vaccine failure

44
Q

Primary vaccine failure

A

Failure to mount an immune response to a vaccine

45
Q

Causes of primary vaccine failure

A

Vaccine factors
Host factors
Inappropriate vaccine schedule

46
Q

Vaccine factors leading to primary vaccine failure

A

Administration error
Manufacturing error
Incomplete strain coverage

47
Q

Host factors leading to primary vaccine failure

A

Immunodeficiency

Immunological issues

48
Q

Secondary vaccine failure

A

Immunity develops initially following immunisation but w/ time immunity wanes

49
Q

What does the innate immune system rely on

A

Interaction between PRR’s and PAMPs

50
Q

What does the innate immune system comprise

A

Mechanical barrier
Proteins (enzymes, complement)
Cells (macrophages, neutrophils, NK cells)

51
Q

What does the adaptive immune system comprise

A 
B cells - antibody production 
T cells (CD4  - 'helper' cels and CD8 - 'cytotoxic' cells)
52
Q

Why do we need 2 vaccines for live attenuated virus vaccines

A

We go from sero-ve to seroprotective but the virus-app antibody titre drops so we become sero+ve, therefore requiring a booster

53
Q

Sero+ve

A

Partial or no protection

54
Q

Why don’t wild - type viruses require a booster

A

Despite virus-app antibody titre drops, it is still enough to be seroprotective

55
Q

Why might a child not have been vaccinated

A

Parents may have refused

Vaccination may have been accidentally missed

56
Q

Examples of misinformation about immunisations

A

Polio (a Western plot to make African women infertile)

HPV (a cause of promiscuity in teenagers)

MBBS - Year 1 (93 decks)

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