Infection, Immunology and Allergy

Question 1

Best investigation to confirm Mumps

Answer 1

Serum mumps IgM

Question 2

What are the live attenuated vaccines in the UK immunisations schedule?

Answer 2

MMR
BCG

Question 3

What are the vaccines which contain inactivated toxins in the UK immunisations schedule?

Answer 3

Diptheria
Tetanus

Question 4

What are the carbohydrate vaccines in the UK immunisations schedule?

Answer 4

Pneumococcal vaccine

Question 5

What are the conjugate vaccines in the UK immunisations schedule?

Answer 5

HiB
Meningococcal vaccine

Question 6

What is a conjugate vaccine and how does it work?

Answer 6

Conjugate vaccines fight a type of bacteria that has antigens with an outer coating of sugar-like substances called polysaccharides. This type of coating disguises the antigen, making it hard for a young child’s immature immune system to recognize it and respond to it.
Conjugate vaccines are effective for these types of bacteria because they connect (or conjugate) the polysaccharides to antigens that the immune system responds to very well. This linkage helps the immature immune system react to the coating and develop an immune response. An example of this type of vaccine would be the Haemophilus influenzae type B (Hib) vaccine.

Question 7

What vaccines would a child receive at 8 weeks / 2 months as part of the UK immunisations schedule?

Answer 7

1) Infrarix Hexa (DTaP (Diptheria, Tetanus and Pertussis), IPV (Polio), Hep B, HiB)
2) Men B
3) Rotavirus

Question 8

What vaccines would a child receive at 12 weeks / 3 months as part of the UK immunisations schedule?

Answer 8

1) Infrarix Hexa (DTaP (Diptheria, Tetanus and Pertussis), IPV (Polio), Hep B, HiB)
2) Pneumococcal conjugate vaccine
3) Rotavirus

Question 9

Which vaccine is given orally?

Answer 9

Rotavirus

Question 10

What vaccines would a child receive at 16 weeks / 4 months as part of the UK immunisations schedule?

Answer 10

1) Infrarix Hexa (DTaP (Diptheria, Tetanus and Pertussis), IPV (Polio), Hep B, HiB)
2) Men B

Question 11

What vaccines would a child receive at 1 year as part of the UK immunisations schedule?

Answer 11

1) HiB and Men C
2) Pneumococcal conjugate vaccine booster
3) MMR
4)

Question 12

What vaccines would a child receive at 3 years 4 months (pre-school age) as part of the UK immunisations schedule?

Answer 12

1) Repevax (DTaP (Diptheria, Tetanus and Pertussis), IPV (Polio))
2) MMR

Question 13

What vaccines would a child receive at 12-13 years as part of the UK immunisations schedule?

Answer 13

HPV

Question 14

What vaccines would a child receive at 14 years as part of the UK immunisations schedule?

Answer 14

1) Revaxis (Tetanus, Diptheria and Polio)
2) Men ACWY

Question 15

When would you offer additional Hep B vaccines and when are they given?

Answer 15

Babies born to hepatitis B positive mothers

Given in addition to the routine immunisations at 2, 3 and 4 months:
- At birth
- 4 weeks
- 12 months

Question 16

When would you offer the BCG vaccine and when would you give it?

Answer 16

Infants in areas with high TB prevalence (>40 per 100,000) or infants with a parent or grandparent born in a high incidence country.

It is given at birth

Question 17

Who would receive and when do you give the pneumococcal vaccine?

Answer 17

Annually for high risk groups:
- Cochlear implants
- Chronic respiratory or cardiac conditions
- Chronic neurological conditions
- Diabetes
- CKD
- Asplenia / splenic dysfunction
- Immunosuppression
- Complement disorders

Question 18

Who would receive and when do you give the influenza vaccine?

Answer 18

Annually for high risk groups:
- Chronic respiratory or cardiac conditions
- Chronic neurological conditions
- Diabetes
- CKD
- Asplenia / splenic dysfunction
- Immunosuppression
- Complement disorders

Question 19

Who would receive the Hep A and B vaccine?

Answer 19

Chronic liver conditions
Haemophilia

Question 20

What are the absolute contraindications to live attenuated vaccines?

Answer 20

Immunosuppression
- Prednisolone 2mg/kg per day for >1 week or 1mg/kg per day for >1 month
- Lower doses of Pred PLUS a cytotoxic / immunosuppressive medication

Impaired cell mediated immunity
- DiGeorge syndrome
- Chemotherapy or Radiotherapy, current or in past 6/12
- Bone marrow transplant in last 6/12
- Immunoglobulin administration in last 3/12

Question 21

What vaccines cannot be given in those with egg allergy?

Answer 21

Influenza (they must have an egg free or very low ovo-albumin content)
Yellow fever

Question 22

Which vaccine can cause intussusception?

Answer 22

Rotavirus (oral)

Question 23

Which vaccine can cause ITP?

Answer 23

MMR

Question 24

Which vaccine can cause bronchospasm?

Answer 24

HPV

Question 25

What is the incubation period for scarlet fever?

Answer 25

1-7 days

Question 26

What is the incubation period for Mumps?

Answer 26

18-21 days

Question 27

What infection causes a high fever for 3-4 days and then a rash which starts on the trunk and spreads to the face/limbs?

Answer 27

Roseola infantum (human herpes virus 6)

Question 28

Organism which causes slapped check

Answer 28

Parvovirus B19

Question 29

Organism which causes hand, foot and mouth disease

Answer 29

Coxsackie virus

Question 30

Which organisms / infections cause rashes which start on the face and spread to the trunk

Answer 30

Measles Rubella Scarlet fever

Question 31

Which vaccine is given intra-dermally?

Answer 31

BCG

Question 32

What are the 4 HPV types that Gardasil protects against?

Answer 32

HPV 6 + 11 (causes 90% of warts) HPV 16 + 18 (causes 70% of cervical cancer as well as some anal and other genital cancers and some head and neck cancers)

Question 33

WHO guidelines of stage 4 HIV (AIDS-defining illness) include complications such as ...

Answer 33

Kaposi sarcoma, cytomegalovirus retinitis and Pneumocystis pneumoniae

Question 34

What is the most common mode of transmission of HIV in children in the UK?

Answer 34

Vertical transmission (pregnancy, breast feeding, child birth)

Question 35

What type of virus is HIV

Answer 35

RNA retrovirus which infects and depletes CD4 cells

Question 36

What age group is most vulnerable to HIV infection?

Answer 36

Those <1 year of age

Question 37

How does HIV infect cells?

Answer 37

It is an RNA retrovirus which contains reverse transcriptase which allows its viral RNA to be incorporated into the host DNA.