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Infection > Immunisation and Prophylaxis > Flashcards

Immunisation and Prophylaxis Flashcards

1
Q

Who is immunisation given to?

A

Childhood schedule
Special patient groups
Occupational
Travelers

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2
Q

Who is prophylaxis given to?

A

Travelers
Post-exposure
Post-exposure - HIV
Surgical

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3
Q

What are the types of immunity?

A

Adaptive immunity - natural (maternal or infection) or artificial (antibody transfer or immunisation)
Innate immunity - body’s own immune system

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4
Q

What happens to the secondary response to infection?

A

Immunological memory - antibodies act quicker and more sustained response

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5
Q

What are the different types of vaccines?

A

Live attenuated
Inactivated (killed)
Detoxified exotoxin
Subunit of micro-organism - purified microbial products and recombinant

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6
Q

What are live attenuated vaccine used against?

A

Measles, mumps and rubella
BCG, Varicella-zoster virus, yellow fever, smallpox, typhoid, polio and rotavirus

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7
Q

What are inactivated (killed) vaccines used for?

A

Polio, hepatitis A, cholera, rabies, Japanese encephalitis, tick-borne encephalitis and influenza

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8
Q

How does a detoxified exotoxin vaccine work?

A

Toxin is rendered inactive
Treat wit formalin to give toxoid
Ex. diphtheria and tetanus

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9
Q

What are subunit vaccines used against?

A

Pertussis, haemophilus influenzae type b, meningococcus, pneumococcus, typhoid, anthrax and hepatitis B

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10
Q

How is a recombinant vaccine formed - ex. hepatitis B?

A

DNA segment coding for HBsAg
Removed, purified and mixed with plasmids
Inserted into yeast
Fermented
HBsAg produced

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11
Q

What does the ‘6 in 1’ vaccine - Infanrix hexa involve?

A

D - purified diphtheria toxoid
T - purified tetanus toxoid
aP - purified Bordetella pertussis
IPV - inactivated polio virus
Hib - purified component of haemophilus influenza B
HBV - hepatitis B rDNA

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12
Q

What ages are the childhood immunisation schedule to immunisations happen?

A

2 months, 3 months and 4 months
1 year, 2-8 years, 3-5 years
Girls 12-13 years - HPV
14 years

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13
Q

What immunisations are given for special patients and occupational groups?

A

BCG, influenza, pneumococcal, hepatitis B, varicella-zoster and herpes-zoster

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14
Q

Who is the BCG vaccine given to?

A

Some infants
Children screened at school for TB risk factors
New immigrants from high prevalence TB countries
Contacts of resp. TB patients
Healthcare workers

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15
Q

What are the indications for influenza vaccine?

A

Age over 65, nursing home residents, health care workers, immunosuppression, asplenia, CLD, CD, chronic renal and lung disease, DM, coeliac disease and pregnant women

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16
Q

Describe the influenza vaccine

A

New vaccine each year
Single dose - caution in egg allergy
Influenza A and B constantly change antigenic structure

17
Q

What are the 2 pneumococcal vaccines?

A

Pneumococcal conjugate polysaccharide vaccine - part of childhood immunisation schedule and 3 doses
Pneumococcal polysaccharide vaccine - if increased risk and single dose

18
Q

What are the indications for pneumococcal polysaccharide vaccine?

A

Immunosuppression, asplenia, sickle cell anaemia, chronic lung, renal, cardiac and liver disease, DM and coeliac disease

19
Q

When is the hepatitis B vaccine given?

A

All new born children from 2018
Children at high risk exposure to HBV
Health care workers, PWID, MSM, prisoners, CLD, CKD
Given at 1,2 months and 1 year

20
Q

When is the Varicella-zoster vaccine given?

A

Patients with suppressed immune system
Children if in contact with severe VZV
Health care workers
Live attenuated virus
2 doses and 4-8 weeks apart

21
Q

When is herpes-zoster vaccine given?

A

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

22
Q

What are the 2 types of passive immunisation?

A

Human normal immunoglobulin
Disease specific immunoglobulin

23
Q

Describe human normal immunoglobulin

A

Contains antibodies against hep A, rubella and measles
Used in immunoglobulin deficiencies
Treatment of some autoimmune disorders

24
Q

What are some disease specific immunoglobulins?

A

Hep B, rabies, tetanus anti-toxin, varicella zoster, diphtheria and botulinum Ig

25
Q

What is the risk assessment for prophylaxis for travel?

A

Health of traveller, previous immunisation, area to be visited, duration, accommodation, activities, remote areas and recent outbreaks

26
Q

What are the sources of info for travel and prophylaxis?

A

British national formulary (BNF)
Green book - immunisation against infectious diseases

27
Q

What are the general measures for travel?

A

Care with food/ water, hand washing, sunburn, altitude, RTA, safer sex and mosquitoes

28
Q

What are common immunisations for travellers?

A

Tetanus, polio, typhoid, hepatitis A, yellow fever and cholera

29
Q

What are some immunisations for travellers in special circumstances?

A

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

30
Q

When is prophylaxis used?

A

Chemoprophylaxis against Malaria
Post-exposure prophylaxis
HIV post-exposure prophylaxis
Surgical antibiotics prophylaxis

31
Q

What is the ABCD of Malaria prevention?

A

Awareness of risk
Bite prevention
Chemoprophylaxis
Diagnosis and Treatment

32
Q

What is involved in bite prevention for Malaria?

A

Cover up at dawn and dusk
Insect repellent sprays and lotions
Mosquito coils
Permethrin impregnated mosquito nets

33
Q

Describe chemoprophylaxis against Malaria

A

Malarone daily - most popular
Doxycycline daily
Mefloquine weekly
Chloroquine weekly and Propuanil daily

34
Q

What is the Malaria advice to traveller on return?

A

Any illness occurring within 1 year esp. 3 months of return might be Malaria
Patients should seek medical attention

Infection (13 decks)

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