miscellaneous

Question 1

vaccine schedule as of 2022 for kids/adolescents

Answer 1

birth (2x): hep B / vit K

2mo (3x)
dtp, hep B, polio and hib = infanrix hexa
rotavirus (rotarix)
pneumococcal (prevenar 13)
+ bexsero for ATSI

4mo (3x): same (+bexsero for ATSI)

6mo (1x)
just infanrix hexa
and prevenar 13 if at risk/ATSI, and bexsero if ATSI

12mo (3x)
meningococcal ACWY (nemenrix)
MMR (MMRII/priorix)
prevenar 13
+ bexsero if ATSI

18mo (3x)
Hib
MMR-V (priorix-tetra / proquad)
dtp only = infanrix
+ hep A if ATSI

4yo (1x)
dtp+polio = infanrix IPV
+and pneumovax 23 if at risk/ATSI, and hep A if ATSI

12-13yo (x2):
gardasil - x2 vax
dtp (boostrix)

14-16yo (1x): meningococcal ACWY (nimenrix)

Question 2

influenza vaccine - who is eligible

Answer 2

6mo-5yo (continues if ATSI, or if at risk)

Question 3

live vaccines - list 5 major ones, and their indications in immunocompromised

Answer 3

1. BCG - always CI
2. MMR - severe immunocompromise can give e.g. transplant, chemo, sig steroids
3. VZV - same as MMR
4. oral typhoid - CI
   5 rotavirus - give EXCEPT in SCID and Hx intusussception

Question 4

prophylactic paracetamol with which vaccine is recommended?

Answer 4

bexsero - men B

Question 5

common and uncommon reactions to vaccines generally

Answer 5

common
- local reaction
- injection site nodule
- low grade fever

uncommon
- febrile convulsion
- anaphylaxis
- Hypotonic-Hyporesponsive Episode (HHE)
- GBS

Question 6

tetanus toxoid containing vaccines causes WHAT side effect

Answer 6

Brachial neuritis

Question 7

which vax in particular is associated with febrile convulsions

Answer 7

MMR/MMR-V 1-2 weeks post

Question 8

what common vax do we give based on chronological age

Answer 8

rotavirus

Question 9

major side effects of MMR/MMR-V

Answer 9

1. fever +/- rash (+ febrile convulsion)
2. thrombocytopaenia
3. anaphylxis - to gelatin NOT egg
4. encephalopathy
5. parotitis

Question 10

what is the theoretical risk with rubella vaccination in pregnancy?

Answer 10

may cross the placenta and infect the foetus, so women advised to avoid pregnancy for 3 months following vaccination

Question 11

BCG not that great - what is it good for then?

Answer 11

Greatest benefit in preventing miliary tuberculosis and tuberculosis meningitis in children, and pulmonary TB in adults

Question 12

when is hep A vax efficacious?

Answer 12

almost universal seroconversion 4 weeks after vaccine

Question 13

the diarrhoeas: foods, incubation, duration.
- staph
- campy
- e.coli

Answer 13

staph = meat, potato, egg. 1-6h inc. dur 1-2 days
campy = poultry, milk. inc 2-5 days. dur 2-10 days.
e.coli = everything. inc. 1-8 days. dur 5-10 days

Question 14

neonates < 1 month = what 3 organisms

Answer 14

GBS
E coli
Listeria

Question 15

asplenia = what organisms

Answer 15

SHINS
strep pneumo
HiB
Neisseria
salmonella

Question 16

sickle cell = what organisms?

Answer 16

functional asplenia:
Sepsis, pneumonia, meningitis (strep pneumoniae)
Osteomyleitis (salmonella, staph)

Question 17

what is lemierre syndrome

Answer 17

Jugular Vein Suppurative Thrombophlebitis:
- caused by Fusobacterium necrophorum > IJV thrombophlebitis with septic emboli (most pulmonary)

Question 18

public health: when can these go to school

Chickenpox
Conjunctivitis
Hand, foot and mouth
Herpes (mouth)
Impetigo
Influenza
Measles
Mumps
Pertussis
Streptococcal

Answer 18

• Chickenpox, conjunctivits, HFM, oral herpes = until dried
• Impetigo: exclude until treatment commenced
• Influenza: until well
• measles: for at least 4 days after ONSET of rash
• mumps: 9 days of until swelling goes down
• pertussis: 21 days post cough onset or 5 days post tx
• strep: 24h post tx and child well

Question 19

post exposure vaccination required for??

Answer 19

varicella, hepatitis B

Question 20

cervical lymphadenopathy: dx process

Answer 20

acute
A) localised: KD, EBV, CMV, lymphadenitis
B) generalised: post-viral

chronic
A) localised: EBV, MAC, TB, bartonella
B) generalised: EBV, CMV, toxo, HIV, malignancy, AI e.g. SLE

Question 21

erythema multiforme = WHAT VIRUS

Answer 21

HSV!

Question 22

EM is what kind of hypersensitivity reaction

Answer 22

type IV

Question 23

SSSS vs SJS/TEN vs impetgio skin biopsy

Answer 23

SSSS: granular layer with no inflammatory cell infiltrate
SJS/TEN: subepidermal layer with necrosis
impetigo bullosa: subepidermal with inflammatory infiltrate

Question 24

cellulitis vs erysipelas

Answer 24

erysipelas well demarcated, raised, more acute, systemic, strep pyogenes.

Question 25

bartonella vs toxo lymphadenopathy

Answer 25

bartonella = tender
toxo = non-tender

Question 26

haemorrhagic cystitis = what virus

Answer 26

adenovirus!