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Yr 3 Infection > Immunisation and prophylaxis > Flashcards

Immunisation and prophylaxis Flashcards

1
Q

Who tends to receive immunisations?

A
  • Children as part of schedule
  • Special patient groups
  • Occupational
  • Travellers
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2
Q

When is prophylaxis given?

A
  • Travellers
  • Post exposure
  • Post exposure (HIV)
  • Surgical
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3
Q

What different types of vaccines are given?

A
  • Live attenuated
  • Inactivated (killed)
  • Detoxified exotoxin
  • Subunit of microorganism (Purified microbial products/recombinant)
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4
Q

Give some 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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5
Q

Give some examples of inactivated (killed) vaccines?

A
  • Polio (combined vaccine)
  • Hep A
  • Cholera (oral)
  • Rabies
  • Japanese encephalitis
  • Tick borne encephalitis
  • Influenza
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6
Q

Detoxified exotoxin vaccines are made by treating a toxin with formalin, giving a toxoid. What are examples of these?

A
  • Diphtheria

- Tetanus

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7
Q

Give some examples of subunit vaccines?

A
  • Pertussis
  • Haemophilus influenzae type b
  • Meningococcus (group c)
  • Pneumococcus
  • Typhoid
  • Anthrax
  • Hep B
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8
Q

An example of recombinant vaccine is hep B. How are these made?

A 
>DNA segment coding for HBsAg
>Removed, purified, mixed with plasmids
>Inserted into yeasts
>Fermented
>HBsAg produced
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9
Q

Out of killed and live vaccines, which one needs a succession of doses to boost immune response?

A

Killed vaccine

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10
Q

What is in the “6 in 1” vaccine: Infanrix hexa?

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 = hep B rDNA
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11
Q

Regarding the UK childhood immunisation schedule, what do children get in the first 18 years of life?

A

> MMR, Hib and Men B vaccines, polio (6 in 1 vaccine) = all in first 6m
MMR = 15m
Tetanus/diphtheria, polio, MMR, pertussis booster = 4-5 years
BCG = 10-14 years
Tetanus/diphtheria booster, polio

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12
Q

What special care groups get treated with BCG vaccine?

A
  • Children found to have TB risk factors
  • New immigrants from high TB prevalance countries
  • Contacts (<35y) of resp TB patients
  • Healthcare workers
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13
Q

What special care groups get treated with influenza vaccine?

A
  • Age >65
  • Nursing home residents
  • Healthcare workers
  • Immunodeficiency/suppression
  • Chronic liver/renal/cardiac/lung disease
  • DM
  • Coeliac disease
  • Pregnant women
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14
Q

Does the conjugate pneumococcal polysaccharide vaccine get given as part of childhood schedule or when patient has indication?

A

Childhood. The pneumococcal polysaccharide vaccine gets given when patient at increased risk.

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15
Q

What are indications for patients to be given pneumococcal vaccine?

A
  • Immunodeficiency/suppression
  • Sickle cell disease
  • Chronic liver/renal/cardiac/lung disease
  • DM,
  • Coeliac disease
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16
Q

New born children are now being given hep B vaccine. Other than children, what groups are susceptible to HBV and should be vaccinated?

A
  • Healthcare workers
  • Drug injectors
  • MSM
  • Prisoners
  • Chronic liver/kidney disease
17
Q

Varicella zoster vaccine is given as part of 2 doses, 4-8w apart. Who should be given it?

A
  • Immunosuppression
  • Children if in contact with those at high risk of severe VZV
  • Healthcare workers
18
Q

Herpes zoster vaccine is a live attenuated vaccine and is given to who?

A

-All elderly patients (over 70)

19
Q

Human normal immunoglobulin is a form of passive immunisation. What is it used for?

A
  • Antibodies against hep A, rubella, measles
  • Immunoglobulin deficiencies
  • Some autoimmune disorders eg myasthenia gravis
20
Q

Disease specific immunoglobulin is a form of passive immunoglobulin given post exposure. What is it given for?

A
  • Hep B Ig
  • Rabies Ig
  • Tetanus anti-toxin Ig
  • Varicella (chickenpox) Ig
  • Diphtheria anti-toxin Ig
  • Botulinum anti-toxin Ig
21
Q

What is part of risk assessment for a traveller who may need immunisation and prophylaxis?

A
  • Health of traveller
  • Previous immunisation and prophylaxis
  • Area to be visited
  • Duration of visit
  • Accomodation
  • Activities
  • Remote areas
  • Recent outbreaks

NEED to look at International Travel Health Advice

22
Q

What is general measures given as travel advice?

A
  • Care with food/water
  • Hand washing
  • Sunburn/sunstroke
  • Altitude
  • Road traffic accidents
  • Safer sex
  • Mosquitoes - bed bets, sprays
23
Q

What is common immunisations for travellers?

A
  • Tetanus
  • Polio
  • Typhoid
  • Hep A
  • Yellow fever
  • Cholera
24
Q

Name some immunisation for travellers in special circumstances?

A
  • Meningococcus A, C, W, Y
  • Rabies
  • Diphtheria
  • Japanese B encephalitis
  • Tick borne encephalitis
25
Q

What are the types of prophylaxis and give an example of each?

A
  • Chemoprophylaxis vs malaria
  • Post exposure prophylaxis (eg ciprofloxacin for meningococcal disease)
  • HIV post exposure prophylaxis (eg needle stick (PEP) and sexual intercourse (PEPSI))
  • Surgical antibiotic prophylaxis (eg perioperative)
26
Q

What is the ABCD of malaria prevention?

A
  • Awareness of risk
  • Bite prevention
  • Chemoprophylaxis
  • Diagnosis and treatment
27
Q

What is involved in awareness of risk of malaria?

A

Locations which carry a higher risk

28
Q

What is involved in bite prevention of malaria?

A
  • Cover up at dawn and dusk
  • Insect repellant sprays, lotions
  • Mosquito coils
  • Permethrin-impregnated mosquito nets
29
Q

What is given as chemoprophylaxis against malaria? What are side effects?

A
  • Malarone daily
  • Doxycycline daily (photosensitivity)
  • Mefloquine weekly (pychosis, nightmares)
  • Chloroquine weekly and proquanil daily
30
Q

What is malaria advice to travellers on return?

A

Any illness occurring within one year and especially within 3m may be malaria. Should seek medical attention especially if within 3m and mention malaria risk

Yr 3 Infection (12 decks)

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