Immunisations & Screening Tests Flashcards by Amy Spicer

Which vaccines contain a ‘live’ strain?

MMR
BCG
Yellow fever
Typhoid
Intranasal influenza
Rotavirus
Varicella

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Which vaccines contain an inactivated/attenuated strain?

Polio (IPV)
Pertussis
Rabies
Hep A
Men B
IM flu

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Which vaccines contain antigens/extracts of the disease?

Hib
Meningococcal A&C
Typhoid
Pneumococcus

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Which vaccines contain toxoids of the disease?

Diptheria

Tetanus

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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

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What sort of immunity do vaccines containing immunoglobulins give?

Passive

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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)

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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

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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

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What does the diphtheria vaccine prevent?

Cardiomyopathy
Neuropathy
Death

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What does the Whooping cough vaccine prevent?

Cerebral Palsy due to hypoxia

Death

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What does the Hib vaccine prevent?

Meningitis
Epiglottitis
Deafness
Death

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What does the Polio vaccine prevent?

Limb deformity
Respiratory problems
Death

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What does the Rotavirus vaccine prevent?

Death

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What does the Mumps vaccine prevent?

Infertility

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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 ```