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Y2 infection > immunisation and prophylaxis > Flashcards

immunisation and prophylaxis Flashcards

1
Q

how many doses are needed for a live vaccine vs killed

A

1 vs 3

live - quicker and sustained response

killed - gradually increasing response with each dose

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2
Q

types of vaccines

A

live attenuated
inactivated (killed)
detoxified exotoxin
subunit of micro-organism - purified microbial products, recombinant

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3
Q

examples of live attenuated vaccines

A 
mumps, measles, rubella (MMR)
BCG 
varicella zoster virus 
yellow fever
smallpox
typhoid, polio, rotavirus (all oral)
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4
Q

examples of inactivated (killed vaccines)

A 
polio (in combined vaccine D/T/P/Hib)
hepatitis A
cholera (oral)
rabies
japanese encephalitis 
tick-borne encephalitis 
influenza
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5
Q

examples of detoxified exotoxin vaccines

A

diphtheria

tetanus

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6
Q

examples of subunit vaccines

A 
pertussis (acellular) 
haemophilus influenzae type B 
meningococcus (group C)
pneumococcus 
typhoid 
anthrax
hepatitis B
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7
Q

how are recombinant vaccines made e.g. hep B

A 
DNA segment coding for HBsAg
removed, purified, mixed with plasmids
inserted into yeasts 
fermented
HBsAg produced
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8
Q

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 = hepatitis B rDNA
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9
Q

UK childhood immunisation schedule (2-4mths)

A

2mths - 6 in 1 vaccine + rotavirus + men B

3mths - 6 in 1 vaccine + rotavirus + pneumococcal conjugate

4mths - 6 in 1 vaccine + men B

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10
Q

UK childhood immunisation schedule (1-14yrs)

A

1yr - Hib/men C + MMR + pneumococcal conjugate + men B

2-8yrs - influenza nasal

3-5yrs - 4 in 1 booster (DtaP/IPV) + MMR

12-13yrs - human papilloma virus twice

14yrs - 3 in 1 booster (dT/IPV) + men C ACWY

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11
Q

what is the target coverage for herd immunity

A

90-95% coverage

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12
Q

immunisation for special patient and occupational groups

A 
BCG 
influenza
pneumococcal 
hep B 
varicella zoster (chicken pox)
herpes zoster (shingles)
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13
Q

BCG vaccination - who is vaccinated

A

some infants (0-12mths)
children - screen at school for TB risk factors, tested and vaccinated if appropriate
new immigrants (previously unvaccinated) from high prevalence countries for TB
contacts (<35y/o) of resp TB pts
healthcare workers

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14
Q

when are infants given BCG vaccine

A

areas of UK w/ annual incidence of TB ≥40/100 000

parents/grandparents born in a country w/ annual incidence of TB ≥40/100 000

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15
Q

influenza vaccine changes

A

influenza A and B constantly change antigenic structure
new vaccine each year
single dose
caution in egg allergy

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16
Q

indications for influenza vaccine

A 
>65y/o
nursing home residents health care workers
immunodeficiency or suppression 
asplenia/hyposplenism
chronic liver/renal/cardiac/lung disease
DM
coeliac disease
pregnancy
17
Q

pneumococcal vaccines

A

2 types:
pneumococcal conjugate polysaccharide vaccine (13 serotypes) - childhood immunisation schedule, 3 doses

pneumococcal polysaccharide vaccine (23 serotypes) - for those at increased risk of pneumococcal infection, single dose

18
Q

indications for pneumococcal polysaccharide vaccine

A 
immunodeficiency or suppression 
asplenia/hyposplenism
sickle cell disease
chronic liver/renal/cardiac/lung disease
DM
coeliac disease
19
Q

hepatitis B vaccination

A

all new born children from 2018 (6 in 1)
children at high risk of exposure to HBV
healthcare workers, PWID, MSM, prisoners, chronic liver/kidney disease
given at 0,1mth,2mths and 1 year

20
Q

varicella zoster vaccine

A

pts who have a suppressed immune system e.g. cancer treatment of organ transplant
children if in contact w/ those at risk of severe vzv
healthcare workers (if sero -ve and in contact w/ pts)

live attenuated virus
2 doses, 4-8wks apart

21
Q

herpes zoster vaccine

A

all elderly pts (70-80y/o)
zostavax
live attenuated virus

22
Q

human normal immunoglobulin

A

contains antibodies against hep A, rubella, measles
used in immunoglobulin deficiencies
treatment of some AI disorders e.g. myasthenia gravis

23
Q

disease specific immunoglobulin

A

post-exposure

hep B Ig 
rabies Ig 
tetanus anti-toxin Ig 
varicella zoster Ig 
diphtheria antitoxin Ig  (horse)
botulinum anti-toxin Ig
24
Q

risk assessment for travellers

A 
health of traveller 
previous immunisation and prophylaxis 
area to be visited 
duration of visit 
accommodation 
activities
remote areas
recent outbreaks
25
Q

travel advice

A

general measures
immunisation
chemoprophylaxis

26
Q

general measures for travel

A 
care with food/water
hand washing 
sunburn/sunstroke avoidance 
care w/ altitude 
road traffic accidents
safer sex
mosquitoes - bed nets, sprays, cover up
27
Q

common immunisations for travellers

A 
tetanus 
polio 
typhoid 
hep A
yellow fever
cholera
28
Q

immunisations for travellers in special circumstances

A

meningococcus A, C, W, Y - subsaharan africa, saudi arabia
rabies - in contact w/ dogs for prolonger periods of time
diphtheria - developing world and former soviet republics
japanese b encephalitis - some parts of far east
tick borne encephalitis - walkers in eastern europe

29
Q

examples of prophylaxis

A

chemoprophylaxis against malaria
post exposure prophylaxis e.g. ciprofloxacin for meningococcal disease
HIV post-exposure prophylaxis - PEP, PEPSI
surgical abx prophylaxis - perioperative

30
Q

ABCD of malaria prevention

A

awareness of risk
bite prevention
chemoprophylaxis
diagnosis and treatment

31
Q

highest risk areas for malaria

A

sub saharan africa
far east

lesser risks in asia and central america

32
Q

bite prevention for malaria

A

cover up at dawn and dusk
insect repellent sprays, lotions (DEET)
mosquito coils
permethrin impregnated mosquito nets

33
Q

chemoprophylaxis against malaria

A

malarone
doxycycline
mefloquine
chloroquine and proquanil

choice depends on country

34
Q

malarone

A

proquanil and atovaquone combination
daily

day before you leave and continue a week after return

35
Q

doxycycline

A

daily
antibiotic w/ anti-malarial properties
not for children <12y/o
photosensitivity

36
Q

mefloquine

A

weekly
side effects: psychosis, nightmares (1:10 000)
avoid if hx of psychosis, epilepsy

37
Q

chloroquine and proquanil

A

chloroquine weekly and proquanil daily

for vivax/ovale/malariae only

38
Q

malaria advice to travellers on return

A

any illness occurring within 1 yr and especially within 3 mths of return might be malaria

pts should seek medical attention if they become ill (esp within 3 mths) and mention malaria risk

Y2 infection (15 decks)

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