Infectious Diseases Flashcards
what antibiotics have anti-anaerobic activity?
• Penicillins
• Cephalosporins (except ceftazidime)
• Erythromycin
• Metronidazole
• Tetracycline
which 3 antibiotics have no anti-anaerobic activity?
• Gentamicin
• Ciprofloxacin
• Ceftazidime
what is the incubation period of:
• Scarlet fever
• Influenza
• Diphtheria
• Meningococcus
1 week
what is the incubation period of:
• Malaria
• Measles
• Dengue fever
• T yphoid
1-2 weeks
what is the incubation period of:
• Mumps
• Rubella
• Chickenpox
2-3 weeks
what is the incubation period of:
• Infectious mononucleosis
• Cytomegalovirus
• Viral hepatitis
• HIV
more than 3 weeks
what type of vaccines are:
• BCG
• measles, mumps, rubella (MMR)
• oral polio
• oral typhoid
• yellow fever
-why is it important to note this?
live attenuated
-may pose a risk to immunocompromised patient
what type of vaccines are:
• rabies
• influenza
whole killed organism/inactivated
what type of vaccine is tetanus?
• tetanus: Detoxified exotoxins
what type of vaccine are:
• diphtheria
• pertussis (‘acellular’ vaccine)
• heptitis B
• meningococcus, pneumococcus, hemophilus
Fragment/Extracts of the organism or virus (may also be produced using recombinant DNA technology)
what different types of influenza vaccine exist?
different types are available, including whole inactivated virus, split virion (virus particles disrupted by detergent treatment) and sub-unit (mainly hemagglutinin and neuraminidase)
what does the vaccine for cholera contain?
contains inactivated Inaba and Ogawa strains of Vibrio cholerae together with recombinant B-subunit of the cholera toxin
what does the vaccine for hepatitis B contain?
hepatitis B: contains HBsAg adsorbed onto aluminium hydroxide adjuvant and is prepared from yeast cells using recombinant DNA technology
what may be used in hep A post-exposure prophylaxis?
• Human Normal Immunoglobulin (HNIG) or hepatitis A vaccine may be used depending on the clinical situation
what is done for hepatitis B post-exposure prophylaxis?
-if a person is a known responder to HBV vaccine
-if a person is a non-responder
• HBsAg positive source: if the person exposed is a known responder to HBV vaccine then a booster dose should be given. If they are in the process of being vaccinated or are a non- responder they need to have hepatitis B immune globulin (HBIG) and the vaccine
• Unknown source: for known responders the green book advises considering a booster dose of HBV vaccine. For known non-responders HBIG + vaccine should be given whilst those in the process of being vaccinated you have an accelerated course of HBV vaccine
what to do for post-exposure prophaxis for hepatitis C?
• Monthly PCR - if seroconversion then interferon +/- ribavirin
what to do for post-exposure prophylaxis for HIV?
• A combination of oral antiretrovirals (e.g. Tenofovir, emtricitabine, lopinavir and ritonavir) as soon as possible (i.e. Within 1-2 hours, but may be started up to 72 hours following exposure) for 4 weeks
• Serological testing at 12 weeks following completion of post-exposure prophylaxis
• ↓ risk of transmission by 80%
what to do for post-exposure prophylaxis for varicella zoster?
Varicella zoster
• VZIG for IgG negative pregnant women/immunosuppressed
when is tetanus vaccine given routinely?
Tetanus vaccine is currently given in the UK as part of the routine immunisation schedule at:
• 2 months
• 3 months
• 4 months
• 3-5 years
• 13-18 years
describe what a ‘clean wound’ is?
Wounds less than 6 hours old, non-penetrating with negligible tissue damage
describe what a tetanus prone wound is?
puncture-type injuries acquired in a contaminated environment e.g. gardening injuries
wounds containing foreign bodies
compound fractures
wounds or burns with systemic sepsis
certain animal bites and scratches
describe what a high-risk tetanus prone wound is?
heavy contamination with material likely to contain tetanus spores e.g. soil, manure
wounds or burns that show extensive devitalised tissue
wounds or burns that require surgical intervention
what should be done for a patient with a clean/tetanus prone/high risk tetanus prone wound who has had full course of tetanus vaccines <10 years ago?
Patient has had a full course of tetanus vaccines, with the last dose < 10 years ago
no vaccine nor tetanus immunoglobulin is required, regardless of the wound severity
what should be done for a patient with a
-tetanus prone wound
-high-risk wound
who have had a full course of tetanus vaccine with the last dose >10 years ago?
Patient has had a full course of tetanus vaccines, with the last dose > 10 years ago
if tetanus prone wound: reinforcing dose of vaccine high-risk wounds (e.g. compound fractures, delayed surgical intervention, significant degree of devitalised tissue): reinforcing dose of vaccine + tetanus immunoglobulin