Vaccines

Question 1

What is the main risk associated with the administration of live-attenuated vaccines?
A) Development of autism as a result of thimerosal (thiomersal) exposure
B) Stronger stimulation of the host’s immune system
C) Development of disease due to requirement of administration using natural portal of entry
D) Development of disease due to reversion to virulent phenotype

Answer 1

D) Development of disease due to reversion to virulent phenotype

Question 2

For which patient population(s) would inactivated vaccines be preferred over live- attenuated ones?
A) Patients undergoing chemotherapy for cancer
B) AIDS patients
C) Pregnant women
D) Elderly patients
E) Transplant patients
F) Neonates and infants

Answer 2

A, B, C, D, E, & F

Question 3

During an outbreak of a vaccine-preventable diarrhea, a 20-month-old girl is brought by her mother to the emergency department following a sudden onset of vomiting and watery diarrhea (no mucus, no blood). On physical exam, the child has a fever, sunken eyes, abdominal pain, and hyperactive bowel sounds; vital signs are: HR 130/min, RR 36/min, and BP 100/60 mmHg. A stool sample sent for analysis is negative for leukocytes, bacteria, cysts or ova. What is a characteristic of the vaccine that could have prevented this child’s illness?
A) Stable at room temperature (22C) for an extended period (1 week)
B) Stimulates a mucosal immune response
C) Provides effective humoral immunity, but little cellular immunity
D) Requires a conjugate protein to stimulate a T-dependent response
E) Requires booster immunization on a yearly basis

Answer 3

B) Stimulates a mucosal immune response

Question 4

A 19-year-old female first-year college student is brought to the emergency department by her roommate. Patient history is significant for acute onset of severe headache, fever, photophobia, nausea, and vomiting. On physical examination, the patient presents with altered mental status. A CSF analysis is performed and is significant for the following: elevated opening pressure (250 mm H2O; RR: 80-200), 2,500 leukocytes/μL (RR: 0-5) with predominance of PMNs (95%), 25 mg/dL glucose (RR: 40-70), 500 mg/dL protein (RR: 20-50), and Gram-negative diplococci (free and within PMNs), which also grow on chocolate agar in a 5% CO2 atmosphere. How are the vaccines that could have prevented this person’s disease adjuvanted? (There are two answers; go onto the CDC website to find the answers)
A) Aluminum hydroxide
B) Complete Freund’s adjuvant 
C) CpG 1018
D Diphtheria toxoid
E) MF59
F) Monophosphoryl lipid A

Answer 4

A) Aluminum hydroxide & D Diphtheria toxoid

Question 5

A 68-year-old woman with a history of COPD is transferred from a nursing home to the emergency department where she presents with fever, chills, shortness of breath, and cough productive of yellow sputum for the last two days. Nursing home personnel report that “the woman had not been eating well and seemed somewhat lethargic over the past week.” She reported a depressed mood and feelings of worthlessness for the past week. On physical examination, BP is 100/54 mmHg, HR is 122/min., RR is 18/min., and crackles are heard in the left lower lobe. The following relevant laboratory investigations are reported: WBC 22,000/mm3, with 70% PMNs and 10% bands, and -hemolytic, optochin-sensitive, Gram-positive diplococci isolated from sputum sample. What type immune response does the 13- valent polysaccharide conjugate vaccine that would have likely prevented this woman’s illness most likely elicit?
A) Cellular immunity
B) Mucosal immunity
C) T-dependent B cell antibody production
D) T-independent B cell antibody production
E) Passive immunity

Answer 5

C) T-dependent B cell antibody production