Immunisations & Screening Tests Flashcards
Which vaccines contain a ‘live’ strain?
MMR BCG Yellow fever Typhoid Intranasal influenza Rotavirus Varicella
Which vaccines contain an inactivated/attenuated strain?
Polio (IPV) Pertussis Rabies Hep A Men B IM flu
Which vaccines contain antigens/extracts of the disease?
Hib
Meningococcal A&C
Typhoid
Pneumococcus
Which vaccines contain toxoids of the disease?
Diptheria
Tetanus
What are the pro’s & con’s of a live vaccine?
Pro: Organism grows over a period of days and immune system reacts as if it were real. Gives long lasting immunity
Con: Can revert to active form in immunoC patient and cause symptoms of the disease
What sort of immunity do vaccines containing immunoglobulins give?
Passive
What are the pro’s and con’s of an attenuated vaccine?
Primary IgM response followed by IgG multiple doses induce accelerated response.
Pro: Minimal risk of infection
Con: Less effective than live vaccine so booster required (multiple injections)
What vaccines are given before (not including) the age of 1?
8w: 6in1 (Hib, Diptheria, Tetanus, Pertussis, Polio, Hep B), Pneumococcal, Men B, Rotavirus (liquid)
12w: 6in1, Rotavirus
16w: 6in1, Pneumococcal, Men B
What vaccines are given at the age of 1 and over?
1yr: MMR, MenC/Hib, Men B, Pneumococcal
3yr4m: MMR, Booster (Diptheria, Tetanus, Pertussis, Polio)
13yr: HPV (strains 6, 11, 16, 18), 2nd dose 6-24months apart
14yr: Men ACWY, Booster (Diptheria, Tetanus, Polio)
65yr: Pneumococcal, Influenza
70yr: Shingles
What does the diphtheria vaccine prevent?
Cardiomyopathy
Neuropathy
Death
What does the Whooping cough vaccine prevent?
Cerebral Palsy due to hypoxia
Death
What does the Hib vaccine prevent?
Meningitis
Epiglottitis
Deafness
Death
What does the Polio vaccine prevent?
Limb deformity
Respiratory problems
Death
What does the Rotavirus vaccine prevent?
GE
Death
What does the Mumps vaccine prevent?
Infertility
What does the Measles vaccine prevent?
SSPE
Death
What does the Rubella vaccine prevent?
Congenital rubella syndrome (sensorineural deafness, cataracts, congenital heart disease, learning difficulties, microcephaly, hepatosplenomegaly)- teratogenic affects worse at earlier gestation
80% chance fetus affected in 1st trimester
25% chance fetus affected at end of 2nd trimester
What does the Pneumococcal vaccine prevent?
Pneumonia
Meningitis
Death
What is the Guthrie test?
Performed at 5days
Heel prick & collect 4 spots of blood
What does the Guthrie test test for?
Sickle cell disease
CF
Congenital hypothyroid
Metabolic conditions: Homocysteinuria, maple syrup urine, PKU
When are the results available for the Guthrie test?
6-8weeks
What is the presentation of a child w/Diptheria?
Flu-like illness
Pharyngitis
Neck swelling
white/grey membrane over tonsils/pharynx
What are the signs of tetanus?
Neurotoxin: Tetanospasmin acts on motor cells in CNS causing spasm
Trismus-Lock jaw
Risus sardonicus: Grinning face due to facial muscle spasm
Opisthotonus: Arched body & hyperextended neck
Autonomic dysfunction: Sweating, tachy, hypoT
Death: RF/CF/Exhaustion/Aspiration
What are the signs of polio?
Flu-like symptoms Muscle pain Flaccid paralysis Areflexia CN affected: Deafness, blindness, dysarthria, dysphagia
What is the most likely diagnosis in someone who has not be immunised: 5yo boy from Uganda presents w/sore throat, generally unwell for the past 3d w/fever & mild sore throat. OE deteriorated, restless, febrile, no stridor, white membrane covering red pharynx
Diptheria
What is the most likely diagnosis in someone who has not be immunised: 6yo boy appears to be fitting. He is very rigid, arching his back, hyperextending neck, unable to speak, face locked in a permanent smile. You notice a small wound on his leg which has been there a few days.
Tetanus
What is the most likely diagnosis in someone who has not be immunised: 18mo boy presenting w/headache, mild fever, lethargy. Blood culture & LP are done
LP: lymphocyte count +++, protein ++, glucose –
Abx commenced but..
Culture: -ve
So stopped but continues to deteriorate
TB (meningitis)
What is the most likely diagnosis in someone who has not be immunised: 7yo boy from China w/Hx of headache, muscle pain, neck stiffness. 3d after onset he gets L leg weakness. OE he has flaccid paralysis & loss of reflexes & normal sensation.
Polio
What is the most likely diagnosis in someone who has not be immunised: 5yo boy w/chronic cough for 3m. For first 4w the cough would occur in bursts & he would get v.distressed occasionally going blue & vomiting.
Pertussis
What does the Varicella Zoster infection do to a growing fetus?
Non-immune mothers
1-2% chance of developing fetal varicella syndrome
Usually before 20w
Dertamological skin scarring, neurological defects, eye defects, limb hypoplasia
What type of test is the newborn hearing test?
Otoacoustic emission test: Computer generated click into ear piece, soft echo indicates healthy cochlear
Abnormal test: Auditory Brainstem Response test
What vaccinations are given to pregnant women?
Pertussis (from 16weeks offered up to 32weeks but not as effective)
Influenza
What causes mumps?
Paramyxovirus
What are the features of mumps?
Parotitis (Swallowing a citrus drink= pain) Orchitis Fever Malaise Coryzal Viral meningitis/encephalitis Seizure
