Vaccines, Chest X-Rays, and Scopes (Extras for Unit 2)

COVID vaccine

Artificially acquired active immunity

M-RNA vaccine

A coding strand of messenger RNA is introduced

Your ribosomes temporarily produce a specific associated with a virus 

Live attenuated vaccine

Weakened version of the whole virus is introduced

MMR, Varicella, Rotavirus

Inactivated vaccine

A “dead” version of the whole virus is introduced

Polio, Hep A, Rabies

Subunit vaccine

Only part of virus is introduced

Includes proteins like surface antigens, capsules, proteins, or internal proteins 

Injectable Flue, HPV, Hep B

Correlation 

Events are associated due to close proximity in place or time 

Causation 

One event causes another 

Vaccine side effects

Activate the immune system including the innate system

Innate immunity includes fever and inflammation 

Rarely allergic reactions 

Vaccine schedule

After 6 mon, natural passive immunity from mom begins to disappear 

Immune system is now developed enough to respond 

These illnesses have risk of death and permanent disabilities 

Vaccines in early childhood minimize traumatic memories 

Antimicrobial

Drugs that target microbes in general

Antifungals, antivirals, antibiotics 

Antibiotics

Drugs that target bacteria specifically 

Penicillin, ceftriaxone, azithromycin, metronidazole 

Probiotic

Reintroduces beneficial bacteria

Types of uses for antibiotics

Prophylactic

Empiric 

Definitive 

Prophylactic

Prevent infection

Usually with surgeries 

Empiric

Cover the most likely culprits

Based on type of infection 

Definitive

Treat exact bacteria

Culture and sensitivities 

Antibiotic resistance

Every use of antibiotics eliminates susceptible bacteria

Any that are resistant survive and reproduce 

Every generation, only the resistance increases 

A bacterial generation can be as short as a few minutes 

Gene transfer

In the case of bacteria, every division creates a new organism 

Horizontal transfer and vertical transfer

Bacteria can pass genes back and forth 

Horizontal transfer

Between two unrelated organisms

Vertical transfer

From parent offspring

Cost of resistance

Pharmaceutical companies spend billions to develop new drugs

Fewer new antibiotics are made, fewer remain effective

Antibiotic misuse

Prescribing when there is no bacterial infection

Quitting early from side effects or feel better

Large scale animal farming

Overuse of broad spectrum antibiotics

Black and white in x rays 

Air is black 

Liquids and solids tend to be white 

Remember ABCs when viewing x ray 

Airway

Bones

Cardiac

Diaphragm

Everything else 

Airway in x rays

Look for the trachea and primary bronchi 

Are they midline? 

Do you see more airway than that? 

Bone in x rays

How many ribs can you see?

Are the clavicles even? 

Can you see spinous process in the vertebrae? 

Are the scapulae in the way? 

Cardiac in x rays

Is the heart on correct side? Left

Is it the right size? About ½ inch or less the width of chest 

AP (Anterior posterior) vs. (Posterior anterior)

The direction of the x ray matters

The heart casts a larger “shadow” in the AP view 

PA is better for looking at lungs 

Diaphragm in x rays

Does it have sharp corners? 

Is it even? 

Everything else in x rays

Look at lungs themselves

Check for lesions 

Remember to look for the “second lesion” (the one you might miss) 

Pleural effusion

Fluid trapped around lungs

Pneumonia

Lung infection with inflammation

Pneumothorax

Collapsed lung

Tumor

Primary ones originate in lungs

Secondary or metastatic come from somewhere else 

What is a laryngoscopy

Imaging of the larynx by entering them

Purpose of laryngoscopy

Looking for obstruction, inflammation, and masses

Who performs a laryngoscopy

Anesthesiologist and ER physicians

What is a bronchoscopy

Imaging of the major bronchi by entering them

Who performs a bronchoscopy

Pulmonologists

Purpose of bronchoscopy

Looking for obstructions, inflammation, masses

Aspiration and foreign body removal 

What is an endoscopy

Imaging of esophagus and stomach

Who performs an endoscopy

Gastroenterologists

Purpose of endoscopy

Looking for obstructions, inflammation, masses

Esophageal strictures and gastric ulcers 

What is a colonoscopy

Imaging of the colon

Who performs a colonoscopy

GI doctors

Purpose of colonoscopy

Looking for obstructions, inflammation, masses

Polyps and inflammatory bowel disease