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Genetics, Perinatal & Paediatrics > Pathology and Infection > Flashcards

Pathology and Infection Flashcards

1
Q

Name 3 early pregnancy disorders

A
  1. Spontaneous abortion
  2. Ectopic pregnancy
  3. Gestational trophoblastic disease
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2
Q

Name 3 late pregnancy disorders

A
  1. Disorders of placentation
  2. Pre-eclampsia / Eclampsia
  3. Amniotic fluid embolism
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3
Q

What percentage of recognised pregnancies terminate in spontaneous abortion?

A

10-15% of recognised pregnancies terminate in spontaneous abortion

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4
Q

What are the foetal causes of spontaneous abortion?

A
  • Genetic abnormalities e.g. Aneuploidy, Trisomy 18, Trisomy 16
  • Infection (TORCH)
  • Defective implantation inadequate to support foetal development
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5
Q

What are the maternal causes of spontaneous abortion?

A
  • Inflammatory disease

- Uterine abnormalities

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6
Q

What is it called when there is implantation of the foetus in any site other than the normal uterine location?

A

Ectopic pregnancy

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7
Q

How often do ectopic pregnancies occur?

A

Occurs 1 in 150 pregnancies

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8
Q

What is the most common site of ectopic pregnancy?

A

Fallopian tube

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9
Q

Name a predisposing condition to ectopic pregnancy

A

Pelvic inflammatory disease

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10
Q

What are the following clinical features a sign of:

  • Severe abdominal pain at approx 6 weeks post LMP
  • Tubal rupture →pelvic haemorrhage→Acute Abdomen
  • Medical Emergency –Cardiovascular shock
  • Diagnosed: Serum ßhCG
A

Ectopic pregnancy.

Side note: These pregnancies are always non-viable.

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11
Q

What disease does this describe: “Spectrum of tumours and tumour-like conditions characterised by the proliferation of pregnancy-associated trophoblastic tissue.”

A

Gestational trophoblastic disease

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12
Q

Name the 3 types of molar pregnancy

A
  1. Complete hydatidiform mole
  2. Partial hydatidiform mole
  3. Choriocarcinoma
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13
Q

What do the following factors put a pregnant patient at risk of?

  • Age: >40 years; <20 years
  • Previous gestational trophoblastic disease
  • Diet deficient in Vitamin A
  • Blood group A woman and group O man
A

Molar pregnancy

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14
Q

How may a clinician detect the early development of persistent trophoblastic disease?

A

It is possible by monitoring the circulating levels of hCG to determine the early development of persistent trophoblastic disease

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15
Q

What are the following clinical presentations associated with during pregnancy:

  • Uterus large for dates
  • Hyperemesis
  • 1st trimester vaginal bleeding
  • Symptoms of thyrotoxicosis
  • Theca lutein cysts
A

Complete hydatidiform mole

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16
Q

Complete moles cause markedly elevated levels of _____?

A

Complete moles cause markedly elevated levels of ßhCG. This information is used in diagnosis.
Additionally, ALL the villi of the placenta have oedema. No foetus is seen. The karyotype is also 46 XX/ 46 XY

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17
Q

What percentage of complete hydatidiform moles progress to choriocarcinoma?

A

2% of complete moles progress to choriocarcinoma

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18
Q

What are the following clinical features associated with during pregnancy:

  • Elevated levels of ßhCG
  • Normal villi + some oedematous villi
  • Minimal trophoblastic proliferation
  • May contain foetal parts
  • Karyotype: Triploid
  • V. rare progression to choriocarcinoma
A

Partial hydatidiform mole

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19
Q

What is the malignant epithelial neoplasm of trophoblastic cells that can develop from hydatidiform moles known as?

A

Choriocarcinoma.
50% of cases arise from hydatidiform moles.
22% from normal pregnancies.

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20
Q

What are the treatments of choriocarcinoma?

A
  • Surgery

- Chemotherapy

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21
Q

Name two placental disorders of implantation

A
  1. Placenta Praevia

2. Placenta creta

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22
Q

What is the implantation of the placenta over the internal cervical os known as?

A

Placenta praevia

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23
Q

What are 2 risk factors of placenta praevia?

A
  1. Prior C-section
  2. Pregnancy termination
  3. Smoking
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24
Q

Name 2 complications of placenta praevia

A
  1. Difficulty in delivery

2. Postpartum haemorrhage

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25
Q

Name the disorder that this definition describes: “A rare disorder in which the chorionic villi are immediately adjacent to the myometrium to a varying degree.”

A

Placenta Accreta

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26
Q

Placenta accreta is associated with a deficiency of _______

A

Placenta accreta is associated with a deficiency of decidua

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27
Q

What is the main risk in placenta accreta spectrum disorders?

A

Antenatal and postnatal bleeding

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28
Q

What does increta imply?

A

Increta implies a moderate degree of myometrial penetration

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29
Q

What does percreta imply?

A

Percreta implies total penetration by chorionic villi

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30
Q

What is placental abruption defined as?

A

Premature separation of the placenta

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31
Q

Name a complication of placental abruption

A

Antepartum haemorrhage

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32
Q

What is the clinical presentation of placental abruption?

A

Bleeding with abdominal pain - hard uterus on palpation

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33
Q

What is a complication of twin pregnancies?

A

Twin to twin transfusion

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34
Q

What do twin pregnancies put the mother at increased risk of?

A
  • Gestational diabetes

- Premature delivery

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35
Q

What 3 symptoms characterise pre-eclampsia toxaemia (PET)?

A

Hypertension
Proteinuria
Oedema

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36
Q

What % of people does toxaemia of pregnancy occur in?

A

6%

It usually occurs in the last trimester

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37
Q

Is convulsions associated with pre-eclampsia toxaemia or eclampsia?

A

Eclampsia

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38
Q

What is the treatment for established PET or Eclampsia?

A

Induction and delivery

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39
Q

What are the complications of PET?

A

HELLP Syndrome

  • Haemolysis
  • Elevated Liver enzymes
  • Low Platelets
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40
Q

What does HELLP syndrome describe?

A
  • Haemolysis
  • Elevated Liver enzymes
  • Low Platelets
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41
Q

What condition is characterised by the following:

  • Severe Shortness of Breath
  • Cyanosis
  • Hypotensive shock followed by seizures & coma
A

Amniotic fluid embolism

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42
Q

Name one thing found in the maternal pulmonary circulation when there is amniotic fluid embolism

A
  • Foetal squamous cells

- Mucin

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43
Q

What is the leading cause of direct maternal death?

A

Thromboembolic disease

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44
Q

What is the most common malignancy exacerbated in pregnancy?

A

Breast cancer

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45
Q

What is the incidence of maternal death?

A

9.2 in 100,000

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46
Q

What does the ‘perinatal period’ describe?

A

The period occurring around the time of birth

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47
Q

How is preterm birth defined?

A

Preterm birth refers to the birth of a baby less than 37 weeks gestation

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48
Q

List 4 risk factors for prematurity

A
  1. Pre-Eclampsia (PET)
  2. Hypertension
  3. Alcohol
  4. Infection
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49
Q

Name one neurological complication of prematurity

A

Developmental disability

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50
Q

Name one cardiovascular complication of prematurity

A

Patent ductus arteriosus

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51
Q

What is the leading cause of morbidity & mortality in premature infants?

A

Respiratory distress syndrome (RDS)

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52
Q

What are the risk factors for respiratory distress syndrome?

A

Prematurity, Maternal diabetes, C-section

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53
Q

The pathogenesis of respiratory distress syndrome is linked to a deficiency of ______

A

The pathogenesis of respiratory distress syndrome is linked to a deficiency of surfactant

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54
Q

What is the biophysical role of surfactant?

relevant for respiratory distress syndrome

A

To decrease surface tension (i.e. decrease the affinity of alveolar surfaces for one another)
When a newborn starts to breathe, type II pneumocytes release their surfactant stores.

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55
Q

How is respiratory distress syndrome prevented?

A

Antenatal maternal glucocorticoids

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56
Q

What is a late complication of respiratory distress syndrome that usually occurs in infants that weigh less than 1500g?

A 
Bronchopulmonary dysplasia (BPD).
It is thought to result from oxygen toxicity.
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57
Q

Name 2 gastrointestinal/metabolic complications of prematurity

A
  • Hypoglycaemia
  • Hypocalcaemia
  • Necrotising Enterocolitis
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58
Q

What is the most common acquired gastrointestinal emergency in newborns?

A

Necrotising Enterocolitis (NEC)

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59
Q

The incidence of necrotising enterocolitis (NEC) is thought to be _______ proportional to the gestational age

A

The incidence of necrotising enterocolitis (NEC) is thought to be inversely proportional to the gestational age

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60
Q

Name 2 haematological complications of prematurity

A
  • Anaemia of prematurity

- Jaundice

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61
Q

In jaundice, what organ is immature? And what is it deficient in?

A

Liver immature - deficient in glucuronyl transferase

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62
Q

What pigment is thought to injure the brain by interfering with mitochondrial function in jaundice?

A

Bilirubin.

When it injured the brain by interfering with mitochondrial function, this is called ‘kernicterus’.

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63
Q

A baby is brought to the clinic and is described to have lost their startle reflex. They have also developed athetoid (slow) movements. They have previously been diagnosed with jaundice. What complication have they developed?

A

Kernicterus

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64
Q

What is the treatment for jaundice?

A

Phototherapy.

In a severe case: exchange transfusion

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65
Q

What is a low birth weight infant classified as?

A

<2500g

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66
Q

What is a cause of ‘small for gestational age’ (SGA) low birth weight?

A

Intrauterine Growth Restriction (IUGR)

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67
Q

Name one cause of Intrauterine Growth Restriction

A

Disorders impairing maternal health & nutrition

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68
Q

Name one cause of symmetrical foetal growth restriction

A

Rubella or Chromosomal abnormalities

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69
Q

What is the most common important birth injury?

A

Intracranial haemorrhage

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70
Q

Which organ has the highest risk of causing death when there is a congenital abnormality?

A

Congenital anomalies of the heart have the highest risk of death in infancy accounting for 28% of infant deaths due to congenital abnormality

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71
Q

What does the following definition refer to: “Intrinsic abnormality occurring during the developmental process.”

A

Malformation

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72
Q

What does the following definition refer to: “Arise later in fetal life and represent an alteration in form or structure resulting from mechanical factors.”

A

Deformation

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73
Q

What does the following definition refer to: “Results from secondary destruction of or interference with an organ or body region that was previously normal in development.”

A

Disruption

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74
Q

What does the following definition refer to: “A pattern of cascade anomalies”

A

Sequence

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75
Q

What does the following definition refer to: “A constellation of congenital abnormalities believed to be pathologically related.”

A

Syndrome

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76
Q

What are the two main features of Potters’ Sequence?

A
  1. Oligohydramnios (caused by Amniotic leak)

2. Foetal compression (Results in Altered faces)

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77
Q

Karyotic abnormalities are present in __ to __% of live infants with congenital abnormalities

A

Karyotic abnormalities are present in 10 to 15% of live infants with congenital abnormalities

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78
Q

What is the most common cause of congenital abnormalities?

A

Down Syndrome

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79
Q

What is the professional term for Oedema of the foetus?

A

Hydrops Fetalis

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80
Q

The hallmark of X disease is the abnormal accumulation of fluid in body cavities. This disease occurs in babies. Name the disease.

A

Hydrops Fetalis

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81
Q

Name a type of immune hydrops, that is also known as ‘haemolytic disease of the newborn’.

A

Rhesus Disease

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82
Q

90% of Rhesus are caused by what?

A

Antibodies against D antigen.

Problem arises with Rh(-) mother & Rh(+) father.

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83
Q

Name one feature of infants who die from hydrops fetalis.

A

Bile stained organs

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84
Q

What is the treatment of Rhesus disease?

A
  • Exchange transfusions

- Phototherapy

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85
Q

How is Rhesus disease prevented?

A

The administration of human anti-D immunoglobulin within 72 hours of delivery

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86
Q

What is the most common cause of non immune hydrops?

A

Fetal cardiac anomalies

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87
Q

Name two things that non immune hydrops results from

A
  1. Cardiac Failure

2. Venous obstruction

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88
Q

What microorganisms are transcervical perinatal infections mainly caused by?

A

Bacteria

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89
Q

What microorganisms are transplacental perinatal infections mainly caused by?

A

Parasites and Viruses.

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90
Q

How do transplacental perinatal infections access the fetal bloodstream?

A

Via chorionic villi

91
Q

Name 4 conditions that are screened in Ireland as part of the national newborn bloodspot screening program

A
  1. Cystic fibrosis
  2. Phenylketonuria
  3. Classic Galactosaemia
  4. Congenital Hypothyroidism
92
Q

Name one criteria for screening

A

Facilities for diagnosis and treatment available

93
Q

What is the screening methodology for cystic fibrosis?

A

Wet chemical method + genetics

94
Q

What is the screening methodology for amino acid disorders?

A

MS/MS methodology

95
Q

What are the 3 main classifications of variants?

A

Benign
Uncertain Significance
Pathogenic

96
Q

Name a disease that undergoes variant specific testing

A

Cystic Fibrosis

97
Q

Name a disease that undergoes gene specific testing

A

Phenylketonuria

98
Q

What disease does this 8 month old girl have?
Characteristics:
- 4/7 Hx vomiting., diarrhoea, reduced oral intake
- Examination: unresponsive, 4cm hepatomegaly, no splenomegaly
- Birth Hx-full term, SVD, BW 3.5 kg, up-to-date vaccination
- 1st child, healthy non consanguineous parents
- Paternal aunt RIP at 4/12-SID and maternal aunt RIP-8/12 SID

99
Q

What is the common MCAD mutation in clinically symptomatic patients?

A

Homozygous mutation (G985A) in the ACADM gene

100
Q

What is an outcome of MCADD with national newborn screening?

A

Avoidance of fasting

101
Q

What is an outcome of MCADD without national newborn screening?

A

Metabolic crises

102
Q

What is a chronic complications of classical Galactosaemia?

103
Q

What enzyme metabolises galactose, which is deficient in classical galactosaemia?

104
Q

By what route are TORCH infections usually transmitted?

A

Via trans-placental route

105
Q

In perinatal infections, when does the baby acquire the infection?

A

During labour and delivery

106
Q

Name 3 congenital infections which the mother acquires BEFORE conception and transmits it to the foetus?

A
  1. HIV
  2. Hepatitis B
  3. Treponema pallidum
107
Q

Where are congenital infections established?

108
Q

What modality is used to detect abnormalities in the foetus?

A

Ultrasound scanning

Laboratory analysis of amniotic fluid is also used

109
Q

In congenital infections, are asymptomatic or symptomatic infections more likely to have long term sequelae?

A

Symptomatic infections are more likely to have long term sequelae

110
Q

What does the acronym ‘TORCH’ stand for?

A 
Toxoplasma gondii
Others
Rubella
Cytomegalovirus (CMV)
Herpes simplex virus
111
Q

Name 4 examples of ‘Other’ TORCH infections

A
  1. Parvovirus B19
  2. Varicella
  3. Syphilis
  4. Zika virus
  5. Treponema pallidum
112
Q

What issues may congenital infections result in?

A
  • Fetal loss (spontaneous miscarriage)
  • Intrauterine growth retardation (IUGR)
  • Fetal anomalies
  • Long term consequences
113
Q

What type of infection is toxoplasmosis? (in terms of organism)

A

Protozoal infection. (Acquired from eating inadequately cooked meat, contaminated foods or contact with infected cat faeces)

114
Q

What is the classical triad seen at birth in congenital toxoplasmosis? (i.e. 3 clinical presentations)

A
  1. Hydrocephalus
  2. Chorioretinitis
  3. Intracranial calcification
115
Q

What are asymptomatic babies with congenital toxoplasmosis likely to develop later in life?

A

Ocular manifestation

116
Q

What maternal infection does treponema pallidum result from?

A

Syphilis.

50% of babies are asymptomatic at birth.

117
Q

What is the treatment for treponema pallidum?

A

Penicillin

118
Q

What is another term that is used to describe Parvovirus B19?

A

Slapped cheek syndrome

119
Q

What may Parvovirus B19 infection result in during the first trimester of pregnancy?

A

Miscarriage

120
Q

What may Parvovirus B19 infection result in during the 2nd trimester of pregnancy?

A

Profound anaemia and Hydrops fetalis

121
Q

With varicella, around when in the pregnancy is maternal infection more common?

A

Infection is more common around birth, which can cause post-natal infection

122
Q

Name a foodborne illness/infection that can affect pregnancy

123
Q

Name 2 things that maternal listeria infection is associated with

A

Sepsis

Preterm birth

124
Q

Zika virus is a _____ borne infection

A

Mosquito borne infection

125
Q

What is the main clinical presentation that Zika virus is associated with?

A

Microcephaly

126
Q

What may rubella infection cause if it occurs in the first trimester of pregnancy?

A

Major fetal defects in heart, eye, brain

127
Q

What may rubella infection cause if it occurs during week 12-16 of pregnancy?

128
Q

Name 3 symptoms of rubella infection that are apparent at birth, if a baby has been congenitally infected.

A
  1. Petechiae “blueberry muffin rash”
  2. Cataract
  3. Microcephaly
129
Q

What is the most common congenital infection?

A

Cytomegalovirus

130
Q

Name 3 symptoms of cytomegalovirus that are present at birth

A
  • IUGR
  • Petechiae / blueberry muffin rash
  • Intracranial calcification
131
Q

Name 4 ways congenital infection can be prevented

A
  1. Antenatal screening: Rubella, HIV, Hep C
  2. Vaccination
  3. Antimicrobial and immunoglobulin treatment
  4. Food safety
132
Q

When is the rubella vaccination given? (In regards to pregnancy)

A

BEFORE pregnancy or AFTER delivery

When the baby is not in the body

133
Q

What is the default delivery method for HIV?

A

Caesarean section

134
Q

Name 3 blood borne viruses

A
  1. HIV
  2. Hepatitis B
  3. Hepatitis C
135
Q

Does Hepatitis C infection require a vaccine, immunoglobulin, or antiviral during pregnancy or in the neonate?

136
Q

How much does the risk of Hepatitis C transmission increase if co-infected with HIV during pregnancy?

137
Q

Gonorrhoea can cause ophthalmia neonatorum on ___ 1-3 of life:

A

Gonorrhoea can cause ophthalmia neonatorum on DAY 1-3 of life:

138
Q

Chlamydia trachomatis can cause ophthalmia neonatorum on ___ 1-3 of life:

A

Chlamydia trachomatis can cause ophthalmia neonatorum on WEEKS 1-3 of life:

139
Q

What STI is transmitted vertically during pregnancy?

A

Herpes Simplex Virus (HSV)

140
Q

What infection is likely to be present if a baby presents with the following symptoms in the first month of life:

  • SEM (Skin, eyes, mouth) lesions
  • Sepsis not responding to antibiotic therapy
  • Severe sepsis
  • Encephalitis e.g. unexplained seizure, hypotonia.
A

Neonatal herpes

141
Q

Name 4 causes of maculopapular rash

A
  1. Measles
  2. Rubella
  3. Parvovirus B19
  4. Scarlet fever (Streptococcus pyogenes)
142
Q

Name two ways that measles is transmitted

A

Airborne and Contact transmission

143
Q

What is the attack rate of measles?

144
Q

What are the blue-white specks with surrounding red areola on oral mucous membranes called in measles?

A

Koplik’s spots

145
Q

What infection are the following clinical features associated with:

  • Incubation period 8-13 days
  • High fever, cough, conjunctival inflammation, runny nose
  • Koplik’s spots
  • Maculopapular rash starts on day 3-4 of illness
146
Q

Name 2 complications of measles

A
  1. Pneumonia
  2. Death
    (Also: post measles acute encephalitis)
147
Q

What infection are the following clinical features associated with:

  • Incubation period 14-23 days
  • Mild fever
  • Rash appearing on day 2-3
  • Accompanied by lymphadenopathy
  • Older patients may have arthralgia
148
Q

Name 2 complications of rubella

A
  1. Congenital infection

2. Encephalitis

149
Q

When are the 2 MMR doses given?

A

1st dose @ 12 months

2nd dose @ 4-5 years

150
Q

Why is the MMR vaccine not given during pregnancy?

A

It is a live attenuated vaccine

151
Q

Why is the MMR vaccine not given to immunocompromised patients?

A

It is a live attenuated vaccine

152
Q

What age is human parvovirus B19 infection most common in?

A

Children 5-14 years

153
Q

Name 3 infectious systemic viral infections

A

Measles
Rubella
Human parvovirus B19

154
Q

What infection are the following clinical features associated with:

  • Incubation period 1-3 weeks
  • Mild fever
  • Maculopapular rash
  • Arthralgia more common in adults
A

Human parvovirus B19

155
Q

Name 1 complication of human parvovirus B19

A

Aplastic crisis

156
Q

What bacteria causes scarlet fever?

A

Streptococcus pyogenes

157
Q

What is used for the laboratory diagnosis of measles, mumps and rubella?

A

Saliva PCR swab: for viral RNA

158
Q

What is used for the laboratory diagnosis of parvovirus b19?

A

Blood sample: test for IgG + IgM antibody +/- parvovirus DNA by PCR

159
Q

What clinical feature is diagnostic of Herpes 6?

160
Q

What is the most common cause of vesicular rash?

A

Varicella (Chickenpox)

161
Q

Name 2 causes of vesicular rashes

A
  1. Varicella

2. Herpes simplex virus

162
Q

How long is a person with chickenpox usually infectious for?

163
Q

Name 2 complications of Varicella

A
  1. Pneumonia

2. Zoster (Shingles)

164
Q

Which of the following tests is used to determine recent infection: IgM antibody or IgG antibody?

165
Q

What infection causes gingivostomatitis?

A

Herpes simplex virus

166
Q

What group of viruses cause hand, foot and mouth illness?

A

Enteroviruses

167
Q

What distinguishes mumps from other common infectious viral illnesses?

A

Systemic viral illness with NO RASH

168
Q

What is the main presenting symptom of mumps?

A

Swelling of salivary gland

169
Q

List 2 complications of mumps

A
  1. Encephalitis

2. Orchitis

170
Q

Name 2 bacterial respiratory tract infections in childhood

A
  1. Pertussis ‘whooping cough’

2. Epiglottitis

171
Q

Name 2 viral respiratory tract infections in childhood

A
  1. Bronchiolitis

2. Croup

172
Q

What is the name of the bacterium that causes whooping cough?

173
Q

List 2 complications of pertussis/whooping cough

A
  1. Intracranial haemorrhage

2. Secondary bacterial pneumonia

174
Q

How can pertussis/whooping cough be prevented?

A

Vaccination

175
Q

What childhood condition caused by a bacterial infection are the following clinical features associated with:

  • Cold and sore throat
  • Pain and difficulty swallowing
  • Stridor
  • Respiratory emergency
A

Epiglottitis

176
Q

What virus is bronchiolitis caused by?

A

Respiratory syncitial virus (RSV).

Every child will develop 1 or more episodes of RSV.

177
Q

What viral childhood infection causes a harsh barking cough and noisy breathing?
Note: It is also very common in infants

178
Q

What organism causes croup?

A

Parainfluenza viruses 1, 2 or 3

179
Q

What term describes the following: A form of immunity that occurs when the vaccination of a significant proportion of a population provides a measure of protection for individuals who have not developed immunity.

A

Herd immunity.

People that benefit from herd immunity include people not vaccinated and contraindicated people.

180
Q

Vaccines act as ______ and most stimulate _________ production and through activating ________ effector functions

A

Vaccines act as antigens and most stimulate protective antibodies production and through activating T cell-mediated effector functions

181
Q

Are the following characteristics associated with T-cell dependent antigens or T-cell independent antigens?

  • Activate T cells
  • Response from birth
  • Long term immunity
  • Booster response
A

T-cell dependent antigens

182
Q

Are the following characteristics associated with T-cell dependent antigens or T-cell independent antigens?

  • Activated B cells
  • Poorly responsive under 2 y/o
  • No long term immunity
  • No booster response
A

T cell independent antigen

183
Q

What type of antigen are T cell dependent antigens? (In terms of protein, fat, polysaccharide etc)

A

T cell-dependent antigens are protein antigens

184
Q

What type of antigen are T cell independent antigens? (In terms of protein, fat, polysaccharide etc)

A

T cell-independent antigens are polysaccharide antigens

185
Q

How do you overcome the problems of T cell-independent antigens?

A

Coupling polysaccharide to protein carrier

186
Q

Name the type of antibody which does the following:

Neutralisation of bacterial exotoxin

187
Q

Name the type of antibody which does the following:

Neutralisation of viruses

A

Neutralising antibodies

188
Q

Name the type of antibody which does the following:

Initiation of complement-mediated lysis of bacteria

189
Q

Name the type of antibody which does the following:

Initiation of phagocytosis

190
Q

Name the type of antibody which does the following:

Prevention of bacterial adhesion to mucosal surfaces

A

Antiadhesins

191
Q

Name 4 types of antibodies

A
  1. Antitoxin
  2. Neutralising antibodies
  3. Lysins
  4. Opsonins
192
Q

How long does a live attenuated vaccine offer protection for?

A

Life-long protection with one dose

193
Q

Name 2 things that may inactivate an ‘inactivated vaccine’

A
  1. Heat

2. Acetone

194
Q

What does the following description refer to:

“Modified bacterial toxins rendered non-toxic but retains ability to stimulate anti-toxin formation”

195
Q

Name two types of subunit /subcellular fraction vaccines

A
  1. Polysaccharide capsule e.g. pneumococcal

2. Fragmented virus or surface antigen e.g. influenza

196
Q

Name 5 types of vaccines and an example of each

A
  1. Live attenuated, e.g. MMR
  2. Inactivated, killed, e.g. Pertussis
  3. Toxoids, e.g. Tetanus
  4. Subunit fraction vaccines, e.g. Influenza
  5. Recombinant vaccine, e.g. Hepatitis B
197
Q

Name an immunisation that is administered at birth.

198
Q

Name 4 contraindications to immunisation

A
  1. Anaphylaxis
  2. Fever > 40.5 degrees Celsius within 48 hours of vaccination
  3. Live vaccines and pregnancy
  4. Live vaccines and immunosuppression
199
Q

What is the name of the vaccine used for Pertussis?

200
Q

What are the two types of DTaP vaccines

A
  1. Acellular vaccine

2. Whole-cell pertussis vaccine

201
Q

Name 2 adverse reactions of DTaP vaccine

A
  1. Malaise
  2. Fever
  3. Convulsions (rare)
202
Q

Name a live attenuated bacterial vaccine

203
Q

What adverse reaction to the live oral polio vaccine is the reason why it is no longer routinely recommended?

A

Vaccine-associated paralytic poliomyelitis (VAPP)

204
Q

Name 2 vaccines that require boosts

205
Q

How many doses of inactivated polio vaccine should children receive?

206
Q

What is Haemophilus influenzae type b (Hib) vaccine conjugated to?

A

H. Influenzae type b capsular polysaccharide conjugated to a protein carrier

207
Q

What are two contraindications for MMR vaccine?

A
  1. Pregnancy
  2. Untreated malignant disease
  3. Immunosuppressive therapy
208
Q

List 2 indications for MMR vacine

A
  • All children age 12 to 15 months

- A second dose a 4-5 years

209
Q

List 2 adverse reactions of MMR vaccine

A

Fever

Headache

210
Q

List 2 indications for pneumococcal vaccine

A
  • 65 years and over

- Immunodeficiency

211
Q

What are the 2 types of pneumococcal vaccines available?

A
  • Polysaccharide pneumococcal vaccine

- Pneumococcal conjugate vaccine

212
Q

List 3 types of influenza vaccine

A
  1. Inactivated whole virus vaccine
  2. Subvirion or split-virus vaccine
  3. Surface antigen vaccine
213
Q

How much protection does the influenza vaccine confer? (%)

A

70-90% protection

214
Q

List 2 indications for influenza vaccine

A
  • Health care workers

- Immunosuppression

215
Q

What vaccine contains recombinant HBsAg?

A

Hepatitis B vaccine

216
Q

What are the 2 indications for Hepatitis B vaccine?

A
  1. Pre-exposure prophylaxis

2. Post-exposure prophylaxis

217
Q

List 2 types of passive immunisation

A
  1. Non-specific immunoglobulins

2. Specific immunoglobulins

218
Q

List 2 indications for non-specific immunoglobulins

A
  1. Measles prophylaxis

2. Hepatitis A prophylaxis

219
Q

List 2 types of specific immunoglobulins

A
  1. Varicella-Zoster immunoglobulin

2. Hepatitis B immunoglobulin

220
Q

What do COVID mRNA vaccines encode?

A

Spike protein

221
Q

With the COVID mRNA vaccines, what receptor do the neutralising antibodies block the viral spike protein from binding to on the host cell?

A

ACE2 Receptor

222
Q

What is the efficacy of COVID mRNA vaccines against death?

223
Q

List 2 TYPES of COVID vaccines

A
  • mRNA vaccine

- Viral vector vaccine

Genetics, Perinatal & Paediatrics (4 decks)

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