Immunisation and prophylaxis

Question 1

what are the types of acquired immunity?

Answer 1

natural active (infection), natural passive (maternal), artificial active (immunization), artificial passive (antibody transfer)

Question 2

outline thhe graphs of killed vs live vaccines

Answer 2

killed need mulitiple doses to build up an immune response, live only needs one dose.

Question 3

give examples of live vaccines

Answer 3

MMR, BCG, varicella voster virus, smallpox, typhoid, polio, rotavirus

Question 4

inac tivated viruses

Answer 4

polio, hep a, cholera, rabies, japenese encephalitis, tick-bourne encephalitis, influenza

Question 5

how are detoxified exotixin vaccines made? Give e.g.’s

Answer 5

treat a toxin with formalin to make it a toxioid e.g. diptheria and tetanus

Question 6

give examples f subunit vaccines

Answer 6

pertuissis, haemophilius influenzae type b, meningococcus group c, pneumococcus, typhoid, anthrax, hep b.

Question 7

what is the 6 in 1 vaccine called and what does it contain?

Answer 7

Infantrix hexa - diptheria, tetanus, bordetella pertussis, polio, haemophilus influenzae b, hep B

Question 8

outline the childhood immunisation schedule uptil 4mo…

Answer 8

at 2 mo - 6in1, pneumococcal conjugate, rotavirus, and meningitis B
at 3 mo - 6in1 and rotavirus
at 4 mo - 6in1, pneumococcal conjugate and meningitis B

Question 9

outline the childhood vaccination schedule from 1 - 14yo…

Answer 9

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

Question 10

what % of the population does herd immunity aim to target?

Answer 10

90-95%

Question 11

Who gets the BCG vaccine?

Answer 11

some infants, TB rf, immigrants, contacts of resp tb patients, healthcare workers

Question 12

Who gets the Influenza vaccine?

Answer 12

> 65, healthcare workers, DM, chronic disease patients, immunosupressed patients, coeliac disease patients, pregnant women (caution for people with egg allergies)

Question 13

Who gets the Pneumococcal vaccine?

Answer 13

childhood vaccine, immunosupressed, sickle cell disease, chrinic disease patients, DM, coeliac disease patients

Question 14

Who gets the Hep B vaccine?

Answer 14

all new born children from 2018, high risk children to HBV exposure, healthcare workers, MSM, prisoners, chronic disease patients.

Question 15

Who gets the Varicella-zoster (chickenpox) vaccine?

Answer 15

immunosupressed patients, children if in contact with vsv, healthcare workers (2 doeses 4-8 weeks apart, live attenuated virus)

Question 16

Who gets the Herpes-zoster virus? (shingles)

Answer 16

elderly (zostavax, live attenuated virus).

Question 17

in terms of passive immunisation what does Human normal immunoglobulin contain?

Answer 17

antibodies agaunst hep a, rubella, measles. Used in immunoglobulin deficiencies and some autoimmune disorders i.e. myasthenia gravis.

Question 18

name some post exposure immunoglobulins given…

Answer 18

hep b, rabies, tetanus antitoxin, varicella zoster, diptheria, botulinium antitoxin.

Question 19

risk assessment of travellers to get immunisation, what would be asked?

Answer 19

current health, hx of immunisations, area to visit, duration, accommodation, activities, remote areas, recent outbreaks.

Question 20

under travel advice what advice would be given regarding general measures?

Answer 20

care with food and water, handwashing, sunburn and sun stroke, altitude, RTA’s, safer sex, mosquitos (bed nets, sprays, coverup.

Question 21

what are the common immunisations for travellers?

Answer 21

tetanus, polio, typhoid, hep a, yellow fever, cholera.

Question 22

immunisation for travellers with specific circumstances?

Answer 22

meningococcus A,C,W,Y, Rabies, dipthheria, japenese B enchaphalitis, tick bourne encephalitis.

Question 23

Outline chemoprophylaxis against Malaria

Answer 23

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