Recently, the number of cases of whooping cough pertussis has been increasing in the adult populatio

1
Recently, the number of cases of whooping cough
(pertussis) has been increasing in the adult
population. This disease was always considered
an infant disease and a very effective vaccine
was developed to establish immunity against this
bacterial infection. It is part of the DPT
combined vaccine that is recommended for infants
and young children. So, WHY is this disease now
becoming a problem in the ADULT population? Any
suggestions?

• A. bacteria has changed its antigens
• B. the vaccine lacked the P part
• C. persons immune system has changed
• D. 20-year immunity and we now have a
  non-protected population
• E. should be considering a booster shot as an
  adult

2
About one in four teen girls last year got the
groundbreaking vaccine that prevents cervical
cancer, federal health officials reported
Thursday. How could this vaccination rate be
significantly increased? Any suggestions?

• A. require that cost is NOT an issue (insurance
• B. primary care health professionals encourage
  immunization
• C. make vaccination easier
• D. legally required for entrance into the public
  school system
• E. make is safe and effective for young children

3
Which ONE letter below best describes the
reason(s) why the innate immune respsonse may not
be effective against some bacterial and viral
infections?

• A. No PAMPS expressed by bacteria or PAMPS masked
  by bacterial capsules
• B. complement not activated by bacteria (or
  viruses)
• C. if virus-infected cells are expressing MHCs
  (KIR inhibits NK cell-mediated destruction)
• D. phagocytosis may not be fully successful
  (endocytosis occurs, but not complete degradation
  of of all endocytosed bacteria)
• E. all of the above

4
Which ONE letter best describes bacterial
virulence factors against which the innate or
adaptive immune systems may prove successful in
providing some protection from harm due directly
or indirectly to that (those) virulence factor(s)?

• A. adherence mechanisms
• B. capsules that interfere with phagocytosis
• C. secreted protein exotoxins
• D. very rapid bacterial cell replication that
  exceeds the ability of innate response to destroy
  all of those cells in time to prevent harm
• E. all of the above

5
Which ONE letter below suggest(s) a type of
adaptive immune response that may be able to
provide protection when the innate immune
response may not be effective?

• A. No PAMPS expressed by bacteria or PAMPS masked
  by bacterial capsules opsonization by
  antibodies
• B. complement not activated by bacteria (or
  viruses) complement activation by antibodies
• C. if virus-infected cells are expressing MHCs
  (KIR inhibits NK cell-mediated destruction)
  ADCC (antibody dependent cellular cytotoxicity)
• D. phagocytosis may not be fully successful
  (endocytosis occurs, but not complete degradation
  of of all endocytosed bacteria) enhancement of
  phagocytosis by T-helper 1 cell cytokines
• E. all of the above

6
Repeated attempts to design and then introduce an
FDA-approved vaccine for which one of the
following infectious diseases have been
frustrated because the important epitopes of the
pathogen that exist(ed) when the vaccine was
initially being developed may have completely
changed in the time needed to develop, test and
have approved this vaccine

• A. whooping cough (pertussis)
• B. yellow fever
• C. polio
• D. HIV/AIDS
• E. rabies

7
An ideal vaccine would provide initiate a
lifetime protection against a pathogen. However,
some vaccines are deliberately designed to
provide only short-term protection and, thus, are
safer than the riskier lifetime vaccines. This
is especially true if the protection need not
last any longer than a few months while the
pathogen is circulating among a population. An
example of a vaccine that is designed to provide
only a few months protection from virus infection
is which one of the following?

• A. measles (assume the vaccine has been made
  properly)
• B. injected flu vaccine
• C. the flumist (inhaled) flu vaccine
• D. the tetanus toxoid vaccine
• E. None of the above (ALL have been shown to
  provide a lifetime protection from virus-induced
  diseases)

8
Until quite recently, a risky vaccine was NOT
recommended for anyone younger than 2 years of
age to minimize the possibility of harm.
However, considerable clinical data have now
shown that this vaccine is, indeed, safe for
infants as young as 6 months. This vaccine is
intended to initiate a lifetime immunity against
a virus infection that rarely causes problems in
adults, but can be quite serious in young infants
or persons who are elderly. This vaccine is

• A. DPT
• B. flumist
• C. MMR
• D. trivalent polio
• E. rabies

9
Which one of the following is considered an
advantage of the Sabin attenuated (weakened)
polio vaccine when compared to the Salk
(inactivated) polio vaccine?

• A. the Salk vaccine should provide a lifetime
  protection, while the Sabin vaccine may only
  provide a limited (albeit several years)
  protection
• B. the route of immunization places the Sabin
  vaccine directly at the site where the pathogenic
  polio virus will likely enter the body, thus
  establishing a local (mucosal) immunity to
  prevent the pathogen from even entering the body
• C. the Salk vaccine is made by multiple passages
  through cultured mammalian cells and, thus, is
  more likely to be able to infect human cells
• D. only the Sabin vaccine is highly recommended
  for use in young infants

10
One of the following has been such a highly
successful vaccine that its use was deliberately
discontinued about 25 years ago because it was
felt the risk from the vaccine actually exceeded
the very low chance of getting the disease
itself. Unfortunately, this has resulted in a
rather large segment of the population now being
susceptible to this quite serious infectious
viral disease, should the virus ever reenter the
human population (e.g., as bioterrorism)

• A. anthrax
• B. hepatitis A
• C. smallpox
• D. sabin polio (discontinued because of the
  hazardous nature of this live virus vaccine)

11
Although considered almost harmless for an adult
woman, one of the following viral diseases may
cause very serious harm to a fetus, especially
during the first trimester. Thus, women who are
pregnant or may become pregnant within a few
weeks are strongly encouraged to NOT get the
vaccine for this disease (either as a single
vaccine or as part of a multiple vaccine). The
reason given is that the form of the vaccine
(attenuated), while not harmful to an adult, may
cause very serious consequences if the weakened
virus reaches the fetus. This vaccine is
intended to provide protection against which one
of the following diseases?

• A. whooping cough (part of the DPT vaccine)
• B. Sabin polio (part of the trivalent polio
  vaccine)
• C. rubella (part of the MMR vaccine)
• D. tuberculosis (often called the BCG vaccine)

12
Several vaccines now use recombinant gene
technology to add a desired nucleotide sequence
an existing, approved viral vaccine. This
recombinant/conjugate virus is then injected into
the patient. The additional nucleotide sequence
will (hopefully) generate proteins in the
cytoplasm which will then be processed by the
usual MHC Class I pathway and presented by that
cell. The result would be an expansion of
T-cytotoxic cells specific for the desired
epitope(s). This expanded cell population is
then ready to respond with a classical
secondary response when the pathogen (which has
the desired epitope) first enters the body. The
existing viral vaccine MOST commonly used for
this vaccine design is which one of the following?

• A. smallpox
• B. sabin polio
• C. any one of the vaccines in the MMR combination
  vaccine
• D. attenuated flu vaccine (flumist)

13
Although FDA-approved vaccines should be safe,
this is never a 100 guarantee. For example, one
attenuated virus vaccine that had been used for
over four decades and even recommended for use in
young infants is, as of about 2000, no longer
recommended or used for that population. This
change in vaccine use was probably in response to
public pressure that may have resulted from news
reports that this vaccine may have actually
caused the very disease it was intended to
protect from (the reports originated in Africa).
Although these reports have been difficult to
confirm with sound data, the result remains the
same the vaccine is no longer used. This
vaccine is which one of the following?

• A. salk polio
• B. sabin polio
• C. rubella
• D. HIV

14
This XXX vaccination season brings several new
things for Rochester-area parents to know.For
the first time, the XXX vaccine is recommended
for school-age children, not just their younger
siblings. The federal guidelines now include all
children ages 6 months to age 18. XXXXX a
needle-free XXX vaccine given by a squirt in each
nostril is now typically being covered by the
health insurance plans that cover other vaccines.
XXX is approved for healthy people ages 2 to 49.
Pregnant women and people with certain chronic
conditions are not eligible for the nasal spray
XXX vaccine.The very young infants and
toddlers and the very old are most at risk of
serious effects from the XXXXXX vaccine is
considered effective, although the protection
rate varies each year. Even when the vaccine
isn't a good match to a season's XXX strains as
happened last year the vaccine helps some avoid
getting sick or makes the illness much milder.
15
The vaccines discusses in these news quotes is
intended to provide protection from which one of
the following diseases?

• A. meningitis
• B. flu (influenza)
• C. measles
• D. hepatitis A