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Infection > immunisation and prophalaxis > Flashcards

immunisation and prophalaxis Flashcards

1
Q

who are immunisations given to?

A

Childhood schedule
Special patient groups
Occupational
Travelers

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2
Q

who are prophalaxis given to?

A

Travelers
Post-exposure
Post-exposure (HIV)
Surgical

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3
Q

what is immunity divided into?

A
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4
Q

how does the primary response to infection differ to the secondary response?

A
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5
Q

what is the response to killed versus live vaccine?

A
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6
Q

what are the different types of vaccinations available?

A
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7
Q

what are examples of live attenuated vaccines?

A

Measles, mumps, rubella (MMR)
BCG
Varicella-zoster virus
Yellow fever
Smallpox
Typhoid (oral)
Polio (oral)
Rotavirus (oral)

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8
Q

what are examples of inactivated (killed) vaccines?

A

Polio (in combined vaccine D/T/P/Hib)
Hepatitis A
Cholera (oral)
Rabies
Japanese encephalitis
Tick-borne encephalitis
Influenza

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9
Q

how do detoxified exotoxini vaccines work?

A
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10
Q

what are examples of subunit vaccines?

A

Pertussis (acellular)
Haemophilus influenzae type b
Meningococcus (group C) conjugated: capsular polysaccharide antigen & Corynebacterium diphtheria protein
Pneumococcus
Typhoid
Anthrax
Hepatitis B

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11
Q

how do recombinant vaccine work?

A
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12
Q

what is the infanrix hexa (6 in 1 vaccine)?

A

D = purified diphtheria toxoid
T = purified tetanus toxoid
aP = purified Bordetella pertussis
IPV= inactivated polio virus
Hib= purified component of Haemophilus influenzae b
HBV= hepatitis B rDNA

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13
Q

what is the UK childhood immunisation schedule?

A

2 months: 6-in-1 vaccine + pneumococcal conjugate + rotavirus + Men B

3 months: 6-in-1 vaccine + rotavirus

4 months: 6-in-1 vaccine + pneumococcal conjugate + Men B

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14
Q

what is the UK childhood immunisation schedule following 1y?

A

1 year: Hib/Men C+ MMR + pneumococcal conjugate + men B
2 -8 years: influenza nasal

3 - 5 years: 4-in-1 booster (DTaP/IPV) + MMR
Girls, 12-13 yrs: Human papilloma virus

14 years: 3-in-1 booster (dT/IPV) + Men ACWY

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15
Q

what is the Bacille Calmette-Guerin (BCG) vaccine?

A

Some infants (0-12 months)
areas of UK with annual incidence of TB >40/100,000
Parents/grandparents born in a country with annual incidence of TB >40/100,000
Children screened at school for TB risk factors, tested and vaccinated if appropriate
New immigrants (previously unvaccinated) from high prevalence countries for TB
Contacts (<35yrs) of resp TB patients
Healthcare workers

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15
Q

what immunisations should be given for special patients and occupational groups?

A

BCG
influenza
pneumococcal
hepatitis B
varicella-zoster (chickenpox)
herpes-zoster (shingles)

16
Q

what is the influenza vaccine?

A

Influenza A and B constantly change antigenic structure
haemagglutinins (H)
neuraminidases (N) on surface of virus
New vaccine each year (WHO)
2017-18 Vaccine contains
A/ (H1N1)
A/ (H3N2)
B/
Single dose
Caution in egg allergy

17
Q

what are indications for the influenza vaccine?

A
18
Q

what are the two pneumococcal vaccinations offered?

A

pneumococcal conjugate polysaccharide vaccine (13 serotypes): Prevenar13®

pneumococcal polysaccharide vaccine (23 serotypes) Pneumovax II ®

19
Q

when is pneumococcal polysaccharide vaccine (23 serotypes) Pneumovax II ® given?

A

for those at increased risk of pneumococcal infection
single dose

20
Q

when is pneumococcal conjugate polysaccharide vaccine (13 serotypes): Prevenar13® given?

A

Part of childhood immunisation schedule
3 doses

21
Q

when is hep B vaccination given?

A

All new born children from 2018 (6-in-1)

Children at high risk of exposure to HBV
Health care workers, PWID, MSM, prisoners, ch. liver disease, ch. kidney disease,
Given at 0, 1 month, 2 months and 1 year

22
Q

when is the varicella-zoster vaccine (chickenpox) given?

A

patients who have a suppressed immune systems, for example having cancer treatment or organ transplant
children if in contact with those at risk of severe vzv
Health case workers (if sero-neg and in contact with patients)
Live attenuated virus
2 doses, 4-8 weeks apart

23
Q

when is the varicella-zoster vaccine (shingles) given?

A

All elderly patients (70-80 years)
Zostavax
Live attenuated virus

24
Q

what is human normal immunoglobulin?

A

contains antibodies against hepatitis A, rubella, measles
used in immunoglobulin deficiencies
treatment of some autoimmune disorders, e.g. myasthenia gravis

25
Q

what is disease specific immunoglobulin?

A

hepatitis B Ig
rabies Ig
tetanus anti-toxin Ig
Varicella zoster (chickenpox) Ig
diphtheria anti-toxin Ig (horse)
botulinum anti-toxin Ig

26
Q

what risk assessment should be done for travellers?

A

Health of Traveller
Previous immunisation and prophylaxis
Area to be visited
Duration of visit
Accommodation
Activities
Remote areas
Recent outbreaks

27
Q

what is general travel advice?

A

General Measures

Immunisation

Chemoprophylaxis

28
Q

what are general health measures for trvelers?

A

Care with food/water
Hand washing
Sunburn / Sunstroke
Altitude
Road traffic accidents
Safer sex
Mosquitoes - bed nets, sprays, “cover up”

29
Q

what are common immunisations for travellers?

A

Tetanus
Polio
Typhoid
Hepatitis A
Yellow fever
Cholera

30
Q

what immunisation are given to travellers in special circumstances?

A

Meningococcus A, C, W, Y
Rabies
Diphtheria
Japanese B encephalitis
Tick borne encephalitis

31
Q

what are different types of prophalaxis available?

A

Chemoprophylaxis against Malaria
Post-exposure prophylaxis*
e.g. ciprofloxacin for meningococcal disease
HIV post-exposure prophylaxis*
“needle stick” (PEP), sexual intercourse (PEPSI)
Surgical antibiotic prophylaxis*
perioperative

32
Q

what is ABCD for malaria prevention?

A

Awareness of risk
Bite prevention
Chemoprophylaxis
Diagnosis and treatment

33
Q

how can bites be prevented?

A

Cover-up at dawn and dusk
Insect repellent sprays, lotions (DEET)
Mosquito coils
Permethrin-impregnated mosquito nets

34
Q

what chemoprophylaxis is available against malaria?

A

Malarone ® (proquanil & atovaquone) daily
doxycycline daily
Not for children <12 years
photosensivity
mefloquine weekly
Side effects: psychosis, nightmares (1:10,000)
Avoid if history of psychosis, epilepsy
chloroquine weekly + proquanil daily
For vivax/ovale/malariae only

35
Q

what malaria advice is given to travellers on return?

A

Any illness occurring within 1 year, and especially within 3 months, of return might be malaria

Patients should seek medical attention if they become ill, particularly within 3 months, and mention malaria risk

Infection (14 decks)

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