Infectious disease Flashcards

1
Q

The Psychological and Social Determinants of Vaccine Hesitancy

A

(confidence, complacency, convenience)

Religious views
Misinformation
Education
Perceived risk of disease
Side effects of vaccine
Geographic barriers
Personal/familial experience with vaccination
Disgust government and of healthcare system
Political views
Cost (free for children)
Historical context of discrimination

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2
Q

Review vaccine administration techniques including age, site, and parent involvement.

A

Infants and toddlers best held in parent’s arms—make sure the parent or HCP is HOLDING all the child’s limbs

Always be sure to verify and document

Older children best held in parents’ lap

Explain what is happening but also move confidently!

For older children distraction and calming techniques are helpful

Be prepared for vaso-vagal responses (from children and parents)

Ensure that you are comfortable and practicing proper technique—DO NOT PUT THE NEEDLE THROUGH YOUR HAND!
–Get the needling in, get the medicine/vaccine in, pull the needle out, SAFETY NEEDLE!!!!

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3
Q

Identify injection site based on age and appropriate landmark

younger than 12months?
older than 12 months?
adolescents?

A

Younger than 12 months- Vastas Lateralis (anterolateral thigh)

Older than 12 months- Vastas Lateralis (anterolateral thigh) or IF WALKING preferably Deltoid muscle

Adolescents-Deltoid muscle

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4
Q

Review common adverse effects with vaccine administration mild

A

Redness
Swelling
Pain
Fever Defined as (>100.4F)

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5
Q

Mild to Moderate Reaction of reactions

Treatment?

Medications for children less than 6 months and older than 6 months?

A

Soreness
Redness
Itching
Swelling

Treatment: Cool, damp cloth to help reduce redness, soreness, and/or swelling at the injection site.

Children < 6months: Acetaminophen (tylenol)

Children > 6mo Ibuprofen (Motrin).

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6
Q

Severe Anaphylaxis Reactions:

A

Hoarseness,
wheezing,
airway constriction,
difficulty breathing,
pale or mottled skin,
hypotension,
altered mental status,
fever,
redness,
rash.

Treatment: call 911, administer cardiopulmonary resuscitation (CPR), provide epinephrine or equivalent (e.g., EpiPen), immediate transfer to hospital

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7
Q

Differentiate between contraindication and precaution to vaccination.

A

-Precautions
Moderate or severe acute illness with or without fever

-Contraindications
–Severe allergic reaction (i.e., anaphylaxis)
–Severe immunodeficiency (CD4 < 200)
–Live vaccines and pregnancy

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8
Q

Identify age-appropriate immunizations (Birth, 12 months, 4-6 years, 11-12 years).

A

Birth: Hepatitis B

12 months:
Hepatitis A
Varicella
MMR

4-6 years:
DTaP
Inactivated poliovirus (IPV)
Varicella
MMR

11- 12 years
Tdap
HPV
Meningococcal

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9
Q

Identify vaccine-preventable diseases.

Pertussis?
Epiglottis?

A

Measles -MMR (Measles, Mumps, Rubella)

Varicella (Rubeola) -Varicella vaccine

Pertussis -DTap or Tdap

Influenza -Influenza vaccine

Pneumonia -Pneumoccal (PCV vaccine)

Rotavirus -Rotavirus vaccine

Epiglottis- Haemophilus Influenzae B (Hib)

Respiratory Syncytial Virus- RSV vaccine

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10
Q

Identify live vaccines and populations who should not receive live vaccines.

A

MMR
Varicella
Intranasal influenza
Rotavirus

Severe immunodeficiency and pregnancy

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11
Q

Measles

Agent:
Transmission:
Isolation:
Prevention:

A

Agent: Paramyxovirus
Transmission: Nasopharynx droplets
Isolation Precautions: Airborne
Prevention: MMR vaccine

(2-dose series beginning at 12-15 months of age. Second dose at 4-6 years of age)

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12
Q

Measles Clinical Features

3 C’S?
Other prodrome symptoms? 2

rash emerges when and persists for how long?

begins where and goes where?

A

Prodrome
-3 “Cs” - cough, coryza, and conjunctivitis
(Coryza - inflammation and congestion of mucous membranes in the nose)
-Fever (103°F-105°F)
-Koplik spots (blue-white spots) on buccal mucosa in the mouth

Rash
-Emerges 14 days after exposure and persists 5-6 days
-Begins at hairline, then involves face and upper neck
-Progresses downward and outward to hands and feet

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13
Q

People At High Risk For Severe Illness and complications from Measles?

A

-Infants and children younger than 5 years

-Adults older than 20 years

-Pregnant women

-People with compromised immune systems (e.g., leukemia, HIV infection)

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14
Q

Measles Complications
mostcommon cause of death from measles?

A

Otitis media

Diarrhea and related dehydration

Pneumonia

Encephalitis

Most common cause of death is from respiratory and/or neurological complications

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15
Q

Measles management
maintain what?
administer what vitamin?
assess what?

A
  • Maintain strict I and O
  • Administer Vitamin A - supports the immune system- decreases complications and mortality
  • Assess neuro signs
  • Assess lungs sounds
  • Encourage fluids- intravenous fluids if needed
  • Acetaminophen or ibuprofen for fever.
  • Antibiotics for secondary infections (pneumonia, otitis media)
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16
Q

Varicella (Chickenpox)

Agent:
Transmission:
Isolation:
Prevention:

A

a. Agent: varicella-zoster virus

b. Transmission: Direct contact, droplet secretions

c. Precautions: Contact and Airborne

d. Prevention: Varicella vaccine

17
Q

Symptoms of varicella
prodromal stage?
contagious when?

A
  1. Prodromal stage— fever, malaise
  2. Pruritic rash begins a macule vesicle then erupts

Contagious a day before rash appears and until vesicles are crusted

18
Q

treatment of varicella

A

Supportive, prevent skin infections

19
Q

varicella complications

A

Secondary bacterial infection of skin lesions

Pneumonia

Central nervous system manifestations
ꟷ Meningitis
ꟷ Encephalitis
ꟷ Seizures

20
Q

Erythema Infectiosum (Fifth disease)

agent
transmission
Isolation

A

Agent: Parvovirus B19

Transmission: Respiratory secretions

Precautions: Contact/Droplet
–Avoid exposure to pregnant mothers

21
Q

symptoms of fifth disease

A

-Persistent fever for 3-7 days

“Slapped Cheek” appearance

-Mild URI symptoms, cough

22
Q

Pertussis (whooping cough)

agent
transmission/precaution
prevention

A

Agent: Bordetella pertussis

Transmission/Precautions: Droplet

Prevention (Vaccines: DTaP, Tdap)

23
Q

symptoms of pertussis

A

Upper respiratory infection symptoms 1-2 weeks

Paroxysmal, short, rapid cough followed by high-pitched “whoop” or gasp. Cyanosis may occur

24
Q

treatment of pertussis

A

Supportive during hospitalization with oxygen, rest, hydration, careful feedings, and antibiotics

25
Q

complications of pertussis

A

respiratory distress

26
Q

Scarlet fever

agent:
transmission/precaution:

A

Agent: Group A Beta-hemolytic streptococci

Transmission/Precautions: Droplets

27
Q

scarlet fever complications

A

Acute rheumatic fever - heart, brain, joints

Acute glomerulonephritis

Pneumonia

28
Q

scarlet fever symtoms

5

A

Abrupt high fever,

halitosis (bad breath)

Tonsils large, edematous, covered with exudate

“Strawberry tongue”

Sandpaper-like pink rash to body

29
Q

Treatment of scarlet fever
medication?

A

Penicillin (if allergic Azithromycin) and supportive care

30
Q

Lyme disease

agent
transmission

A

Agent: Spirochete Borrelia burgdorferi

Transmission: Infected deer tick

31
Q

clinical manifestations of lyme disease

A

Fever
Headache
Rash (Erythema migrans)
Malaise
Lymphadenopathy

32
Q

Diagnosis of lyme disease

Complications of Lyme disease

treatment of Lyme disease

A

history and serologic testing

Carditis
Arthritis

Doxycycline >8 yrs

Amoxicillin < 8 yrs

33
Q

Rocky Mountain Spotted Fever.

Agent:
transmission:

A

Agent: Spirochete Rickettsia rickettsii

Transmission: Infected tick bite

34
Q

Clinical manifestations of rocky mountain spotted fever

A

Fever, malaise

Severe headache

Petechial rash on palms, soles of feet

35
Q

treatment of rocky mountain

A

IV Doxycylcine 1st line therapy

36
Q

Infectious Mononucleosis

agent
transmission/precautions

A

Agent: Epstein Barr Virus or “EBV” (90% of cases)

Transmission/Precautions: Oral secretions; shed for >6 months after acute infection and then intermittently throughout life

37
Q

Clinical manifestations of mono

A

Look for “Triad”

Fatigue, pharyngitis, generalized
lymphadenopathy Splenomegaly (~50%)

38
Q

treatment of mono

A

Rest and symptomatic therapy

Avoid contact sports and strenuous activities for 4 weeks or while splenomegaly is present

39
Q

Transmission-Based Precaution

Airborne
Droplet
Contact

A

Airborne
Small particle
Negative pressure isolation room

Droplet
Large-particle droplets (sneeze, cough, speech, cry)

Contact
Gloves and gowns