T4: Infectious diseases/ Immunizations Flashcards
This is the time when a disease has the ability to be passed from one person to another:
Communicability.
This is the time from contact with a pathogen until symptoms appear:
Incubation.
This is a foreign agent that produces a response within our bodies:
Antigen.
In immunology, an antigen is a molecule capable of inducing an immune response on the part of the host organism, though sometimes antigens can be part of the host itself. In other words, an antigen is any substance that causes an immune system to produce antibodies against it.
This is a molecule that is evoked by an antigen and then reacts with that antigen:
Antibody.
An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein produced mainly by plasma cells that is used by the immune system to identify and neutralize pathogens such as bacteria and viruses. The antibody recognizes a unique molecule of the harmful agent, called an antigen, via the variable region.
This type of immunity is achieved through the transfer of antibodies, only lasting a few weeks up to a few months:
Passive Immunity
Ex: Mom to fetus.
Inoculation with antiserum.
What do we use to treat children’s fever, malaise?
We AVOID aspirin (ASA).
Use acetaminophen, maybe NSAIDs
What do we use on children for itching?
Cool compresses.
Keep child cool.
Pressure instead of scratching.
Mittens
Keep nails short and clean
Calamine or Benadryl or Atarax may be ordered.
When should we AVOID cold/cough medicine for children?
When they are under 4 years old.
When a child presents with an infectious disease, what sort of precautions are taken at the hospital?
They are placed in isolation.
When at home: keep away from others.
This disease is from the herpes virus and is also known as “6th Disease”:
Roseola.
S and S:
- Maybe URI then…
- Abrupt fever (104-105) then…
- Fever drops and…
- Pruritic rash appears on TRUNK to face and extremities) within a day or so
Tx:
Symptomatic (it’s a virus).
This viral disease is the most benign of childhood illness but devastating to a fetus, also known as the “German measles”:
Rubella.
S and S:
- Lymphadenopathy
- then Low fever
- URI symptoms
- Mildly pruritic rash starting on the FACE to trunk and extremities.
Tx: It’s a virus. Symptomatic.
KEEP AWAY FROM PREGNANT WOMEN
This type of measles gets placed in airborne isolation:
Rubeola.
S and S:
- Fever
- URI with 3 C’s: Cough, Coryza (runny nose), Conjunctivitis (inflamed, pink, eye) for 3 days.
- then, Koplik spots (grayish white spots with a slight red areola, usually on buccal mucosa opposite the lower molars or on the pharynx, fleeting - they are gone in 12-18 hours)
- then RED RASH 3-4 days after fever and turns brown.
Tx:
- Vitamin A greatly reduces length and severity of disease.
- Bedrest
- Dim lights (may be sensitive bc of their conjunctivitis)
- Symptomatic
- Airborne isolation: negative pressure room.
Which viral disease presents with a high fever followed by a rash?
Roseola or 6th Disease.
Which viral disease presents with the 3 C’s and Koplik spots?
Rubeola measles.
3 C’s:
Cough
Coryza
Conjunctivitis
Which viral disease presents with a rash that starts on the face and should be isolated from pregnant women?
Rubella.
Benign to children, devastating to a fetus.
This viral disease is communicable usually right before and after swelling begins:
Mumps
S and S: Fever HA Earache worse with chewing Parotitis (maybe with swelling) Parotitis is an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans. The parotid gland is the salivary gland most commonly affected by inflammation.
Tx:
- Stretch bathing suit for boys with orchitis (inflammation of one/both testicle(s). Rarely causes sterility.
- Hot/cold packs to face
- Symptomatic
- Bedrest
- IV fluids if necessary
Why is a second vaccination recommended for Mumps?
After the outbreak in 2005, affecting 56,000 people in UK and US, and affecting some previously vaccinated, a second booster is now recommended.
This is caused by the varicella zoster virus and is communicable 1 day before rash until all lesions are crusted:
Varicella: Chicken pox
Lesions are crusted; direct, indirect, airborne
S and S:
- Slight fever
- Pruritic vesicular rash IN CROPS: mostly on trunk but can be everywhere including the mucous membranes.
This viral illness is placed on airborne and contact isolation:
How do we treat?
Varicella.
Tx:
– Zovirax (Acyclovir): Antiviral drug, can treat herpes virus infections, including shingles and genital herpes. It can also treat chickenpox. This medication does not cure herpes, but may prevent herpes sores or blisters.
This disease is caused by the parvovirus B-19:
Fifth Disease…
S and S:
- low fever, rash has “slapped face” appearance and may spread to extremities.
- Rash has lacey appearance that worsens with heat.
Tx:
Symptomatic
NOT around pregnant women!
Prior to the vaccine, cities were shut down and iron lungs were utilized…
Polio
Nearly eradicated with the oral polio vaccine (OPV) that was developed in 1954.
OPV caused 1 case/2.4 million but we only use the inactivated polio vaccine (IPV) now.
What is the communicability of Polio?
What is the incubation period for Polio?
Unknown.
1 week to more than a month.
How is Polio transmitted?
Direct oral-fecal and oral route.
Virus can stay active in bowel and feces for 6 weeks.
Varies in severity from very mild URI to paralysis/death.
S and S and Tx of Polio:
S and S: Fever Sore throat HA Stiffness Paralysis
Tx: Supportive Bedrest ROM PT Sedatives Hot packs Skin care Ventilate as needed
What causes Scarlet Fever?
Group A beta hemolytic strep (which also causes meningitis, Rheumatic fever, AGN and OCDs)
S and S:
- Abrupt high fever
- Vomiting
- Sore throat
- HA
- Enlarged tonsils covered with exudate
- Strawberry tongue (white to red)
- Sandpaper rash mostly in groin, axilla, neck and NOT on face.
How is scarlet fever treated?
After a throat culture, antibiotics are given (PCN or erthromycin).
Symptomatic
What causes diphtheria, what are the signs and symptoms, and how do we treat it?
Any isolation precautions?
Bacteria.
S and S:
Tachycardia
Fever
Pharyngeal membrane can cause airway obstruction and death (usu within 6-10 days)
Tx: Trach Suction O2 Antibiotics Antitoxin
CONTACT isolation
What are the three diseases that are put on isolation precautions? What are their individual precautions and what causes these diseases?
- Rubeola - the measels - AIRBORNE isolation. Virus.
- Varicella - the chickenpox - AIRBORNE and CONTACT isolation. Virus.
- Diphtheria - CONTACT isolation. Bacteria.
What two diseases are extremely dangerous to a pregnant woman’s fetus?
Rubella and Fifth Disease
What countries are still struggling with Polio?
India, Pakistan, Nigeria, Afganistan
This disease has nearly an 800% rise in teen cases over the last decade. It is communicable prior to the cough:
Pertussis - Whooping cough
This is from a bacteria.
S and S:
URI
Low fever
Cough 1-2 weeks dry… then looser with copious secretions and vomiting which may last 4-6 weeks.
Teens usually miss a week of school.
Adults usually miss more than a week of work.
This disease is from a bacteria’s toxin. It is anaerobic so it does better deeper in the body and manifests first in the jaw:
Tetanus (Lockjaw)
Dormant spores enter through broken skin or umbilical cord contamination.
30% mortality, 100% in newborns.
What is the “path” of infection, starting with the entry of a pathogen?
Pathogen entry.
Incubation.
Disease apparent and communicable.
Which vaccines are live?
When would you NOT give a live vaccine?
Rotavirus (oral) MMR Oral polio Varicella LAIV (intranasal flu) Zostavax (herpes zoster vaccine).
Don’t give if:
Pregnant
Immune suppressed
Within 28 days of another live vaccine.
Which vaccines would a 2 month old get?
DTaP Rotavirus (oral) Hib (Haemophilus Influenza) PCV (Pneumococcal conjugate) IPV (polio)
Which vaccines would a 1 year old get?
Hep A - new at 1 yr Hep B Hib PCV (Pneumococcal conjugate) IPV (polio) Influenza MMRV - new at 1 yr (unless traveling abroad)
This vaccine starts at 2 months of age and is 4 doses:
IPV - Polio
Given IM or SQ
What is the route of administration of the MMR/V?
SQ
Given at 1 year, 2 doses 6 months apart.
What are the odd-ball-route vaccines? They’re all IM’s except for?
Polio can be given IM or SQ or oral
MMR/V is given SQ
Rotavirus is given orally
LAIV is intranasally
Guidelines for giving immunizations (what is needed)?
On hand: epinephrine
Give: on time, not early, only 4 day grace period or will have to repeat it.
If minor illness (slight fever, runny nose, cough) STILL give.
When would you hold a pertussis vaccine for someone?
- Non stop crying (4 hours) after previous vaccine.
2. Encephalopathy within 7 days of previous vaccine (coma, seizure, decrease LOC)
What complications (illnesses) are associated with a strep infection?
AGN - Acute Glomerular Nephritis
Rheumatic fever
Scarlet fever
OCDs
What is the hallmark sign for Roseola?
Treatment?
Abrupt high fever (105 F)
Fever drops then rash presents
Tx:
Symptomatic
What is the hallmark sign for Rubella?
Treatment?
Mild signs and symptoms then
lymphadenopathy (swollen lymph nodes) then
Slight fever/rash/URI
Rash is FACE to trunk
Tx:
Symptomatic
What is the hallmark sign for Rubeola?
Treatment?
Koplik spots
Rash RED to BROWN
Tx:
Symptomatic
Vitamin A
Dim lights
What is the hallmark sign for mumps?
Treatment?
Parotitis (inflammation of parotid glands in face)
Earache
Tx:
Symptomatic
Fluids
Warm/Cool pack to face
Stretch bathing suit if orchitis
What is the hallmark sign for varicella?
Treatment?
Vesicular rash in CROPS
Tx:
Symptomatic
Varivax
Airborne and Contact Isolation.
What is the hallmark sign for Fifth disease?
Treatment?
“Slapped face”
Lacey rash
Tx:
Symptomatic
What is the hallmark sign for Scarlet fever?
Treatment?
High fever
Strawberry tongue
Sandpaper rash
Tx:
Symptomatic
Antibiotics
What is the hallmark sign for Pertussis?
Treatment?
Copious secretions
Cough and gag
Tx:
Fluids
Suction
Antibiotics
What is the hallmark sign for Rotavirus?
Treatment?
Diarrhea
Tx:
Symptomatic,
ORS/ IV
What is the hallmark sign for Impetigo?
Treatment?
Honey colored crusty lesions
Tx:
Antibiotics
Good hygiene
What is the treatment for lice?
Louse buster (kills lice and nits with 30 min hot air Tx)
Spinosad (4 and up, no need to comb nits, repeat in a week if needed)
Ivermectin (PO for resistant households).
Clean/bag things for 2 weeks
Wash and dry under hot temperature
Vacuum couch, etc.
What is the treatment for scabies?
Elimite cream kept on skin for 8-14 hours then wash.
The itch will linger (bc feces irritate)
What is the treatment for candidiasis?
Nystatin (PO or ointment)
Keep dry
Keep clean
How long can lice live off of host?
How long can nits live?
48 hours
Nits hatch in 7-10 days.
Need to recheck… may have reinfestation, hard to kill sometimes.
What is Ivermectin used for?
Lice - Pediculosis Capitis
These parasites are only found in humans:
Pinworms
Live in cecum (a pouch connected to the junction of the small and large intestines - bottom of ascending colon).
The pregnant worms travel to the anus to lay their eggs which hatch in a few hours.
This virus can live up to 7 months on a counter-top:
Rotavirus.
Kills a half million children worldwide every year from the diarrhea-induced dehydration.
This disease is from a spirochete:
Lyme disease
Prevent with DEET
Remove ticks
Apply antiseptics
Watch signs and symptoms for several weeks
Symptomatic treatment
This infection is from a bacteria that progress to vesicular pustules with honey-colored crusts:
Impetigo
Tx:
Mupirocin (ointment)
Cephalosporin
maybe Clindamycin
Remove crusts with cool compresses.
Good hygiene.
There are 100’s of different types of this virus and is vaccinated with Gardasil:
Most common STD : 50% sexually active have HPV
Types 16 and 18 cause cancer
Types 6 and 11 cause genital warts
Gardasil: 3 doses starting at 9 years old, max 26 yo
You need to get this vaccine if you have slept in a room with a bat:
Rabies.
Incubation time is months.
What percentage range is needed to have herd immunity?
80-95%
