Final 4- Immunization, Behaviour and nutrition, self help, medical equipment, hemorrhoids Flashcards
vaccine
administration of antigenic material to stimulate a person’s immune system to develop adaptive immunity to a pathogen, creates memory
-expose body to a weaker or inactivated pathogen to prepare it for future exposure
purpose of vaccine
prevent or ameliorate morbidity from infection
antigen
substance, usually protein base, that enters your body and stimulates formation of antibodies
-ex// bacterial infection
antibody
-formed and inactivates or destroys antigen
months baby relies on mother’s antibodies
0-6 months
if have anaphylactic reacton to neomycin, can’t get this vaccine
IPR or MMR
if pregnant, can’t get these vaccines
MMR, Varicella
if anaphylactic reaction to egg ingestion, can’t get these vaccines
influenza, yellow fever
if immunodeficient state, can’t get these vaccines
MMR, BCG, OPV, yellow fever
immunogen
part that stimulates immune response
live attenuated (weakened) vaccine
whole, living bacteria or virus that replicates within host
- response is mild because weakened
- don’t give to immunodeficient
inactivated vaccine
- killed virus or bacteria
- may need multiple doses
- safer
subunit vaccine
-purified products from virus or bacteria (ie hep B surface antigen, etc)
toxoid vaccine
made from inactivated toxic compounds that cause illness rather than microorganism
conjugate vaccine
certain bacteria have polysaccharide outer coats that are poorly immunogenic; proteins linked to these other coats with proteins, give place to adhere to. Allows immune system to recognize polysaccharide as if it were a protein antigen
adjuvant
added to vaccine to enhance immune response
preservatives in vaccines
-added to multidose, killed or subunit vaccines to prevent secondary infection from contamination
additives vaccines
substance added to support growth of immunogen, inactivate toxins, help purify immunogens or help confirm product quality and stability
monovalent vaccine
immunize against single antigen microorganism (faster and stronger response)
polyvalent vaccine
immunize against 2 or more strains of same or diff microorganisms (better if don’t know exactly what targetting)
polyvalent vaccine
immunize against 2 or more strains of same or diff microorganisms (better if don’t know exactly what targetting)
measles complication
- encephalitis
- otitis media
- pneumonia
- death
measles vaccine
live, attenuated
- comes combined with mumps (lvie, atten) and ruebella
- efficacy increases with age
- 2 doses
mumps complications
- inflammation of saliva glands*
- resp symptoms
- viral meningitis
- orchitis and oophoritis of post pubertal cases (damage to genitals)
- congenital malformations/abortion
rubella: cause, symptoms, main concern
- caused by virus
- causes rash, lymphadenopathy, arthralgias and fever
- main concern is infection during pregnanacy (causes congenital rubella syndrome- malformation, congenital heart disease, cataracts, deafness, mental retardation)
MMR vaccine (dosing, SEs, trace amounts of)
- at 12 and 18 months
- possible SEs= infection, thrombocytopenia, joint aches, encephalitis
- contains trace neomycin and gelatin
avoid MMR in
pregnant
immunosuppressed
neomycin or gelatin allergy
pertussis
whooping cough, highly contagious resp disease casued by bordetella pertussis
stages of pertussis
1) cold symptoms
2) cold fades, cough worse and violent/uncontrolled
3) pnt improves, gains strength, but cough can get louder and sound worse
stages of pertussis
1) cold symptoms
2) cold fades, cough worse and violent/uncontrolled
3) pnt improves, gains strength, but cough can get louder and sound worse
pertussis vaccine (type, 2 names, dosing)
inactivated, acellular (whole cell were discontinued due to higher ARs)
- given in combo with diptheria and tetanus toxoid and polio
- DTaP is infant formulation (given at 2,4,6 and 18 months, and at 4-6 years and at grade 8)
- Tdap is adolescent and adult formulation
diptheria and tetanus vaccine types
detoxified toxins, so body produces antibodies towards the toxin
haemophilus influenze type b vaccine (Hib)
- was most common cause of bacterial meningitis
- leader in pneumonia, septic arthritis and cellulitis
- contains polysaccharide of Hib bound to a protein
- available as pentacel (combo with diptheria, tetanus, pertussis and poli0)
- given at 2,4,6 and 18 months
common vaccine SEs
-swelling, tenderness, redness and pain at injection site
-fever
-
one of most common causes of respiratory infections
influenza- spread by inhalation of droplets and direct contact wiht contaminated objects
-can be spread one day before symptoms and up to 7 days after onset in adults, kids even longer
one of most common causes of respiratory infections
influenza- spread by inhalation of droplets and direct contact wiht contaminated objects
-can be spread one day before symptoms and up to 7 days after onset in adults, kids even longer
influenza vaccine contents every year
3 strains: 2 A, 1 B
- reformulated each year due to short lived antibodies and changing virus
- produces IgG antibodies to viral proteins
- protection occurs 2 weeks following vaccine and lasts about 6 months (4 in elderly)
influenza vaccine effectiveness varies based on
age, immunocompetence and match of vaccine to circulating virus (good match prevents illness in 70-90% of healthy people)
priority groups for influenza vaccine
- over 65
- pregnant
- serious med conditions
- live in long stay residential or care home
- main caretaker for elderly or disabled person
- frontline health or social care worker
can influenza vaccine cause flu?
no! doesn’t contain live virus
- can give soreness, fever, malaise, myalgia
- oculo respiratory syndrome (ORS)= red eyes, resp symptoms, facial edema, or combo within 24 hrs of shot, lasting less than 2 days (mild, self resolving, benefits outweigh risk)
CIs for influenza vaccine
-allergic to eggs
-infection with fever
-
CIs for influenza vaccine
- allergic to eggs
- infection with fever
strep pneumoniae vaccine (child)
- Prevnar
- for wks to 9 years
- given 2,4,6,18 months (but only 3 doses if over 6 months of age)
- derived from capsular antigens of 7 serotypes
strep pneumoniae vaccine (adult)
- pneumovax 23/ Pneumo 23
- derived from capsular polysaccharides of 23 types of pneumococci
- reimmunize every 5-7 years if received before age 65
- response in children under 2 is inadequate
- antibody levels decline after 5-10 years
who should get strep pneumoniae adult vaccine
the people most likely to die from infection ie
- over 65
- over 2 with asplenia, splenic dysfunction of sickle cell disease
- over 2 with chronic cardiorespiratory disease, cirrhosis, alcoholism, CKD, DM, immunosuppression
neisseria meningitidis serogroups and affected groups
- causes meningitis (mostly in under 1 or between 15 and 19)
- 4 serogroups: BCY and W (2 most isolated are C and B, C is higher fatality than B)
- meningococcal vaccines have group C conjugates, bivalent have polysaccharides of A and C, quad have polysaccharides of ACY and W
group c meningococcal vaccines
- for any age
- 2-12 yrs require 3 doses
- over 1 needs one dose
neisseria meningitidis serogroups and affected groups
- causes meningitis (mostly in under 1 or between 15 and 19)
- 4 serogroups: BCY and W (2 most isolated are C and B, C is higher fatality than B)
- meningococcal vaccines have group C conjugates, bivalent have polysaccharides of A and C, quad have polysaccharides of ACY and W
- *get vaccine at 1 year old in SK, reimmunization not needed
group c meningococcal vaccines
- for any age
- 2-12 yrs require 3 doses
- over 1 needs one dose
menomune
meningococal bi and quad vaccine
- for over 2, but low efficacy if under 10
- if under 2, give 2 doses, over 1
3 major antigens of hep B
- HBsAg (hep B surface antigen, if positive for this you are infectious)
- HBeAg (hep B e antigen)
- HBcAg (hep B core antigen- for viral replication and associated with high infectiousness)
incubation period of hep b
- 45 to 160 days
- initial infection may be asymptomatic
- once infected can become chronic carrier (90-95% of time in infants, 25-50 in children, 3-10 in adults)
incubation period of hep b
- 45 to 160 days
- initial infection may be asymptomatic
- once infected can become chronic carrier (90-95% of time in infants, 25-50 in children, 3-10 in adults)
- all carriers infectious, increased risk cirrhosis and liver cancer
spread of Hep B
blood, vaginal secretions, semen, serous fluid, mother to newborns
3 forms of Hep B vaccine
Energix B
Recombivax HB
Twinrix
-all contain purified HBsAg
how Hep B vac is given
IM (deltoid) in grade 6: 2 doses, 6 months apart (95% effective)
-can be 3 doses at 0,1 and 6 months apart
protection length hep B vac
at least 15 years: persistance of immune memory tends to stay despite disappearance of antibodies
who should get hep B vac
- all infants/children
- healthcare workers
- post exposure prophylaxis (infants born to infected mothers must be within 12 hours_
- multiple unprotected sex
- men sex with men
- drug users
- close contacts of infected
- travelling to high incidence area
- chronic liver disease/hepatotoxic meds
- anyone who wants it
havrix
hep A vaccine, for 1 year and older
- should be given at least 2 weeks prior to expected exposure
- single dose, then booster 6-12 months later in children
- adults same but double dose (1 ml)
almost all cases of HPV lead to
cervical cancer
-one of most common STIs in Canada
gardasil
HPV vaccine for females age 9-26
- protects against 2 high risk types (16 and 18-cervical cancers) and 2 low (6 and 11-ano genital warts)
- given in grade 6- 2 doses over 6 months
- DO NOT give pregnant women
- protected at least 5 years
gardasil
HPV vaccine for females age 9-26
- protects against 2 high risk types (16 and 18-cervical cancers) and 2 low (6 and 11-ano genital warts)
- given in grade 6- 2 doses over 6 months
- DO NOT give pregnant women
- protected at least 5 years
varicella zoster vaccine
live attenuated
- single dose if under 13, 2 doses 28 days apart if over
- usually given at 1 year old
varicella zoster vaccine
live attenuated
- single dose if under 13, 2 doses 28 days apart if over
- usually given at 1 year old
fishbein model of behaviour
attitudes and social pressure determine behaviour
model of behaviour: Kelly Really Says Motivation
Knowledge, Resources, Skills, Motivation (influence behaviour)
health belief model of change 4 pillars (PBSS)
1) Perceptions of efficacy (P)
2) how susceptible you feel (S)
3) possible barriers for change (B)
4) severity of potential illness (S)
stages of change
precontemplation contemplation preparation action maintenance
grams of Na per day sufficient
1.5 grams, officials want us down to 2.3, we are at 3.3
most important part of behaviour change
what are their expectations
stress incontinance
50% of cases, women
-bladder weakness or sudden abdominal pressure (cough, sneeze, laugh, etc)
urge incontinance
aka overactive bladder
-overactive detrusor, contracts before should, urgency
antispasmodics (anticholinergics) with which incontinence?
urge NOT overflow (makes worse)
overflow incontinance
aka urinary retention
- bladder always full, leakage without urge to urinate
- men over women, prostate enlargement
- want smooth muscle stimulation (finasteride, tamsulosin)
alpha adrenergic antagonist for BPH and overflow incontinance
flomax (tamsulosin) –> decreased pinching therefore pee
