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Infection > Immunisation and prophylaxis > Flashcards

Immunisation and prophylaxis Flashcards

1
Q

Who tends to receive immunisations? [4]

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

When is prophylaxis given? [4]

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

What different types of vaccines are given? [4]

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?
3 oral egs
5 others

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? [7]

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? [2]

A
  • Diphtheria

- Tetanus

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7
Q

Give some examples of subunit vaccines? [7]

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? [4]

A

> DNA segment coding for HBsAg
Removed, purified, mixed with plasmids
Inserted into yeasts and 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 4 months of life?

A

2m: Infanrix Hexa + pneumococcal conjugate + rotavirus + Men B
3m: Infanrix Hexa + rotavirus
4m: Infanrix Hexa + penumococcal conjugate + Men B

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12
Q

What special care groups get treated with BCG vaccine? [4]

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? [8]

A
  • Age >65
  • Nursing home residents
  • HCW
  • 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

Both
Part of childhood immunization schedule with 3 doses
Pneumovax given when patient at increased risk

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15
Q

What are indications for patients to be given pneumococcal vaccine? [5]

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? [5]

A
  • Healthcare workers
  • Drug injectors/PWID
  • 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? [4]

A
  • Immunosuppression
  • Children if in contact with those at high risk of severe VZV
  • Healthcare workers
  • all elderly patients over 70 yo
18
Q

Human normal immunoglobulin is a form of passive immunisation. What is it used for?
Contains: Antibodies against hep A, rubella, measles

A
  • Immunoglobulin deficiencies

- Some autoimmune disorders eg myasthenia gravis

19
Q

Disease specific immunoglobulin is a form of passive immunoglobulin given post exposure. Name [6]

A
  • Hep B Ig
  • Rabies Ig
  • Tetanus anti-toxin Ig
  • Varicella (chickenpox) Ig
  • Diphtheria anti-toxin Ig
  • Botulinum anti-toxin Ig
20
Q

What is part of risk assessment for a traveller who may need immunisation and prophylaxis? [8]

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

21
Q

What is general measures given as travel advice? [7]

A
  • Care with food/water
  • Hand washing
  • Sunburn/sunstroke
  • Altitude
  • Road traffic accidents
  • Safer sex
  • Mosquitoes - bed bets, sprays
22
Q

What is common immunisations for travellers? [6]

A
  • Tetanus
  • Polio
  • Typhoid
  • Hep A
  • Yellow fever
  • Cholera
23
Q

Name some immunisation for travellers in special circumstances? [5]

A
  • Meningococcus A, C, W, Y
  • Rabies
  • Diphtheria
  • Japanese B encephalitis
  • Tick borne encephalitis
24
Q

What are indications of prophylactic vaccines and give an example of each? [4]

A
  • Chemoprophylaxis against 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)
25
Q

What is the ABCD of malaria prevention?

A
  • Awareness of risk of the area that you are traveling to
  • Bite prevention
  • Chemoprophylaxis
  • Diagnosis and treatment
26
Q

What is involved in bite prevention of malaria? [4]

A
  • Cover up at dawn and dusk
  • Insect repellant sprays, lotions
  • Mosquito coils
  • Permethrin-impregnated mosquito nets
27
Q

What 4 drugs are given as chemoprophylaxis against malaria? What are side effects?

A
  • Malarone daily
  • Doxycycline daily (photosensitivity)
  • Mefloquine weekly (pychosis, nightmares)
  • Chloroquine weekly and proquanil daily
28
Q

What is malaria advice to travellers on return? [2]

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

29
Q

SE of mefloquine [2] and doxycyline

A

Doxycycline - photosensitivity

Mefloquine - psychosis, nightmares

Infection (20 decks)

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