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Infectious Disease > ID Prevention and Immunoprophylaxis- Exam 2 > Flashcards

ID Prevention and Immunoprophylaxis- Exam 2 Flashcards

1
Q

_____ A biological attack, or bioterrorism, is the intentional release of viruses, bacteria, or other germs that can sicken or kill people, livestock, or crops

A

bioterrorism

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2
Q

_____ the processing of microbes or toxins in a manner that would ensure a devastating effect following release

A

weaponization

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3
Q

What are the categories of bioterrorism agents?

A

Category A-C

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4
Q

What is a category A bioterrorism mean? B? C?

A

Easily spread person - person
High mortality and morbidity
Requires special action for public health preparedness
Potential for public panic and social disruption

Moderately easy to spread
Low to moderate morbidity and mortality

Readily available
Could be engineered for mass spread in the future
Potential for major health impact

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5
Q

Anthrax -(Bacillus anthracis)
Botulism - (Clostridium botulinum toxin)
Plague - (Yersinia pestis)
Smallpox - (Variola major)
Tularemia - (Francisella tularensis)

What category?

A

Category A

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6
Q

Brucellosis (Brucella spp.)
Epsilon toxin of Clostridium perfringens
Food safety threats (e.g., Salmonella spp., Escherichia coli 0157:H7, Shigella)
Glanders (Burkholderia mallei)
Melioidosis (Burkholderia pseudomallei)
Psittacosis (Chlamydophila psittaci)
Q fever (Coxiella burnetii)
Ricin toxin from Ricinus communis (castor beans)
Staphylococcal enterotoxin B
Typhus fever (Rickettsia prowazekii)
Viral encephalitis (alphaviruses [e.g., Venezuelan, eastern, and western equine encephalitis])
Water safety threats (e.g., Vibrio cholerae, Cryptosporidium parvum)

What category?

A

B

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7
Q

Nipah
hantavirus
SARS
MERS coronavirus
pandemic influenza

What category?

A

C

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8
Q

____ is the worst form in term of mass spread for bioterrorism agents

A

anything aerosol

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9
Q

Gram + rod
Spore-forming
Found in soil
Can form painless vesicle that turns into necrotic eschar
Fever, fatigue, malaise, N/V, cough, SOB ⇾ pneumonia ⇾ pleural effusions ⇾ death

What am I?
What form is most likely used in bioterrorism?

A

Anthrax

respiratory (aka inhaled) is most common

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10
Q

What is the treatment for Anthrax? What about post-exposure? For how long?

A

antitoxin
cipro or clindamycin

vaccination
cipro or doxy

lasts up to 60 days due to persistent spores

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11
Q

_____ is the only bioterrorism agent that is non-living. Can it spread person to person?

A

Botulism

does NOT spread person to person

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12
Q

T/F: The botulism antitoxin does not work on all the 7 distinct forms

A

False, DOES work on all the different forms

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13
Q

What is the pathophys behind botulism?

A

Toxin prevents the release of acetylcholine = flaccid paralysis of muscles

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14
Q

Multiple cranial nerve palsies leading to descending flaccid paralysis
Diplopia
dysphagia
dysarthria
dry mouth
ptosis
dilated pupils
fatigue
extreme weakness

What am I?
How do you dx?

A

Botulism

toxin immunoassay

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15
Q

What is the treatment for botulism?

A

Intubation, mechanical ventilation, parenteral nutrition

Equine antitoxin if dx early in disease

Weeks to months of regeneration of new motor neuron synapses w/in the muscle cell

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16
Q

T/F: There is a good botulism vaccine on the market, recommended for ages 18+

A

FALSE! no approved FDA vaccine

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17
Q

Gram - bacillus
Painful LAD w/ necrosis, fever, bacteremia ⇾ septicemia ⇾ death
Nodes called buboes
Extensive ecchymosis and necrosis of digits and nose
either can be from a bite of an infected rat flea or inhalation of the bacteria
Fever, cough, hemoptysis, and GI Sx

What am I?

A

Bubonic plague

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18
Q

How do you dx bubonic plague? What is the treatment?

A

Blood cultures and / or cultures of buboes, sputum
Antibodies

gentamicin, streptomycin, doxycycline, fluoroquinolone

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19
Q

What is the prophylaxis treatment for bubonic plague? What is the prevention?

A

Doxycycline and ciprofloxacin X 7 day

No vaccine available

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20
Q

_____ has been eradication globally. What is the virus called?

A

smallpox

Variola major

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21
Q

_____ is a double-stranded DNA virus from Poxviridae family. Virus infects host ⇾ spreads to lymphoid tissue ⇾ localized infection of skin dermis ⇾ 2-14 days later ⇾ fever, malaise, HA, N/V, back pain, rash (maculopapular to face and extreme ⇾ spreading to trunk ⇾ turn to vesicles, then pustules, then scabs), mouth ulcers

A

Smallpox

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22
Q

How do you dx smallpox? What is the treatment?

A

Culture, PCR
Antibodies

Strict isolation
Supportive measures only
Antivirals have not really been studied

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23
Q

Small, non-motile, gram - coccobacillus
NOT spread person to person
Non-spore forming
rabbit fever or deer fly fever
spread through ticks and fleas that bite an infected host and pass to humans

What am I?

A

Tularemia

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24
Q

Pharyngitis, pleuritis, bronchopneumonia
Fever, HA, chills, fatigue, malaise
Conjunctivitis and exanthems also possible
50% will have an infiltrate on CXR; hilar adenopathy w/o infiltrate also possible

What am I?
How do you dx?

A

Tularemia

Gram stain or cultures of infected tissues or blood

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25
Q

What is the treatment for tularemia?

A

Streptomycin, doxycycline, gentamicin, fluoroquinolones

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26
Q

What is a very deadly viral hemorrhagic fever used for bioterrorism?

A

Ebola virus

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27
Q

All are enveloped, single-stranded RNA viruses that require a host. Human’s contract ____ by being in direct contact with body fluids

A

viral hemorrhagic fevers

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28
Q

Fever, myalgia, prostration, DIC w/ thrombocytopenia and capillary hemorrhage

A

Viral hemorrhagic fevers

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29
Q

When should you suspect a viral hemorrhagic fever?

A

Should be suspected in any person w/ temp >38.3 ℃ (or 101 ℉) for <3 weeks with at least 2 of the following (in the absence of another cause):
Hemorrhagic or purpuric rash
Epistaxis
Hematemesis
Hemoptysis
Hematochezia

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30
Q

What is the dx testing for Viral Hemorrhagic Fevers? What is the treatment?

A

Serological testing for antigen and antibody; PCR - sent to the CDC

No approved treatment or vaccine
Experimental - antibody cocktails and ribavirin

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31
Q

In September 2001 ____ was released through USPS, with 22 infections and 5 fatalities

A

anthrax

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32
Q

____ was the main focus of the pre-1991 Iraqi bioweapons program. Japan produced it in 1930 and used it to poison prisoners
Japanese cult successfully infected civilians in Tokyo on 3 separate occasions

A

Botulism

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33
Q

_____ WWII - Japanese dropped _____ over China causing an outbreak in areas of target

A

Yersinia pestis aka the plague

plague-infested fleas

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34
Q

smallpox has a ____ mortality rate when infected

A

10-30%

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35
Q

____ was possibly used to infect sheep and sent into enemy lines by the Hittites in the 14th century. There was an outbreak among German and Soviet soldiers on the frontline in WWII

A

Tularemia

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36
Q

1992 - a Japanese cult travelled to Africa under false assumptions to aid _____ in an effort to obtain the virus for bioterrorism use. What dz?

A

Ebola victims

Viral hemorrhagic fever

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37
Q

What is the short version of the Universal Precautions?

A

Treat all human body fluids as if they are infected

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38
Q

Includes hand hygiene; PPE based on certain types of exposure; safe injection practices; and safe management of contaminated equipment and other items in the environment. Applies to all patients and all bodily secretions (urine, feces, nasal secretions, sputum, vomit)

A

Standard Precautions

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39
Q

Gown and gloves required for pt or environment contact
Sometimes above needed to even enter patient room

What kind of precautions?

A

Contact precautions

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40
Q

Surgical mask required w/in 3 feet of patient

What kind of precaution?

A

Droplet precaution

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41
Q

Negative pressure isolation room
Respirator must be worn

What kind of precaution?

A

Airborne infection isolation

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42
Q

When in contact w/ blood, body fluids, secretions, excretions, mucous membranes, non-intact skin, or contaminated equipment

What types of PPE?

A

Gloves

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43
Q

During procedures when contact of clothing, exposed skin w/ blood/body fluids, secretions, excretions, or body fluid is anticipated

What type of PPE?

A

Gowns

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44
Q

Any activity which may result in splashes or sprays of blood, body fluids, secretions, or excretions

What type of PPE?

A

Mask/Goggles or Face shield

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45
Q

_____ induced by vaccines prepared from bacteria or their products

A

active immunity

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46
Q

_____ administration of preformed antibodies in preparations called immunoglobulins

A

passive immunity

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47
Q

An _____ vaccine is a vaccine created by reducing the virulence of a pathogen, but still keeping it viable. _____ takes an infectious agent and alters it so that it becomes harmless or less virulent.

A

attenuated

Attenuation

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48
Q

More stable
Safest form
Weaker immune response
often requires multiple doses/boosters

What type of vaccine?
Give some examples

A

inactivated/dead virus

seasonal influenza, polio

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49
Q

Does not cause active disease (typically)
Provides greatest immunity

What type of vaccine?
Give some examples

A

Live, attenuated - live but weakened virus

MMR

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50
Q

Contain only antigens
Less risk of adverse reactions
Very time-consuming to make

What type of vaccine?
Give some examples

A

Subunit vaccines

Hep B

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51
Q

For bacterial infections that secrete toxoids
Inactivated toxoids

What type of vaccine?
Give some examples

A

toxoid vaccines

tetanus, diphtheria, pertussis

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52
Q

Works against bacteria w/ a cell wall
Produce synthetic product containing cell wall similar to the bacteria

What type of vaccine?
Give some examples

A

conjugate vaccine
HIB type B vaccines, Pneumococcal

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53
Q

______ use a live bacteria as a vector

A

Recombinant vector vaccines

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54
Q

**What is the CI for all vaccines? What is a precaution?

A

Severe allergic reaction - anaphylaxis

Pregnancy and severe immunosuppression - no LIVE vaccines, including live-attenuated vaccines

Acute illness that is moderate to severe - with or without fever

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55
Q

_____ is approved for ages 6 weeks ⇾ 7 years of age
Made up of inactivated forms of the toxins produced by these bacteria, as well as acellular antigens of pertussis

A

DTaP

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56
Q

____ lower dose of the toxin components used for booster doses only
Indicated for those 7 years of age and older

What is it called w/o the pertussis component

A

Tdap

Td

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57
Q

Hx of encephalopathy - coma or prolonged seizures w/in 7 days of administration of the vaccine w/ pertussis components
Progressive, unstable neurological d/o, uncontrolled seizures, etc. - hold off on vaccine until controlled

These are the CI of _____

A

Diphtheria, Tetanus, Pertussis vaccine

58
Q

What type of vaccine is MMR?

A

live-attenuated vaccine

59
Q

When do you give Td?

A

Given for a dirty wound if it’s been > 5 years since last tetanus

60
Q

What are the CI of the Diphtheria, Tetanus, Pertussis vaccines?

A

Hx of encephalopathy - coma or prolonged seizures w/in 7 days of administration of the vaccine w/ pertussis components

Progressive, unstable neurological d/o, uncontrolled seizures, etc. - hold off on vaccine until controlled

61
Q

What pt population should you NOT give the MMR vaccine to? Why?

A

pregnant women and immunocompromised because it is a LIVE attenuated vaccine

62
Q

What is the dosing schedule for MMR? When do you NOT give the MMRV combo?

A

2-part series given at WCC:

12 months
4 years - typically combined w/ varicella - ProQuad vaccine

MMRV combo not given under 23 months due to febrile seizure risk

63
Q

What is the timeframe to give MMR prophlaxis?

A

May be administered w/in six days of exposure

64
Q

What are the CI to MMR vaccine?

A

Pregnancy

Severe immunodeficiency

Postpone a month if pt has been on long-term (>14 days) of steroids

**Immediate hypersensitivity reaction to gelatin or neomycin - components of the vaccine

65
Q

What type of vaccine is Polio? What is the dosing schedule?

A

inactivated vaccine

Given IM or SQ
4-dose series given at WCC
2 months
4 months
6 months
4 years

66
Q

What are the CI to the polio vaccine?

A

Previous reaction to IPV

**Allergy or sensitivities to streptomycin, polymyxin B, and neomycin

caution in pregnancy

67
Q

What type of vaccine is Hep A? What is the dosing schedule? What are the CI?

A

Inactivated / killed virus

Given IM
2-dose schedule given at WCC
12 months
2 years

No CI

68
Q

____ MOA causes an immune reaction by activating lymphocytes to attack the antigen, engulf it, which releases inflammatory mediators signaling B and T-cells. These cells go on to produce new B and T-cells with specific activity against _____

A

hepatitis A

hepatitis A antigen

69
Q

What type of vaccine is Hep B? What is the dosing schedule?

A

Subunit vaccine

Given IM
4-dose vaccine given at WCC
Birth - 1 month
2 months
4 months
6 months

70
Q

____ MOA is ____ proteins in the vaccine are recognized by antigen presenting cells process the antigen and introduce it to the T-helper cells. B-cells now recognize the antigen causing a weak immune response which then produces neutralizing antibodies

A

Hep B

HBsAg proteins

71
Q

What are the CI to Hep B?

A

Hypersensitivity to yeast
Severe allergic reaction to latex

72
Q

What type of vaccine is rotavirus? Based on what?

A

Live-attenuated vaccine

Issue w/ different strains of RV in geographical regions

73
Q

Which type of rotavirus vaccine? _____ live-attenuated G1P human RV vaccine

74
Q

Which type of rotavirus vaccine? _____ live pentavalent bovine-reassortant vaccine containing G1,2,3,4 and P1

75
Q

Why is rotavirus considered dangerous in kids?

A

can result in 40 poopy diapers an hour, sever risk of dehydration

76
Q

What is the dosing schedule for rotavirus? (Rotarix)

A

2-dose vaccine:
2 months
4 months

77
Q

What is the dosing schedule for rotavirus? (RotaTeg)

A

2 months
4 months
6 months

78
Q

What are the requirements for all Rotavirus vaccines regardless of the brand? Are you able to “catch up” on this vaccine?

A

Dose of either of the above should be given before 15 weeks of age and all doses given before 8 months of age

NOT able to catch this vaccine up

79
Q

What are the CI of the rotavirus vaccine?

A

Severe immunodeficiency

Previous h/o intussusception

Severe illness - wait until recovery to give vaccine

80
Q

What type of vaccine is HIB? Haemophilus Influenzae

A

Polysaccharide conjugate vaccine

81
Q

In the 1980s, prior to the vaccine, ____ was the leading cause of meningitis in children < 5 yo

82
Q

_____ MOA attaches a polyribosylribitol phosphate (PRP) capsule to a protein, which will recruit T-cells and lead to the formation of sufficient numbers of anti-PRP antibodies

A

HIB vaccine

83
Q

What is the dosing schedule for HIB?

A

IM
can be given in combo

2 months
4 months
6 months
12-15 month - booster

84
Q

What are the CI of the HIB vaccine?

A

Same w/ all other vaccine
Do no give to infants < 6 weeks of age

85
Q

____ vaccine is active against strep pneu, immunity begins in 2-3 weeks and lasts around 5 years. What type of vaccine?

A

Pneumococcal vaccine

all conjugate polysaccharide vaccines

86
Q

What are the 4 types of pneu vaccines?

A

PCV13 - Prevnar 13
PPSV23 - Pneumovax 23
PCV 15 - Vaxnuvance
PCV 20 - Prevnar 20

87
Q

What is the dosing schedule for PCV13?

A

IM
4-dose series given at WCC
2 months
4 months
6 months
12 - 15 months
>6 y/o - single dose

88
Q

What is the dosing schedule for PPSV23?

A

IM or SQ
1-dose
Indicated in adult population of those >65 y/o who have already received Prevnar 13

89
Q

What is the dosing schedule for PCV15 and PCV20?

A

1-dose
Indicated in adult population of those >65 who have not received either PCV 13 or PPSV23

90
Q

The flu vaccine types can either be _____ or ______

A

Inactivated / killed vaccine

or

Live-attenuated vaccine

91
Q

What is the inactived/killed flu vaccine derived from?

A

Derived from hybrid strain mixed w/ laboratory strain and grown in eggs

92
Q

What is the live-attentuated flu vaccine’s target/goal?

A

Donor virus is mated w/ an anticipated epidemic wild strain

Induces nasal IgA antibodies

93
Q

What are the important points about Fluzone?

A

6 months and older for standard dose of Fluzone

egg based

quadrivalent

94
Q

What are the important points about Flucelvax?

A

4 years and older

egg free and grown in cells of mammals

cell culture based

quadrivalent

95
Q

What are the important points about Flublok?

A

uses recombinant technology and is egg-free as well

18 years and older

quadrivalent

96
Q

The trivalent vaccine of Fluzone high dose, who is it indicated for?

A

65 and over

Contains 4 times the antigen of the standard vaccine to provide better protection

egg based

97
Q

What are the important points about FLUAD?

A

formulated with the adjuvant MF59

65 and over

Standard dose

98
Q

What are the CI for the intranasal live attenuated flu vaccine? What age range?

A

Pregnancy
Children 2-17 receiving ASA therapy
Immunosuppression
Children 2-4 w/ asthma or wheezing in past 12 months
People who have taken influenza antiviral meds in the past 48 hrs
People who care for immunosuppressed individuals
Chronic medical conditions, such as DM, chronic kidney dz, etc.

2-49

99
Q

**What is the dosing schedule for the flu vaccine in children 6 months to 8 years?

A

should receive 2 doses of influenza vaccine in the same season if they have never had two in one season previously

season is October through March

100
Q

**What is the dosing schedule for the flu vaccine in children 9 years and older?

A

only need 1 dose regardless of previous vaccination hx

101
Q

**What are the CI for the inactivated flu vaccine?

A

Severe latex allergy
Precautions
GBS infection w/in 6 wks of previous influenza vaccine

**Egg allergy is NOT a CI

102
Q

What type of vaccine is Varicella? What is the dosing schedule?

A

Live-attenuated vaccine

Given SQ
2-dose series at WCC
12 month WCC
4 year WCC - usually in combo w/ MMR vaccine

103
Q

____ MOA produces an IgG humoral immune response causing a cell-mediated immune response by varicella-zoster-specific activation of both CD4+ T-helper and CD8+ T-lymphocyte cells

A

Varicella vaccine

104
Q

What are the CI to the varicella vaccine?

A

Hx of allergy to neomycin
Blood dyscrasias (leukemia, lymphoma - anything that affects the bone marrow)
Moderate to severe illness
Anyone who has received blood products w/in 3-11 months
Immunocompromised or pregnant

105
Q

What strands of N. meningitidis does the meningococcal vaccine protect against?

A

A, B, C, W, X, and Y are responsible for majority of invasive disease

106
Q

_____ and ______ are conjugated polysaccharide vaccines - protects against serotypes A,C,W, and Y

A

Menactra

and

Menveo

107
Q

____ and ____ are recombinant vaccines - protect against serotype B

A

Bexsero

and

Trumenba

108
Q

What is the dosing schedule for Meningococcal ACWY?

A

given IM
2-dose series at WCC - required for public schools
11 years
16 years

109
Q

What is the dosing schedule for Meningococcal B?

A

2-dose series - still optional, but most colleges require

16 years
6 months after 1st dose

110
Q

What are the CI to the meningococcal vaccine?

A

Severe allergic reaction to latex

111
Q

What type of vaccine is HPV? What is the dosing schedule?

A

Subunit vaccine

Given IM

Indicated in ages 9-45, but most have no benefit over age 26

2 or 3-dose series dependent upon timing of administration of the vaccine
If administered before age 15 - only 2 doses needed
11 years old
Next dose in 6-12 month

112
Q

____ MOA is recombinant DNA was used to generate virus-like particles capable of mimicking the natural virus and eliciting high-titers of virus neutralizing antibodies

A

HPV vaccine

113
Q

_____ (name of vaccine) protects against strains 6, 11 (genital warts) and 16, 18 (cervical cancers) and now 31, 33, 45, 52, and 58

A

Gardasil 9

114
Q

What are the CI to HPV?

A

Immediate hypersensitivity to yeast
Severe latex allergy
Precaution
Pregnancy

115
Q

Live vaccine is introduced into system and patient produces a low-level viremia
IgM antibodies are produced against __
Virus may be passed through blood products so no blood donations allowed in pts who have received __ vaccine w/in 14 days

What vaccine?

A

yellow fever

116
Q

What type of vaccine is yellow fever? What is yellow fever spread by? What type of virus is yellow fever?

A

live-attenuated vaccine

spread by Aedes mosquitoes

Enveloped, single-stranded RNA virus, flavivirus

117
Q

What is the dosing schedule of yellow fever? What age range?

A

one injection for those traveling to or living in an area that is at risk for yellow fever

9 months - 59 years of age

118
Q

Does yellow fever immunity last a lifetime?

A

Usually lifelong protection, but given again in 10 years if traveling to high risk areas

119
Q

What are the CI to the yellow fever vaccine?

A

6 months or younger
Immunocompromised

120
Q

What are the two types of typhoid vaccines?

A

Capsular, polysaccharide vaccine

Oral, live-attenuated vaccine

121
Q

What type of bacteria does the Typhoid vaccine protect you from?

A

Protects from gram negative Salmonella enterica serotype typhi (Salmonella typhi)

122
Q

Works by causing lipopolysaccharide biosynthesis inducing a local protective immune response in the intestine
Due to the build up of lipopolysaccharide intermediates, the bacterial cells lyse before causing a virulent infection

What vaccine?

A

oral, live attenuated typhoid vaccine

123
Q

What is the oral typhoid vaccine dosing schedule?

A

1 capsule by mouth every other day totaling 4 pills
May travel 1 week after last dose
Given at 6 years of age and older
Booster every 5 years

124
Q

What is the IM injection typhoid vaccine schedule?

A

One dose
May travel 2 weeks after vaccination
Given at 2 years of age and older
Booster every 2 years

125
Q

What are the CI for the typhoid vaccine?

A

Oral vaccine:
Pregnancy
Immunocompromised

IM injection:
No real contraindication except as w/ all vaccinations, but best to delay until 2nd trimester of pregnancy

126
Q

Binds to the RV preventing it from invading the CNS
Also builds up antibodies to allow the vaccine to work more proactively

What am I?

A

Rabies immunoglobulin - passive immunization

127
Q

Inactivated antigen vaccine
Builds antibodies against the RV

What am I?

A

Rabies vaccine - active immunization

128
Q

Who needs to receive the rabies vaccine?

A

Used for pre-exposure immunization in high risk individuals as well as those who require post-exposure prophylaxis

infected person need both passive and active immunization

129
Q

What is the dosing schedule for HRIG - Human rabies immunoglobulin?

A

Injected around the wound up to 7 days after first dose of vaccine
If full amount not used, inject the rest at a different site from rabies vaccine
Is not given to those who have had previous vaccination

130
Q

What is the dosing schedule for the rabies vaccine?

A

1 mL given IM (deltoid) on days 0, 3, 7 and 14
If previously immunized, it’s given only on days 0 and 3
Immunocompromised persons should receive a fifth dose on day 28
In 2013, the vaccine age indication was dropped to 2 months of age

131
Q

_____ is immunoglobulin only - not an actual vaccine

A

Synagis / palivizumab: Humanized monoclonal anti-RSV antibody

132
Q

What is the MOA for Synagis?

A

Bind RSV F protein, which plays a role in virus attachment and mediates fusion

Does not inhibit virus attachment
Does inhibit viral transcription

133
Q

What is the dosing schedule for Synagis?

A

Must be given monthly to high-risk individuals during respiratory season (Sept - May)
15mg/kg/month IM
55% reduction in RSV admissions in premature infants

134
Q

Antibodies or antibody fragments derived from the plasma of large mammals (generally horses, but also sheep, goats, or rabbits) that have been previously immunized with non-lethal ______. Attaches to and neutralizes the _____ proteins causing it to be released from the receptor site

A

venomous doses

poisonous venom

135
Q

What is the dosing schedule for antivenoms?

A

The sooner initiated, the more effective - typically w/in 4 hours of bite
Indicated for progressive local tissue findings, hematologic laboratory abnormalities, and/or evidence of systemic toxicity
Airway swelling, neurological toxicity, cardiovascular collapse

136
Q

What is the proper protocol to administer antivenoms?

A

Initial dose:
4-6 vials IV over 1 hour
95% of cases control is achieved w/ initial dose

Subsequent doses:
An additional 4-6 vials

Maintenance dose:
2 vials every 6 hours up to 3 doses
This is started 6 hours after control achieved
Decreases recurrence of symptoms

137
Q

What is “control” defined as in antivenom cases?

A

Systemic symptoms resolved

Hematologic abnormalities are improving

Local effects have begun to improve

138
Q

What are some cautions when using antivenom?

A

Sensitivity should be tested first by injecting 0.1 mL SQ first and watching for any localized reaction over the next 30 min

Epinephrine and antihistamine should be at the bedside

Serum sickness

139
Q

Can occur days to weeks after administration of antivenom

Hypersensitivity reaction to the alien immunoglobulin

Anaphylactic and pyrogenic reactions

Fever, chills, rigor, headache and tachycardia

Skin rash, generalized allergic reaction

What am I?

A

Serum sickness in response to antivenom

Infectious Disease (16 decks)

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