Infections and Immunizations

Question 1

Vaccine tricks

Answer 1

Handle injection site as little as possible
Arnica or ledum homeopathy (before)
Give sweet ahead of time
VIS

Question 2

Post vaccine

Answer 2

Arnica, ledum, thuja, silica homeopathically

reassure parents, low fever ok

Question 3

Tetanus vaccine sequalae

Answer 3

Anaphylaxis

brachial neuritis

Question 4

Pertussis vaccine sequalae

Answer 4

Anaphylaxis

Encephalopathy

Question 5

MMR Vaccine Seq

Answer 5

Anaphylaxis

Encephalopathy

Question 6

Rubella Vaccine Seq

Answer 6

Chronic arthritis

Question 7

Measles Vaccine Seq

Answer 7

High fever
Rash
Thrombocytopenia purpura
Measles

Question 8

Polio Vaccine seq

Answer 8

Paralytic polio

Polio

Question 9

Hepatitis B Vaccine Seq

Answer 9

Anaphylaxis

Question 10

Rotavirus Vaccine Seq

Answer 10

Intussusception

Question 11

Measles

Paramyxovirus

Answer 11

communicable 2-4 days before rash

**never give MMR vaccine before 12 mos, maybe wait until 2 yrs

Question 12

Measles sxs

Answer 12

1st-fever, cough, conjunctivitis, photophobia, coryza, Koplik spots on oral mucosa
2nd- maculopapular rash

Question 13

Measles Dx

Answer 13

Koplik spots!

helpful- coryza+photophobia

Question 14

Measles Complications

Answer 14

UNCOMMON
pneumonia, OM, strep

TP, encephalitis, subacute pancencephalitis

Question 15

Measles Managment

Answer 15

150-400,000 IU Vit A

Question 16

Rubella Sxs

Answer 16

prodrome: 1-5 days, malaise, LAD
rash: face/neck to trunk and body. Gone in 3 days
“Scarlantiform rash” (appears like Scarlet fever)

Question 17

Rubella Dx

Answer 17

NO Koplik spots, mild, no photophobia

Question 18

Rubella Complications

Answer 18

Congenital Rubella Syndrome if contracted in first trimester (rare after 20 weeks)
deafness, eye problems, heart defects, mental retardation

Question 19

Roseola infantum

most commonly HHV6

Answer 19

sxs: high fever, fever leaves then rash (starts on trunk), alert and active

convulsions during febrile phase

Question 20

Roseola Dx

Answer 20

rule out UTI, OM, meningitis, pneumonia, sepsis…you can presume Roseola!

Question 21

Roseola complications

Answer 21

seizures most common
aseptic meningitis
encephalitis
thrombocytopenic purpura

Question 22

Erythema infectiosum

ParvoB19 infection

Answer 22

can recur for several weeks

sxs: mild; slapped-cheek rash that spreads to extremities and trunk, (maybe arthralgia)

Question 23

Erythema infectiosum Dx

Answer 23

cx rash

IgM during acute

Question 24

Erythema infectiosum Complications

Answer 24

during preg can cause fetal death (but NOT teratogenic)
aplastic crisis
arthritis can last for mos

Question 25

Varicella sxs

Answer 25

prodrome: HA, low fever, malaise rash: vesicular, comes in crops, crust over

Question 26

Varicella dx

Answer 26

lesions | can titer or immunoflourescnece or PCR of vesicular fluid

Question 27

Varicella complications

Answer 27

arthritis, GI organ involvement, pneumonia, encephalitis, nephritis, congenital varicella

Question 28

Varicella vaccine Seq

Answer 28

chicken pox, pain, fever, rash | *probably will need booster for rest of life

Question 29

Coxsackie virus

Answer 29

Hand, foot, mouth vesicular exanthem Herpangina (mouth blisters)

Question 30

Coxsackie TX

Answer 30

mouthwash: clove oil in carrier oil | Magic mouth wash: Maalox (milk of magnesia) with liquid benadryl

Question 31

Bordatella pertussis

Answer 31

incubation 7-14 catarrhal--most transmissible! sneezing, lacrimation, coryza, hacking nocturnal cough paroxysmal--most transmissible! 2 weeks after cough starts, thick mucus, may vomit after coughing paroxysms convalescent--starts week 4, lasts 1-3 months

Question 32

Pertussis dx

Answer 32

PCR

Question 33

Pertussis management

Answer 33

oral erythromycin or azithromycin during catarrhal and early paroxysmal quarantine

Question 34

Pertussis vaccine

Answer 34

acellular | 2, 4, 6 mos, 15-18 mos, 4-5 years

Question 35

DTap

Answer 35

diptheria toxoid, tetanus toxoid, acellular pertussis only need Td every ten years for children > 7 yrs/adults

Question 36

Corynebacterium diptheriae

Answer 36

toxin causes tissue necrosis --> pseudomembrane sxs: rhinorrhea that becomes bloody/mucopurulent pharyngeal/tonsillar pseudomembrane

Question 37

Diptheria complications

Answer 37

myocarditis (most are transient) | nerve palsies, dysphagia

Question 38

Diptheria Management

Answer 38

Antitoxin ASAP

Question 39

Clostridium tetani | "lockjaw"

Answer 39

following deep wound, jaw stiffness complications: from tetany- fractures, urinary retention, dysphagia, cerebral hemorrhage

Question 40

Tetanus Tx

Answer 40

hospitalization, air way maintenance, Ig, antibiotics

Question 41

Mumps Paramyxovirus

Answer 41

painful swelling of parotid glands or testicles | BL, non-erythematous

Question 42

Mumps complications

Answer 42

orchitis in post-pubertal males (sterility rare) meningoencephalitis self-limiting pancreatitis any glandular tissue can be involved

Question 43

Mumps management

Answer 43

avoid acids/things that increase salivation homeopathic parotidinum vaccine- 12-15 mos and 4-6 yrs

Question 44

Mononucleosis Espstein-Barr

Answer 44

malaise/ fatigue then | fever, paharyngitis, LAD, splenomegaly

Question 45

Mono Dx

Answer 45

CBC with diff-- atypical lymphocytes! | monospot for heterophil Abs

Question 46

Mono complications

Answer 46

strep pharyngitis splenic rupture airway obstruction from LAD (tx with roids)