Pediatric Vaccines

Question 1

5 types of vaccines

Answer 1

1. Live attenuated
2. Inactivated
3. Viral particles
4. Subunit
5. toxoid

Question 2

what 3 vaccines are live attenuated

Answer 2

MMR
Flu Mist
Varicella

Question 3

Toxoid vaccine example

Answer 3

tetneus

Question 4

what are the 4 groups in which a vaccine is contraindicated

Answer 4

1. Pregnant
2. Compramised immune system
3. anaphylactic reaction
4. Moderate or severe illness currently

Question 5

what is the allergy that should not get the flu vaccine

Answer 5

Egg or chicken allergy

Question 6

Common Misconceptions These are NOT contraindications 3

Answer 6

fever
breast feeding
antibiotics

Question 7

when do you want to give 2 live virus

Answer 7

same time if not 28 days apart

Question 8

what you should know for vaccines

Answer 8

1. 1st does
2. Last does
3. Contraindications

Question 9

Meningococcal Conjugate Vaccine is also called

Answer 9

MCV 4

Question 10

MCV4 first does

Answer 10

11

Question 11

MCV 4 booster

Answer 11

16

Question 12

high risk Meningococcal

Answer 12

2-10 year old

Question 13

Contraindications to MCV4 3

Answer 13

i. Latex allergy
ii. History of life-threatening allergic reaction to diphtheria toxoid
iii. Previous history of Guillain-Barré Syndrome (GBS)

Question 14

what ages gets the flu shot

Answer 14

2-49

Question 15

who should NOT get the flu vaccine 5

Answer 15

i. children 2-17 years receiving aspirin or aspirin-containing products persons who are allergic to eggs
ii. pregnant women
iii. immunosuppressed persons
iv. children 2-4 years of age with asthma or who had wheezing in the past 12 months
v. persons who have taken influenza antiviral medications in the previous 48 hours

Question 16

what is the vaccine for RSV

Answer 16

Synagis

Question 17

what is the most serious normal reaction to a vaccine

Answer 17

i. Low grade fevers (<101.5F)

Question 18

what are the abnormal reaction to a vaccine 4

Answer 18

i. crying for >3 hr
ii. High fever >104-105F
iii. Seizure
v. Anaphylactic reaction

Question 19

Roseola infantum caused by what

Answer 19

Human Herpes Virus 6 or 7

Question 20

Roseola infantum ages

Answer 20

6 months - 3 years

Question 21

Roseola infantum textbook

Answer 21

1. fever > 104 3 days
2. rash that starts on trunk and spreads to head
3. adenopathy

Question 22

Roseola infantum treatment

Answer 22

supportive

Question 23

a. Erythema Infectiosum “Fifth’s disease”

cause

Answer 23

. Parvo B-19

Question 24

1. Lace-like rash (trunk/limbs) follows slapped cheeks

What disease

Answer 24

Erythema Infectiosum “Fifth’s disease”

Question 25

Fifth’s disease treatment

Answer 25

supportive

Question 26

i. Candida albicans yeast infection of the oral mucosa

Answer 26

Oral Candidiasis “thrush"

Question 27

Oral Candidiasis “thrush" treatment

Answer 27

Nystatin suspension | Treat mom PRN

Question 28

a. Enterobiasis (Enterobus vermicularis) “Pinworms” | symptoms 2

Answer 28

1. Asymptomatic | 2. Anal itching

Question 29

nterobiasis (Enterobus vermicularis) “Pinworms” treatment 2

Answer 29

1. Mebendazole | 2. Treat the whole family

Question 30

a. Molluscum Contogiosum | what virus

Answer 30

Pox

Question 31

i. Bacterial infection of the meninges of the brain and spinal cord

Answer 31

a. Bacterial Meningitis

Question 32

i. Suspected bacterial meningitis = emergency; untreated mortality almost 100%

Answer 32

TRUE

Question 33

Bacterial Meningitis | 1-3 months

Answer 33

a. Group B streptococcus

Question 34

Bacterial Meningitis | 3 months - 10 years

Answer 34

a. S. pneumonia

Question 35

Bacterial Meningitis | 10 years - 19 years

Answer 35

a. N. meningitides

Question 36

i. Petechial rash of N. meningitides:

Answer 36

does NOT blanch

Question 37

i. Keep index of suspicion high in children…it may look A LOT like many other Peds infections

Answer 37

TRUTH

Question 38

i. Bottom line: it’s bacterial meningitis until proven otherwise

Answer 38

truth

Question 39

Defined as disorders resulting from inherited defects of the immune system (both isolated and combined defects)

Answer 39

1. Primary Immunodeficiency | - a. Defect may be present in any part (or multiple parts) of the immune system, including the humoral immune system

Question 40

Humoral immunodeficiency

Answer 40

impaired antibody (Ig) production

Question 41

Recurrent, severe URI/LRTI, including OM, sinusitis, pneumonia Infection w/ encapsulated bacteria (Hib, S pneumo, N menigitidis, Group B strep, Klebsiella pneumoniae, Salmonella typhi)

Answer 41

Primary immunodeficiency

Question 42

Most common immunodeficiency

Answer 42

Selective IgA Deficiency

Question 43

Deficiency of serum IgA (w/ normal IgG & IgM) in a child > 4 yo

Answer 43

Selective IgA Deficiency

Question 44

Selective IgA Deficiency MC symptoms

Answer 44

asymptomatic

Question 45

Any of the following: Giardiasis (GI infection w Giardia lamblia, intestinal protozoan) Family Hx of any primary immunodeficiency

Answer 45

Selective IgA Deficiency

Question 46

Impaired B-cell, T-cell and dendritic cell production impaired Ig production

Answer 46

Common Variable Immunodeficiency

Question 47

``` Criteria: Reduced serum IgA, IgG & IgM Presence of B-cells Poor response (or no response) to vaccines Absence of other immunodeficiency ```

Answer 47

Common Variable Immunodeficiency

Question 48

S/S: Chronic or recurrent URI/LRTI May develop bronchiectasis (even in peds!), watch for abnormal CXRs GI infections Diarrhea, malabsorption, weight loss FTT Atopic triad

Answer 48

Common Variable Immunodeficiency

Question 49

A severe defect in both the T- & B-lymphocyte systems, which leads to early death from overwhelming infection, typically in the first year of life

Answer 49

Severe Combined Immunodeficiency

Question 50

Multiple forms- most common form is X-linked (males only) “bubble boy” disease Part of newborn screening in all states

Answer 50

Severe Combined Immunodeficiency

Question 51

Children may become ill from live vaccines: varicella, MMR, OPV or RV Infant may not have a visible thymus on CXR

Answer 51

Severe Combined Immunodeficiency

Question 52

Manifestations: Persistent mucocutaneous candidiasis (thrush) Death from common viral infections (CMV, VZV, EBV, HSV, flu, etc.) P. jirovecii infection Intrauterine graft-vs-host disease- caused by transplacental maternal T-cells Lymphoma and other malignancies

Answer 52

Severe Combined Immunodeficiency

Question 53

Therapy managed by Immunology | Stem cell transplantation

Answer 53

Severe Combined Immunodeficiency

Question 54

Chromosomal deletion (22q11.2) affecting multiple body systems

Answer 54

DiGeorge Syndrome

Question 55

The most prevalent microdeletion syndrome in the US (up to 1/4000

Answer 55

DiGeorge Syndrome

Question 56

Immune dysfunction (hypoplastic thymus gland) T-cell deficits; severity varies Most severe form is considered a SCID Cleft palate & other craniofacial abnormalities Hypocalcemia (parathyroid hypoplasia)

Answer 56

DiGeorge Syndrome

Question 57

X-linked disorder caused by mutation in WASp protein

Answer 57

Wiskott-Aldrich Syndrome

Question 58

Classic presentation Susceptibility to infections (bacterial, viral, fungal) Thrombocytopenia (plts are also SMALL) Eczema

Answer 58

Wiskott-Aldrich Syndrome

Question 59

SCT only curative treatment (stem cell transplant)

Answer 59

Wiskott-Aldrich Syndrome

Question 60

Homozygous presentation: progressive cerebellar ataxia (first sign), abnormal eye movements, other neurologic abnormalities, oculocutaneous telangiectasias, immune deficiency (esp. pulmonary infection), and malignancy

Answer 60

Ataxia-Telangiectasia

Question 61

- Walk at normal age but don’t develop fluidity of gait, wobbly - Telangiectasias of the conjunctive, face, neck

Answer 61

Ataxia-Telangiectasia