Vaccination

Question 1

What are some innate defenses?

Answer 1

lysozyme in tears which dissolve cell walls / normal flora / skin / rapid pH change which inhibits microbial growth / flushing of urinary tract prevents colonisation / removal of particles by rapid passage of air over cilia / mucus, cilia lining trachea suspend and move microorganisms out of body / mucus and phagocytes in lungs prevent colonisation / stomach acid

Question 2

What is the purpose of antibodies and the different classes?

Answer 2

produced by wbc in response to foreign antigen, bind to pathogens and can bind to toxins to inactivate them / IgM and IgG found in blood, IgA found in secretions from mucous membranes, IgE involved in parasite immunity and allergies, IgD found on surface of B cell

Question 3

What’s the difference between natural active and natural passive immunity?

Answer 3

natural active is developed by getting an infection that initiates an adaptive immune response and natural passive developed through antibody transfer across the placenta or in breast milk

Question 4

What are some advantages and disadvantages of live attenuated vaccines?

Answer 4

adv- fewer dose required, adjuvants not needed, cheaper, lower hypersensitivity, single procedure / disadv- reversion, possibly infectious, cold chain required

Question 5

What are some advantages and disadvantages of inactivated vaccines?

Answer 5

adv- more doses required, adjuvants needed, more stable / disadv- no reversion, less immunogenic

Question 6

What are some alternative approaches for preparations of immunisations and their purpose?

Answer 6

Synthetic peptides, recombinant-vector vaccines, recombinant-antigen vaccines, DNA vaccines and virus like particles. They eliminate exposure to microbes and protein antigens

Question 7

Explain the basis of vaccination

Answer 7

specificity and memory

Question 8

What is clonal selection?

Answer 8

when B cells are clones some become plasma cells that secrete antibodies and the rest become memory cells

Question 9

What kind of vaccines are normally viable/ non-viable?

Answer 9

viral vaccines often viable (give better protection) and bacterial vaccines normally inactivated (non-viable)

Question 10

What are some examples of live attenuated vaccines

Answer 10

MMR, TB, yellow fever, poliomyelitis

Question 11

What are some example of killed suspension and how are they administered?

Answer 11

Bordetella pertussis, vibrio cholera, salmonella typhi, administered on multiple occasions – monthly intervals with boosters later years

Question 12

What are some examples of component vaccines and how are they administered?

Answer 12

Haemophilus influenza, meningitis C , given on multiple occasions, monthly intervals with boosters years later

Question 13

What are some examples of toxoids and how are they administered?

Answer 13

Diphtheria and tetanus, multiple occasions, monthly intervals with boosters years later

Question 14

Describe the composition of the diphtheria toxoid

Answer 14

cell free diphtheria toxoid, antibodies respond to the toxin, protection against disease not infection, administered on 3 occasions

Question 15

Describe the composition of the tetanus toxoid

Answer 15

cell free toxoid from C tetani, formaldehyde treated preparation, toxin absorbed onto an aluminium phosphate or hydroxide adjuvant

Question 16

Describe the composition of the bordetella pertussis vaccine

Answer 16

5 highly purified pertussis components, 3 injections, protects against infection/ colonisation and also disease

Question 17

What is meningitis and which symptoms do you experience?

Answer 17

An acute inflammation of the meninges with an infective cause that is either bacterial, fungal or viral. Symptoms include severe headache, stiff neck, convulsions, dislike bright lights

Question 18

Who’s affected by meningitis?

Answer 18

infants, children 2-12 & adolescents 19-25

Question 19

What are the causes of meningitis and vaccinations available?

Answer 19

Listeria monocytogenes, streptococcus pneumonia (PCV- contains parts of polysaccharide coat from 7 serotypes of bacteria), Haemophilus influenza (HiB- capsular polysaccharide, nonliving), Neisseria meningitis (A,B,C): capsular antigen conjugate vaccine non living

Question 20

Why is compliance important with MMR vaccine?

Answer 20

danger of loss of herd immunity if compliance falls

Question 21

Describe the composition of the MMR vaccine

Answer 21

living/viable, freeze dried preparations containing live attenuated strains, 3 strains cultured separately and mixed before being lyophilized. Doesn’t contain thiomersal, Priorix an alternative for Muslims

Question 22

What is measles and what are some complications of it?

Answer 22

an acute viral illness called paramyxovirus. Causes fever, malaise, coryza, conjunctivitis and cough. Rash may appear on mouth / complications include otitis media, pneumonia, diarrhoea and convulsions

Question 23

What is mumps?

Answer 23

also an acute viral illness cause by paramyxovirus, characterised by bilateral parotid swelling may experience fever, headache, malaise, myalgia and anorexia

Question 24

What is rubella?

Answer 24

a mild disease cause by togavirus , low grade fever, malaise, coryza and conjunctivitis. Lymphadenopathy may precede rash on ears, face or neck

Question 25

What problems can be caused by maternal rubella infection?

Answer 25

may result in fetal loss or congenital rubella syndrome which presents cataracts and eye defects, deafness, cardiac abnormalities, microcephaly etc

Question 26

What are the selective use vaccines for travellers?

Answer 26

cholera, hep A, Japanese encephalitis, meningococcal disease, rabies, tick-borne encephalitis, typhoid fever and yellow fever

Question 27

What is cholera, the type of vaccine used, its dosage regimen and side effects?

Answer 27

A bacterial infection which causes diarrhoea and vomiting / caused by vibrio cholerae bacterium /inactivated vaccine/ 2 doses 1-6 weeks apart

Question 28

What is Hep A, the type of vaccine used, its dosage regimen and side effects?

Answer 28

infectious disease of the liver / inactivated virus given IM / single dose / side effects: local reactions

Question 29

What is Japanese encephalitis, type of vaccine used / dosage / side effects?

Answer 29

an infectious disease which cause inflammation in the brain / transmission via vector / inactivated aluminium adjuvanted vaccine given IM / 2 doses 28 days apart / side effects: local reactions

Question 30

What is meningococcal disease, the type of vaccine used, dosage and side effects?

Answer 30

infection of the meninges that surround the brain and spinal cord causing headaches, fever, photophobia , stiff neck etc / caused by Neisseria meningitidis bacteria / Quadrivalent meningococcal conjugate vaccine / MenACWY given IM at least 10 days before travel / side effects: nausea, headache, local reactions

Question 31

What is Rabies, the type of vaccine used, dosage and side effects?

Answer 31

a viral zoonotic encephalitis, affecting the brain and NS / lyssavirus transmitted by bite, scratch or saliva / inactivated IM vaccine / when travelling 3 days day 0,7 & 28) / side effects: local reactions

Question 32

What is tick-borne encephalitis, the type of vaccine used, dosage and side effects?

Answer 32

disease caused by bite or infected tick resulting in infection and inflammation of brain and spinal cord, has influenza like symptoms / inactivated IM vaccine 3 doses / side effects: local reactions

Question 33

What is typhoid fever, type of vaccine used, dosage and side effects?

Answer 33

a bacterial infection that spreads through the body with complications like internal bleeding and perforation of digestive tract or bowel / Salmonella typhi bacteria / 2 types of vaccine oral live attenuated vaccine or IM capsular polysaccharide vaccine / inactivated by concomitant admin of antibacterials and antimalarial so 3 day gap / side effects: local reactions & GI disturbances

Question 34

What is yellow fever, type of vaccine used, dosage and possible side effects?

Answer 34

an infectious disease in 2 phases / live attenuated IM vaccine / phase 1 lasts 3-6 days and phase 2 causes jaundice, abdominal pain, vomiting, haemorrhage

Question 35

How many parasites cause malaria and which are the greatest threat?

Answer 35

5 parasites, P.falciparum & P.vivax pose greatest threat

Question 36

What is the treatment for malaria?

Answer 36

quinine, Malarone or Riamet

Question 37

What general strategies can you use for the prophylaxis of malaria?

Answer 37

long sleeves, DEET spray , chemoprophylaxis a week before travel and up to 4 weeks after

Question 38

What drugs would you use for suppressive prophylaxis of malaria?

Answer 38

doxycycline, chloroquine & mefloquiine which are directed against RBC stage of parasite, 4 weeks

Question 39

What drugs would you used for causal prophylaxis of malaria?

Answer 39

Malarone & primaquine which are directed against liver stage of parasite 7 days

Question 40

Pregnant women cannot take which drugs for prophylaxis of malaria?

Answer 40

doxycycline & Malarone

Question 41

People with epilepsy cannot take which drugs for malaria prophylaxis?

Answer 41

melfoquine & chloroquine

Question 42

People with renal impairment cannot take which drugs for prophylaxis of malaria?

Answer 42

Malarone if eGFR is low