Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Infection > immunisation and prophylaxis > Flashcards

immunisation and prophylaxis Flashcards

1
Q

5 in 1 vaccine

A 
D-purified diphtheria toxoid
T- purified tetanus toxoid
aP = purified boardetella pertussis
IPV= inactivated polio virus
Hib= purified
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

UK childhood immunisation schedule

A

2 months,3 months 4 months: 5in 1 vaccine+ pneumococcal conjugate +men B

  • 1 year: Hib/Men C+ MMR + pneumococcal conjugate + men B
  • 2, 3 and 4 years: influenza
  • 3 - 5 years: 4-in-1 booster (DTaP/IPV) + MMR
  • Girls, 12-13 yrs: Human papilloma virus
  • 14 years: 3-in-1 booster (dT/IPV) + Men ACWY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

influenza vaccine

A 
•	Indications: 
o	o	Age >65 years
o	Nursing home residents
o	Some health care workers
o	Immunodeficiency 
o	Immunosuppression
o	Asplenia/hyposplenism
o	Chronic liver disease 
o	Chronic renal disease
o	Chronic cardiac disease
o	Chronic lung disease
o	Diabetes mellitus 
o	Coeliac disease
o	Pregnant women
o	Heath care workers
•
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

pneumococcal vaccine

A

o Part of childhood immunisation schedule

o 3 doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hep B

A

Hep B vaccination:
• Children at high risk of exposure to HBV, and babies born to infected mothers
• Health care workers, PWID, MSM, prisoners, ch. liver disease, ch. kidney disease,
• Given at 0, 1 month,2 months and 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

varicella zoster

A

suppresed immune system
• Health case workers (if sero-neg and in contact with patients)
• Live attenuated virus
• 2 doses, 4-8 weeks apart
Adults who get chicken pox tend to develop pneumonitis which can be fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

herpes zoster vaccine

A

all elderly patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

passive immunisation

A

• Human normal immunoglobulin
o contains antibodies against hepatitis A, rubella, measles
o used in immunoglobulin deficiencies
o treatment of some autoimmune disorders, e.g. myasthenia gravis
• Disease specific immunoglobulin
o hepatitis B Ig
o rabies Ig
o tetanus anti-toxin Ig
o varicella (chickenpox) Ig – can be used in pregnant women to provide instant protection
o diphtheria anti-toxin Ig (horse)
o botulinum anti-toxin Ig

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

common immunisations for travellers

A

tetanus polio tyhphoid hepatitis A yellow fever cholera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

antimicrobial prophylaxis

A

o Chemoprophylaxis against Malaria
o Post-exposure prophylaxis
♣ e.g. ciprofloxacin for meningococcal disease
o HIV post-exposure prophylaxis
♣ “needle stick” (PEP), sexual intercourse (PEPSI)
Surgical antibiotic prophylaxis – perioperative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

UK guidelines for malaria

A 
Awareness of risk
Bite prevention
Chemoprophylaxis
o	Malarone ® (atovaquone & proquanil) daily
o	doxycycline daily
♣	Not for children <12 years
♣	photosensivity
o	mefloquine weekly
♣	Side effects: psychosis, nightmares (1:10,000)
♣	Avoid if history of psychosis, epilepsy 
o	chloroquine weekly + proquanil daily
♣	For vivax/ovale/malariae only 
o	Choice depends on country. 
•	Diagnosis and treatment
•	Advice on return:
Any illness occurring within 1 year and especially within 3 months of return might be malaria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

symptoms of malaria

A 
o	fever
o	rigors
o	aching bones
o	abdo pain
o	headache
o	dysuria
o	sore throat
o	cough
o	hepatomegaly
o	Splenomegaly
o	Mild jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

complications

A 
cerebral malaria
o	Blackwater fever
severe intravascular haemolysis, high parasitaemia, profound anaemia, haemoglobinuria (black urine), acute renal failure (or pH < 7.3)
o	Pulmonary oedema or ARDS
o	Jaundice
o	Severe anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

diagnosis

A 
high clinical suspicion
thick &amp; thin blood films- giemsa, field's stain
quantitative buffy coat
-centrifugation, UV microscopy
rapid antigen tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

treatment

A

o Uncomplicated P. falciparum malaria
♣ Riamet ® (artemether-lumefantrine) 3 days
• First line
♣ Eurartesim ® (dihydroartemisinin-piperaquine) 3 days
♣ Malarone ® (atovaquone-proguanil) 3 days
♣ Quinine 7 days (plus oral doxycycline or clindamycin)
• S/E nausea, tinnitus, deafness (cinchonism), rash, hypoglycaemia
Quinine is generally difficult to tolerate

o Severe or complicated P. falciparum malaria
♣ IV artesunate (unlicensed in UK)
♣ IV quinine (plus oral doxycycline or clindamycin)
• (S/E cardiac depression, cerebral irritation, N&V)
♣ When patient is stable & able to swallow, switch to oral treatments

o Treatment of P. vivax, P. ovale, P. malariae, P. knowlesi
♣ chloroquine 3 days
♣ Riamet ® (artemether-lumefantrine) 3 days
♣ Add primaquine (14 days) in vivax and ovale, to eradicate liver hypnozoites
• Prevent recurrence by latent malaria in liver
• Check for G6PD deficiency
G6PD deficiency leads to haemolysis in patients whenever they are exposed to oxidative stress in the form of drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

typhoid (enteric)

A

• Caused by: Salmonella typhi, salmonella paratyphi
o poor sanitation, unclean drinking water
• Clinical features:
o Incubation period: 7 days - 4 week
o 1st week:
♣ fever, headache, abdo. discomfort, constipation, dry cough, relative bradycardia, neutrophilia, confusion
o 2nd week:
♣ fever peaks at 7-10 days, Rose spots, diarrhoea begins, tachycardia, neutropenia
o 3rd week (Complications):
♣ intestinal bleeding, perforation, peritonism, metastatic infections
o 4th week (Recovery):
♣ 10 - 15% relapse

17
Q

Diagnoses

A

clinical: evolution of features
lab tests: blood culture, urine, stool
bone marrow culture

18
Q

treatment

A

o Oral Azithromycin
♣ now drug of choice for Asian-acquired, uncomplicated enteric fever
o IV Ceftriaxone
if complicated

19
Q

Dengue fever

A 
•	Classic dengue fever symptoms
o	Sudden fever
o	Severe headache, retro-orbital pain
o	Severe myalgia and arthralgia
o	Macular/ maculopapular rash
o	Haemorrhagic signs: petechiae, purpura, positive tourniquet test (due to fragile skin and vessels)
20
Q

diagnosis

A 
clinical
♣	Thrombocytopenia
♣	Leucopenia
♣	Elevated transaminases
♣	Positive tourniquet test
o	Laboratory: 
♣	PCR, serology
21
Q

Management

A

no specific therapeutic agents

22
Q

shistosomiasis

A

spread via fresh water snails
• Clinical features:
o Swimmers Itch (1st few hrs)
♣ clears 24-48hrs
o Invasive stage (after 24hrs)
♣ cough, abdo discomfort, splenomegaly, eosinophilia
o Katayama Fever (after 15-20 days)
♣ prostrate, fever, urticaria, lymphadenopathy, splenomegaly, diarrhoea, eosinophilia
o Acute disease (6-8 weeks)
♣ eggs deposited in bowel (dysentery) or bladder (haematuria)
Chronic disease

23
Q

diagnosis

A

o Clinical diagnosis
o Antibody tests
♣ It usually takes 4-8 weeks for seroconversion to occur, although it can be up to 22 weeks and serology remains positive for two years after eradication. (not useful to differentiate past illness)
o Microscopy for ova in stools and urine
o Rectal snip - When it is necessary to obtain a rapid diagnosis of schistosomiasis, or if screening tests have been inconclusive.

24
Q

treatment

A

o PRAZIQUANTEL

o Prednisolone if severe

25
Q

rickettsiosis

A 
group of dieases species of Rickettsia
classified into two main groups: 
1.	the spotted fever group, transmitted by ticks or mites 
2.	typhus group, mainly transmitted by lice or fleas. 
Examples:
•	Tick typhus (R. conorii, R. africae)
o	Maculopapular rash 
o	Commonest, imported to UK 
•	Rocky Mountain Spotted Fever (R. rickettsii)
•	Epidemic typhus (R. prowazekii)
o	Vector: lice 
o	Mortality up to 40%
26
Q

clinical features

A

abrupt onset of swinging fever, headache, confusion,endovasculitis, rash (macular, petechial)

27
Q

diagnosis and management

A 
•	Diagnosis: 
o	Clinical diagnosis &amp; response to treatment 
o	Serology or PCR 
•	Management: 
o	Tetracycline or doxycycline
28
Q

Viral haemorrhagic fevers

A 
•	Serious infections (but rare in UK): 
o	Ebola 
o	Congo-Crimea haemorrhagic fever 
o	Lassa fever
o	Marburg disease
•	Maximum incubation period 3 weeks
•	Isolation: High Security Infection Unit
Treatment: supportive
29
Q

Zika

A

• sexual contact, blood transfusion
• Related to dengue, yellow fever, Jap B encephalitis and West Nile viruses
• Clinical features:
o None or mild symptoms - headache, rash, fever, malaise, conjunctivitis, joint pains (like dengue)
o In pregnancy, can cause microcephaly and other neurological problems
o Can cause Guillain-Barre syndrome

30
Q

Approach to returning traveler

A 
History:
is it tropical
travel history
precautions taken
risks
symptoms
incubation period

examination
rash-typhoid, tyhus, dengue
jaundice- hepatitis, malaria, yellow fever
lymph nodes-leishmania, schistosomiasis, trypanosomiasis
liver- malaria, typhoid, amoebic abscess
spleen- visceral leishmaniasis, typhoid, malaria

31
Q

Investigation

A 
•	FBC
•	malaria films
•	liver function tests
•	stool microscopy &amp; culture
•	urine analysis &amp; culture
•	blood culture(s)
•	CXR
•	Special tests as indicated 
o	dengue
o	respiratory viral/atypical
o	hepatitis A, B, C
o	tick typhus (Rickettsia)
o	schistosomiasis
o	amoebic
o	leptospirosis/hantavirus
o	viral haemorrhagic fevers
Treatment
•	Isolation
o	personal protective equipment
•	Supportive measures (resuscitation)
•	Empirical treatment if patient unwell 
o	Antimicrobial therapy based on likely diagnosis
o	aim to treat life-threatening conditions		
e.g. typhoid, septicaemia 
Specific treatment once diagnosis

Infection (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions