Immunization and Infectious Disease Flashcards
Contraindications to vaccinations?
-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
Contraindications to live vaccines?
-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)
Live Vaccines include?
BCG Yellow Fever Rubella Typhoid Mumps Measles
(HIV not severely immunocompromised may recieve all except BCG and yellow fever)
Causes of Lymphadenopathy?
Infective: Bacterial, TB, Brucella, EBV, HIV, CMV, toxoplasmosis, syphilis
Non-infective: Sarcoidosis, RA, Eczema, Psoriasis, Phenytoin, berylliosis, malignancy
Lymphadenopathy:
Referral
- 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
Causes of pyrexia?
Infection Malignancy Immunogenic: RA, SLE, PAN, sarcoisosis Thrombosis: PE, DVT Drugs: antibiotics
Night sweats can be caused by which drugs?
opiods
SSRIs
PUO?
Intermittent or continuous fever >3wks, no cause has been found
Notifiable Infectious Diseases?
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 & 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
Malaria
Great mimic- prodrome: headache, malaise, myalgia, anorexia
recurring fever, rigors and drenching sweats
Exam: anaemis, jaundice and hepatosplenomegaly
blood test daily - 3 days
Malaria falciparum may present upto?
3mnths
Complications of malaria falciparum? 50% cases
Cerebral malaria hypoglycaemia renal failure pulmonary oedema splenic rupture disseminated intravascular coagulation
Benign malaria may present upto? and is caused by?
18mnths
p. vivax, p.ovale.(liver)
p. malariae (blood)
Typhoid and Paratyphoid
Salmonella typhi & paratyphi
faecel oral route
rose coloured spots on the trunk
malaise, fever, headache, constipation/ diarrhoea, epistaxis, delirium
Dengue fever
Aedes mosquito
red maculopapular rash 2-5days after fever
Dengue haemorrhagic fever?
purpuric rash appears 2-3 days after symptoms
minor injuries cause bleeding
Traveller’s Diarrhoea
Cholera:
Giardiasis: explosive diarrhoea tx: metronidazole
Amoebic dysentry: bloody stool
Measles
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
Rubella
Fever, LNs (suboccipital), pink maculopapular rash lasts 3d
Birth defects, arthritis, thrombocytopenia, encephalitis
Mumps
Fever, malaise, tender parotid and submandibular glands
Meningitis, epididymo-orchitis, pancreatitis
Chickenpox
Macule-Papule-Vesicle
Eczema Herpeticum, Encephalitis (cerebellar symptoms), Pneumonia, birth defects, neonatal infection
Erythema Infectiosum
Fifth disease/ Slapped-cheeck
Parvovirus
Erythematous maculopapular rash, starting on the face,
Lacy rash on trunk and limbs
Hand, foot and mouth disease
Coxsackie virus
oral blisters/ulcers
red-edged vesicles- hands and feet
fever
Women recieving the MMR vaccine should avoid pregnancy for how long afterwards?
1mnth
