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Infection > Immunisation > Flashcards

Immunisation Flashcards

1
Q

Who gets immunisation?

A
  • Childhood schedule
  • Special patient groups
  • Occupational
  • Travelers
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2
Q

Who gets prophylaxis?

A
  • Travelers
  • Post-exposure
  • Post-exposure (HIV)
  • Surgical
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3
Q

What are the two forms of immunity?

A

Adaptive and innate

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4
Q

What are the two forms of adaptive immunity?

A

Natural and artificial

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5
Q

What are the passive and active forms of natural and artifical immunity?

A
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6
Q

How did edward jenner discover the smallpox vaccination?

A

He noticed that people who suffered mild disease of cowpox never contracted smallpox

Inserted pus from a cowpox pustule into a boys arm

He proved that the boy having been inoculated with cowpox was now immune to small pox

(1798)

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7
Q

Where can you find out information about vaccinations?

A

Green book

BNF

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8
Q

What are the different types of vaccines?

A
  • live attenuated
  • inactivated (killed)
  • detoxified exotoxin
  • subunit of micro-organism

–purified microbial products

–recombinant

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9
Q

Give examples of live attenuated vaccines

A

MMR

BCG

Varicella-zoster virus

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10
Q

What are examples of inactivated (killed) vaccines

A

Polio

Hep A

Cholera

Rabies

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11
Q

Give exmamples of detoxified exotoxin vaccines

A

Diptheria

Tetanus

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12
Q

Give examples of subunit vaccines

A

Pertussis

Hamophilus infulenzae type b

Typhoid

Pneumococcus

Hep B

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13
Q

How is the recombinant hep B vaccine made?

A

The DNA segment coding for HBsAg is removed purified and mixed with plasmids

The plasmids are inserted into yeasts

Yeasts are fermeted

HBsAg is produced

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14
Q

What is the primary antibody response to infection?

A

Increase in total Ab

Early increase in IgM

Later increase in IgG

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15
Q

How does dosing differ between killed vaccine and live vaccine?

A

Killed vaccine requires multiple doses

Live vaccine - 1 dose

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16
Q

What is within the infranrix hexa vaccine?

A
  • D = purified diphtheria toxoid
  • T = purified tetanus toxoid
  • aP = purified Bordetella pertussis
  • IPV= inactivated polio virus
  • Hib= purified component of Haemophilus influenzae b
  • HBV= hepatitis B rDNA
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17
Q

What is the UK childhood immunisation schedule?

A
  • 2 months: 6-in-1 vaccine + pneumococcal conjugate + rotavirus + Men B
  • 3 months: 6-in-1 vaccine + rotavirus
  • 4 months: 6-in-1 vaccine + pneumococcal conjugate + Men B
  • 1 year: Hib/Men C+ MMR + pneumococcal conjugate + men B
  • 2 -8 years: influenza nasal
  • 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
18
Q

What other demographic may be offered the HPV virus?

A

Gay men

19
Q

What is the greatest reservoir of influenza?

A

Children - giving children influenza nasal spray at ages of 2-8 is trying to eliminate the risk of a pandemic

20
Q

What immunisations are offered to special patient and occupational groups?

A
  • BCG
  • influenza
  • pneumococcal
  • hepatitis B
  • varicella-zoster (chickenpox)
  • herpes-zoster (shingles)
21
Q

Who is offered BCG vaccine?

A

Some infants (0-12 months) - in areas of high TB incidence, if parents or grandparents are born in a country with annual incidence of TB greater than 40/100,000

  • Children screened at school for TB risk factors, tested and vaccinated if appropriate
  • New immigrants (previously unvaccinated) from high prevalence countries for TB – may be offered BCG
  • Contacts (<35yrs) of resp TB patients
  • Healthcare workers
22
Q

Describe the influenza vaccine

A

Influenza A and B constantly change (haemaglutinins and neuraminidases)

New vaccine each year

Single dose

Caution in egg allergy

23
Q

What are the indications for influenza vaccine?

A
  • Age >65 years
  • Nursing home residents
  • Some health care workers
  • Immunodeficiency,
  • Immunosuppression
  • Asplenia/hyposplenism
  • Chronic liver disease
  • Chronic renal disease
  • Chronic cardiac disease
  • Chronic lung disease
  • Diabetes mellitus
  • Coeliac disease
  • Pregnant women
  • Heath care workers
24
Q

Who is given the pneumococcal conjugate polysaccharide vaccine?

A

Part of childhood immunisation schedule

3 doses

25
Q

Who is given the pneumococcal polysaccharide vaccine?

A

Those with increased risk of pneumococcal infection

Indications

Immunodeficiency

Immunosuppression

Asplenia/hyposplenism

Sickle cell disease

Chronic liver disease

Chronic renal disease

Chronic cardiac disease

Chronic lung disease

Diabetes mellitus

Coeliac disease

26
Q

Who gets the Hep B vaccination?

A
  • All new born children from 2018 (6-in-1)
  • Children at high risk of exposure to HBV
  • Health care workers, PWID (people who inject drugs), MSM, prisoners, ch. liver disease, ch. kidney disease,
  • Given at 0, 1 month, 2 months and 1 year
27
Q

Who is given varicella zoster vaccine?

A
  • patients who have a suppressed immune systems, for example having cancer treatment or organ transplant
  • children if in contact with those at risk of severe vzv
  • Health case workers (if sero-neg and in contact with patients)
  • Live attenuated virus
  • 2 doses, 4-8 weeks apart
28
Q

Who gets herpes-zoser vaccine?

A

All elderly patients - 70-80 years

zostavax - live attenuated virus

29
Q

What is human normal immunoglobulin?

A

–contains antibodies against hepatitis A, rubella, measles

–used in immunoglobulin deficiencies

treatment of some autoimmune disorders, e.g. myasthenia gravis

30
Q

What post exposure diseases require immunoglobulins?

A
  • hepatitis B Ig
  • rabies Ig
  • tetanus anti-toxin Ig
  • varicella (chickenpox) Ig
  • diphtheria anti-toxin Ig (horse)
  • botulinum anti-toxin Ig
31
Q

What are sources of information for travellers seeking vaccinations?

A

BNF

Immunization against infectious diseases (green book)

Internet

32
Q

General measures for travellers

A
  • Care with food/water
  • Hand washing
  • Sunburn / Sunstroke
  • Altitude
  • Road traffic accidents
  • Safer sex
  • Mosquitoes - bed nets, sprays, “cover up”
33
Q

What are the common immunisations for travellers?

A
  • Tetanus
  • Polio
  • Typhoid
  • Hepatitis A
  • Yellow fever
  • Cholera
34
Q

What are immunisations for travelers in special circumstances?

A

Meningococcus A, C, W, Y

Rabies

Diptheria

Japanese B encephalitis

Tick borne encephalitis

35
Q

When might prophylaxis be indicated?

A

Chemoprophylaxis against malaria

Post-exposure prophylaxis (ciprofloxacin for meningococcal disease)

HIV post-exposure prophylaxis (needle stick)

Surgical antibiotic prophylaxis (perioperative)

36
Q

What is malaria prevention?

A

ABCD

Awareness of risk

Bite prevention

Chemoprophylaxis

Diagnosis and treatment

37
Q

How do you prevent bites?

A

Cover-up at dawn and dusk

Insect repellant sprays, lotions (DEET)

Mosquito coils

Permethrin-impregnated mosquito nets

38
Q

What are the available chemoprophylaxis measures against malaria?

A

Malarone

Doxycycline

Melfloquine (SE include psychosis, nightmares. Avoid if there is a history of psychosis or epilepsey)

Chloroquine weekly and proquanil daily

39
Q

What is malaria advice for travellers on return?

A
  • Any illness occurring within 1 year and especially within 3 months of return might be malaria
  • Patients should seek medical attention if become they ill particularly within 3 months and mention malaria risk
40
Q
A

Infection (17 decks)

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