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Pediatric immunizations
PA CLin Med
81
Health Care
Graduate
11/18/2009

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Term
what is active immunity?
Definition
stimulation of persons immune sys to produce immunity
Term
passive immunity:
Definition
protection by products produced animal or human and transfered to another human
Term
which vaccines provide life long immunity?
Definition
live attenuated vaccines
Term
5 examples of live attenuated vaccines:
Definition
1,2,3: MMR
4. varicella
5. rotovirus
Term
which class of vaccines require boosters
Definition
inactivated & polysacharide vaccines
Term
difference btwn polysaccharide and unconjugated polysaccharide vaccines:
Definition
polysaccharid = just sugar moiety (unable to obtain booster)
unconjugated = sugar plus protein (able to obtain booster)
Term
Corynebacterium diptheria: gram + or -
Definition
gram +
Term
mechanism of diptheria toxin:
Definition
deterioration of myelin sheaths of CNS & PNS
Term
what are the 2 types of diptheria infections:
Definition
repiratory and cutaneous
Term
key word: "dirty gray membrane"
Definition
cutaneous diptheria
Term
respiratory diptheria: toxigenic or non-toxigenic diptheria?
Definition
toxigenic
Term
cutaneous diptheria: toxic or non-toxic?
Definition
both
Term
transmission diptheria:
Definition
person to person; phys and respiratory contact
Term
which is more severe, cutaneous or respiratory diptheria?
Definition
respiratory
Term
clinical features of diptheria:
Definition
sore throat
adherant gray membrane on tonsils
"bull neck" (severe dz)
Term
key word: "bull neck"
Definition
diptheria
Term
Dx of diptheria:
Definition
culture w special medium
Term
diptheria Tx:
Definition
severe cases get anti-toxin & erythromycin
Term
anaerobic, spore forming, gram positive bacteria in soil & animal feces:
Definition
Clostridium tetani
Term
mechanism of tetani toxin:
Definition
interferes w neurotransmitter release to block inhibitor impulses
Term
incubation period for tetani:
Definition
8 days
Term
5 clinical features for tetanus:
Definition
1. trismus(lock jaw)
2. dysphagia
3. muscle rigidity
4. spasms (3-4wks)
5. awake/PAIN
Term
tetanus Tx:
Definition
tetanus immunoglobulin IV or IM
metronidazole IV
Diazapam
tetanus vaccine
Term
organism for whooping cough:
Definition
bordetela pertusis
Term
B pertusis, gram + or -
Definition
gram -
Term
how is B pertusis transmitted?
Definition
respiratory dropletts
Term
B. pertusis incubation:
Definition
7-10d
Term
3 stages of pertusis infection:
Definition
1. catarrhal (rhinorrhea/cough/uri)
2. proximal (continuous cough w whoop)
3. convelescent (gradual resolution wks - months)
Term
children w cough >14 days consider
Definition
pertusis
Term
pertusis Dx:
Definition
culture & PCR
Term
pertusis Tx:
Definition
supportive care,
macrolides,
vaccine,
Term
Hib gram - or +
Definition
gram - rod
Term
transmission of Hib:
Definition
direct contact w resp droplets
Term
Hib Tx:
Definition
erythromycin or azithromycin
Term
Polio etiology:
Definition
enterovirus 1,2,& 3
Term
pathogenesis of polio:
Definition
mouth>GI>blood>CNS
Term
Sx for 95% of polio patients:
Definition
asymptomatic
Term
3 presentations of polio:
Definition
1. asymptomatic
2. gastroenteritis
3. paralysis
Term
measles etiology:
Definition
Paramyxovirus
Term
measles transmission:
Definition
respiratory droplets;
Term
when is measeles contagious?
Definition
4d before, 4d after rash onset
Term
Key word: "Koplick spots"
Definition
Measles
Term
Rash beginning on scalp line that descends & lesions may become confluent:
Definition
Measles
Term
5 prodrome Sx for measles:
Definition
1. increasing fever
2. coryza
3. cough
4. conjuctivitis
5. koplick spots
Term
describe koplick spots:
Definition
white spots in mouth, assoc w measles
Term
Mumps etiology:
Definition
paramyxovirus
Term
when was the last mumps outbreak?
contributing factors:
Definition
2006: college campus, lack of MMR vaccination
Term
transmission of mumps:
Definition
resp droplets
Term
when is mumps contagious?
Definition
1-7d before onset and 9d after
Term
mumps clinical features:
Definition
HA, Fatigue, salivary gland inflammation
Term
laboratory for mumps:
Definition
IgM within 5d of onset, swab for viral culture of affected salivary gland
Term
mumps Tx:
Definition
tylenol, cold/hot compress, avoid things that cause salivation
Term
Rubella etiology:
Definition
Togavirus (RNA virus)
Term
Rubella transmission:
Definition
direct contact with nasopharyngeal secretions and crosses placental barier
Term
when is Rubella contagious?
Definition
7d before and 5-7d after onset of rash
Term
infants with RUbella and CRS can shed the virus for up to:
Definition
1 year
Term
Rubella clinical stages:3
Definition
1. prodrome = low grade fever
2. lymphadenopathy in second week
3. maculopapilar rash 14-17d after exposure
Term
Mumps Tx:
Definition
1. tylenol/IBP for pain
2. cold/hot compress
3. avoid fruit juice,acidic foods
Term
type of bacteria: Strep pneumoniae
Definition
gram positive cocci
Term
what is the leading cause for bacterial meningitis in patients <5yo?
Definition
S. pneumo
Term
transmission of S. pneumo:
Definition
respiratory droplets
Term
3 clinical syndromes of pneumococcal infections:
Definition
1. pneumonia
2. bacteremia
3. meningitis
Term
5 S/Sx of pneumococcal pneumonia:
Definition
1. abrupt onset
2. Fever/chills
3. pleuritic CP
4. productive cough
5. dyspnea/tachypnea/hypoxia
Term
what is a common bacterial complication of influenza & measles:
Definition
oneumococcal pneumonia
Term
type of bacteria: nisseria meningitidis
Definition
gram negative rod
Term
where on the body does nisseria meningitidis colonize?
Definition
nasopharynx
Term
two classes of infection that make up 43% and 47% of Nisseria meiningitidis infections respectively:
Definition
47% meningitis
43% bacteremia
Term
Fever, petechial/purpuric rash, hypotension, multiorgan failure:
Definition
meningococcemia
Term
meningococcal Dz Dx:
Definition
1. culture
2. Gram stain
3. Antigen detection in CSF or serum
Term
ABx for nisseria meningitidis
Definition
penicillin
Term
primary infection of varicella zoster results in:
Definition
chicken pox
Term
recurrent infection from varicella zoster results in:
Definition
shingles
Term
transmission of varicella zoster:
Definition
1. respiratory droplet
2. fluid from pox vesicle
Term
when are pregnant women at risk for congenital varicella syndrome?
Definition
first 20weeks of pregnancy
Term
varicella zoster clinical findings:
Definition
1. mild fever
2. rhinorrhea
3. pruitic vesicular rash on head mostly on trunk
Term
transmission of rotavirus:
Definition
fecal/oral route
Term
when is rotavirus season?
Definition
november to april
Term
after you've had rotavirus can you be infected agian?
Definition
yes - less severe
Term
clinical findings for rotavirus:
Definition
1. vomitting
2. watery diarrhea
3. Fever
4. Abd pain
Term
rotavirus Dx:
Definition
stool specimen rapid antigen detection
Term
rota virus Tx:
Definition
self limited 3-8 days, prevent dehydration
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