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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
Q

Enterobiasis: diagnosis

A

scotch tape test

26
Q

Enterobiasis: treatment

A

mebendazole

treat whole family

wash bedding in hot water

27
Q

Enterobiasis: prevention

A

hand washing
short nails
avoid scratching the anus

28
Q

Molluscum Contagiosum:

  • etiology
  • common age group
  • transmission
A

poxvirus

childhood

transmitted through skin contact (sex, sports) and fomites (sheets, towels)

29
Q

Molluscum Contagiosum: treatment

A 
curettage
crypotherapy
cantharidin
podophyllotoxin
retinoids
salicyclic acid
lasers

(no great data for any)
(may resolve spontaneously)

30
Q

Bacterial Meningitis: what is it

A

bacterial infx of the meninges of the brain and spinal cord

EMERGENCY

31
Q

Bacterial Meningitis: age groups and pathogens

A

1+mo - <3mo: group B streptococcus

3+mo - <3yr: S. pneumoniae

3+yr - <10yr: S. pneumoniae

10+yr - <19yr: N. meningitis

32
Q

Bacterial Meningitis: presentation

A

fever, N/V, irritability, anorexia, HA, confusion, photophobia, back pain, nuchal rigidity

N. meningitides: nonblanchable petechial rash

33
Q

Viral Meningititis: presentation

A

similar to bacterial meningitis – differentiate w/ lab studies

34
Q

Primary Immunodeficiency: peds presentation

A

recurrent, sev URI/LRTI
infx w/ encapsulated bacteria
poor growth, failure to thrive
unexplained splenomegaly, chronic diarrhea

35
Q

What is the most common immunodeficiency?

A

selective IgA deficiency

36
Q

Selective IgA Deficiency: diagnosis

A

deficiency of serum IgA (normal IgG, IgM) in a child over 4yo

**under 4: don’t always have optimized levels of Ig’s

37
Q

Selective IgA Deficiency: presentation

A

MC: asymptomatic

recurrent sinopulmonary infx
AI disorders
GI infx and other intestinal disorders
allergic disorders
anaphylactic transfusion reactions
38
Q

Selective IgA Deficiency: indications for workup

A 
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
Q

Common Variable Immunodeficiency (CVID):

  • what is it
  • when sx present
A

impaired B cell, T cell, dendritic cell production –> impaired Ig production

present around puberty (peak: 8yo)

40
Q

Common Variable Immunodeficiency (CVID): criteria

A

reduced serum IgA, IgG, IgM
presence of B cells
poor/no response to vaccines
absence of other immunodeficiency

41
Q

Common Variable Immunodeficiency (CVID): presentation

A

variable clinical manifestations

chronic/recurrent URI/LRTI (bronchiectasis)
GI infx
diarrhea, malabsorption, weight loss –> FTT
atopic triad

42
Q

Common Variable Immunodeficiency (CVID): management

A

refer to immunologist

IVIG

43
Q

Selective Combined Immunodeficiency (SCID):

  • what is it
  • MC form
A

sev defect in T and B lymphocyte systems –> early death from overwhelming infx (PNA, meningitis, bacteremia)

X linked (males only)

44
Q

Selective Combined Immunodeficiency (SCID): random tidbits

A

part of newborn screening

can become ill from live vaccines (MMR, OPV, RV)

45
Q

What is an possible indication for Selective Combined Immunodeficiency (SCID)?

A

infant may not have visible thymus on CXR

46
Q

Selective Combined Immunodeficiency (SCID): manifestations

A 
persistent thrush
death from common viral infx
P jirovecii infx
intrauterine graft vs host disease
lymphoma + other malignancies
47
Q

Selective Combined Immunodeficiency (SCID): management

A

stem cell transplantation

48
Q

DiGeorge Syndrome: what is it

A

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

49
Q

DiGeorge Syndrome: manifestations

A

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
Q

Wiskott Aldrich Syndrome: what is it

A

X linked disorder caused by mutation of WASp protein

51
Q

Wiskott Aldrich Syndrome: classic presentation

A

susceptibility to infx
thrombocytopenia (sm platelets)
eczema

**can also develop AI diseases and malignancies

52
Q

Wiskott Aldrich Syndrome: management

A

prophylactic abx and antivirals
plt transfusion PRN
Ig (if def)

SCT (only curative tx)

53
Q

Ataxia Telangiectasia: what is it

A

autosomal recessive disorder

54
Q

Ataxia Telangiectasia: homozygous presentation

A

1st: progressive cerebral ataxia

abnormal eye movements 
neurologic abnormalities
oculocutaneous telangiectasias
immune deficiency 
malignancy
55
Q

Ataxia Telangiectasia: manifestations in children

A

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
Q

Ataxia Telangiectasia: management

A

manage manifestations individually
watch for aspiration
vaccinate (if they make Ig)

57
Q

Molluscum Contagiosum: presentation

A

flesh colored dome shaped papules w/ central umbilication

PHA 581 (6 decks)

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