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D2 E1 Shea > Immun/Infectious > Flashcards

Immun/Infectious Flashcards

1
Q

What 3 organizations issue an annual schedule of recommended vaccinations?

A
  • CDC (center for dz control/prevention)
  • AAP (american academy of peds committee)
  • AAFP (american academy of family physicians)
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2
Q

What are the 5 vaccine types?

A
  • Live-attenuated
  • Inactivated
  • Viral particles
  • Subunit vaccine
  • Toxoid

(LIV To Serve)

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3
Q

Which vaccine?

  • Virus is alive, but weakened
  • Virulence reduced
  • What are 3 examples?
A

Live-attenuated

  • MMR
  • FluMist
  • Varicella
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4
Q

Which vaccine?

  • Killed-viurs
  • capsid proteins remain and are antigenic
A

Inactivated

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5
Q

Which vaccine?

  • small virus particles
  • no viral DNA
A

Viral Particles

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6
Q

Which vaccine?

  • viral proteins only
A

Subunit

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7
Q

Which vaccine?

  • inactivated toxin stimulates antibody production
  • What is an example?
A

Toxoid

  • Tetanus vaccine
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8
Q

2 contraindications of Live Virus vaccines

A
  • Pregnancy
  • Compromised immunity
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9
Q

Contraindication for what type of reaction to vaccine / vaccine constituent?

A
  • anaphylactic rxn to vaccine/constituent
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10
Q

What is a contraindication for influenza vaccine?

A
  • egg or chicken allergy
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11
Q
  • Vaccines are contraindicated if the patient has what type of illness regardless of ____.
  • Which vaccine is the exception?
A
  • moderate or severe illness / fever
  • pneumococcal
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12
Q

What is a common misconception people have about why they should not get a vaccine? (10 total)

(NOT a contraindication)

A

*Immunosuppression of household contact*

  • mild illness
  • low grade fever
  • recent exposure to infectious dz
  • mild-mod local rxn to previous vaccine
  • current abx therapy
  • breasfeeding
  • prematurity
  • malnutrition
  • Fam hx of SIDS or seizures
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13
Q

T/F

  • Healthy patients who live in the same household as an immunocompromised patient CANNOT safely receive inactivated vaccines
A

False

  • Can safely receive inactivated vaccine
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14
Q

If the immunocompromised patient is __ months or older, the household members may receive which vaccine if needed?

A
  • 6 months
  • live attenuated influenza vaccine
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15
Q

A household member of an immunocompromised pt 6 months or older, may receive the live attenuated influenza vaccine unless the immunocompromised pt received what treatment in the past 2 months, has which disease, or has which comorbidity?

A
  • Tx: hematopoietic stem cell transplant
  • Dz: graft vs. host disease
  • Comorbidity: Severe Combined Immunodeficiency
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16
Q
  • A live vaccine should not be administered to household members if the 6 month old immunocompromised pt received a hematopoeitic stem cell transplant in the past 2 months, has a graft vs. host dz, or has severe combined immunodeficiency (SCID)
    • HOWEVER, if the household member receives the live vaccine, contact between the 6 month old and member should be avoided for how many days?
A

7 days

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17
Q
  • What leads to an impaired immune response when giving live-virus vaccines?
  • How do we prevent this?
A

When live virus vaccines are NOT given silmutaneously

  • Live virus vaccines NOT administered on the same day should be given at least 28 days apart
18
Q
  • Who should you report adverse reactions of vaccines to?
  • What resource should you utilize for regional recommendations on vaccines?
A
  • Report rxns: CDC/local health department
  • Recommendations: local health department
19
Q

**What are the 3 things you should FOR SURE know about each vaccine?**

A
  • When 1st dose should be given
  • When last dose is given
  • CONTRAINDICATIONS
20
Q

What resource should you use for immunization schedules?

A

CDC

  • catch up schedule
  • minimum intervals
  • contraindications
21
Q

At what age should a patient receive MMR?

(1st and 2nd dose)

(measles, mumps, rubella)

A
  • 1st: 12-15 months
  • 2nd: 4-6 years
22
Q

MCV4 (Meningococcal Conjugate Vaccine)

  • 1st dose at what age?
  • Booster at what age?
  • High risk in what age range?
A
  • 1st: 11-12 yrs
  • Booster: 16 yrs
  • High risk: 2-10 yrs
23
Q
  • MCV4 is preferable to what vaccine?
  • Because of what 3 circumstances?
A
  • MPSV4
  1. asplenia
  2. complement deficiency
  3. travel/reside where meningococcal disease is epidemic
24
Q

Which group of patients should be vaccinated with MCV4 if they did not receive vaccine at 11 yrs or booster at 16 yrs?

A

All college freshman living in dorms

25
Q

3 contraindications to MCV4 (Menactra or Menveo)

A
  • Latex allergy
  • Hx of life threatening allergic rxn to diphtheria toxoid
  • Prev hx of Guillain-Barre Syndrome (GBS)
26
Q

Live-attenuated Influenza Vaccine (FluMist)

  • Route?
  • Quadrivalent
  • For HEALTHY people of age __ yrs - ___ yrs old
  • Studies show moderate evidence that the Live Attenuated Influenza Vaccine has created a better response than what vaccine in children aged __ - __ yrs old (but DO NOT wait if this vaccine is not available)
A
  • Intranasal
  • 2 - 49 yrs
  • Inactivated Vaccine
  • 2 - 8
27
Q

6 contraindications to Live-attenuated Influenza Vaccine (FluMist)

A
  1. Severe allergic rxns to LAIV/components of vaccine/other influenza vaccines
  2. Children 2 - 17 yrs receiving ASA containing products
  3. Children 2 - 4 yrs w/ asthma or whzing past in the past 12 months
  4. Persons allergic to eggs
  5. Pregnant women
  6. Immunosuppressed persons
  7. Persons who have taken influenza antiviral meds in the past 48 hours

“AAAA PIE”

28
Q

Which vaccine?

  • High risk children <2 y/o (includes premature infants w/ additional RFs)
  • Montly injections during RSV season
  • Very expensive $$$
  • Requires prior authorization
A

Synagis (RSV immunoprophylaxis)

NOT A VACCINE

29
Q

What are the 6 normal SE of vaccinations?

A
  • Fussiness (<3 hr, consolable)
  • Tiredness
  • Low grade fevers (<101.5F)
  • Pain at site of injection
  • Redness at site of injection
  • Swelling at site of injection

(Pain, redness, swelling For Tired Little ones)

30
Q

5 abnormal reactions for vaccinations

A
  • Inconsolable crying for >3 hr
  • High fever >104-105F
  • Seizure
  • Neurological abnormalities
  • ****Anaphylactic reaction****
    • Facial/oral swelling, dyspnea
    • *Always a subsequent contraindication*

(SHANI)

31
Q

6 Pediatric Infectious Diseases on this test

A
  • Erythema subitum (Roseola)
  • Erythema infectiosum (Fifth’s disease, Parvo B19)
  • Pinworms
  • Oral candidiasis (thrush)
  • Molluscum contagiosum
  • Meningitis (viral, bacterial)
32
Q

Roseola Infantum

  • Another name for this?
  • Benign viral infection caused by which 2 Human Herpes Virus? (HHV)
  • Common in ages __ - ___
A
  • Erythema subitum
  • HHV 6 or 7
  • 6 months - 3 years
33
Q

Describe clinical presentation of Roseola infantum (erythema subitum)

(4 stages)

A
  1. Abrupt HIGH fever for 3-7 days (104ish)
  2. Abrupt cessation of fever
  3. Rosy-pink maculopapular rash (trunk –> head & extremities) (non-pruritic, blanching)
  4. Rash resolves in 1-2 days
34
Q

Besides the fever and rash, what other sxs may be present with Roseola?

A
  • Adenopathy (neck)
  • Minimal URI sxs (TM injection, congestion)
35
Q

Treatment for Roseola infantum (erythema subitum)

A
  • fever control
  • fluids
36
Q

Diagnosis?

A

Roseola infantum (erythema subitum)

  • nonpruritic
  • blanching
  • rosy-pink maculopapular
  • Starts on trunk/neck –> spreads to extremities
37
Q

Erythema Infectiosum

  • another name for this?
  • Etiology?
  • Kids ages __ - __
A
  • Fifth’s disease
  • Human Parvovirus B-19 (we slap 19 yr olds)
  • 5 - 15
38
Q

Erythema Infectiosum (Fifth’s disease)

  • 4 initial sxs?
  • 2 - 5 days later develop what sxs?
  • Treatment?
A
  • 4 Initial sxs:
    • Mild - mod fever
    • HA
    • Nausea
    • Diarrhea
  • 2-5 days later…
    • “slapped cheeks” w/ circumoral pallor
    • Lace-like rash (trunk/limbs) follows slap cheek
  • Tx: supportive
39
Q

Diagnosis?

A

Erythema Infectiosum (Fifth’s Disease)

  • “slapped cheek” & circumoral pallor
  • Parvo B19
  • This rash occurs 2-5 days after fever/HA/N/D
  • Kids 5 - 15 y/o
40
Q

Diagnosis?

A

Erythema Infectiosum (Fifth’s disease)

  • lace like rash on trunk/limbs (after slap cheek)
  • Reticular pattern
  • 2-5 days after initial sxs: F/HA/N/D

D2 E1 Shea (13 decks)

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