Newborn 2 months 4 months 6 months 12 months 15 months 2 years 4-6 years 11-12 years Hep B #1 Hep B #2 Hep B #3 DTaP DTaP DTaP DTaP DTaP PPV PPV PPV HiB HiB HiB HiB Polio #1 Polio #2 Polio #3 Polio #4 Rota Rota VCZ MMR MMR HAV Meningitis Introduction Immunization allows for individuals to be protected against disease Immunity can be conferred in two ways including active immunity that is maintained by the immune system passive immunity that is given transiently from outside Vaccinations are a major source of conferring immunity outside normal infection and include viral vaccines divided into killed vaccines live attenuated vaccines bacterial vaccines Often vaccinations require an adjuvent that enhances the immune reaction against the vaccine provided increases the development of memory to non inflammatory antigens can be of several types including aluminum potassium sulfate muramyl dipeptide LPS/polyribonucleotides Though vaccines are generally safe, contraindications to their use include people with egg allergies who should avoid yellow fever vaccine and other vaccines made in eggs pregnant women who should avoid rubella vaccines immunocompromised individuals who should avoid all live vaccines Active vs Passive Immunity Immunity can be either active or passive with several notable differences Differences Between Active and Passive Immunity Feature Passive Active Acquisition method Receiving preformed antibodies Exposure to infection or to foreign antigens Examples Maternal IgG crossing placenta Babies getting IgA in breast milk Administration of antitoxin Infection with the specific pathogen Administration of a vaccine Onset Immediate upon administration Slow to allow for development of full immune response Duration Very short with a half life between two weeks and four weeks Long or even lifetime Due to generation of memory Viral Vaccines Viral vaccines can either be live attenuated or killed with several notable differences Differences Between Live and Killed Vaccines Feature Live Killed Production method Design a nonpathogenic version of a virus that can still grow transiently in the host Inactive pathogen or pathogen antigens by treatment with heat or chemicals Pros Induce both cellular and humoral responses induces lifelong immunity (usually) Safer than live vaccines because they cannot revert to pathogenic state Cons Cannot give to immunocompromised patients Small chance of reverting to pathogenic state Weaker response (usually only humoral) May require booster shots Examples Everything else MMR VZV Polio (Sabin) Etc Rest In Peace Always Rabies Influenza Polio (Salk) Hepatitis A Bacterial Vaccination Bacterial vaccination involves administration of characteristic protein which can be inactivated toxin produced by pathogen called a toxoid coat protein that surrounds the pathogen called a capsule other important proteins that are conserved by the pathogen Select examples of vaccines against pathogenic bacteria include DTaP that is composed of C. diptheriae toxoid C. tetani toxoid B. pertussis toxoid H. influenzae capsular type B S. pneumoniae that comes in two forms including a pediatric version with 7 capsule types think: a 7 year old gets PCV an adult version with 23 capsular types N. meningitidis with 4 capsular proteins
QUESTIONS 1 of 1 1 Previous Next Lab Values Blood Hematologic Cerebrospinal Sweat, Urine, and BMI Blood, Plasma, Serum Reference Range ALT 8-20 U/L Amylase, serum 25-125 U/L AST 8-20 U/L Bilirubin, serum (adult) Total // Direct 0.1-1.0 mg/dL // 0.0-0.3 mg/dL Calcium, serum (Ca2+) 8.4-10.2 mg/dL Cholesterol, serum Rec: < 200 mg/dL Cortisol, serum 0800 h: 5-23 μg/dL //1600 h: 3-15 μg/dL 2000 h: ≤ 50% of 0800 h Creatine kinase, serum Male: 25-90 U/LFemale: 10-70 U/L Creatinine, serum 0.6-1.2 mg/dL Electrolytes, serum Sodium (Na+) 136-145 mEq/L Chloride (Cl-) 95-105 mEq/L Potassium (K+) 3.5-5.0 mEq/L Bicarbonate (HCO3-) 22-28 mEq/L Magnesium (Mg2+) 1.5-2.0 mEq/L Estriol, total, serum (in pregnancy) 24-28 wks // 32-36 wks 30-170 ng/mL // 60-280 ng/mL 28-32 wk // 36-40 wks 40-220 ng/mL // 80-350 ng/mL Ferritin, serum Male: 15-200 ng/mLFemale: 12-150 ng/mL Follicle-stimulating hormone, serum/plasma Male: 4-25 mIU/mL Female: premenopause: 4-30 mIU/mL midcycle peak: 10-90 mIU/mL postmenopause: 40-250 pH 7.35-7.45 PCO2 33-45 mmHg PO2 75-105 mmHg Glucose, serum Fasting: 70-110 mg/dL2-h postprandial:<120 mg/dL Growth hormone - arginine stimulation Fasting: <5 ng/mLProvocative stimuli: > 7ng/mL Immunoglobulins, serum IgA 76-390 mg/dL IgE 0-380 IU/mL IgG 650-1500 mg/dL IgM 40-345 mg/dL Iron 50-170 μg/dL Lactate dehydrogenase, serum 45-90 U/L Luteinizing hormone, serum/plasma Male: 6-23 mIU/mL Female: follicular phase: 5-30 mIU/mL midcycle: 75-150 mIU/mL postmenopause 30-200 mIU/mL Osmolality, serum 275-295 mOsmol/kd H2O Parathyroid hormone, serume, N-terminal 230-630 pg/mL Phosphatase (alkaline), serum (p-NPP at 30° C) 20-70 U/L Phosphorus (inorganic), serum 3.0-4.5 mg/dL Prolactin, serum (hPRL) < 20 ng/mL Proteins, serum Total (recumbent) 6.0-7.8 g/dL Albumin 3.5-5.5 g/dL Globulin 2.3-3.5 g/dL Thyroid-stimulating hormone, serum or plasma .5-5.0 μU/mL Thyroidal iodine (123I) uptake 8%-30% of administered dose/24h Thyroxine (T4), serum 5-12 μg/dL Triglycerides, serum 35-160 mg/dL Triiodothyronine (T3), serum (RIA) 115-190 ng/dL Triiodothyronine (T3) resin uptake 25%-35% Urea nitrogen, serum 7-18 mg/dL Uric acid, serum 3.0-8.2 mg/dL Hematologic Reference Range Bleeding time 2-7 minutes Erythrocyte count Male: 4.3-5.9 million/mm3Female: 3.5-5.5 million mm3 Erythrocyte sedimentation rate (Westergren) Male: 0-15 mm/hFemale: 0-20 mm/h Hematocrit Male: 41%-53%Female: 36%-46% Hemoglobin A1c ≤ 6 % Hemoglobin, blood Male: 13.5-17.5 g/dLFemale: 12.0-16.0 g/dL Hemoglobin, plasma 1-4 mg/dL Leukocyte count and differential Leukocyte count 4,500-11,000/mm3 Segmented neutrophils 54%-62% Bands 3%-5% Eosinophils 1%-3% Basophils 0%-0.75% Lymphocytes 25%-33% Monocytes 3%-7% Mean corpuscular hemoglobin 25.4-34.6 pg/cell Mean corpuscular hemoglobin concentration 31%-36% Hb/cell Mean corpuscular volume 80-100 μm3 Partial thromboplastin time (activated) 25-40 seconds Platelet count 150,000-400,000/mm3 Prothrombin time 11-15 seconds Reticulocyte count 0.5%-1.5% of red cells Thrombin time < 2 seconds deviation from control Volume Plasma Male: 25-43 mL/kgFemale: 28-45 mL/kg Red cell Male: 20-36 mL/kgFemale: 19-31 mL/kg Cerebrospinal Fluid Reference Range Cell count 0-5/mm3 Chloride 118-132 mEq/L Gamma globulin 3%-12% total proteins Glucose 40-70 mg/dL Pressure 70-180 mm H2O Proteins, total < 40 mg/dL Sweat Reference Range Chloride 0-35 mmol/L Urine Calcium 100-300 mg/24 h Chloride Varies with intake Creatinine clearance Male: 97-137 mL/minFemale: 88-128 mL/min Estriol, total (in pregnancy) 30 wks 6-18 mg/24 h 35 wks 9-28 mg/24 h 40 wks 13-42 mg/24 h 17-Hydroxycorticosteroids Male: 3.0-10.0 mg/24 hFemale: 2.0-8.0 mg/24 h 17-Ketosteroids, total Male: 8-20 mg/24 hFemale: 6-15 mg/24 h Osmolality 50-1400 mOsmol/kg H2O Oxalate 8-40 μg/mL Potassium Varies with diet Proteins, total < 150 mg/24 h Sodium Varies with diet Uric acid Varies with diet Body Mass Index (BMI) Adult: 19-25 kg/m2 Calculator ( ) xy AC 7 8 9 ÷ 4 5 6 × 1 2 3 - 0 . = + (M1.MC.74) Two patients are vaccinated for poliomyelitis. Patient A receives the Sabin oral vaccine, and Patient B receives the Salk intramuscular vaccine. Six weeks after their initial vaccinations, which of the following would be the greatest difference regarding these two patients? Review Topic QID: 106656 1 Patient A has a higher level of duodenal IgA antibodies 64% (128/200) 2 Patient B has a higher level of duodenal IgA antibodies 6% (11/200) 3 Patient A has a lower level of serum IgA antibodies 5% (10/200) 4 Patient B has a lower level of serum IgM antibodies 8% (15/200) 5 Patient A has a higher level of serum IgG antibodies 17% (34/200) M1 Select Answer to see Preferred Response PREFERRED RESPONSE 1