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vaccines Flashcards

1
Q

RSV Pathogen

A

It is a Paramyxovirus

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2
Q

Respiratory Syncytial Virus Mode of Transmission

A

Contact with droplets

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3
Q

RSV S/S

A

25-40 / 100 infants will develop bronchiolitis or pneumonia.
btw oct. to jan.
Bronchiolitis- proliferation and necrosis of bronchiolar epithelium- sloughed epithelium and increased mucous cause obstruction.
MOST COMMON cause of LRI in children, also causes acute otitis media

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4
Q

RSV Treatment and which children it is given to

A

Palivizumab(Synagis)- monoclonal antibody product, only given to high risk infants.

  • born before 35 weeks
  • born with some types of heart disease
  • has chronic lung disease
  • Dosing is every 28-30 days throughout the RSV seasen++++++
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5
Q

Diphtheria (role of ____ and abx in tx of dz)

A

Antitoxin- Equine single dose, dose depends on size and site

Erythromycin PO or IV or PCN G to stop the toxin production.

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6
Q

Diphtheria (ppl in close contact with infected individual)

A

Booster vacc and erythromycin or Pcn G

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7
Q

Diphtheria’s Pathogen

A

Corynebacterium diphtheriae G+ bacillus

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8
Q

Diphtheria’s Incubation

A

Incubation 2-5 days

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9
Q

Diphtheria’s S/S

A

any mucous membrane
exudative pharyngitis spreads and may form adherent membrane which may cause respiratory obstruction
skin infections may manifest as scaling rash or by ulcers

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10
Q

Diphtheria’s Complications

A

myocarditis, neuritis, death occurs in 5-10%

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11
Q

Diphtheria Vaccination Schedule

A

DTaP or DT(children) Td or Tdap (children >/= 7 years and adults.
Dosing: 2,4,6,mo, then 15-18mo, then 4-6 years, Booster at 11-12 years then every 10 years

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12
Q

Role of Tetanus Ig (TIG)

A

Dx made clinically, cultures are not helpful, TIG only removes unbound toxin, supportive therapy, abx, prophylaxis/wound management.
TIG=given ONLY IF FEWER THAN 3 OR UNKNOWN VACC HX AAAAAND WOUNDS THAT WERE NOT CLEAN OR MINOR.
Booster= fewer than 3 or unknown vacc hx.; also, for clean wounds with 3 in hx then within 10 years. for dirty wounds within 5 years.

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13
Q

Tetanus Pathogen

A

Clostridium tetani

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14
Q

Tetanus Incubation

A

3-21 days (neonates 4-14d)

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15
Q

Tetanus Transmission

A

wound introduces bacteria from soil or animal feces

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16
Q

Tetanus First sign, and following signs

A

Trismus! followed by stiffness of the neck, dysphagia, rigidity of abdominal muscles.
Hyperthermia, diaphoresis, HTN, episodic tachy. Spasms that may occur freq and last for several minutes, could continue for 3-4 weeks. complete recovery could take months.

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17
Q

Tetanus Vaccine Schedule

A

DTaP or DT(children) Td or Tdap (children >/= 7 years and adults.
Dosing: 2,4,6,mo, then 15-18mo, then 4-6 years, Booster at 11-12 years then every 10 years

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18
Q

Pertussis Stage 1

A

Catarrhal:
Coryza
Low-grade fever
Mild, occasional cough (which gradually becomes more severe after 1-2 weeks)

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19
Q

Pertussis Stage 2

A

Paroxysmal:
Real cough comes in.
Usually bursts of coughs due to the difficulty of expelling thick mucus.
Characterized by inspiratory high-pitched whoop after repeated cough on the same breath, which commonly is followed by vomiting(posttussive emesis)
NO fever usually.

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20
Q

Pertussis Stage 3

A

Convalescent:

Gradual Recovery weeks to months Typical total infection lasts 6-10 weeks

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21
Q

Pertussis Pathogen

A

Bordetella pertussis

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22
Q

Pertussis Incubation

A

7-10days

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23
Q

Pertussis Transmission

A

Large respiratory droplets generated by coughing or sneezing

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24
Q

Pertussis Vaccination Schedule

A

DTaP or DT(children) Td or Tdap (children >/= 7 years and adults.
Dosing: 2,4,6,mo, then 15-18mo, then 4-6 years, Booster at 11-12 years then every 10 years

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25
When should a pregnant woman receive her Tdap shot? and why?
btw weeks 27 and 36 of gestation. for optimal transfer of ab to neonate
26
Pertussis Tx. who do you tx and how soon?
Tx suspected cases and those exposed- do not wait on labs to confirm. - Macrolide (Bactrim if macrolide contraindicate) - -azithromycin preferred if <1 month
27
Pertussis Complications. Who is at highest risk for complications with pertussis? How do these differ in their presentation of pertussis?
Pneumonia, seizures, encephalopathy, death. Infants under 6mo are at highest risk of complications. younger infants may present with shorter catarrhal stage, followed by gaggin, gasping, brady, or apnea (67%) as prominent early manifestations.
28
When should we consider pertussis in ddx for a cough
any patient with a cough lasting >2weeks
29
Haemophilus infuenzae type b colonizes what area
Nasopharynx, ppl can be asymptomatic carriers
30
Hib causes what diseases
``` Pneumonia bacteremia meningitis epiglottitis septic arthritis cellulitis otitis media purulent pericarditis (endocarditis, endophthalmitis, osteomyelitis, peritonitis, and gangrene) ```
31
What type of Hib most commonly causes infections of the respiratory tract? What percent of meningitis was caused by Hib in the pre-vacc era?
nontypable strains | 50-65%
32
15-30% of survivors experienced ____ or other neurologic sequelae? Case fatality rate is ????%?
hearing loss, 2-5 percent
33
Hib Vaccination Schedule
Dosing: 3-4 doses depending on brand, given at 2, 4, 6* months, then 12-15 months. -ActHIB, Hiberix, or Pentacel are given in 4 doses PedcaxHIB is given in a 3-dose series ( the 6mo dose is not necessary)
34
Hib Tx (Epiglottitis/Meningitis/other)
Epiglottitis: drooling, voice, stridor- Tx ET tube or tracheostomy. Meningitis: Ceftaxime or ceftriaxone(with steroids is controversial) Other H. influenzae: Augmentin, cefdinir, cefuroxime
35
Pneumococcal Disease Pathogen
Streptococcus pneumoniae (10 of 90 known, cause 62% of invasive disease)
36
Pneumococcal Dz Transmission
person to person respiratory droplet contact
37
Pneumococcal Incubation
1-3 days
38
Pneumococcal Dz -Major Syndromes
Pneumonia, bacteremia, meningitis
39
Pneumonia "prodrome" caused by Pneumococcal Dz
fever, chills, rigor, pleuritic CP, RUSTY SPUTUM, cough, dyspnea, tachypnea tachycardia.
40
Leading cause of bacterial meningitis in <5 years of age
Pneumococcal Dz
41
Vaccination Routine of PCV13
PCV13 in 4 doses- usually 2,4,6mo then 12-15mo | PCV13 given to adults >65 first if never given then PPSV23.
42
Adults 19+ with immunocompromise are given 1 dose ____ then ____8 weeks later, additional ____5 years later, then again at age ___
PPSV, PPSV, age 65
43
Adults 19-65 with certain chronic conditions, alcoholism, or smokers:
1 dose PPSV23 then another dose after 65 (at least 5 years after first)
44
Tx of Pneumococcus infection
``` Bacterial meningitis and other: Vancomycin plus cefotaxime or ceftriaxone plus dexamethasone. noninvasive disease(AOM, sinusitis): amox ```
45
Poliomyelitis pathogen and spread
enterovirus that enters through mouth and replicated, then hematologically spreads to lymphatics and CNS(destruction of motor neurons) type 2 and 3 are gone
46
Poliomyelitis response by children
highly variable, approx 70% are asymptomatic
47
IPV Vaccination Schedule
Dosing: 4 doses- 2mo,4mo, 6-18mo, then 4-6 years
48
Measles Pathogen and Transmission
Paramyxovirus, droplets or, less commonly, by airborne spread
49
Measles Incubation
8-12 days
50
Measles Prodrome and PECKER
2-4 days of Fever, Rash, CCC, Koplik spots. Rash is maculopapular beginning on the face and spreading head to toe
51
Measles Complications
Pneumonia, OM, Encephalitis(1:1,000 cases), seizures, death
52
Measles Vaccination Schedule
Dosing: First dose 12-15mo (not MMRV), Second dose 4-6 years. Should be given at 6 months if traveling internationally or an outbreak- requires revaccination after 12 months with 2 dose.
53
Tx of Measles
No specific antiviral. | WHO currently recommends Vit A for all children with acute measles to reduce morbidity and mortality
54
Mumps Pathogen and Incubation
Paramyxovirus, 14-18 days
55
Mumps Prodrome
Myalgia, malaise, HA, low-grade fever
56
Mumps Complications
Meningitis/encephalitis, Orchitis, arthritis, pancreatitis, deafness, death
57
Mumps Vaccination Schedule
Dosing: First dose 12-15mo (not MMRV), Second dose 4-6 years. Should be given at 6 months if traveling internationally or an outbreak- requires revaccination after 12 months with 2 dose. NEW- Third dose can be given during an outbreak
58
Rubella Pathogen and Incubation
Togavirus, 14 days
59
Rubella Prodrome
Fever, respiratory symptoms and malaise, then generalized erythematous maculopapular rash lasting ~3 days, lymphadenopathy can occur after the rash and lasts several weeks. Clinical Disease is usually mild.
60
Complications of Rubella
Arthralgia, thrombocytopenia(1:3,000), encephalitis(1:6,000), neuritis, orchitis
61
Rubella's primary objective of vaccine is:
Prevention of Congenital Rubella Syndrome
62
Rubella Vaccination Schedule
Dosing: First dose 12-15mo (not MMRV), Second dose 4-6 years. Should be given at 6 months if traveling internationally or an outbreak- requires revaccination after 12 months with 2 dose.
63
Manifestations of CRS:
Auditory, Ophthalmologic, Cardiac, Neurologic Dz. Neonatal infections can result in Bone alterations, hepatospelnomegaly, thrombocytopenia
64
Varicella Pathogen and Incubation
Chicken Pox-VZV(HHV-3), 14-16 days
65
Prodrome of Varicella infection
Mild prodrome for 1-2 days then rash
66
Progression of Varicella lesions
Rash is pruritic and progresses from macules to papules to vesicles before crusting
67
Complications of Varicella
Secondary infection of skin, pneumonia, CNS manifestations, Reye's syndrome, death 1:60,000 cases
68
Maternal Varicella
from 5 days before to 2 days after birth has neonatal fatality rate of 30%. (meaning mother didn't have immunity from prior illness and will likely spread to infant
69
Congenital Varicella Syndrome
Maternal VZV infection <20 weeks gestation is associated with wide range of abnormalities
70
Varicella Vaccination Schedule
Dosing: 1st dose 12-15mo, 2nd dose 4-6 years (4-6% of people get a rash after)
71
PEP Varicella
studies show that varicella vaccine is >70% effective in preventing illness if given with in 3 days of exposure (can give up to 5 days post exposure)
72
VariZIG (when is it given)
available for high risk individuals with significant exposure to VZV (immune comp, pregnant, newborn with maternal varicella, hospitalized preterm <28 weeks without maternal immunity or regardless of maternal immunity if <1000g birthweight
73
Hepatitis A Transmission
Fecal-Oral route
74
Hep A Incubation period
28 days
75
Hep A S/S
Fever, malaise, anorexia, nausea, abdominal pain, dark urine and jaundice. lasts less than 2mo but 10-15% have prolonged illness or relapsing disease up to 6months.
76
Fatality of Hep A
0.3% worse with age >40
77
Hep A Vaccination Schedule
Dosing: given in two doses 6-18 months apart, given at ages 12-23mo
78
Meningococcal Dz
Neisseria meningitidis is gram - diplococcus with 13 serogroups
79
Leading cause of bacterial meningitis in the U.S.
Meningococcal Dz
80
Incubation period of Meningococcal
3-4 days
81
MenACWY-D and MenACWY-CRM(routine) vaccination schedule
Dosing: 2 doses: 11-12 years and 16 years. - _-_-Men B-FHbb(Trumenba), Men B-4C (Bexsero) in children. -Dosing: 2 doses btw ages 16-23, given sooner to those with RF and those who travel to high risk areas or military (approved at age 10 in that case) - Bexsero - 2 doses 1mo apart - Trumenba - 2 doses 6mo apart (special dosing with RF)
82
Meningococcal Dz Tx
Cefotaxime or ceftriaxone initially until microbiologic dx is established
83
PEP of Meningococcal Dz
Rifampin, ceftriaxone, ciprofloxacin, and aziothromycin. DOC in children is rifampin. Vaccination
84
HPV pap test even with vaccination since---
30% of cervical CA caused by HPV types NOT in vaccine
85
HPV Vaccination Schedule
9vHPV: approved age 9 and older Dosing: if initiated age 11-12 given in 2-dose series, if initiated after age 15 given as 3-dose series
86
Rotavirus Route and Incubation
Fecal-Oral transmission, <48 hours! and stays in the stool up to 30days
87
Rotavirus Presentation/Complications
Watery Diarrhea, may result in severe dehydration when fever and vomiting occur, fever >102 in 1/3 of cases. Comp: dehydration, electrolyte imbalance, metabolic acidosis.
88
Rotavirus Vaccination Series
Dosing: given ORALLY at 2, 4, and (6) months | RotaTeq requires the third dose at 6mo, Rotarix does not.
89
Hepatitis B Transmission
Blood Borne
90
How long can Hep B live on environmental surfaces
7 days at room temp
91
Causes/Complications of Hep B
acute and chronic hepatitis, cirrhosis and is the cause of 80% of hepatocellular carcinomas. (5% progress to chronic infection)
92
Hep B Vaccination Schedule.
Recommended in pt's with DM. Dosing: 3 doses series given at birth, then 2mo&6mo(see notes about 4th dose) 1st dose given at hospital after birth. FINAL DOSE not to be given before 24 weeks of age(must check catch-up schedule if this happens zac ya silly goose)
93
Tx for infant born to Hep B surface antigen positive mother(HBsAg)
Administer HepB vaccine and hepatitis B immunoglobulin within 12hrs of birth.
94
Adult dosing of Hep B Vaccines
HepB-CpG: 2 doses, 1 month apart. | second choices: Engerix, Recombivax HB given in 3 dose series
95
Persons at risk for Hep B infection should receive what after vaccine?
Post vaccination serologic testing is recommended 1-2 months after final dose for persons at risk

Preventative Med (2 decks)

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