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Primary Care > Immunization and Infectious Disease > Flashcards

Immunization and Infectious Disease Flashcards

1
Q

Contraindications to vaccinations?

A

-Acute Illness

-Severe Local Reaction to previous dose:
extensive area of redness and swelling

-Severe generalized reaction to previous dose:
Fever >39.5 <48hrs, anaphylaxis, bronchospasm, laryngeal oedema, inconsolable screaming >4hrs, convulsions/ encephalopahy <72hrs

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2
Q

Contraindications to live vaccines?

A

-Pregnant or immunocompromised:
high dose steroids >1wk, haematological malignancy, radio/chemotherapy <6mnths
- <3mnths after another live vaccine
-with immunoglobulin (from 3wk before until 3mnths after)

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3
Q

Live Vaccines include?

A 
BCG 
Yellow Fever
Rubella
Typhoid
Mumps 
Measles

(HIV not severely immunocompromised may recieve all except BCG and yellow fever)

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4
Q

Causes of Lymphadenopathy?

A

Infective: Bacterial, TB, Brucella, EBV, HIV, CMV, toxoplasmosis, syphilis

Non-infective: Sarcoidosis, RA, Eczema, Psoriasis, Phenytoin, berylliosis, malignancy

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5
Q

Lymphadenopathy:

Referral

A
  • Rapidly growing
  • Non-tender, firm/hard, > 3cm
  • ass. w/t fever, night sweats, weight loss
  • ass. w/t petechial rash, head and neck ca signs
  • Enlarged SC nodes in the abscence of local infection
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6
Q

Causes of pyrexia?

A 
Infection
Malignancy
Immunogenic: RA, SLE, PAN, sarcoisosis
Thrombosis: PE, DVT
Drugs: antibiotics
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7
Q

Night sweats can be caused by which drugs?

A

opiods

SSRIs

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8
Q

PUO?

A

Intermittent or continuous fever >3wks, no cause has been found

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9
Q

Notifiable Infectious Diseases?

A 
Acute encephalitis
acute infectious hepatitis
acute meningitis
acute poliomyelitis
anthrax
botulism
brucellosis
cholera
diphtheria
typhoid/ paratyphoid fever
food poisoning
haemolytic uraemic syndrome
infectious bloody diarrhoea
Group A strep disease &amp; scarlet fever
Legionnaire's disease 
leprosy
malaria
measles
meningococcal septicaemia
mumps
plague
rabies
rubella
SARS
smallpox
tetanus
TB
typhus
viral haemorrhagic fever
whopping cough 
yellow fever
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10
Q

Malaria

A

Great mimic- prodrome: headache, malaise, myalgia, anorexia
recurring fever, rigors and drenching sweats

Exam: anaemis, jaundice and hepatosplenomegaly

blood test daily - 3 days

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11
Q

Malaria falciparum may present upto?

A

3mnths

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12
Q

Complications of malaria falciparum? 50% cases

A 
Cerebral malaria
hypoglycaemia
renal failure 
pulmonary oedema
splenic rupture
disseminated intravascular coagulation
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13
Q

Benign malaria may present upto? and is caused by?

A

18mnths

p. vivax, p.ovale.(liver)
p. malariae (blood)

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14
Q

Typhoid and Paratyphoid

A

Salmonella typhi & paratyphi
faecel oral route
rose coloured spots on the trunk
malaise, fever, headache, constipation/ diarrhoea, epistaxis, delirium

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15
Q

Dengue fever

A

Aedes mosquito

red maculopapular rash 2-5days after fever

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16
Q

Dengue haemorrhagic fever?

A

purpuric rash appears 2-3 days after symptoms

minor injuries cause bleeding

17
Q

Traveller’s Diarrhoea

A

Cholera:
Giardiasis: explosive diarrhoea tx: metronidazole
Amoebic dysentry: bloody stool

18
Q

Measles

A

Fever + 3Cs (conjunctivitis, coryzal, cough)
Koplik’s spots (cheeks), florid maculopapular rash after 4d
Bronchopneumonia, otitis media, stomatitis, corneal ulcers, gastroenteritis, appendicitis, encephalitis, subacute sclerosing panencephalitis

19
Q

Rubella

A

Fever, LNs (suboccipital), pink maculopapular rash lasts 3d

Birth defects, arthritis, thrombocytopenia, encephalitis

20
Q

Mumps

A

Fever, malaise, tender parotid and submandibular glands

Meningitis, epididymo-orchitis, pancreatitis

21
Q

Chickenpox

A

Macule-Papule-Vesicle

Eczema Herpeticum, Encephalitis (cerebellar symptoms), Pneumonia, birth defects, neonatal infection

22
Q

Erythema Infectiosum

A

Fifth disease/ Slapped-cheeck
Parvovirus
Erythematous maculopapular rash, starting on the face,
Lacy rash on trunk and limbs

23
Q

Hand, foot and mouth disease

A

Coxsackie virus
oral blisters/ulcers
red-edged vesicles- hands and feet
fever

24
Q

Women recieving the MMR vaccine should avoid pregnancy for how long afterwards?

A

1mnth

25
Q

How should pregnat women and neonates exposed to chickenpox be managed?

A 
Zoster Ig (VZ Ig) <3d after contact
Check Ab levels if immune status unknown
26
Q

Shingles exposure?

A

Infectious until all lesions have scabbed over

May acquire chickenpox (but not vice-versa)

27
Q

Tx: Shingles?

A

Oral aciclovir <48hrs after onset of rash

if immunocompromised: IV aciclovir

28
Q

Complications of Shingles?

A

Post herpetic neuralgia
Eye Involvement
Ramsay Hunt Syndrome: facial paralysis and hearing loss

29
Q

Presentation of streptococcal infection?

A 
Pharyngitis
Tonsilitis 
Wound/skin infection
Septicaemia
Scarlet Fever (Group A)
Pneumonia 
Rheumatic Fever (Group A)
Glomerulonephritis
Neonatal Sepsis
Postpartum Sepsis
Endocarditis
Septic Arthritis
Pneumonia
UTI
Dental caries
30
Q

Treatment to streptococcal infection?

A

Penicillin V

31
Q

Tx: Pneumococcal infection?

A

Amoxicillin

32
Q

Pneumococcal Vaccine is covered for how long?

A

5-10yrs

33
Q

Scarlet Fever Presentation?

A

Fever, malaise, headache, tonsillitis, fine punctate erythema (sparing face), Scarlet facial flushing, strawberry tongue,

34
Q

Complications of scarlet fever?

A

Rheumatic fever

Glomerulonephritis

35
Q

Risk Factors for toxic shock syndrome?

A 
tampon use
postpartum
staphylococcal wound infection
influenza
osteomyelitis
cellulitis
36
Q

Haemophilus influenzae infection should be treated with?

A

clarythromycin or doxycycline

37
Q

Clostridium infections?

A

C.difficile: vancomycin or metronidazole
C.botulinum: neuro symptoms, admit
C.tetani: tonic spaticity or convulsions, skin wound/burn, admit tx: antitoxin, debridement

Primary Care (9 decks)

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