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Infection > Immunisation and Prophylaxis > Flashcards

Immunisation and Prophylaxis Flashcards

1
Q

Define immunisation

A

Induction of immunity to a specific infectious disease

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2
Q

Define prophylaxis

A

Prevention of disease

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3
Q

Break down immunity into its different categories

A

Immunity - innate and acquired
Acquired - natural and artificial
Natural - passive (maternal) & active (dx)
Artificial - passive (Ig) & active (vaccination)

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4
Q

Where is all the information about vaccines held?

A

Green book

BNF

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5
Q

How do vaccines work?

A

Stimulate active immunity and provide immunological memory (so if you were to encounter the pathogen you’d have a rapid response)

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6
Q

What are the different types of vaccines?

A

Live attenuated
Inactivated
Subunits of micro-organism
Detoxified exotoxin

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7
Q

What are live attenuated vaccines?

A

Live micro-organisms that have been modified to make them less deadly/closely related microorganisms
Provoked better immune response but not suitable for immunocompromised

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8
Q

Give examples of live attenuated vaccines

A

Yellow fever, MMR, BCG, VV, smallpox, typhoid, polio, rotavirus

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9
Q

What are inactivate vaccines?

A

Whole micro-organism has been killed with radiation, chemicals, antibiotics
Cannot become infected from this

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10
Q

Give examples of inactivated vaccines

A

Polio, hep A, cholera, Japanese encephalitis, tick-borne encephalitis, influenza

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11
Q

What are detoxified exotoxin vaccines?

A

Mix toxin with formula to make it inactive

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12
Q

Give examples of detoxified exotoxin vaccines?

A

Tetanus, diptheria

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13
Q

What are the different types of subunit micro-organisms?

A

A. purified microbial products

B. recombinant DNA

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14
Q

Give examples of recombinant DNA vaccines

A

Hep B, Hib, pertussis, MenC, pneumococcus, typhoid, anthrax

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15
Q

What are IgM?

A

Ab released after immediate exposure to a pathogen
Temporary - only stays in body for a while
Indicator of current infection

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16
Q

What are IgG?

A

Responsible for long lived immunity and memory

Indicator of previous infection

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17
Q

How many doses of killed vaccines do you need?

A

Often 2-3 as first few may not be adequate in producing an immune response

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18
Q

How many doses of live vaccines do you need?

A

Often only req. single dose as they are more immunogenic

19
Q

What is in the 6 in 1 vaccine Infranrix hexa?

A 
D - purified diptheria toxin 
T - purified tetanus toxin 
aP - purified Bordetella pertussis
IPV - inactive polio virus 
Hib - purified component of Hib
HBV - hepB rDNA
20
Q

Define herd immunity

A

Immunity that occurs when a significant percentage of population are vaccinated (90-95%)
Really important to protect those who are too ill/young to be vaccinated

21
Q

What patients are offered BCG?

A

Infants 0-12m from area in UK with/parents/grandparents from country with incidence of 40/100, 000 or more of TB
New immigrants from high prevalence countries
Contacts <35y of resp TB
Healthcare workers

22
Q

Who is offered influenza vaccine?

A 
>65y
Nursing home resident 
Immunodeficiency/suppression
Asplenia/hyposplenism 
Chronic liver/renal/heart/lung dx 
DM 
Coeliac disease
Pregnant woman
23
Q

What are the two pneumococcal vaccines?

A

13 serotype: Prevenar13 - 3 doses, part of childhood immunisation schedule

23 serotype: pneumovax II (single dose) - for certain indications

24
Q

What indicates the 23 serotype pneumonoccal polysaccharide vaccination?

A 
Immunodeficiency/suppression
Asplenia/hyposplenism 
Sickle cell dx 
Chronic liver/renal/cardiac/lung disease
DM 
Coeliac dx
25
Q

Who are offered HepB vaccination?

A

All new born children from 2018 (0, 1, 2 m & 1y)

Healthcare workers, PWID, MSM, prisoners, ch. liver/kidney disease

26
Q

Who is the VZV vaccine offered to?

A

Immunosupression, e.g. cancer/organ tx
Children if at high risk of severe VZV
Healthcare workers (if sero-neg)

27
Q

What kind of vaccine is VZV and when is it given/

A

Live attenuated

2 doses - 4-8wks apart

28
Q

What is a lifethreatening complication of VZV?

A

Pneumonitis

29
Q

Who is the shingles vaccine given to?

A

All elderly patients (70-80)

30
Q

What is shingles?

A

Dermatomal rash with painful blistering assoc with reactivation of VZV (virus remains dormant in dorsal root ganglia)

31
Q

When should human normal Ig be given?

A

Immunodeficiencies, some autoimmune dx, e.g. myasthenia gravis

32
Q

What does human normal Ig contain?

A

Hep A, rubella, measles

33
Q

What are some disease specific Ig you can give post-exposure?

A 
Hep B Ig
Rabies Ig
Tetanus antitoxin Ig
Varicella Ig
Diphtheria anti-toxin Ig
Botulinium anti-toxin Ig
34
Q

What is involved in risk assessment of a traveller?

A 
Health of traveller
Prev. immunisation/prophylaxis
Area to be visited
Duration of visit
Accommodation 
Activities 
Remote areas
Recent outbreaks
35
Q

What general travel advice should you give?

A 
Avoid sunburn, sunstroke, altitude sickness
Care with food/water
Handwashing
Road traffic accidents
Safer sex
Mosquitos - bed nets, sprays, cover up
36
Q

What are some common immunisations for travellers?

A

Yellow fever, tetanus, polio, hep B, cholera, typhoid

37
Q

When should you give men ACWY vaccine?

A

If going to certain areas with high incidence of meningococcus, e.g. Saharan Africa

38
Q

When should you give rabies vaccine?

A

Working with bats/dogs/likely to be bitten

39
Q

What is the ABCD of malaria prevention?

A

Awareness of risk
Bite prevention - cover up at dusk/dawn/insect repellent, DEET, mosquito nets
Chemoprophylaxis
Diagnosis and Rx

40
Q

What chemoprophylaxis options are there for malaria prevention?

A

Malarone (proquanil and atovaquone) daily
Doxycycline daily (>12 only, photosensitivity)
Mefloquine weekly
Chloroquine weekly & proquanil daily

41
Q

What are the side effects of mefloquine?

A

Psychosis, nightmares

42
Q

What type of malaria does chloroquine and proquanil protect against?

A

Vivax, ovale, malariae only

43
Q

What malaria advice is given to travellers on return?

A

Any illness occurring within 1 year, esp 3 months of return may be malaria

Infection (22 decks)

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