Green book 2 Flashcards
In the UK immunisation programme, all children should be protected against:
a) Diphtheria
b) Pertussis
c) Polio
d) Measles
e) Hepatitis A
Diphtheria
Pertussis
Polio
Measles
The combined vaccine given at 2, 3 and 4 months of age is:
a) DTaP/IPV/Hib
b) DTaP/IPV/PCV
c) DTaP/IPV/MenC
d) DTaP/IPV/Hib/Hep B
e) DTaP/IPV/PPV
DTaP/IPV/Hib/Hep B
By 14 months of age all children should have received:
a) Three doses of DTaP/IPV/Hib/Hep B
b) One dose of PCV
c) Three doses of MenB
d) Two doses of MMR
e) 3 doses of Rotavirus vaccine
Three doses of DTaP/IPV/Hib/Hep B
Three doses of MenB
A child aged 2 years and 3 months has just joined your practice. Vaccination was
begun abroad, but the parents are vague about what was given and there is no
documentation. Which of the following would you give to the child?
a) Three doses of DTaP/IPV/Hib/Hep B
b) Two doses of MenB
c) Two doses of PCV
d) One dose of MMR
e) One dose of Hib/MenC
Three doses of DTaP/IPV/Hib/Hep B
One dose of Hib/Men C (but only if being used for Men C component, as Hib requirement already covered by giving DTaP/IPV/Hib)
The number of doses of diphtheria/ tetanus and polio vaccines required to ensure
long-term protect throughout adulthood is:
a) Three
b) Four
c) Five
d) Six
e) None of the above
Five
Which of the following is/are true:
a) A child coming to the UK who has had a fourth dose of a diphtheria/tetanus/pertussis
containing vaccine at 18 months will not need a pre-school booster
b) The school leaver booster contains the higher dose of diphtheria toxoid (D)
c) If any course of immunisation is interrupted, there is no need to start the course
again
d) Children should receive 2 doses of Men B vaccine in the 1st year of life
e) Premature babies are at increased risk of adverse reactions from vaccines
If any course of immunisation is interrupted, there is no need to start the course again
Children should receive 2 doses of Men B vaccine in the 1st year of life
At around 14 years of age children should receive:
a) Men ACWY vaccine
b) DTaP
c) DT/IPV
d) Td/IPV
e) Td
Men ACWY vaccine
Td/IPV
The adult immunisation programme includes:
a) Men C vaccine in those under 35 who are unvaccinated
b) Annual pneumococcal polysaccharide vaccine for those aged 65 and above
c) Annual influenza vaccine for those aged 65 and above
d) One dose of shingles vaccine for those aged 70 and above
e) Two doses of shingles vaccine for those aged 65 and above
Annual influenza vaccine for those aged 65 and above
One dose of shingles vaccine for those aged 70 and above
The following is/are true about vaccination in pregnancy:
a) Inactivated influenza vaccines are preferred to live attenuated vaccine in pregnancy
b) Influenza vaccine should be offered to pregnant women after the second trimester
c) A temporary programme for the vaccination of pregnant women against pertussis
was introduced in October 2012
d) Influenza vaccine should not be given at the same time as pertussis vaccine as it
might affect response to that vaccine
e) Vaccination of pregnant women will provide active immunity against influenza in the
first few months of life in the baby
Inactivated influenza vaccines are preferred to live attenuated vaccine in pregnancy
A temporary programme for the vaccination of pregnant women against pertussis was introduced in October 2012
The following is/are true about the UK routine schedule:
a) HPV vaccine is offered to girls and boys aged 12-13
b) The pneumococcal conjugate vaccine booster (PCV) is given at 3 years 4 months
c) 2 doses of oral rotavirus vaccine are given at 2 months and 3 months
d) The first dose of primary immunisations can be given from 6 weeks of age if
required in certain circumstances
e) Rotavirus vaccine should not be started later than 10 weeks of age
HPV vaccine is offered to girls and boys aged 12-13
2 doses of oral rotavirus vaccine are given at 2 months and 3 months
The first dose of primary immunisations can be given from 6 weeks of age if required in certain circumstances
In addition to being up to date with the routine immunisations, which of the following
should be considered for healthcare staff involved in direct patient contact:
a) BCG
b) Hepatitis B
c) Influenza
d) Varicella
e) Hepatitis A
BCG
Hepatitis B
Influenza
Varicella
Which of the following vaccines is/are routinely recommended for non-clinical staff
in healthcare settings (i.e. not directly involved in patient care):
a) BCG
b) MMR
c) Influenza
d) Varicella
e) None of the above
MMR
Satisfactory evidence of protection against Measles and Rubella would include:
a) Documentation of having received one dose of MMR
b) Documentation of having received 2 doses of MMR
c) Positive antibody tests for Measles and Rubella
d) A recollection of having Measles and Rubella infection in childhood
e) None of the above
Documentation of having received 2 doses of MMR
Positive antibody tests for Measles and Rubella
In addition to being up to date with the routine immunisation, which of the following
should be given to the relevant laboratory and pathology staff:
a) BCG
b) Hepatitis B
c) Polio booster every 10 years for those handling faecal specimens
d) A booster of diphtheria if necessary
e) All the above
All the above
Which of the following is/are true about anthrax:
a) It is spread by spores of the anaerobic bacillus Bacillus anthracis
b) Has an incubation period of 2-7 days
c) Can cause cutaneous, inhalational and gastrointestinal infections
d) It primarily affects carnivorous animals
e) Is difficult to treat with antibiotics even if diagnosed early
Has an incubation period of 2-7 days
Can cause cutaneous, inhalational and gastrointestinal infections
Which of the following would be routinely considered for anthrax vaccine in the
UK:
a) Textile workers working with goat hair
b) Veterinary surgeons
c) First responders attending a confirmed anthrax spore release incident
d) Bonemeal workers
e) Health Care staff working on an Infectious Diseases Unit
First responders attending a confirmed anthrax spore release incident
. Which of the following is/are true about anthrax vaccine:
a) It is a live attenuated vaccine
b) The vaccine course consists of 3 doses given at 3-week intervals
c) It can be given to pregnant women
d) It is administered by intramuscular injection
e) A reinforcing dose should be given every 3 years to those at continued risk
It can be given to pregnant women
It is administered by intramuscular injection
Anthrax:
a) Is a notifiable disease
b) Primarily affects herbivorous animals
c) Is a common animal disease in Western Europe
d) Is fatal in around 20% of cases
e) Has been described in IV drug users in the UK
Is a notifiable disease
Primarily affects herbivorous animals
Has been described in IV drug users in the UK
Adverse reactions to anthrax vaccine can include:
a) Swelling at the injection site
b) Urticaria
c) Regional lymphadenopathy
d) Generally, a higher risk of a reaction after subsequent doses if there was a reaction
to the first dose
e) Cutaneous anthrax at the injection site in a very small number of cases
Swelling at the injection site
Urticaria
Regional lymphadenopathy
Which of the following is/are true:
a) Immunoglobulins are effective if given as post exposure prophylaxis to anthrax
b) Anthrax vaccine should not be given at the same time as live vaccines
c) A person who has had a severe local reaction to the first dose of anthrax vaccine
should not receive a second dose
d) Patients with HIV infection and a very low CD4 count should not receive anthrax
vaccine
e) Anthrax vaccine contains an aluminium adjuvant and thiomersal
Anthrax vaccine contains an aluminium adjuvant and thiomersal
Which of the following statements is/are true regarding cholera vaccines available
in the UK:
a) There are 2 vaccines available one for oral and one for intramuscular administration
b) The oral vaccine is a live vaccine.
c) The oral vaccine protects against 4 strains of V. cholerae O1
d) The oral vaccine contains recombinant B toxins
e) The oral vaccine is thiomersal free
The oral vaccine protects against 4 strains of V. cholerae O1
The oral vaccine contains recombinant B toxins
The oral vaccine is thiomersal free
Cholera vaccines:
a) Should be stored in their original packaging
b) Can be used for post exposure prophylaxis
c) Should be protected from light in storage
d) Can be used safely after freezing
e) Can be stored at room temperature
Should be stored in their original packaging
Should be protected from light in storage
Oral cholera vaccine should be administered to anyone over the age of 6 years as
follows
a) First dose is given with food
b) Second dose is given between one and 6 weeks after the first dose
c) It is necessary to use the sodium hydrogen carbonate buffer power when preparing
the vaccine for administration
d) No other vaccines should be given at the same time as the cholera vaccine
e) Can be stored at room temperature
Second dose is given between one and 6 weeks after the first dose
It is necessary to use the sodium hydrogen carbonate buffer power when preparing the vaccine for administration
Oral cholera vaccine should be administered to anyone over the age of 6 years as
follows
a) The buffer sachet should be mixed with 150 ml of cold water in a disposable plastic
cup
b) Vaccinees should avoid food, drink and oral medicines for an hour before to an hour
after administration
c) The vaccine solution when mixed with the buffer solution can be kept for 8 hours
before drinking
d) The second dose should be administered at least a week before potential exposure
e) If more than 2 years have elapsed since the last cholera vaccination the primary
course must be repeated
The buffer sachet should be mixed with 150ml of cold water in a disposable plastic cup
Vaccinees should avoid food, drink and oral medicines for an hour before to an hour after administration
The second dose should be administered at least a week before potential exposure
If more than 2 years have passed since the last cholera
Which of the following is/are true about oral cholera vaccine:
a) The vaccine is recommended for use in children under the age of 2 years
b) There is data suggesting an excellent protective efficacy profile after booster doses
c) The vaccine when constituted should be a blue liquid
d) The vaccine is not recommended for prevention of traveller’s diarrhoea
e) Immunisation does not protect against V Cholerae serogroup 0139
The vaccine is not recommended for prevention of travellers’ diarrhoea
Immunisation does not protect against V Cholerae serogroup 0139
Oral cholera vaccine is considered for the following:
a) Relief and disaster aid workers
b) Anyone visiting an area where a cholera epidemic is occurring
c) Sewage workers in the UK
d) Nurses working on an infectious diseases unit in the UK
e) People with a past history of traveller’s diarrhoea
Relief and disaster aid workers
Anyone visiting an area where a cholera epidemic is occurring
. Cholera vaccine should not be given to the following:
a) Severely immunocompromised individuals
b) Anyone who is acutely unwell
c) Pregnant and breast-feeding women
d) Anyone who is HIV positive
e) Those with pre-existing gastro-intestinal disorders
Anyone who is acutely unwell
Adverse reactions attributable to oral cholera vaccine include:
a) A rash at a rate of 1 per 1,000 doses
b) A flu-like syndrome at a rate of less than 1 per 10,000 doses
c) Mild gastro-intestinal symptoms at a rate of 1 per 100-1,000 doses
d) Arthralgia (joint pains) at a rate of fewer than 1 per 1,000 doses
e) Paraesthesia (“pins and needles”) at a rate of 1 per 100 doses
A flu-like syndrome at a rate of less than 1 per 10,000 doses
Mild gastro-intestinal symptoms at a rate of 1 per 100-1,000 doses
Which of the following is/are true about Diphtheria:
a) Corynebacterium diphtheriae is the only bacterium causing diphtheria
b) Those carrying C diphtheriae are always ill
c) Diphtheria toxin affects the heart, nerves and adrenal tissues
d) Infected people may be infectious for up to 4 weeks if untreated
e) Corynebacterium diphtheriae may cause skin infections
Diphtheria toxin affects the heart, nerves and adrenal tissues
Infected people may be infectious for up to 4 weeks if untreated
Corynebacterium diphtheriae may cause skin infections
In the UK:
a) About half of adults over 30 years are susceptible to diphtheria
b) Diphtheria vaccine was introduced in the 1950s
c) An increase in notifications of diphtheria has been caused by a rise in numbers of
isolations of non-toxigenic strains of C diphtheriae
d) Most cases of diphtheria are imported
e) Secondary cases of diphtheria are rare
About half of adults over 30 years are susceptible to diphtheria
An increase in notifications of diphtheria has been caused by a rise in numbers of isolations of non-toxigenic strains of C diphtheriae
Most cases of diphtheria are imported
Secondary cases of diphtheria are rare
Which of the following is/are true about Diphtheria vaccines:
a) They are live attenuated vaccines
b) They are produced in 2 strengths
c) They contain an adjuvant to improve immunogenicity
d) Higher dose diphtheria vaccines should be used for primary immunisation in the UK
schedule in those under 10 years
e) Diphtheria vaccine is thiomersal free
They are produced in 2 strengths
They contain an adjuvant to improve immunogenicity
Higher dose diphtheria vaccines should be used for primary immunisation in the UK schedule in those under 10 years
Diphtheria vaccine is thiomersal free
Which of the following is/are true about Diphtheria vaccine:
a) It is only available in combination with other vaccines
b) When given as a primary immunisation course 2 weeks should be allowed between
vaccinations
c) The first booster dose of diphtheria vaccine should be given at least 12 months after
the last in the primary course
d) There should be 3 years between the first and second booster doses
e) If it has been given as part of a vaccination following a tetanus prone wound the
routine booster is always necessary
It is only available in combination with other vaccines
The first booster dose of diphtheria vaccine should be given at least 12 months after the last in the primary course
A 14-year-old child who is up-to-date with their vaccine schedule stepped on a
rusty nail at a riding school in France a year ago and was given a vaccination
abroad following the injury. There is no written record of what was given,
although the parents believe this was tetanus vaccine. The child has now
presented for a school leaving booster, which of the following is/are true:
a) The booster is not necessary
b) The risk of side effects from another tetanus vaccination so soon after the last one is
such that Td/IPV should not be given
c) The vaccination given at the time of injury should be discounted and Td/IPV given
now
d) The child should have a further tetanus vaccination in 10 years’ time
e) The child should be tested for tetanus antibodies before any further doses of tetanus
vaccine
The vaccination given at the time of injury should be discounted and Td/IPV given now
Which of the following statements is/are true about Hib vaccine:
a) Made from capsular polysaccharide that has been extracted from cultures of Hib
bacteria
b) Has been conjugated with either non-toxic variant of diphtheria vaccine or tetanus
toxoid
c) Is available as DTaP/IPV/Hib or Hib/PCV
d) Is thiomersal-free
e) Contains live organisms
Made from capsular polysaccharide that has been extracted from cultures of Hib bacteria
Has been conjugated with either non-toxic variant of diphtheria vaccine or tetanus toxoid
Is thiomersal-free
Which of the following is/are true about Hib/MenC vaccine:
a) Can be given at the same time as other vaccine such as MMR and Hep B
b) Can also be given routinely at the same time as the booster of pneumococcal
conjugate vaccine (PCV)
c) Is better given subcutaneously to reduce risk of local reaction
d) Should be given at least 2.5cm apart from other vaccines given in the same limb at the
same session
e) None of the above
Can be given at the same time as other vaccine such as MMR and Hep B
Can also be given routinely at the same time as the booster of pneumococcal conjugate vaccine (PCV)
Should be given at least 2.5cm apart from other vaccines given in the same limb at the same session
Which of the following is/are true:
a) Children under the age of 10 with asplenia or splenic dysfunction should complete the
primary immunisation schedule
b) Those aged 10 years and over, with asplenia or splenic dysfunction should receive 2
doses of combined Hib/Men C vaccine 2 months apart if unimmunised
c) Those fully immunised with Hib who then develop splenic dysfunction, need no further
doses of Hib containing vaccine
d) Hib vaccine should not be given to a person with a confirmed anaphylactic reaction to
a previous dose of Hib-containing vaccine or component of the vaccine
e) None of the above
Children under the age of 10 with asplenia or splenic dysfunction should complete the primary immunisation schedule
Hib vaccine should not be given to a person with a confirmed anaphylactic reaction to a previous dose of Hib-containing vaccine or component of the vaccine
Hib vaccine should be deferred in the following situations:
a) Pregnancy and breast-feeding women
b) Premature infants
c) Immunosuppressed people or those with HIV infection
d) Those with stable pre-existing neurological conditions
e) Those with evidence of evolving neurological deterioration
Those with evidence of evolving neurological deterioration
Which of the following should close contacts of a case of Hib infection be given:
a) If they have never had any immunisation and are under 10 years old 3 doses of
DTaP/IPV/Hib vaccine
b) If between 1-10 years of age and have never received Hib vaccine but have been
vaccinated against diphtheria, tetanus, pertussis and polio, 3 doses of Hib/Men C
c) If aged between 1-10 years and have never been vaccinated against diphtheria,
tetanus, pertussis and polio, one dose of Hib/MenC
d) Prophylaxis with isoniazid to the index case, and all household contacts, where there
is any individual in the household who is also ‘at risk’
e) Antibody tests to check if they are immune
If they have never had any immunisation and are under 10 years old 3 doses of DTaP/IPV/Hib vaccine
Which of the following is/are true about Hepatitis A vaccine:
a) The vaccine may cause mild jaundice 2-6 weeks after administration
b) It can be given to pregnant women when clinically indicated
c) Hepatitis A antibody levels should be tested to check for a response
d) Is only effective if given to unvaccinated contacts of Hepatitis A within 72 hours of
the onset of jaundice in the index case
e) Should not be given to someone who may already be incubating Hepatitis A infection
It can be given to pregnant women when clinically indicated
Which of the following is/are true:
a) All available monovalent Hepatitis A vaccines are licensed for patients aged 12
years and above
b) There are paediatric Hepatitis A vaccines available which contain higher doses of
antigen than the adult preparations
c) A booster dose of Hepatitis A vaccine should be given 6-12 months after the first
d) If the Hepatitis A booster dose is delayed the course should be restarted
e) A booster dose at 10 years is indicated for those at ongoing risk
A booster dose of Hepatitis A vaccine should be given 6-12 months after the first
Hepatitis A vaccine is routinely recommended for the following groups:
a) Food handlers working in a shellfish market
b) Individuals going to reside in Spain
c) Sewage workers
d) Patients with chronic renal disease
e) Injecting drug users
Sewage workers
Injecting drug users
Human Normal Immunoglobulin (HNIG):
a) When being used as post-exposure prophylaxis for Hepatitis A may protect against
disease if given within 14 days of exposure
b) Live vaccines (except yellow fever vaccine) should preferably not be given for 3
months after administration of HNIG
c) Can provide protection lasting up to 2-3 years
d) Should not be given to those with an allergy to eggs
e) The dose of HNIG for a child aged 5 years is 250 mg
When being used as post-exposure prophylaxis for Hepatitis A may protect against disease if given within 14 days of exposure
Live vaccines (except yellow fever vaccine) should preferably not be given for 3 months after administration of HNIG
The dose of HNIG for a child aged 5 years is 250 mg
Which of the following Hepatitis A vaccine products is/are available:
a) Combined Hepatitis A and B vaccine
b) Combined Hepatitis A and C vaccine
c) Monovalent Hepatitis A vaccine
d) Combined Hepatitis A and typhoid vaccine
e) Combined Hepatitis A and cholera vaccine
Combined Hepatitis A and B vaccine
Monovalent Hepatitis A vaccine
Combined Hepatitis A and typhoid vaccine
Which of the following is/are true:
a) HNIG is routinely recommended for travel prophylaxis for Hepatitis A
b) HNIG is usually administered subcutaneously
c) If HNIG is given live vaccines should preferably not be given for 3 weeks
d) Hepatitis A vaccine should preferably be administered at least 2 weeks before travel
departure
e) After a dose of monovalent Hepatitis vaccine Hepatitis A antibodies are generally
detectable in all individuals at 7 days using current assays
Hepatitis A vaccine should preferably be administered at least 2 weeks before travel departure
