Immunisation and Prophylaxis Flashcards

1
Q

What is the primary response to infection?

A

Slower, smaller

IgG and IgM roughly equal

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2
Q

What is the secondary response to infection?

A

Faster, larger

IgG much higher than IgM

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3
Q

How do Killed and Live vaccines differ?

A

Live is one dose with a huge immune response

Killed is a smaller response needing multiple doses

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4
Q

What are the main types of vaccines?

A

Live attenuated
Inactivated/killed
Detoxified exotoxin
Subunit of microorganism

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5
Q

Name 2 killed vaccines?

A

Polio
Hep A
Rabies
Influenza

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6
Q

Name 2 live attenuated vaccines?

A

MMR
BCG
Smallpox
Varicella-zoster

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7
Q

How are detoxified vaccines made?

A

Toxin is treated with formalin to form Toxoid

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8
Q

Name 2 subunit attenuated vaccines?

A

Pertussis
Hep B
H. influenzae type B

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9
Q

What is the infant immunisation schedule?

A

2 months: 6 in 1, pneumococcus, rotavirus, meningitis B
3 months: 6 in 1 + rotavirus
4 months: 6 in 1 + pneumococcal + men B

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10
Q

What is the 6-in-1 vaccine

A
Diphtheria
Tetanus
Pertussis
Polio
H. influenzae type B
Hepatitis B
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11
Q

What is the target coverage needed for herd immunity?

A

90-95%

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12
Q

What immunisations are indicated for special patient/occupation groups?

A

BCG
Flu
Hep B
Varicella-zoster, herpes zoster

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13
Q

When is BCG indicated?

A

Healthcare workers
Infants in high incidence areas/family from high incidence
Contact with TB patients

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14
Q

Give 3 indications for flu 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
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15
Q

What vaccines are offered for pneumococcus?

A
Pneumococcal conjugate (childhood, 3 doses)
Pneumococcal polysaccharide (increased risk patient, single dose)
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16
Q

Give 3 indications for Pneumococcal polysaccharide vaccine?

A
Immunodeficiency 
Immunosuppression
Asplenia/hyposplenism
Sickle cell disease
Chronic liver disease 
Chronic renal disease
Chronic cardiac disease
Chronic lung disease
Diabetes mellitus
17
Q

Give 3 indications for hep B vaccine?

A
All newborn children
Children at high risk
Healthcare workers 
IVDA 
MSM
18
Q

Give 3 indications for Varicella-zoster vaccine?

A

Immunosuppression
Children at risk
Healthcare workers

19
Q

What is the indication for Shingles vaccine?

20
Q

What passive immunisations with Ig are given?

A

Human normal immunoglobulin

Disease specific immunoglobulin

21
Q

Human normal immunoglobulin is indicated for what?

A

Ig deficiencies
Hep A, rubella, measles
Autoimmune diseases

22
Q

Disease specific immunoglobulin is indicated for what?

A
Post-exposure 
Hep B
Rabies
Tetanus 
Varicella zoster 
Diphtheria/Botulinium anti-toxin
23
Q

What should be assessed in a risk assessment for infection in travellers?

A
Traveller health
Previous immunisation
Area to be visited
Duration of visit
Accommodation
Activities
Recent outbreaks
24
Q

Give 3 sources of information for a patient travelling and their risk of infection

A

BNF
Immunisation Against Infectious disease
CDC
Schools of Tropical Medicine

25
What common immunisations are given to travellers?
``` Tetanus Polio Typhoid Hepatitis A Yellow fever Cholera ```
26
What are the main types of prophylaxis?
Chemoprophylaxis against malaria PEP HIV PEP Surgical antibiotic prophylaxis
27
What is the ABCD of malaria prevention?
A - Awareness of risk B - Bite prevention C - Chemoprophylaxis D - Diagnosis and treatment
28
How can mosquito bites be prevented?
Cover up at dawn and dusk Insect repellant Mosquito coils, nets
29
What Chemoprophylaxis is indicated against malaria?
Malarone Doxycycline Mefloquine Chloroquine + Proquanil
30
What malarial advice is given to patients returning from travel?
Any illness within 1 year (esp. first 3 months) may be malaria Seek medical attention if ill in first 3 months