Miscellaneous

Question 1

What technique is used to amplify a DNA genome

Answer 1

Polymerase Chain Reaction (PCR)

Question 2

What technique is used to amplify a RNA genome

Answer 2

Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) or Nucleic Acid Based Amplification (NASBA)

Question 3

When would you order a molecular test

Answer 3

1. If the virus does not grow in culture (HCV, HBV HPV etc)
2. If the amount of patient sample is very small (blood or CSF from a baby)
3. If therapy is to be initiated and monitored (HIV, HCV, CMV etc)
4. If the patient is immunosuppressed and mounts a poor antibody response (ie bone marrow transplants)

Question 4

What technique does not amplify nucleic acid but rather measures copies of virus in sample “directly”

Answer 4

bDNA Signal Amplification Assay

Question 5

What is the difference in effect on immunity of the polio vaccine vs the natural disease

Answer 5

The Polio vaccine confers humoral immunity only. The natural disease confers humoral and secretory immunity

Question 6

Name the vaccine type: Influenza (whole virus), Polio (Salk, IPV), Hepatitis B

Answer 6

Inactivated virus (repetitive doses required)

Question 7

Name the vaccine type: Tetanus and Dibtheria

Answer 7

Toxiod Vaccine (toxin-mediated diseases. Multiple doses required)

Question 8

Name the vaccine type: Measles, Mumps, and Rubella

Answer 8

Live attenuated vaccine

Question 9

Name the vaccine type: Hepatitis B surface antigen, Human Papilloma Virus, “Acellular” Pertussis vaccine,

Answer 9

Component vaccine

Question 10

Name the vaccine type: Heamophilus Influenzae, Heptavalent pneumococcal vaccine, and meningococcal vaccines

Answer 10

Conjugate Vaccine (component vaccine attached to a carrier molecule

Question 11

Disease characterized by paroxysmal cough; post-cough vomiting, cyanosis, or whoop; impressive lymphocytosis. Can be fatal in infancy. No good transplacental immunity. Highly communicable. Life-long immunity with recovery.

Answer 11

Pertussis (Bordetella pertussis)

Question 12

When is the Pertussis vaccine administered and what is its efficacy

Answer 12

Administered at 2, 4, 6, and 18 months, and finally at 4 years of age. 80-90% efficacy

Question 13

Disease characterized by exudative pharyngitis with pseudo-membrane. Pseudomembrane can cause respiratory embarrassment or suffocation. Systemic absorption of toxin yields myocarditis which may also be fatal. Current epidemic in Russia.

Answer 13

Diptheria (Corynebacterium diphtheriae)

Question 14

When is the Diptheria vaccine administered and what is its efficacy

Answer 14

Administered at 2, 4, 6, and 18 months, and 4 and 15 years of age. 100% efficacy

Question 15

Disease characterized by profound muscle spasms and irritability, most typical are trismus, “risus sardonicus” and opisthotonos, due to neurotoxicity of toxin. Neonatal condition is usually the result of inadequate cord care. Condition in older children and adults usually results from soil-contaminated wounds with anaerobic conditions (deep penetration and devitalized tissue).

Answer 15

Tetanus (Clostridium tetani)

Question 16

When is the Tetanus vaccine administered and what is its efficacy

Answer 16

Administered at 2, 4, 6, and 18 months, and 4 and 15 years of age. 100% efficacy

Question 17

Disease usually is a nonparalytic aseptic meningitis. From one to four percent of cases are paralytic, with varying degrees of severity depending on motor neurons involved Bulbar or cervical polio is worst, because it affects breathing (iron lung), sympathetics, and swallowing.

Answer 17

Poliomyelitis (Poliovirus)

Question 18

When is the Poliomyelitis vaccine administered and what is its efficacy

Answer 18

Administered at 2, 4, and 6-18 months, and 4-6 years of age. 100% efficacy

Question 19

Classic prodrome consists of the “three C’s”; cough, coryza, and conjunctivitis. Pathognomonic on day one or two of rash is appearance of pustules with red base on buccal mucosa and gingiva–Koplik’s spots. Characteristic rash begins as discrete macules, progresses to almost-coalescing maculopapules, especially of chest and face, over a five-day period. High fever and prostration are impressive. Increasing severity with increasing age.

Answer 19

Measles (measles virus)

Question 20

When is the Measles vaccine administered and what is its efficacy

Answer 20

At 15 months (6-15 months in epidemics and 12 months in endemic areas) with a booster required at school entry. Exposed children can be protected if vaccinated within 72 hours of exposure. 100% efficacy

Question 21

Mild illness whose major consequence is causing congenital syndrome if mother infected in months 0 - 4 gestation. Usual symptoms are malaise, low grade fever, and discrete macular rash which begins centrally and spreads centrifugally. Often posterior cervical lymphadenopathy. Occasional arthritis/arthralgia as rash fades.

Answer 21

Rubella (rubella virus)

Question 22

When is the Rubella vaccine administered and what is its efficacy

Answer 22

At 15 months with a booster required at school entry. Recommended for susceptible women after delivering a baby (do not give to pregnant women). 100% efficacy

Question 23

Generally mild illness (60 - 70% of cases subclinical). Classic feature is parotitis. Orchitis in males may lead to sterility if bilateral (but it’s usually unilateral). May resemble testicular torsion. Common etiology of aseptic meningitis and encephalitis in the pre-vaccine era.

Answer 23

Mumps (mumps virus)

Question 24

When is the Mumps vaccine administered

Answer 24

At 15 months with a booster required at school entry

Question 25

The major cause of bacterial meningitis, septic arthritis, epiglottitis, facial cellulitis, and purulent pericarditis (at least, until recently)

Answer 25

Hemophilus Influenzae type b

Question 26

When is the Hemophilus Influenzae type b vaccine administered and what is its efficacy

Answer 26

Now recommended at 2, 4, 6, and 15 months (oligo-CRM 197 and PRP-TT) or at 2, 4, and 12 months (PRPOMP). Near 100% efficacy in clinical trials.

Question 27

When is the Hepatitis B vaccine administered

Answer 27

For babies born to carrier mothers, vaccine is administered along with HBIG at birth and then at 1 and 6 months. For babies whose mother’s status is unknown or negative, vaccine (without HBIG) is now recommended at birth, 1 to 4 months, and 6 to 18 months. Vaccine is administered to adults in larger dosages but at approximately the same intervals.

Question 28

When is the Varicella vaccine administered

Answer 28

Universal infant immunization is now
recommended at age 15 months (except compromised hosts).

Question 29

What type of vaccine must replicate in the host to produce immunity and thus must not be given until neutralizing maternal antibody disappears

Answer 29

Live attenuated vaccines