1. Immunisations & Infection Prevention Control

Question 1

What is considered to be the single most effective medical intervention?

Answer 1

Vaccinations

Question 2

What role did Edward Jenner play in immunisation?

Answer 2

Inoculation with cowpox against smallpox

Question 3

What role did Louis Pasteur play in immunisation?

Answer 3

Produced vaccines against chickenpox, cholera, diphtheria, anthrax & rabies

Question 4

When were the first successful live viral vaccines used?

Answer 4

Post WW2

Question 5

What is the biggest cause of childhood death due to infectious disease?

Answer 5

Pneumococcal infection

Question 6

What are the 2 main types of aim for vaccinations?

Answer 6

STRATEGIC AIM (selective protection, elimination, eradication)
PROGRAMMATIC AIM (prevent deaths/infection/transmission)

Question 7

What are the 3 main methods of immunity?

Answer 7

• NON-SPECIFIC DEFENCE (skin, stomach acid, etc)
• INNATE IMMUNITY (complement, WBC, cytokines)
• IMMUNE SYSTEM (Ig&raquo_space; specific IgG response)

Question 8

What is passive immunity?

Answer 8

Introduction of antibodies from another person.

|&raquo_space; short term immunity

Question 9

Give a natural example of passive immunity.

Answer 9

Mother&raquo_space; baby

-maternal antibodies protect baby for up to a year

Question 10

What is active immunity?

Answer 10

Production of antibodies by the immune system in response to antigens.
»long term immunity (immunological memory)

Question 11

Give 2 examples of active immunity.

Answer 11

• Natural infection

- Vaccination

Question 12

Is injecting someone with immunoglobulin active or passive immunity?

Answer 12

Passive immunity

-antibodies injected

Question 13

What is an antigen?

Answer 13

A substance that causes the immune system to produce antibodies.

Question 14

What is an antibody?

Answer 14

Protein produced in response to a specific antigen.

-eg. IgM, IgG

Question 15

What is a primary immune response?

Answer 15

Develops in the weeks following 1st exposure to an antigen.

-Mainly IgM antibody

Question 16

What is a secondary immune response?

Answer 16

Response on subsequent exposures to an antigen&raquo_space; faster & stronger.
-mainly IgG antibody

Question 17

What is the basic process by which antibodies produce immunity?

Answer 17

B lymphocytes produce antibodies
» antigen binds to antibody
»CLONAL EXPANSION (IgM production then IgG production)
»IgG facilitates mircoorganism destruction

Question 18

What happens to levels of IgG when an infection is resolved?

Answer 18

IgG levels decline.

-one set of the specific B lymphocytes persist (IMMUNOLOGICAL MEMORY)

Question 19

What type of organism are in a vaccine that causes active immunity?

Answer 19

Attenuated live/Inactivated

Question 20

Give 4 examples of live vaccines that produce active immunity.

Answer 20

• MMR
• BCG
• Yellow fever
• Varicella

Question 21

Give 3 examples of inactivated vaccines that produce active immunity.

Answer 21

• pertussis
• typhoid
• IPV

Question 22

Give 2 examples of vaccines that contain components of organisms and lead to active immunity.

Answer 22

• Influenza

- Pneumococcal

Question 23

Give 2 examples of vaccines that contain inactivated toxins and lead to active immunity.

Answer 23

• Tetanus

- Diptheria

Question 24

How can mothers pass on immunity to their offspring?

Answer 24

Vertical transmission of auto-antibodies from mother to foetus, & breastfeeding.
» Passive immunity

Question 25

Give 5 examples of passive immunity vaccines involving the injection of immunoglobulin.

Answer 25

- Tetanus - Botulism - Hepatitis B - Rabies - Varicella

Question 26

What are the advantages of live vaccines? (3)

Answer 26

- single dose often >> long term immunity - strong immune response - local and systemic immunity

Question 27

What are the disadvantages of live vaccines? (4)

Answer 27

- potential to revert virulence - contraindicated when immunosupressed - poor stability - contamination potential

Question 28

What are the advantages of inactivated vaccines? (3)

Answer 28

- stable - constituents clearly defined - unable to cause infection

Question 29

What are the disadvantages of inactivated vaccines? (3)

Answer 29

- need several doses - local reactions common - shorter lasting

Question 30

What is a recent development in the UK childhood immunisation schedule?

Answer 30

More serogroups added to pneumococcal vaccine

Question 31

What are the 2 different types of injection of immunoglobulin for passive immunity?

Answer 31

- pooled plasma (HNIG) | - specific antigens (eg. tetanus)

Question 32

What vaccines are routinely given to children

Answer 32

- DTaP/IPV/Hib - pneumococcal - rotavirus - men C - MMR

Question 33

What vaccines are provided to 65 year olds by the NHS?

Answer 33

Pneumococcal | Annual flu

Question 34

What vaccine is provided to 70 year olds by the NHS?

Answer 34

Shingles

Question 35

What is the prevalence of HCAI in hospital admissions?

Answer 35

5-10%

Question 36

What are the activities undertaken to reduce HCAI? (6)

Answer 36

- Eliminate pathogenic organism - Remove source - Minimise transmission - Eliminate entry - Reduce susceptibility - Surveillance

Question 37

How are pathogenic organisms eliminated?

Answer 37

- Environmental cleaning & decontamination (eg. H2O2) | - Antisepsis

Question 38

How is the source of infection removed?

Answer 38

- Hand hygiene | - Environmental cleaning

Question 39

How is transmission minimised?

Answer 39

- Hand hygiene - Protective equipment - Disposable equipment

Question 40

How is entry of microorganisms eliminated?

Answer 40

- Asepsis - Antisepsis - Air handling - Sharps management

Question 41

How is susceptibility to infection reduced?

Answer 41

- Antibiotic stewardship (SMART) | - Immunisation

Question 42

What is surveillance in terms on infection control?

Answer 42

Process of gathering information on infections

Question 43

What is sterilisation?

Answer 43

Complete killing/removal of all types of microorganisms.

Question 44

Name 4 sterilisation methods.

Answer 44

- Heat (moist - autoclave/dry - oven) - Chemical - Filtration - Ionising radiation (disposable equipment)

Question 45

What is disinfection?

Answer 45

Removal/killing of sufficient numbers of potentially harmful micro-organisms to make an item safe to use.

Question 46

What is antisepsis?

Answer 46

Disinfection applied to damaged skin/tissue.

Question 47

What is the difference between sterilisation and disinfection?

Answer 47

``` Sterilisation = removal of ALL microorganisms Disinfection = removal of SUFFICIENT microorganisms ```

Question 48

What the least hazardous method of sterilisation?

Answer 48

Heat

Question 49

What is the risk of infection of surgical equipment, and how are they decontaminated?

Answer 49

- High infection risk | - Sterilisation (moist heat)

Question 50

What is the risk of infection of flexible endoscopes, and how are they decontaminated?

Answer 50

- High infection risk | - High level disinfection (too fragile for heat sterilisation)

Question 51

What is the risk of infection of syringe needles, and how are they decontaminated?

Answer 51

- High infection risk | - Sterilisation (a-irradiation)

Question 52

How are central venous catheter insertion site decontaminated?

Answer 52

Living tissue - chemical disinfection