Vaccinations

Question 1

Immune develops a defense against antigens in the form of

Answer 1

antibodies by B lymphocytes

Question 2

How are immune globulin made?

Answer 2

Pooling of IgG antibody fraction from thousand of adult donors

Question 3

What are immune globulins used for?

Answer 3

Post-exposure (hepatitic, meales)

Question 4

What is a specific IgG that targets one specific antigen. Used for post-exposure prophylaxis for hep B, rabies, tetanus and varicella. Specific for one disease

Answer 4

homologous human hyperimmune globin

Question 5

What is produced in animals and contains antibodies against only one antigen. Used for botulism and diphtheria.

Answer 5

Heterologous hyperimmune serum (antitoxin)

Question 6

What are monoclonal antibodies used for?

Answer 6

DIagnosis and certain types of cancer, treatment of cancer, prevention of transplant rejection

Question 7

What is a monoclonal antibody available for prevention of RSV. (only monoclonal antibody available for an infective)

Answer 7

Palivizumab (Synagis)

Question 8

What produces an immune response similar to that produced by natural infection but w/o the disease and complications?

Answer 8

Vaccination

Question 9

What can the presence of maternal antibody do?

Answer 9

Can make it so a vaccine won’t work well int eh first year of life

Question 10

What is extra material that helps stabilize the vaccine?

Answer 10

Adjuvants

Question 11

What is a vaccine produced by modifying a disease producing (wild type) virus of bacterium. Resulting organism retains ability to grow and produce immunity but usually don’t cause illness.

Answer 11

Live attenuated

Question 12

What is composed of whole viruses or bacteria or fractions of either (protein based or polysaccharide based)

Answer 12

Inactivated virus

Question 13

Inactivated vaccine that come from the toxin that bacterial produces.

Answer 13

Protein-based inactivated vaccine

Question 14

Inactivated vaccine that comes from the portion of the polysaccharide wall of the bacteria, or link it to a protein to create vaccination.

Answer 14

Polysaccharide based inactivated vaccine

Question 15

WHat type vaccine can be interfered with maternal antibodies?

Answer 15

Live attenuated

Question 16

What vaccine is most sensitive to mom’s antibodies.

Answer 16

Measles

Question 17

What 2 vaccines are least effected by mom’s antibodies?

Answer 17

Rotovirus

Polio

Question 18

how many doses do life attenuated doses require?

Answer 18

1 dose 
(except if administered orally)

Question 19

What can life attenuated vaccines be destroyed by?

Answer 19

Destroyed by heat and light

Question 20

What are some life attenuated vaccines (viral)?

Answer 20

MMR (measles, mumps, rubella)
Varicella zoster
Rotavirus
Intranasal influenza

Question 21

What is an example of a life attenuated (bacterial)?

Answer 21

Oral typhoid vaccine

Question 22

How many doses do inactivated vaccines usually require?

Answer 22

3-5 doses (ex- Hep B)

Question 23

what does the first dose of the inactivated vaccine do?

Answer 23

Primes the immune system so the response develops after 2nd or 3rd dose
Never give a vaccine too early!

Question 24

What type immune response is there mostly with inactivated vaccines?

Answer 24

Mostly humoral (little cellular immunity occurs)

Question 25

What are three viral whole-cell vaccines (inactivated)

Answer 25

Polio Hep A Rabies

Question 26

What are some subunit fraction vaccines?

Answer 26

``` hep B Influenza Acellular pertussis HPV anthrax ```

Question 27

What are not very good at creating immunogenic resposne in children younger than 2?

Answer 27

Pure polysaccharides so you want | to use a conjugated polysaccharide version

Question 28

What improves immunogenicity upon polysaccharides, T cell dpendent?

Answer 28

Conjugated polysaccharide

Question 29

If there an interference with inactivated vaccine and antibodies?

Answer 29

No, but there is with a live vaccine

Question 30

IF an antibody (immunoglobulin) is given, how long do you have to wait to give a vaccine?

Answer 30

3 months

Question 31

If a vaccine is given, how long do you have to wait to give an antibody?

Answer 31

2 weeks

Question 32

What is an exception to the antibody vaccine rule?

Answer 32

Zoster vaccine

Question 33

Does anti-Rho(D) reduce response to rubella vaccine?

Answer 33

No it doesn't (can administer this regardless of rubella vaccine status)

Question 34

Are oral live vaccines usually affected by circulating antibodies?

Answer 34

No

Question 35

What can you give with live attenuated vaccine?

Answer 35

Inactivated vaccines

Question 36

When do you use immunoglobulin (passive antibodies)?

Answer 36

When you are treating for the disease (ex- rabies)

Question 37

which two vaccines should be separated for the first dose for child 12 months- 47 months?

Answer 37

MMR and varicella vaccines

Question 38

Can you combine vaccines into one injection?

Answer 38

No except DTaP-IPV/Hib

Question 39

Does increasing the interval between doses of a multi-dose vaccine diminish the effectiveness?

Answer 39

No, it is okay to give a vaccine later

Question 40

What type vaccine is most likely to have systemic ADRs?

Answer 40

live attenuated

Question 41

What vaccine can you not given to individuals who have an egg allergy?

Answer 41

Influenza vaccine

Question 42

What serious ADR can pertussis and a contraindication to getting further pertussis vaccines.

Answer 42

Encephalopathy not due to another cause

Question 43

Who can not receive life vaccines?

Answer 43

Pregnant women | immunosuppression

Question 44

If a patient received blood products, what vaccinations should they not receive?

Answer 44

MMR and varicella (Not zoster)

Question 45

Can HPV be given during pregnancy?

Answer 45

No

Question 46

Does breast feeding extend or improve passive immunity for baby?

Answer 46

No, except maybe H. influenzae type B

Question 47

What type bacteria is diptheria?

Answer 47

Aerobic gram positive bacillus

Question 48

What do you give for diptheria?

Answer 48

Antitoxin (passive immunity) to neutralize circulating

Question 49

What antibiotics are given for diptheria?

Answer 49

Erythromycin or procain Pen G

Question 50

What do you do for prevention of diptheria?

Answer 50

diphtheria bosster and antibiotics

Question 51

What vaccine is diptheria (toxoid) combined with?

Answer 51

teatnus toxoid

Question 52

Those under 7 years should receive what form of diptheria and tetanus vaccine?

Answer 52

DT (DTaP for acellular pertussis)

Question 53

Those over 7 years shoudl recieve what type of diptheria and tetanus vaccine?

Answer 53

TD (Tdap for acellular pertussis)

Question 54

The pediatric (DT) toxoid has how many more times diptheria toxoid?

Answer 54

2-4 times as much diptheria toxoid

Question 55

If a patient has had 0-2 prior doses of tetanus vaccination what should you give them?

Answer 55

TIG and Td or Tdap

Question 56

What type bacteria is haemophilus influenze Type B?

Answer 56

grame negative coccbacillus | generally aerobic

Question 57

How do you treat H. influenze type B?

Answer 57

3rd generation cephalosporin x 10

Question 58

what is the combo of Hep A and Hep B if over age 18?

Answer 58

Twinrix

Question 59

What is the name of inactivated whole virus vaccine for hep A?

Answer 59

HAVRIX

Question 60

What vaccine contains trace amounts of neomycin, streptomycin and polymixin B?

Answer 60

IPV-1 (inactivated polio)

Question 61

Which type of polio virus is a life attenuated?

Answer 61

Oral poliovaccine (shed in patients stool for up to 6 weeks- so transmission possible)

Question 62

What is the drug of choice for pertussis?

Answer 62

Erythromycin and supportive care (manage airway)

Question 63

Is rotavirus a life attenuated vaccine?

Answer 63

Yes (oral vaccine)

Question 64

What HPV virus is recommended for females and males aged 9-26 (strain 16,18,6,11)

Answer 64

Gardasil- Quadrivlanet HPV (HPV4)

Question 65

What is a HPV vaccine approved for females only and cover types 15-18. Can be given to females 10-25.

Answer 65

Cervarix

Question 66

What types bacteria is neisseria meningitidis?

Answer 66

Aerobic gram negative bacteria

Question 67

What are the 2 vaccines for meningococcal (ages 2-55)?

Answer 67

Menactra and Menveo

Question 68

Who is the intranasal spray for influenza approved for?

Answer 68

Healthy, non-pregnant persons aged 2-49 years of age (can be shed in nasopharyngeal secretiosn for up to 3 weeks)

Question 69

what type bacteria is streptococcus penumoniae?

Answer 69

gram positive bacteria

Question 70

what is the vaccine for pneumococcal?

Answer 70

``` Pneumovax 23 (adults >65 or high risk) PCV13- pneumococcal conjugate (2-59 months) ```

Question 71

What is the life attenuated varicella vaccine?

Answer 71

Varivax (also in MMRV)

Question 72

Who is the herpes zoster vaccine available to?

Answer 72

Patients >60