Immunisations for childhood infections

Question 1

Why are children more susceptible to infections:

Immunological? [2]
Anatomical? [3]
Exposure? [1]

Answer 1

Immunological
* Immaturity
* Lack of memory

Anatomical
* Thinner skin
* Shorter airways
* Anatomy of Eustachian tube: otitis media

Exposure
* Hygiene, nursery/daycare

Question 2

Most infections present with which symptom? [1]

Answer 2

Fever (>37.8) [1]

Question 3

How do the following compare to rectal core temperature thermometers

Tympanic membrane (ear) [1]
Oral [1]
Axilla [1]

Answer 3

Tympanic membrane (ear): similar
Oral: 0.5 lower
Axilla: 1 lower

Question 4

What is the causative agent of Strep throat? [1]

How does someone with Strep throat present? [4]

When is it a problem? [1]

Answer 4

group A Streptococcus

Sore throt
Trouble swallowing
Fever
Stomach Pain
Headache

problem when it becomes septic

Question 5

Name a viral infection that is worse in childhood than in adulthood? [1]

Name a viral infection that is worse in adulthood than in childhood? [1]

Answer 5

Name a viral infection that is worse in childhood than in adulthood? [1]
HSV

Name a viral infection that is worse in adulthood than in childhood? [1]
VZV - leads to shingles

Question 5

Name a viral infection that is worse in childhood than in adulthood? [1]

Name a viral infection that is worse in adulthood than in childhood? [1]

Answer 5

Name a viral infection that is worse in childhood than in adulthood? [1]
HSV

Name a viral infection that is worse in adulthood than in childhood? [1]
VZV - leads to shingles

Question 6

Why are there less treatment options for viruses than bacterial infections?

Question 7

At what age is the MMR vaccine first given to children? [1]

When is booster? [1]

Answer 7

A one years old

At three years old

Question 8

What do we not vaccinate agaisnt [1]

Answer 8

RSV (in regulatory approval)

Question 9

Which vaccines are given in the 6 in 1 vaccine? [6]

At what ages is it given to children? [3]

Describe the vaccination plan so that th full course is given [:)]

Answer 9

Diptheria, tetanus, pertusis, polio, Haemophilus influezae type B (Hib) and hep B

All given at: 8 weeks; 12 weeks; 16 weeks

Diphtheria, tetanus, pertussis and polio given again at 3 years 4 months

Tetanus, diphtheria and polio at 14 years

Question 10

Diphtheria is an infection caused by the bacterium []

Answer 10

Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae.

Question 11

When is rotavirus vaccine given? [2]

Answer 11

8 weeks
12 weeks

Question 12

What is the target for herd immunity for measles? [1]

Answer 12

Target 95% coverage for herd immunity

Question 12

The HPV vaccine protects agaisnt which strains? [4]

What pathologies do these strains cause? [2]

Answer 12

Protects agaisnt: 6, 11, 16, 18, 31, 33, 45, 52, and 58

Human papillomavirus (HPV) types 16 and 18

Genital warts: caused by type 6 and 11

Question 13

Name two severe types of infections that Staphylococcus aureus can cause in children [2]

Answer 13

Osteomyelitis (inflammation of bone marrow)

Septic arthritis

Question 14

Describe how bacterial meningitis causes change by age group

Answer 14

Newborns: are more likely to suffer from Group B Streptococcus

Adults are more likely to suffer from Streptococcus pneumonia

Question 15

Which is more likely to cause severe disease in children

Bacteria
Fungal
Viral

Answer 15

Which is more likely to cause severe disease in children

Bacteria
Fungal
Viral

Question 16

Why is treating viral infections more difficult than treating bacterial infections (in childhood) [1]

Answer 16

Limited treatment options for viruses compared to bacterial preventions

Question 17

Which of the following can lead to chronicity

Varicella zoster virus
Hepatitis B virus
Epstein-Barr virus
Smallpox

Answer 17

Which of the following can lead to chronicity

Varicella zoster virus
Hepatitis B virus
Epstein-Barr virus
Smallpox

Question 18

Name three viral childhood infections that could cause cancer [3]

Answer 18

Hep B
Papilloma
EBV

Question 19

Explain how active immunity works [2]

Answer 19

Antibody mediated response:
* B cells produce immunoglobulins which can opsonise / phagocytose / neutralise / complement / lyse pathogens

Cell mediated response
T cells
* :CD8 cytotoxic
* CD4 stimulate direct activity of B cells

Question 20

Which antibody is produced first in response to an infection? [1]

Answer 20

IgM

Question 21

Which antibody takes over as the main antibody response to an infection? [1]

Answer 21

IgG

Question 22

Which antibody is the most common?

IgA
IgM
IgG
IgD
IgE

Answer 22

Which antibody is the most common?

IgA
IgM
IgG
IgD
IgE

Question 23

Describe the shape of IgA [1] Describe the locations IgA is found [4] Describe how IgA causes prevents colonisation of pathogens [1]

Answer 23

Shape: **Dimer** Locations: Mucusoal areas: **gut**; **resp**. **tract** ; **breast milk** & **urogential** **tract** Role:causes **agglunation** of pathogens and they get washed out

Question 24

Which antibody is the crosses the placenta? IgA IgM IgG IgD IgE

Answer 24

Which antibody is the crosses the placenta? IgA IgM **IgG** IgD IgE

Question 25

Which antibody is in breast milk? IgA IgM IgG IgD IgE

Answer 25

Which antibody is in breast milk? **IgA** IgM IgG IgD IgE

Question 26

Describe the shape of IgE [1] Describe the locations IgE is found [2] Describe how IgE works [1]

Answer 26

Shape: **Monomer** Location: **lymph nodes** & **site of allergic reactions** Role: binds to **allergens**; triggers **histamines** release from **mast cells and basophils**. protects agaisnt **parastic** **worms**

Question 27

Describe the shape of IgG [1] Describe the locations IgG is found [2] Describe how IgG works [1]

Answer 27

Shape: **Monomer** Locations: **Serum** (most common); **crosses placenta** Role: **Enhances phagocytosis** and **fixes complements**

Question 28

Describe the shape of IgM [1] Describe the locations IgM is found [2] Describe how IgM works [1]

Answer 28

Shape: **Pentamer** Locations: **First response to infection** Role: **Fixes complements**

Question 29

Name molecules that CD4+ T cells produce [4] and what role this has

Answer 29

CD4+ T cell produce **IFNy, TNFa/b, IL2 and IL3** supporting **activation** and **differentiation** of **B cells, CD8+ T cells and macrophages (Th1)**.

Question 30

Name two ways CD8+ T cells directly kill cells [2]

Answer 30

Release of **granzyme** Release of **perforin**

Question 31

Which type of vaccine should not be given to immunocompromised people? Inactivated vaccines Live attenuated vaccines Conjugate vaccines Toxoid vaccine Subunit vaccine

Answer 31

Which type of vaccine should not be given to immunocompromised people? Inactivated vaccines **Live attenuated vaccines** Conjugate vaccines Toxoid vaccine Subunit vaccine

Question 32

Desribe the role of an adjuvant of an antigen [1]

Answer 32

**Increase** **immunogenicity** of vaccines that contain **inactivated antigens**

Question 33

How do you calculate the proportion of population that needs to be vaccinated to prevent sustained spread of a pathogen? [1]

Answer 33

Needs to be larger than **1-1/R0** (e.g. Measles: predicted infection from 1 person is 18: 1-1/18 = 94.4)

Question 34

When is rotavirus vaccination given? [2]

Answer 34

8 weeks 12 weeks

Question 35

When are Meningiococcal and pneumococcal vacines given (probs just be aware)

Answer 35

Meningococcal group B 8 weeks 16 weeks 1 year Meningococcal group C (Hib) 1 year Meningococcal groups A, C, W and Y 14 years Pneumococcal (13 serotypes) 12 weeks 1 year

Question 36

What does immune memory of a pathogen depend upon? [1]

Answer 36

Whether immune memory can protect against a future pathogen encounter **depends on the incubation time of the infection,** the quality of the memory response and the level of antibodies induced by memory B cells Greater incubation: greater immune memory

Question 37

What is the difference between Strep throat and scarlet fever? [1] Name a symptom of scarlet fever not in strep throat

Answer 37

Both caused by **group A Streptococcus** (group A strep). When Group A strep just infects throat: **strep throat** * fever and an inflamed, painful throat with swelling of the tonsils. When Group A strep becomes more systemic: **scarlett fever**: * Rash and strawberry tongue presentation