Immun/Infectious Flashcards
(40 cards)
1
Q
What 3 organizations issue an annual schedule of recommended vaccinations?
A
- CDC (center for dz control/prevention)
- AAP (american academy of peds committee)
- AAFP (american academy of family physicians)
2
Q
What are the 5 vaccine types?
A
- Live-attenuated
- Inactivated
- Viral particles
- Subunit vaccine
- Toxoid
(LIV To Serve)
3
Q
Which vaccine?
- Virus is alive, but weakened
- Virulence reduced
- What are 3 examples?
A
Live-attenuated
- MMR
- FluMist
- Varicella
4
Q
Which vaccine?
- Killed-viurs
- capsid proteins remain and are antigenic
A
Inactivated
5
Q
Which vaccine?
- small virus particles
- no viral DNA
A
Viral Particles
6
Q
Which vaccine?
- viral proteins only
A
Subunit
7
Q
Which vaccine?
- inactivated toxin stimulates antibody production
- What is an example?
A
Toxoid
- Tetanus vaccine
8
Q
2 contraindications of Live Virus vaccines
A
- Pregnancy
- Compromised immunity
9
Q
Contraindication for what type of reaction to vaccine / vaccine constituent?
A
- anaphylactic rxn to vaccine/constituent
10
Q
What is a contraindication for influenza vaccine?
A
- egg or chicken allergy
11
Q
- Vaccines are contraindicated if the patient has what type of illness regardless of ____.
- Which vaccine is the exception?
A
- moderate or severe illness / fever
- pneumococcal
12
Q
What is a common misconception people have about why they should not get a vaccine? (10 total)
(NOT a contraindication)
A
*Immunosuppression of household contact*
- mild illness
- low grade fever
- recent exposure to infectious dz
- mild-mod local rxn to previous vaccine
- current abx therapy
- breasfeeding
- prematurity
- malnutrition
- Fam hx of SIDS or seizures
13
Q
T/F
- Healthy patients who live in the same household as an immunocompromised patient CANNOT safely receive inactivated vaccines
A
False
- Can safely receive inactivated vaccine
14
Q
If the immunocompromised patient is __ months or older, the household members may receive which vaccine if needed?
A
- 6 months
- live attenuated influenza vaccine
15
Q
A household member of an immunocompromised pt 6 months or older, may receive the live attenuated influenza vaccine unless the immunocompromised pt received what treatment in the past 2 months, has which disease, or has which comorbidity?
A
- Tx: hematopoietic stem cell transplant
- Dz: graft vs. host disease
- Comorbidity: Severe Combined Immunodeficiency
16
Q
- A live vaccine should not be administered to household members if the 6 month old immunocompromised pt received a hematopoeitic stem cell transplant in the past 2 months, has a graft vs. host dz, or has severe combined immunodeficiency (SCID)
- HOWEVER, if the household member receives the live vaccine, contact between the 6 month old and member should be avoided for how many days?
A
7 days
17
Q
- What leads to an impaired immune response when giving live-virus vaccines?
- How do we prevent this?
A
When live virus vaccines are NOT given silmutaneously
- Live virus vaccines NOT administered on the same day should be given at least 28 days apart
18
Q
- Who should you report adverse reactions of vaccines to?
- What resource should you utilize for regional recommendations on vaccines?
A
- Report rxns: CDC/local health department
- Recommendations: local health department
19
Q
**What are the 3 things you should FOR SURE know about each vaccine?**
A
- When 1st dose should be given
- When last dose is given
- CONTRAINDICATIONS
20
Q
What resource should you use for immunization schedules?
A
CDC
- catch up schedule
- minimum intervals
- contraindications
21
Q
At what age should a patient receive MMR?
(1st and 2nd dose)
(measles, mumps, rubella)
A
- 1st: 12-15 months
- 2nd: 4-6 years
22
Q
MCV4 (Meningococcal Conjugate Vaccine)
- 1st dose at what age?
- Booster at what age?
- High risk in what age range?
A
- 1st: 11-12 yrs
- Booster: 16 yrs
- High risk: 2-10 yrs
23
Q
- MCV4 is preferable to what vaccine?
- Because of what 3 circumstances?
A
- MPSV4
- asplenia
- complement deficiency
- travel/reside where meningococcal disease is epidemic
24
Q
Which group of patients should be vaccinated with MCV4 if they did not receive vaccine at 11 yrs or booster at 16 yrs?
A
All college freshman living in dorms
25
3 contraindications to MCV4 (Menactra or Menveo)
* Latex allergy
* Hx of life threatening allergic rxn to diphtheria toxoid
* Prev hx of Guillain-Barre Syndrome (GBS)
26
**Live-attenuated Influenza Vaccine (FluMist)**
* Route?
* Quadrivalent
* For _HEALTHY_ people of age __ yrs - ___ yrs old
* Studies show moderate evidence that the Live Attenuated Influenza Vaccine has created a better response than _what vaccine_ in children aged __ - __ yrs old (but DO NOT wait if this vaccine is not available)
* Intranasal
* 2 - 49 yrs
* Inactivated Vaccine
* 2 - 8
27
6 contraindications to Live-attenuated Influenza Vaccine (FluMist)
1. Severe **a**llergic rxns to LAIV/components of vaccine/other influenza vaccines
2. Children 2 - 17 yrs receiving **A**SA containing products
3. Children 2 - 4 yrs w/ **a**sthma or whzing past in the past 12 months
4. Persons allergic to **e**ggs
5. **P**regnant women
6. **I**mmunosuppressed persons
7. Persons who have taken influenza **a**ntiviral meds in the past 48 hours
"AAAA PIE"
28
**Which vaccine?**
* High risk children \<2 y/o (includes premature infants w/ additional RFs)
* Montly injections during RSV season
* Very expensive $$$
* Requires prior authorization
Synagis (RSV immunoprophylaxis)
NOT A VACCINE
29
What are the 6 **normal** SE of vaccinations?
* Fussiness (\<3 hr, consolable)
* Tiredness
* Low grade fevers (\<101.5F)
* Pain at site of injection
* Redness at site of injection
* Swelling at site of injection
(Pain, redness, swelling **F**or **T**ired **L**ittle ones)
30
5 **abnormal** reactions for vaccinations
* **Inconsolable crying for \>3 hr**
* **High fever \>104-105F**
* **Seizure**
* **Neurological abnormalities**
* **\*\*\*\*Anaphylactic reaction\*\*\*\***
* Facial/oral swelling, dyspnea
* *\*Always a subsequent contraindication\**
(SHANI)
31
6 Pediatric Infectious Diseases on this test
* Erythema subitum (Roseola)
* Erythema infectiosum (Fifth’s disease, Parvo B19)
* Pinworms
* Oral candidiasis (thrush)
* Molluscum contagiosum
* Meningitis (viral, bacterial)
32
**Roseola Infantum**
* Another name for this?
* Benign viral infection caused by which 2 Human Herpes Virus? (HHV)
* Common in ages __ - \_\_\_
* Erythema subitum
* HHV 6 or 7
* 6 months - 3 years
33
Describe clinical presentation of Roseola infantum (erythema subitum)
(4 stages)
1. Abrupt HIGH fever for 3-7 days (104ish)
2. Abrupt cessation of fever
3. Rosy-pink maculopapular rash (trunk --\> head & extremities) (non-pruritic, blanching)
4. Rash resolves in 1-2 days
34
Besides the fever and rash, what other sxs may be present with Roseola?
* Adenopathy (neck)
* Minimal URI sxs (TM injection, congestion)
35
Treatment for Roseola infantum (erythema subitum)
* fever control
* fluids
36
Diagnosis?
Roseola infantum (erythema subitum)
* nonpruritic
* blanching
* rosy-pink maculopapular
* Starts on trunk/neck --\> spreads to extremities
37
**Erythema Infectiosum**
* another name for this?
* Etiology?
* Kids ages __ - \_\_
* Fifth's disease
* Human Parvovirus B-19 (we slap 19 yr olds)
* 5 - 15
38
**Erythema Infectiosum (Fifth's disease)**
* 4 initial sxs?
* 2 - 5 days later develop what sxs?
* Treatment?
* **4 Initial sxs:**
* Mild - mod fever
* HA
* Nausea
* Diarrhea
* **2-5 days later...**
* "slapped cheeks" w/ circumoral pallor
* Lace-like rash (trunk/limbs) follows slap cheek
* **Tx:** supportive
39
Diagnosis?
**Erythema Infectiosum (Fifth's Disease)**
* "slapped cheek" & circumoral pallor
* Parvo B19
* This rash occurs 2-5 days after fever/HA/N/D
* Kids 5 - 15 y/o
40
Diagnosis?
**Erythema Infectiosum (Fifth's disease)**
* lace like rash on trunk/limbs (after slap cheek)
* Reticular pattern
* 2-5 days after initial sxs: F/HA/N/D
