the professional Flashcards
what is immunity?
The ability of the human body to protect itself against disease
what is acquired immunity
specific to a certain organism or pathogen
Created an immunological memory, after an initial response to a specific pathogen
what is innate immunity?
Present from Birth
Includes physical barriers, for example the skin, chemical barriers, for example, gastric acid, and phagocytic cells and the complement system
List the two mechanisms for acquiring immunity
Active immunity
Passive immunity
what is passive immunity?
Protection is provided from the transfer of antibodies from immune individuals
Across the placenta
More rarely, transfusion of blood or blood products containing immunoglobulins
what is active immunity?
Protection provided by the bodies own immune response
usually long lasting
Can be acquired through natural disease or by vaccination
What is the definition of vaccination?
The act of introducing a vaccine into the body to produce an immune response to a specific disease
A product that stimulates a persons immune system to produce immunity to a specific disease, protecting that person from the disease
what do vaccines prevent the risk of?
Vaccines generally provide immunity that is similar provided by the natural infection. But without the rest from the disease or it’s complications.
how do vaccines produce their protective affect?
inducing, active immunity
Providing immunological memory
What can vaccines be made from?
inactivated killed organisms
Attenuated live organisms [MMR]
Secreted products [tetanus]
Recombinant components [hepatitis B]
The constituents of cell walls. [Pneumococcal vaccine.]
Tell me about failure in vaccines
no vaccine is 100% effective, small proportion of individuals get infected despite vaccination
Primary failure, when an individual fails to make an initial immunological response to the vaccine
Secondary failure, where an individual response initially, but then the protection Wayne’s overtime
tell me about vaccine side effects [vaccine induced adverse events, following immunization.]
Pain, swelling, redness, episodes of injection
Local adverse reactions
Systemic adverse reactions, for example, fever
Anaphylaxis, whether onset is almost immediate, and potentially fatal
tell me about population immunity
The primary am a vaccination is to protect the individual who received the vaccine, but vaccinated. Individuals are also less likely to be a source of infection to others.
Reduces the risk of unvaccinated individuals being exposed to infection so individuals who cannot be vaccinated still benefit from routine vaccination program
This concept is called , heard immunity
When vaccine coverage is high enough to induce, high levels of population immunity, infections may even be eliminated from a country
What is the economic benefit of a vaccination?
vaccines offer a significant return on investment
Many vaccines will offer a society, a net financial benefit [from the reduction of healthcare expenditure, increases in productivity] more than 10 times higher than the cost of the vaccination
tell me about vaccination policy in the UK
In the UK, there are no mandatory vaccinations
In other countries for example Brazil, there is widespread mandatory vaccination
And some countries, for example America, while they’re in a mandatory vaccinations, 50 states require children to be vaccinated in order for them to access public school
Some other countries require individuals to be vaccinated in order to be eligible for welfare payments
Tell me about some vaccines included in UK immunization schedule
diphtheria
Hepatitis B
HPV
Influenza
Measles
MMR
Polio
Rotavirus
Shingles
Tetanus
What is vaccine hesitancy?
The reluctance or refusal to vaccinate despite the availability of vaccines
It is one of the world health organization’s top 10 threats to global health in 2019
It’s encompasses:
Outright refusal to vaccinate
Delay vaccines
Accepting vaccines, but remaining uncertain about that use
Using certain vaccines, but not others
what are the causes of vaccine hesitancy?
Diseases that we vaccinate against also rare, that people may not understand how serious they are. Some diseases are so common that this generates complacency, some patients asserts that influenza presents no danger.
Success of vaccination: the absence of disease brought about by vaccination, makes vaccination unnecessary and fosters complacency
un Naturalness of vaccination: some anti-vaccinationists claim that it is more natural to develop immunity from the disease itself
Tell me about some common objections to vaccination
objection on religious grounds
Mandatory vaccination is an infringement of individual liberty
Faxing overload, the idea that’s giving many vaccines that wants me overwhelm an infants immune system
Rights of parents versus the rights of children
Tell me about a loss of public confidence in vaccination
Measles, mumps, and rubella vaccine linked to autism
dr. Andrew Wakefield a consultant gastroenterologist at the Royal Hospital hospital in London dismissed assurances over the safety and compliance of the combined MMR jab
He confirmed research fraud
12. Children and his study had been manipulated to fit Wakefield pre-specified conclusion. Children have been paid 5 pound each for blood samples.
Wider fraud: Wakefield planned to profit from making diagnostic testing kits, he had also filed a patent for a single measles vaccine
He was dropped off the medical register by the GMC in May 2010
is there a link between the MMR vaccine and autism?
No
what causes errors in pediatrics and neonates
Off license prescribing
Individualized dosing on calculations
Different medication formulations
Communication with children and parents
Experience working with children
which medicines are most involved in prescribing errors for children and neonates
antimicrobials
Paracetamol
Intravenous fluids
Parental nutrition
Opiates
Corticosteroids
Nonsteroidal, anti-inflammatory drugs
Benzodiazepines
Anticonvulsants
Insulin
how do we prevent making errors when prescribing for children and neonates
right, patient, right indication, right to drug, right dose, right timing, right route
Make sure the professionals and patient/parents are absolutely clear about intentions by screening
If unsure about the calculation, ask for double check
If you’re doing a check, do so independently and away from distractions
Do not be afraid to challenge others
What does water distribution in children compared to adults mean?
neonates have a significantly higher proportion of extra cellular water than children or adults
this means that a water-soluble drug like gentamicin will be distributed more extensively in this fluid
If the drug is distributed into extra cellular water, but it is not active, not able to have an effect. As such it is inactive.
This means that neonates, in particular I have a higher percentage volume of distribution, but lower Renal clearance, which explains the difference is dosing and frequency of dosing.
What is a side effect of ramipril
Ramipril dosing should be given at nighttime for the first few days as it can cause, potential hypotension, and this could be why a side effect is feeling dizzy
what are some signs and symptoms associated with high T3 and low TSH
palpitation
Diarrhea and vomiting
Dryness and coarsening of the skin and hair
goitre
Heat intolerance
Weight loss
Tachycardia
What indicates hypothyroidism?
low T3/T4 high TSH
what indicates hyperthyroidism
high T3/T4 and low TSH
What is a thyroid storm?
A medical emergency
Usually undiagnosed
Overacted, hyperthyroidism
usually presents after infection, trAUmA, child, bath, and surgery
Symptoms of a thyroid storm include:
Tachycardia
High fever above 38°C
Diarrhea and vomiting
Jaundice
Severe agitation and confusion
Loss of consciousness
