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PHA 581 > Peds: Immunology & Infectious Disease > Flashcards

Peds: Immunology & Infectious Disease Flashcards

1
Q

Live Virus Contraindications

A

pregnancy

compromised immunity

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2
Q

Influenza (and yellow fever) Vaccine Contraindications

A

egg or chicken allergy

anaphylactic reaction to vaccine/constituent

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3
Q

General Vaccine Contraindication

A

moderate or severe illness regardless of fever

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4
Q

What are the rules for vaccinations in patients with IM household contacts?

A

inactivated vaccines: can safely administer

live attenuated vaccines: as needed if IM is 6+mo old
UNLESS (should not be administered):
-IM received SCT in prev 2 mo
-IM has graft vs host disease
-IM has SCID
(if administered: avoid contact w/ IM for 7d)

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5
Q

What is a concern with prolonged vaccine scheduling?

A

possible impaired immune response if LIVE VIRUS vaccines not given simultaneously

should be given at least 28d apart

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6
Q

MCV4: schedule

A

1st dose: age 11-12

booster: age 16

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7
Q

MCV4: contraindications

A

latex allergy
hx of life threatening allergic reactions to diphtheria toxoid
hx of guillain barre syndrome

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8
Q

Can the live attenuated influenza vaccine (flumist) cause the flu?

A

no, it is a weakened virus

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9
Q

Which population is FluMist (LAIV) indicated for?

A

healthy people

age 2-49

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10
Q

LAIV: contraindications

A

severe allergic reactions
children 2-17yo w/ ASA or ASA containing products or allergic to eggs
pregnancy
IM
children 2-4yo w/ asthma/wheezing in past 12mo
influenza antiviral meds in prev 48hrs

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11
Q

Synagis:

  • what is it
  • indication
  • schedule
A

RSV immunoprophylaxis

high risk children <2yo

monthly injections during RSV season (fall-early spring)

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12
Q

Vaccinations: normal side effects

A

fussiness (<3hr)
tiredness
low grade fever (<101.5)
pain, redness, swelling at injection site

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13
Q

Vaccinations: abnormal reactions

A 
inconsolable crying >3hr
high fever (>104-105)
seizure
neurologic abnormalities
anaphylactic reaction (facial/oral swelling, dyspnea)
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14
Q

Which adverse reaction is always a contraindication for subsequent vaccinations?

A

anaphylactic reaction

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15
Q

Roseola Infantum:

  • aka
  • etiology
  • common age group
A

erythema subitum

HHV 6, 7

6mo-3yr

**benign viral infection

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16
Q

Roseola Subitum:

  • typical features
  • S/S
A

abrupt, high fever (104) for 3-7d –> abrupt cessation of fever –> rosy, pink maculopapular rash (trunk –> head, extremities)

  • *rash is nonpruritic, blanchable
  • *rash disappears in 1-2d

adenopathy (neck)
minimal URI findings

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17
Q

Roseola Subitum: treatment

A

symptomatic (fever control, fluids)

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18
Q

Erythema Infectiosum:

  • aka
  • etiology
  • common age group
A

fifth’s disease

human parvovirus B19

children 5-15yo

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19
Q

Erythema Infectiosum:

presentation

A

initial sx:

  • mild-mod fever
  • HA
  • nausea, diarrhea

2-5d later:
-slapped cheeks w/ circumoral pallor

Followed by:
-lace like rash (trunk/limbs)

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20
Q

Erythema Infectiosum: treatment

A

supportive

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21
Q

Oral Candidiasis:

  • aka
  • etiology
A

thrush

candida albicans

**yeast infx of the oral mucosa

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22
Q

Oral Candidiasis: presentation

A

adherent white plaques

red, friable mucosa

dec feeding

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23
Q

Oral Candidiasis: treatment

A

nystatin suspension

treat mom PRN

24
Q

Enterobiasis:

  • aka
  • presentation
A

pinworms (enterobus vermicularis)

asymptomatic 
anal itching (esp at night)
25
Enterobiasis: diagnosis
scotch tape test
26
Enterobiasis: treatment
mebendazole treat whole family wash bedding in hot water
27
Enterobiasis: prevention
hand washing short nails avoid scratching the anus
28
Molluscum Contagiosum: - etiology - common age group - transmission
poxvirus childhood transmitted through skin contact (sex, sports) and fomites (sheets, towels)
29
Molluscum Contagiosum: treatment
``` curettage crypotherapy cantharidin podophyllotoxin retinoids salicyclic acid lasers ``` (no great data for any) (may resolve spontaneously)
30
Bacterial Meningitis: what is it
bacterial infx of the meninges of the brain and spinal cord EMERGENCY
31
Bacterial Meningitis: age groups and pathogens
1+mo - <3mo: group B streptococcus 3+mo - <3yr: S. pneumoniae 3+yr - <10yr: S. pneumoniae 10+yr - <19yr: N. meningitis
32
Bacterial Meningitis: presentation
fever, N/V, irritability, anorexia, HA, confusion, photophobia, back pain, nuchal rigidity N. meningitides: nonblanchable petechial rash
33
Viral Meningititis: presentation
similar to bacterial meningitis -- differentiate w/ lab studies
34
Primary Immunodeficiency: peds presentation
recurrent, sev URI/LRTI infx w/ encapsulated bacteria poor growth, failure to thrive unexplained splenomegaly, chronic diarrhea
35
What is the most common immunodeficiency?
selective IgA deficiency
36
Selective IgA Deficiency: diagnosis
deficiency of serum IgA (normal IgG, IgM) in a child over 4yo **under 4: don't always have optimized levels of Ig's
37
Selective IgA Deficiency: presentation
MC: asymptomatic ``` recurrent sinopulmonary infx AI disorders GI infx and other intestinal disorders allergic disorders anaphylactic transfusion reactions ```
38
Selective IgA Deficiency: indications for workup
``` recurrent OM, sinusitis, PNA giardiasis FH of any primary immunodeficiency incidental finding low IgA celiac disease recurrent AI sx anaphylactic reaction to blood products ```
39
Common Variable Immunodeficiency (CVID): - what is it - when sx present
impaired B cell, T cell, dendritic cell production --> impaired Ig production present around puberty (peak: 8yo)
40
Common Variable Immunodeficiency (CVID): criteria
reduced serum IgA, IgG, IgM presence of B cells poor/no response to vaccines absence of other immunodeficiency
41
Common Variable Immunodeficiency (CVID): presentation
variable clinical manifestations chronic/recurrent URI/LRTI (bronchiectasis) GI infx diarrhea, malabsorption, weight loss --> FTT atopic triad
42
Common Variable Immunodeficiency (CVID): management
refer to immunologist | IVIG
43
Selective Combined Immunodeficiency (SCID): - what is it - MC form
sev defect in T and B lymphocyte systems --> early death from overwhelming infx (PNA, meningitis, bacteremia) X linked (males only)
44
Selective Combined Immunodeficiency (SCID): random tidbits
part of newborn screening can become ill from live vaccines (MMR, OPV, RV)
45
What is an possible indication for Selective Combined Immunodeficiency (SCID)?
infant may not have visible thymus on CXR
46
Selective Combined Immunodeficiency (SCID): manifestations
``` persistent thrush death from common viral infx P jirovecii infx intrauterine graft vs host disease lymphoma + other malignancies ```
47
Selective Combined Immunodeficiency (SCID): management
stem cell transplantation
48
DiGeorge Syndrome: what is it
chromosomal deletion (22q11.2) affecting multiple body systems
49
DiGeorge Syndrome: manifestations
cardiac defects (tetralogy of fallot, ASD, VSD, truncus arteriosus, interrupted aortic arch) immune dysfunction (hypoplastic thymus gland, T cell deficits) cleft palate, craniofacial abnormalities hypocalcemia (parathyroid hypoplasia -- tetany, seizure) behavioral/emotional problems
50
Wiskott Aldrich Syndrome: what is it
X linked disorder caused by mutation of WASp protein
51
Wiskott Aldrich Syndrome: classic presentation
susceptibility to infx thrombocytopenia (sm platelets) eczema **can also develop AI diseases and malignancies
52
Wiskott Aldrich Syndrome: management
prophylactic abx and antivirals plt transfusion PRN Ig (if def) SCT (only curative tx)
53
Ataxia Telangiectasia: what is it
autosomal recessive disorder
54
Ataxia Telangiectasia: homozygous presentation
1st: progressive cerebral ataxia ``` abnormal eye movements neurologic abnormalities oculocutaneous telangiectasias immune deficiency malignancy ```
55
Ataxia Telangiectasia: manifestations in children
no fluid gait, wobbly (normal walking age) difficulty coordinating eye, head movement (saccades) nystagmus telangiectasias (conjunctivae, face, neck) swallowing problems variable immune deficiency (recurrent URI/LRTI) malignancy (lymphoma)
56
Ataxia Telangiectasia: management
manage manifestations individually watch for aspiration vaccinate (if they make Ig)
57
Molluscum Contagiosum: presentation
flesh colored dome shaped papules w/ central umbilication

PHA 581 (6 decks)

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