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2. Foundations of Medicine PoD > Principles of Immunisation > Flashcards

Principles of Immunisation Flashcards

1
Q

Types opf immunity

A
  • adaptive= active (immunisation vaccines, infection or
    exposure)
  • innate= passive: recieved immunity (placental transfer of IgG, colostral transfer of IgA, immunoglobulin
    therapy or immune cells)
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2
Q

Passive immunity

A
  • short term immunity using antibodies produced outside the body
  • specificity
  • no memory
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3
Q

Active immunity

A
  • the immunity that results from the production of antibodies by the immune system in response to the presence of an antigen
  • specificity
  • memory
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4
Q

Advantages of passive immunity

A
  • Gives immediate protection
  • A quick fix
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5
Q

Disadvantages of passive immunity

A
  • Short term effect - no immunological memory
  • Serum sickness - incoming antibody is recognised as a foreign antigen by the recipient and results in anaphylaxis
  • Graft versus host disease (cell grafts only) - incoming immune cells reject the recipient
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6
Q

Give natural and artificial examples of passive immunity

A

Natural: maternal immunoglobulins transferred to foetus or neonate naturally using a specialised mechanism involving the neonatal Fc receptor
Artificial:
* Snake bite - passive infusion of antibody specific for the toxin
* Hypogammaglobulinaemia (1/2ndry indsion of gamma-globulins to reduce infection
* Rabies immunoglobulin - “post-exposure prophylaxis” together with vaccination

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7
Q

Examples of natural and artificial, active immunity

A
  • natural= exposure/infection
  • artificial= vaccination
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8
Q

Advantages of active immunity

A
  • Antigen (whole organism or part of it) stimulates immune response
  • (often) Long term immunity - may be lifelong
  • Immunological memory
  • No immediate effect, but faster and better response to next antigenic encounter
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9
Q

Vaccination

A

administration of antigenic material (a vaccine) to stimulate an individual’s immune system to develop adaptive immunity to a pathogen

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10
Q

common diseases vaccinated against

probs don’t need to know

A

measles, mumps, rubella, polio, diptheria, tetanus, cholera, typhoid, yellow fever, HPV, shingles, hep A

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11
Q

Explain vaccines which kill the whole organism

A
  • arget organism, e.g., polio virus is killedT
  • Effective and relatively easy to manufacture
  • Booster shots likely required
  • Virus must be heat killed effectively - any live virus can result in vaccine-related disease
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12
Q

Explain vaccines that attenuate the whole organism

A
  • An avirulent strain of target organism is isolated
  • Can be very powerful and better than killed
  • Simulate natural infection
  • Reversion back to virulent form
  • Refrigeration required
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13
Q

Give the mechanism of attenuation

A
  1. pathogenic virus is isolated from a patient and grown in human cultured cells
  2. cultured virus used to infect monkey cells
  3. virus acquires many mutations that allow it to grow well in monkey cells
  4. the virus no longer grows well in human cells (it is attenuated) and can be used as a vaccine
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14
Q

Types of vaccine

4 types

A
  • Live attenuated (LAV)
  • Inactivated (killed antigen)
  • Toxoid (inactivated toxins)
  • Subunit (purified antigen)
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15
Q

How does the subunit vaccine work

A
  • Recombinant proteins
  • Generally very safe
  • Easy to standardise
  • Not very immunogenic without an effective adjuvant
  • Need to understand how to generate immunity
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16
Q

How does the toxoid vaccine work

A
  • Toxin is treated with formalin
  • Toxoid retains antigenicity but has no toxic activity
  • Only induces immunity against the toxin, not the organism that produces it
  • Can’t proliferate in environment???

ex inc: tetanus, diphtheria

17
Q

Diseases LAV used for

A

*Tuberculosis (BCG)
*Oral polio vaccine (OPV)
*Measles
*Rotavirus
*Yellow fever

18
Q

Diseases inactivated vaccines used for

A

*Whole-cell pertussis (wP)
*Inactivated polio virus (IPV)

19
Q

what diseases are toxoid vaccines used for

A

*Tetanus Toxoid (TT)
*Diphtheria toxoid

20
Q

Diseases subunit vaccines used for

A

*Acellular pertussis (aP)
*Haemophilus influenzae type B (Hib)
*Pneumococcal (PCV-7, PCV-10, PCV-13)
*Hepatitis B (hepB)

21
Q

Vaccine schedule for children

A
  • 2 months old= Diphtheria, tetanus, pertussis, polio, Haemophilis influenzae type b, Streptococcus pneumoniae, rotavirus
  • 3 months old= Diphtheria, tetanus, pertussis, polio, Haemophilis influenzae type b, Neisseria meningitidis C, rotavirus
  • 4 months old= Diphtheria, tetanus, pertussis, polio, Haemophilis influenzae type b, Streptococcus pneumoniae
  • 12-13 months old= Haemophilis influenzae type b, Neisseria meningitidis C, measles, mumps, rubella, Streptococcus pneumoniae
  • 2/3/4 years old= Influenza
  • > 3 years 4 months old= Diphtheria, tetanus, pertussis, polio, measles, mumps, rubella
  • 12-13 years old= Human papilloma virus (females only)
  • 13-18 years old= Diphtheria, tetanus, polio, Neisseria meningitidis C
22
Q

vaccines for travellers

A
  • Hepatitis A
  • Typhoid
  • Neisseria meningitidis serogroups A, C, W135, Y
  • Cholera
  • Yellow fever
  • Japanese encephalitis
  • Tick-borne encephalitis
  • Rabies
23
Q

Contraindications of vaccination

reason for someone not to recieve treatment (harmful)

A

Temporary:
* Febrile illness
* pregnancy - cannot be given live attenuated vaccines
Permanent:
* allergy
* immunocompromised - cannot be given live attenuated vaccines as individuals may develop disease from the vaccine strain

24
Q

Explain herd immunity

A
  • Primary aim (of vaccination) is to protect individual who recieves the vaccination
  • Vaccinated person less likely to be source of infection to others
  • Dec risk of unvaccinated individual being exposed
  • Individuals who can’t be vaccinated still benifit
25
Q

What vaccine coverage levels (ish) would lead to herd immunity

A

90-95%

26
Q

What makes a good vaccine

A
  • Potent antibody response - high antibody titers
  • Potent CD8+ cytotoxic T cell response
  • CD4+ T helper response
  • Memory
27
Q

Challeneges to vaccines

A
  • Conventional vaccines cannot elicit immunity against all infectious disease
  • Persistance - don’t always give lifelong protection
  • Generation of memory cells
  • Antigenic shift/drift an strain diversity
  • Cold chain netwok (how get them to where they need to go)
28
Q

Antigenic shift

A

1.Influenza virus has eight separate RNA strands
2.Co-infection of a host with the virus allows genetic reassortments that give rise to novel antigenically distinct virus particles
3.Immune evasion and step increase in virulence

29
Q

What does antigenic drift arise from

A

point mutations

30
Q

cold chain network

A

Maintain product quality from time of manufacture until point of administration by ensuring vaccines are stored and transported within reccomemded temp ranges

31
Q

vulnerability of neonates

A
  • Vulnerability <18-24 months to encapsulated bacteria such as pneumococcus, Hib and meningococcus
  • Fewer FDC, and B cells do not express costimulatory molecules
  • Short term antibody production
32
Q

vulnerability of elderly

A
  • Reduced efficacy or responsiveness to vaccination
  • Oligoclonal responses lacking specificity
  • Reduced plasma cell survival niches
33
Q

Explain conjugate vaccines

A
  • The antigen is the carb capsule (polysacharride)
  • Carbs are poor antigens (don’t stimulate the immune system as broadly as protein antiges), especially in babaies
  • Conjugation of the carb to a protein carrier makes them more effective
34
Q

checkpoint inhibitors

A

*Checkpoint inhibitor antibodies unlock the gateway to the adaptive immune system
*Powerful anti-tumour responses
*But potential for immune related adverse effects

Boost immune response against cance cells

35
Q

how does an immune response occur following vaccination

(brief)

A

Vaccination increases the levels of circulating antibodies against a certain antigen.

2. Foundations of Medicine PoD (28 decks)

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