Vaccinations Flashcards
Which vaccines are given in the first 6 months?
Hep B, DTaP, IPV, PCV-13, Hib, Rotavirus
Hep B virus Tx
none for acute infection
chronic active hepatitis:
anti-virals – lamivudine
interferon-alpha
What is given if infants born to hep B surface antigen positive mothers?
HBIG at birth with Hep B vaccination
Diptheria clinical findings
acute URI
swelling, respiratory symptoms
dehydration
thick exudative membrane over pharynx
pharyngeal diptheria
obstructive tracheolaryngitis
can cause cutaneous, vaginal, conjunctival or otic infection
complications (“bull neck,” myocarditis, peripheral polyneuropathy)
Diptheria Tx
IV equine anti-toxin
erythromycin or penicillin
active immunization
Tetanus clinical presentation
Pain at the site of inoculation
Hypertonicity
Spasm
Exaggerated spasms in response to light stimuli
Tetanus Tx
human tetanus immune globulin (TIG):
IVIG if TIG is not available
equine tetanus antitoxin (not available in U.S.)
treatment of wounds:
wound excision if necrotic tissue is present
antibiotics:
metronidazole or penicillin
spasm control:
minimized stimulation
muscle relaxants
time (if not fatal, symptoms subside in a few weeks)
Pertussis Labs
Leukocytosis – lymphocytosis predominance (right shift)
lymphocytosis
Charcoal-Lowe media culture (poor sensitivity in practice)
PCR
Pertussis Tx
antibiotics:
azithromycin (drug of choice)
may shorten course of disease in catarrhal phase
alternate – TMP/SMX
prevent spread of infection
inpatient monitoring until cyanotic episodes clear
supportive care:
oxygen
ventilatory support
Pertussis vaccine contraindicated for who?
vaccines can cause seizure and are contraindicated in some children who have neurologic diseases or are undergoing evaluation for neurologic diseases. In these cases you would give DT.
Those who had encephalopathy within 7 days of administration of previous dose without another identifiable cause
Who must we take precautions for when giving the pertussis vaccine?
temperature of 40.5°C within 48 hours without another identifiable cause
collapse or shock-like state within 48 hours
persistent crying of or over 3 hours within 48 hours
seizure within 3 days
when do you have to switch from DTaP to Tdap?
once the child is over 7 y/o
Tdap is routine in adolescents 11-12 y/o, as they are a common reservoir.
Polio Sx
headache, low-grade fever, sore throat, muscle weakness
(originally inoculates the oropharynx
headache may represent aseptic meningitis)
asymmetric, flaccid paralysis
(infection of anterior horn of spinal cord
0.1 to 2.0% of infected )
muscle tenderness and hyperesthesia; intact sensation
later - muscle atrophy
What pathogen is the most common cause of invasive bacterial infection in children?
strep pneumo
what is the current vaccine recommended for pneumococcus?
PCV-13
Hib classic infections
meningitis, acute epiglottitis, pneumonia, septic arthritis, cellulitis.
Hib Tx
3rd gen cephalosporin
What viral pathogen is the most common cause of severe diarrhea in infants and children?
Rotavirus
*nearly every child is infected by 5 yo
severe infection at 4-36 mos of age
Rotavirus Tx
hydration
Rotavirus diagnostics
typically made without lab testing
antigen test of stool if diagnosis is uncertain
Measles Dz progression
Starts with prodrome of fever and malaise. Progresses to cough, coryza and conjunctivitis.
2 days prior to rash Koplik’s spots can occur in the mouth. These are bluish, grey spots on the buccal.
2-4 days after fever patient will develop an erythematous, blanching full body rash.
complications of measles
Diarrhea
Pneumonia- number one cause of mortality from measles
Encephalitis and Acute disseminated encephalomyelitis (ADEM)
Mumps Dz progression
Starts with flu-like symptoms: fever, malaise, headache.
Progresses to parotitis (inflammation of the salivary glands) and in some cases orchitis or oopheritis
Symptoms of rubella
Symptoms include a low grade fever, lymphadenopathy and pinpoint rash that starts on the face and progresses down to trunk and then generalizes.
Arthralgias can also be present.
