preventative measures

Question 1

Indications for IVIG

Answer 1

1. replacement in primary immune def disorders
2. Kawazaki - prevent coronary, shorten clinical course
3. immune mediated thrombocytopenia
4. prevent serious bacterial infection in kids withHIV infction
5. prophylaxis post bone marrow transplant
6. Toxic shock syndrome
7. GBS
8. Parvo 19 induced anemia
9. Can use if no access to varicella Ig

Question 2

IViG side effetcs

Answer 2

fever, hadache, myalgia, chills, nausea and vomiting - rate dependent
anaphylaxis, thromboembolic events, aseptic meningitis, renal insuff

Question 3

toxoids?

Answer 3

tetanus and diphtheria

modified bacterial toxin made nontoxic

Question 4

who needs Tetanus immune globulin

Answer 4

if significant wound and received less than 3 doses or unknown doses
Also get vaccine at same time

Question 5

who should get the flu vaccine?

Answer 5

1) All children six to 59 months of age
2) ≥6 months + chronic health conditions:
3) morbid obesity (body mass index ≥40 kg/m2)
4) prolonged treatment with acetylsalicylic acid
5) All Aboriginal peoples
6) All residents of chronic care facilities
7) All pregnant women
8) household contact, healthcare, daycare…

Question 6

who should not get the LAIV?

Answer 6

if egg allergy

if severe asthma or recent wheezing

Question 7

what vaccines should Asplenics get?

Answer 7

at risk from pneum, hib and men

1) PCV 13 - 4 doses
2) PPSV 23 at age 2 ( > 8 weeks post PCV 13)
3) MCV 4
4) 4CMenB
5) if > 5 yrs - needs Hib booster

Question 8

if pt is on systemic steroids . 2mg/kg/d for > 14 D, do you need to wait to vaccinate?

Answer 8

yes

Wait 1 month post end

Question 9

what is considered a varicella exposure?

Answer 9

household contact
touching lesion
same room . 1 hour
face to face > 15 min

Question 10

who gets post varicella prophylaxis

Answer 10

if susceptible ie no varicella and not titer

get vaccine as soon and up to 5 days

Question 11

who gest post varicella immunoglobulin

Answer 11

were EXPOSED and can’t get vaccine:

• pregnant
• neonates of moms who developped rash 5 d pre del or 2 d post
• prem neonates
• immune compromised
• HSCT

ideal

Question 12

what is the age for Rotavirus administration

Answer 12

starts at 6 week ( 2 mon and 4 mo)
should complete by 8 month
first dose no later than 15 mo!

Question 13

if you have been exposed to Men C, what should you receive

Answer 13

Rifampin for 2 days

4CMenB vaccine

Question 14

what is the work up for child new to canada?

Answer 14

CBC and differential
Liver and renal function tests
Serology for HBV, HCV, HIV, syphilis 
TB skin test
Chest x-ray
Stool O&P
Urinalysis
Cultures and other investigations on an individual basis

Question 15

who should get Hep A vaccine post exposure

Answer 15

up to 2 weeks

for close contacts > 12 mo

Question 16

if

Answer 16

hep A Ig

Question 17

if immunocompromised and exposed to Hep A, mgnt?

Answer 17

Vaccine and hep A Ig

Question 18

if mom is HBsAg, what is the management of the baby?

Answer 18

1. HBIG AND HB vaccine within 12 hours
2. Vaccine at 1 and 6 months if > 2kg
   Vaccine at 0, 1, 2, 6 if

Question 19

if mom HBsAg unknown, assess if can test mother and have results in 12 hours. If + or cannot get results?

Answer 19

HB vaccine
and
HBIG

Question 20

what is the mgnt of a close contact post exposure to Hib

Answer 20

rifampin 4d

Question 21

what is the mgnt of a close contact post exposure to N. Meningitis

Answer 21

Rifampin 2 d + vaccine

Question 22

what is the mgnt of a close contact post exposure GAS invasive disease

Answer 22

cephalexin

Question 23

what is the mgnt of a close contact post exposure to measles

Answer 23

IG within 6 days

or IVIG

Question 24

when d you use IM immune globulin (3)

Answer 24

1. replacement therapy in primary immunodef
2. hep A prophylaxis
3. Measles prophylaxis