Fever and rash Flashcards
What does UTD stand for
Up to date - in terms of immunisation
What are some questions that can be asked in hx.
Vaccine schedule - Have they only got the measles vaccine (usually overseas)
Where were they born?
Have they been overseas or been in contact with someone from overseas (baby sitter)?
Is there an outbreak at the moment?
How contagious is measles
Highly
What does the prodrome (symptoms before measles rash itself) for measles consist of and how long does it last for?
2-3 days
Fever, conjunctivitis, Kopliks spots (in mouth)
When does the characteristic rash occur
3-7 days - most unwell during rash period
What are complications of measles and how often they occur
10 % get secondary infection (Otitis media, pneumonia)
0.1% get encephalitis (25% die)
Mumps complications
Meningoencephalitis
Oophoritis and orchitis - main complications
Mumps presentation
Infection of salivary glands, large face
Sign of meningitis in infants, that’s not I adults?
NO neck stiffness, more flaccid neck.
Causes of bacterial meningitis and their gram stains
Strep. Pneumonia - GP cocci
N. Meningiditis - GN Cocci
Haemophilus Influenzae - GN bacilli
What is most appropriate management if severely unwell.
Antibiotics - then lumbar puncture when you can
Why are conjugate vaccines used in kids
Young children only produce weak antibodies to polysaccharide antigens.
What are conjugate vaccines
A polysaccharide unit bound to a conjugate/carrier protein (usually immunogenic e.g tetanus toxoid).
It is taken up by a B cell, processed and presented to helper T cells. This creates a T-cell dependant antigen response.
Creates production of memory cells.
First example of conjugated vaccine?
Haemohpilus Influenzae B
- Induces antibodies to PRP
- Initial vaccines were unconjugated and poorly immunogenic
- Very effective now though, if vaccine uptake >80% virtually eradicated in population.
When was conjugate HiB introduced and what is the shedule
1994
6 weeks, 3 months, 5 months and 15 months.
