Glht Exam 2 - L.7, 8

Front 1

3 stages of prevention

Back 1

1. Primary - Vaccines (healthy pt)
2. Secondary - Screening (sick pt)
3. Tertiary - Treatment (disabled/dying pt)

Front 2

Leading global causes of death

Back 2

1. cardiovascular diseases
2. infectious/parasitic
3. cancers
4. respiratory infections
5. respiratory diseases
6. unintentional injuries
7. perinatal conditions

Front 3

Diseases for which vaccination is part of most national immunization schedules (8)

Back 3

Measles
Hib
Pertussis
Tetanus
Yellow fever
Diphtheria
Polio
Hepatitis B

Front 4

3 considerations for developing vaccines

Back 4

- vaccine design
- production
- testing safety & effectiveness

Front 5

Name some viruses

Back 5

hepatitis
SARS
Herpes
AIDS, HIV
Warts
Chicken pox
Cold sores
Influenza

Front 6

Name some bacteria pathogens

Back 6

Tuberculosis
Anthrax
Pneumonia
Strep throat
Stomach ulcers
urinary tract infection (E. coli)
upper respiratory tract infection
bacterial meningitis
STDs (chlamydia)

Front 7

Describe bacteria

Back 7

- cells with membranes and cell walls
- can survive and reproduce outside host
- can be killed/inhibited by antibiotics
- responsible for >90% of hospital infections

Front 8

How do bacteria cause disease?

Back 8

- invade host through various routes of exposure
- reproduce
- produce toxins that disturb function of normal cells

Front 9

Describe viruses

Back 9

- nucleic acid core surrounded by protein capsid
- use host to reproduce
- antibiotics don't work

Front 10

How do virsues cause disease?

Back 10

1. invade host cell
- bind to cell membrane receptors
-enter by endocytosis
2. take over cell
- use viral nucleic acid and host resources to make new viral proteins
3. more viruses are released from host cell
- lyse host cell or bud from host cell surface

Front 11

Name types of pathogens (6)

Back 11

bacteria, virus, fungi, toxins, pollution, parasites

Front 12

What are the viral components of HIV?

Back 12

nucleic acid core
envelope
protein capsid
glycoproteins

Front 13

What are the roles of the immune system (5)?

Back 13

1. defend the body against pathogens
2. recognize self vs. non-self
3. eliminate microbial agents
4. display immunologic memory
5. tolerance of self antigens

Front 14

Defense mechanism against pathogens (3)

Back 14

1. physical barriers
- skin
- mucous membranes
2. innate immune system
- general inflammatory response to extracellular pathogens
3. adaptive
- can adapt to defend against specific invaders in&out of cell
- provides immunological memory

Front 15

5 types of cells of the immune system

Back 15

neutrophil, monocyte, basophil, eosinophil, lymphocyte

Front 16

Neutrophil and monocyte (macrophage) function

Back 16

innate immunity - phagocytosis

Front 17

Basophil and eosinophil function

Back 17

defense vs.parasites
allergic rxns

Front 18

Lymphocyte types & function

Back 18

B lymphocytes, T lympho., natural killer cells

function: adaptive immunity - antibody production, pathogen killing

Front 19

Cells of innate immunity

Back 19

neutrophils, macrophages, complement proteins

Front 20

2 branches of adaptive immunity

Back 20

1. humoral (B cells)
2. cell-mediated (T cells)

Front 21

Functions of activated macrophages (innate immunity)

Back 21

1. phagocytose pathogens
2. produce chemicals that lead to an inflammatory response
- increase blood flow (redness, heat)
- cause fluid leaking (swelling)
- recruit neutrophils (pus)
3. present antigen to adaptive immunity

Front 22

Functions of complement proteins (innate immunity)

Back 22

1. present in tissue & blood
2. attach to surface of bacteria and virsues to target them for phagocytosis
3. recruit other immune cells

Front 23

What happens when you get a splinter (general answer)?

Back 23

- pathogen passes physical barrier (skin)
- innate immunity goes to work - symptoms show (red, swollen, hot, pus)

Front 24

What happens when you get a splinter (specific answer, 5 steps)?

Back 24

1. damaged tissues attract mast cells which release histamine that diffuses into the capillaries
2. histamine causes the capillaries to dilate and become leaky; complement proteins leave the capillaries and attract phagocytes
3. plasma and phagocytes move to infected tissue
4. phagocytes eat bacteria and dead cells
5. everything stops

Front 25

Humoral vs. cell-mediated

Back 25

Humoral:
- relies on antibodies produced by B lymph
- fights pathogens outside cells

Cell-mediated:
- relies on specific receptors on the surface of T lymph
- fights pathogens inside cells

Front 26

How do antibodies (adaptive immunity, humoral) work ?

Back 26

1. neutralization: blocks the biological activity of the toxin or pathogen
2. bridge: brings together pathogens & phagocytes

Front 27

Two regions of antibodies

Back 27

1. Fab - binds antigen or surface of virus infected cell
2. Fc - binds macrophages, neutrophils, and NK cells to induce phagocytosis & killing

Front 28

3 types of T cells

Back 28

1. cytotoxic T lymphocytes
2. helper T
3. regulatory T

Front 29

How do T cells recognize virus-infected cells?

Back 29

All cells have MHC molecules on their surfaces. T cells use MHC proteins to identify infected cells. Antigens (fragments of viral proteins) get loaded onto MHC molecules.

Front 30

How does Influenza evade immune extinction?

Back 30

1. Antigenic drift - mutation
2. Antigenic shift - reassortment

Front 31

2 major glycoproteins of Influenza A envelope and their respective functions

Back 31

HA - hemagglutinin;
mediates entry
main target of humoral immunity

NA - neuraminidase
mediates release

Front 32

Talk about antigenic drift.

Back 32

- changes to the antigens of the virus
- occurs when viral RNA polymerases do not proofread reproduction
- point mutation changes in HA/NA change antigenicity
- can lead to loss of immunity or vaccine mismatch

Front 33

Talk about antigenic shift.

Back 33

- a random reassortment of at least two different viral gene segments
- achieved by co-infection of a single cell with these viruses
- how: viruses in bird feces gets into pigs drinking water; humans handle or cough on the pig = new virus

Front 34

10 great public health achievements

Back 34

1. vaccination
2. motor-vehicle safety
3. safer workplaces
4. control of infectious diseases
5. decline in deaths from coronary heart disease
6. safer and healthier foods
7. healthier mothers & babies
8. family planning
9. fluoridation of drinking water
10. recognition of tobacco as a health hazard

Front 35

Requirements of an effective vaccine (7)

Back 35

1. produce good humoral & cellular response
2. immune response is similar to natural infection
3. produce protection against clinical disease and reinfection
4. protection lasts several years
5. minimal side effects
6. simple administration
7. cost/benefits outweigh cost/risk of natural disease and risks of immunization

Front 36

Types of vaccines

Back 36

1. non-infectious
2. non-attenuated
3. carrier
4. DNA

Front 37

What is a non-infectious vaccine?

Back 37

whole or part of a pathogen that can't multiply, infect, or cause diseases

Front 38

Types of non-infectious vaccines (3)

Back 38

1. inactivated/killed (rabies, salk polio)
2. subunit (Hep A&B, influenza b)
3. toxoid (diphteria, tetanus, pertussis)

Front 39

Noninfectious vaccines: pros/cons

Back 39

Pros:
- makes memory cells for B and T-helper
- good antibody response

Cons:
- will not make memory killer T cells
- need booster vaccines

Front 40

Describe live attenuated vaccines & list examples

Back 40

- pathogen is weakened so that it cannot produce disease in healthy people (induced mutations)
- elicits a strong immune response
- pathogen grown in host cells
- infects without causing disease
- examples: MMR, sabin polio, varicella

Front 41

Live attenuated vaccines: pros/cons

Back 41

pros:
- makes all memory cells: b, helper t, killer t
- life long immunity

cons:
- can cause disease in immunocompromised host
- viral shedding

Front 42

Describe carrier vaccines & give 1 example

Back 42

Use virus or bacteria that does not cause disease to carry viral genes to APCs

example: smallpox

Front 43

Carrier vaccines:
pros/cons

Back 43

pros:
- makes all memory cells: b, t-helper, t-killer
- no danger of infection

cons:
- immuno-compromised individuals can get infected by the carrier
- pre-existing immunity to carrier might block effect
- may be difficult to engineer proper expression

Front 44

Describe DNA vaccines

Back 44

DNA injections can transduce cells to express and present antigens; can make from a few viral genes

Front 45

DNA vaccines:
pros/cons

Back 45

pros:
- makes memory b and t-killer cells
- no danger of infection

Front 46

Talk about herd immunity

Back 46

- 1 or 2 out of 20 ppl will not develop an adequate immune response
- vaccinated ppl are less likely to transmit pathogens
- 85 - 95% of the community must be vaccinated

Front 47

Overview process for testing vaccines

Back 47

1. Lab
2. Human trials
- phase i
- phase ii
- phase iii
3. Post-licensure surveillance

Front 48

Describe human trials: phase I

Back 48

- 20 ~ 100 healthy volunteers
- determine vaccine dosages and side effects

Front 49

Describe human trials: phase II

Back 49

- several hundred volunteers
- controlled study w/ placebo or existing vaccine
- determine effectiveness and safety

Front 50

Describe human trials: phase III

Back 50

- several hundred to thousands of volunteers
- double blind study

Front 51

Challenges for vaccine development: developed world

Back 51

- cost of development
- market size
- litigation costs

Front 52

Challenges for vaccine development: developing world

Back 52

- storage & transportation (UV, freeze watch)
- syringe use
- cost

Front 53

What 3 vaccines are still needed?

Back 53

HIV
Malaria
Tb