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Infectious Diseases > Lecture 9: Prevention of Infections/Adult Immunizations > Flashcards

Lecture 9: Prevention of Infections/Adult Immunizations Flashcards

1
Q

What type of vaccines provides both good humoral and cell mediated immunity and typically does NOT require a booster?

A

Live vaccines

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2
Q

What are 2 examples of Live vaccines

A

Live Vaccines

  1. MMR
  2. Zoster
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3
Q

What types of vaccines are a/w a weaker immune response, induce humoral immunity and therefore pts may need a booster

A

Killed/Inactivated vaccines

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4
Q

What are 2 examples of Killed vaccines

A

Killed/Inactivate Vaccines

  1. Influenza
  2. Hep A
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5
Q

What types of vaccines only present the necessary antigens, and are made of capsular polysaccharides so they are used for encapsulated organisms

A

Subunit Conjugate vaccines

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6
Q

What types of vaccines are Hep B and HPV

A

Subunit Recombinant Vaccines

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7
Q

What type of vaccines is Tdap

A

Toxoid vaccine

chemically inactivated toxin –> body recognizes harmless toxin

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8
Q

Vaccines & pregnancy

  1. What are the only 3 vaccines SAFE in pregnancy
  2. What types of vaccines are CI in pregnancy
A

Vaccines & pregnancy

  1. only safe vaccines = Tdap, influenza, HBV
  2. Live vaccines = CI in preg
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9
Q

General Principles of Adult Immunization

  1. what should you do if pts vax hx is incomplete/unknown?
  2. When giving dose in series should you restart the series if 1 dose is going to be late?
  3. If pt has immunity to tetanus should you still give the Tdap vaccine?
  4. What 2 pt populations are live vaccines CI in?
A

General Principles of Adult Immunization

  1. pts vax hx is incomplete/unknown –> vacinate!
  2. dont need to restart series if giving one dose late
  3. Give combo vaccine even if pt has immunity to 1 part
  4. Live vaccines CI in preg + immunosuppressed (HIV and CD4 < 200)
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10
Q

Influenza vaccine

  1. who should it be given to + how often
  2. what type of vaccine is it (2 diff kinds)
  3. what type sometimes given to younger pts
  4. what type given if > 65 or HIV+ (immunosupp)
  5. What is the CI to giving this vaccine
A

Influenza vaccine

  1. given to everyone annually
  2. inactivated or recombinant
  3. sometimes younger pts –> live vaccine
  4. > 65 or HIV+ (immunosupp) –> high dose and adjuvanted
  5. CI = severe egg allergy
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11
Q

Can you get the flu from the flu vaccine? why or why not?

A

CANT GET FLU FROM THE VACCINE b/c its inactivated or recombinant

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12
Q

What vaccine should preg women get w/EVERY pregnancy b/tween 27-36 wks

A

Tdap vaccine

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13
Q

Tdap vaccine

  1. which part(s) is acellular? which part(s) toxoid?
  2. how often must a booster be given?
A

Tdap vaccine

  1. Pertussis = acellular? Tetanus + Diptheria = toxoid
  2. booster every 10yrs
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14
Q

Pt suffered a penetrating injury on their foot. Wound cultures grow gram (+) rods that are anaerobic

  1. What bacteria is the likely cause?
  2. What vaccine should they be given in addition to wound care?
A

Penetrating injury w/ wound cultures growing gram (+) rods that are anaerobic

  1. bacterial cause = Clostridium
  2. Give Tdap vaccine + clean wound
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15
Q

MMR Vaccine

  1. what type of vaccine is it
  2. why should women of childbearing age be vaccinated
  3. what group of pts are typically immune (had infxn) and usu dont need vaccinated
  4. What groups of pts (general) need 2 doses 28 days apart rather than the typical single dose
A

MMR Vaccine

  1. live vaccine
  2. women of childbearing age be vaccinated to prevent congenital Rubella syndrome
  3. pts born before 1957 = usu immune (had infxn) and usu dont need vaccinated
  4. Immune defect or high risk pts = need 2 doses 28 days apart rather than typical single dose
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16
Q
  1. HIV+ w/CD4 > 200 6+ mos
  2. Students in post2ndary edu
  3. international travelers
  4. household contacts of immunocompromised
  5. healthcare workers

should get what vaccine and how many doses?

A
  1. HIV+ w/CD4 > 200 6+ mos
  2. Students in post2ndary edu
  3. international travelers
  4. household contacts of immunocompromised
  5. healthcare workers

give MMR (2 doses 28 days apart)

17
Q

Varicella Vaccine

  1. what type of vaccine is it
  2. how many doses? how far apart?
  3. how does dosing schedule change for HIV+ pt
  4. Who is considered to have assumed immunity in US
A

Varicella Vaccine

  1. live vaccine
  2. 2 doses 4-8 wks apart
  3. HIV+ pt –> doses further apart (3 mo)
  4. assumed immunity in US if born before 1980
18
Q

Zoster Vaccines

  1. What are the names of the 2 types of vaccines + which is live and which is recombinant
A

Zoster Vaccines

  1. RZV = recombinant
  2. ZVL = live
19
Q

Zoster Vaccines: RZV and ZVL

  1. which is indicated in ALL pts > 50
  2. which is preferred overall (no matter what age)
  3. which can only be given if pts > 60
  4. If pt received ZVL vaccine how long must you wait to give RZV
A

Zoster Vaccines: RZV and ZVL

  1. RZV = ALL pts > 50
  2. RZV = preferred overall (no matter what age)
  3. ZVL = only given if pts > 60
  4. pt received ZVL vaccine–> wait 2 months to give RZV
20
Q

HPV vaccine

  1. best if given _____
  2. what type of vaccine
  3. 2 doses if start at what age? 3 doses if?
  4. What ages is this vaccine indicated until for women vs men
  5. what age indicated until for MSM and HIV+
A

HPV vaccine

  1. best if given before sex
  2. subunit conjugated vaccine
  3. 2 doses if start age 9-14, 3 doses if start later
  4. women up to age 26 and men up to age 22
  5. MSM and HIV+ –> up to age 26
21
Q

Hep A vaccine

  1. what type of virus is it and typical # of doses
  2. what is it given in combo with/what should you test for 1st
    - how many doses for combo
A

Hep A vaccine

  1. killed vaccine, 2 doses
  2. combo w/HBV
    - test for HBV–> then give combo
    - 3 doses (vs normal 2)
22
Q

healthy pt < 40 is exposed to HAV. What is the preferred vaccination for this patient?

A

HAV immunoglobulin preferred over the vaccine

23
Q
  1. MSM, drug use
  2. Work in high risk setting
  3. Clotting factor d/o
  4. chronic liver dz
  5. close personal contact w/internat’l adoptee

these patients are indicated to receive which vaccine?

A

Hep A vaccine indicated for

  1. MSM, drug use
  2. Work in high risk setting
  3. Clotting factor d/o
  4. chronic liver dz
  5. close personal contact w/internat’l adoptee

and anyone who wants it

24
Q

What vaccine should be given to IVDU, pts w/ sexual RFs and healthcare workers that is a subunit conjugate vaccine given as 3 dose series at 0, 1 and 6 mo

A

Hep B vaccine

25
Q

How does the Hep A vaccine indications differ from Hep B indications (2 ways)

A

Hep A vs B

  1. Hep B indication does NOT include close personal contact
  2. MUST test pts Hep B status before giving vaccine
26
Q

What are the names of the 2 types of Meningococcal vaccines and what types of vaccines are they

A

Meningococcal vaccines

  1. MenACWY
  2. MenB

subunit conjugated vaccines

27
Q

Meningococcal vaccines: MenBFH-bp

  1. who should receive 2 doses
  2. who should receive 3 doses
A

Meningococcal vaccines: MenB-FHbp

  1. 2 doses for healthy teens/adults
  2. 3 doses for high risk pts
28
Q

Which vaccine is mainly indicated in kids but indicated in adults for before splenectomy or after a hematopoietic stem cell transplant?

A

HiB

29
Q

What is the benefit of giving vaccines to HIV pts

A

vaccines may incr CD4 count of HIV pts

Infectious Diseases (9 decks)

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