Green book Flashcards
Which of the following confer(s) passive immunity?
a) Hepatitis B vaccine
b) MMR vaccine
c) Hepatitis B immunoglobulin
d) Infection with measles virus
e) Cross placental transfer of maternal antibodies
Hepatitis B immunoglobulin
Cross placental transfer of maternal antibodies
Immunoglobulins are made:
a) In a laboratory from deactivated viruses and bacteria
b) From the plasma of a person in the acute phase of an infectious disease
c) From the pooled plasma of blood donors
d) From protein produced artificially in a laboratory
e) From treating red blood cells
From the pooled plasma of blood donors
In the immune system:
a) B lymphocytes secrete antibodies
b) Vaccines provide passive immunity
c) B cells stimulate T cells to produce antibodies
d) Cell-mediated immunity is controlled by T lymphocytes
e) Macrophages neutralise toxins
B lymphocytes secrete antibodies
Cell-mediated immunity is controlled by T lymphocytes
- Which of the following is/are true about conjugated vaccines?
a) Conjugated vaccines are those in which there is more than one vaccine antigen e.g.
MMR
b) Conjugated vaccines tend to induce a poorer response than polysaccharide
vaccines
c) Meningitis C vaccine is not available in a conjugated form
d) Hib vaccine is an example of a conjugated vaccine
e) Conjugation involves attaching a polysaccharide antigen to a carbohydrate carrier
Hib vaccine is an example of a conjugated vaccine
Which of the following is/are true?
a) Immunological memory is only present if there are detectable antibodies
b) The response to vaccine antigen is dominated by IgG initially followed by IgM
c) Herd immunity reduces the risk of unvaccinated individuals being exposed to
infection
d) Pertussis vaccine contains an inactivated toxin (toxoid)
e) BCG is a live vaccine
Herd immunity reduces the risk of unvaccinated individuals being exposed to infection
BCG is a live vaccine
Specific immunoglobulins are available for:
a) Rabies
b) Pertussis
c) Tetanus
d) Rubella
e) Varicella Zoster
Rabies
Tetanus
Varicella Zoster
Consent to immunisation:
a) Must be obtained in writing
b) Need only be obtained once, provided it is documented
c) Is voluntary
d) Can be given by a person aged 16 years for themselves
e) Should include provision of information on the process, benefits and risks of
immunisation
Is voluntary
Can be given by a person aged 16 years for themselves
Should include provision of information on the process, benefits and risks of immunisation
Maintaining the cold chain ensures that vaccines are stored according to the manufacturer’s instructions at: a) 0- +4oC b) -1- +5 oC c) +2 - +10 oC d) +4 - +8 oC e) +2 - +8 oC
+2 - +8 oC
Which of the following is/are true of a vaccine refrigerator:
a) An ordinary domestic refrigerator is sufficient provided it has only vaccines stored
in it
b) Can be used to store urine samples
c) Should be lockable or in a lockable room
d) Should be away from radiators
e) Are best plugged into a switchless socket
Should be lockable or in a lockable room
Should be away from radiators
Are best plugged into a switchless socket
Vaccines should be:
a) Taken out of their original packaging to save space in the refrigerator
b) Stored in the bottom drawers of the refrigerator
c) Packed tightly in the refrigerator
d) Protected from light during storage
e) Never be given to patients to transport or store
Protected from light during storage
Immunoglobulins:
a) Should be protected from light
b) Should be stored at +2-+8 oC
c) May be frozen
d) Will tolerate room temperatures for up to one week, but should be refrigerated
e) May be sent by post
Should be protected from light
Should be stored at +2-+8 oC
Will tolerate room temperatures for up to one week, but should be refrigerated
May be sent by post
Which of the following vaccines is/are given by the intramuscular route:
a) Influenza
b) BCG
c) Cholera
d) MMR
e) Varicella
Influenza
MMR
Varicella (but only with Varivax, not Varilix)
BCG is intradermal/ subcutaneous
Cholera is oral
The most suitable site(s) for intramuscular and subcutaneous vaccination is/are:
a) Anterolateral aspect of the thigh
b) Deltoid area of the upper arm
c) Fatty area of buttock
d) Anywhere in buttock
e) All the above
Anterolateral aspect of the thigh
Deltoid area of the upper arm
Which of the following is/are true when giving a vaccine?
a) If the skin is clean no further cleaning is necessary
b) The skin should be disinfected prior to administering any vaccine
c) Only visibly dirty skin needs to be washed with soap and water
d) The needle should be sufficiently long (25mm) for all ages except for pre-term and
very small children
e) Skin should be stretched, not bunched
If the skin is clean no further cleaning is necessary
Only visibly dirty skin needs to be washed with soap and water
The needle should be sufficiently long (25mm) for all ages except for pre-term and very small children
Skin should be stretched, not bunched
After giving a vaccine you should always:
a) Observe the recipient for immediate adverse reactions (ADRs)
b) Keep the recipient under longer observation in the surgery
c) Dispose of equipment used for vaccination in a ‘sharps’ box
d) Keep accurate and accessible records of both the recipient and the vaccine given
e) All the above
Observe the recipient for immediate adverse reactions (ADRs)
Dispose equipment used for vaccination in a ‘sharps’ box
Keep accurate and accessible records of both the recipient and the vaccine given
Which of the following is/are true about vaccine administration?
a) It is better to inject vaccine into fat than muscle
b) A 25mm needle length is suitable for all age groups
c) A 16mm needle length is only recommended for pre-term or very small infants
d) The deltoid area of the upper arm is generally preferred for infants under 1 year old
e) The anterolateral region of the thigh is generally preferred for older children and
adults
A 25mm needle length is suitable for all age groups
A 16mm needle length is only recommended for pre-term or very small infants
If given in the same limb as another vaccine, the second vaccine should be separated by at least: a) 0.5cm b) 1.5cm c) 2.5cm d) 3.5cm e) None of the above
2.5cm
What is a Patient Group Direction with regards to vaccination?
provides legal framework which allows some registered health professionals to supply/ administer specified medicine to a group of pre-defined patients, without them having to see a prescriber
e.g nurse can give vaccine without needing doctor prescription
Patient Group Directions (PGDs):
a) Can be used to administer an unlicensed vaccine
b) Should state that a Black Triangle medicine is being used
c) Are verbal instructions for the supply or administration of medicines to a group of
patients who may not be individually identified before presentation
d) Are legally required to be reviewed at least every 2 years
e) Are a form of prescribing vaccines
Should state that a Black Triangle medicine is being used
Are legally required to be reviewed at least every 2 years
Black Triangle drugs are those recently licensed, and subject to special reporting arrangements for adverse reactions. Often used outside terms of Summary of Product characteristics e.g in specialist paediatric care
A Patient Group Direction (PGD) must be signed by:
a) A senior nurse and a senior doctor
b) A senior nurse and a senior pharmacist
c) A senior doctor and a senior pharmacist
d) A practice manager and a GP
e) 2 nurse prescribers
A senior doctor and a senior pharmacist
A Patient Specific Direction (PSD):
a) Should not be used in preference to a Patient Group Direction
b) Is the usual method for the supply and administration of vaccines in the routine
childhood immunisation schedule
c) Does not require the patient/s to be named
d) Can be a verbal instruction in a busy clinic situation
e) Allows a prescriber to instruct another health professional in writing to supply or
administer a medicine
Is the usual method for the supply and administration of vaccines in the routine childhood immunisation schedule
Allows a prescriber to instruct another health professional in writing to supply or administer a medicine
Vaccination with a live vaccine should be deferred if:
a) The patient has received immunoglobulin in the past 3 months
b) The patient is receiving systemic high-dose steroids
c) The patient is a premature infant
d) The patient is breastfeeding
e) The patient has a family history of epilepsy
The patient has received immunoglobulin in the past 3 months
The patient is receiving systemic high-dose steroids
Which of the following is/are contraindications to all vaccines:
a) An allergy to eggs
b) Pregnancy
c) Receiving immunoglobulin in the past 3 months
d) A documented history of the disease
e) Personal history of febrile convulsion
None of the above are true
Patients with the following conditions may safely be given any immunisation:
a) Asthma
b) Low birth weight
c) A patient with G6PD deficiency
d) Myeloma
e) A history of jaundice at birth
Asthma
Low birth weight
A patient with G6PD deficiency
A history of jaundice at birth
A severely immunocompromised patient can receive the following vaccines:
a) Diphtheria/tetanus/inactivated polio combined (Td/IPV)
b) MMR
c) Pneumococcal conjugate
d) Hepatitis B
e) Hib/MenC combined
Diphtheria/tetanus/inactivated polio combined Td/IPV
Pneumococcal conjugate
Hepatitis B
Hib/Men C combined
Which of the following should not receive live vaccines:
a) Patients suffering from hay fever
b) Adults receiving at least 40mg of prednisolone per day for more than one week
c) Patients who received a stem cell transplant from a donor 18 months ago
d) A patient taking a corticosteroid inhaler
e) Patients with Wiskott-Aldrich syndrome
Adults receiving at least 40mg of prednisolone per day for more than one week
Patients who received a stem cell transplant from a donor 18 months ago
Patients with Wiskott-Aldrich syndrome
For those about to start immunosuppressive treatments:
a) Inactivated vaccines should be administered at least 2 weeks before treatment starts
b) Inactivated vaccines should never be administered after the start of treatment
c) Their close contacts should be considered for vaccination against varicella and
influenza
d) Patients receiving complement inhibitor therapy are at increased risk of
meningococcal infection but not pneumococcal disease
e) Those who receive bone marrow transplants should be considered for reimmunisation post treatment
Inactivated vaccines should be administered at least 2 weeks before treatment starts
Their close contacts should be considered for vaccination against varicella and influenza
Patients receiving complement inhibitor therapy are at increased risk of meningococcal infection but not pneumococcal disease
Those who receive bone marrow transplants should be considered for re-immunisation post treatment
Those who have no spleen, or splenic dysfunction should have:
a) Hib/Men C vaccine
b) Men B vaccine
c) Meningococcal ACWY conjugate vaccine
d) Pneumococcal vaccine
e) Varicella vaccine
Hib/Men C vaccine
Men B vaccine
Meningococcal ACWY conjugate vaccine
Pneumococcal vaccine
A patient aged 7 is up to date with their vaccinations. They lose their spleen after
an accident. They need the following vaccines:
a) Varicella vaccine
b) Single dose of PCV 13
c) Hib/Men C booster, PPV 23 and Men B vaccines followed by a second dose of Men
B and Men ACWY one month later
d) Hib/Men C booster, PPV 23 and Men B vaccines followed by a second dose of Men
B and Men ACWY 2 months later
e) Additional dose of MMR vaccine
Hib/Men C booster, PPV 23 and Men B vaccines followed by a second dose of Men B and Men ACWY 2 months later
Premature infants should receive their first dose of the primary immunisation:
a) 2 months from the actual date of delivery
b) 2 months from the estimated date of delivery
c) Only when they weigh at least 1.5kg
d) Only once they have been discharged from hospital
e) None of the above
2 months from the actual date of delivery
Influenza vaccine is specifically indicated in individuals with:
a) Diabetes
b) Cochlear implants
c) Complement disorders
d) Haemophilia
e) Chronic kidney conditions (including haemodialysis)
Diabetes
Chronic kidney conditions (including haemodialysis)
A child with splenic dysfunction first diagnosed at 9 months will require:
a) Influenza vaccine
b) Two doses of Men B vaccine at least 2 months apart
c) An additional dose of Men B vaccine at aged 2
d) Hepatitis B vaccine
e) 2 doses of Men ACWY vaccine at least one month apart
Influenza vaccine
Two doses of Men B vaccine at least 2 months apart
2 doses of Men ACWY vaccine at least one month apart
Immunosuppressed patients can be protected against some infections by
administration of immunoglobulin post exposure to:
a) Chicken pox
b) Diphtheria
c) Rubella
d) Measles
e) Influenza
Chickenpox
Measles
Signs of anaphylaxis include:
a) Angioedema
b) Tachycardia
c) Wheeze
d) Hypertension
e) Urticaria
Angioedema
Tachycardia
Wheeze
Urticaria
A further dose of the same vaccine should not be given if the patient develops:
a) Pain, swelling or redness of the site
b) Irritability
c) Headache
d) Cardiovascular collapse and other anaphylactic reactions
e) Temperature above 37.5oC
Cardiovascular collapse and other anaphylactic reactions
In the case of anaphylactic reaction to a vaccine in a community clinic you
should:
a) Seek additional health professional assistance
b) Ask a responsible person to dial 999 and state that there is a suspected anaphylaxis
c) Stay with the patient all the time
d) Manage the patient entirely in the clinic, if they appear to make a full recover
e) Send the patient to a nearest hospital
Seek additional health professional assistance
Ask a responsible person to dial 999 and state that there is a suspected anaphylaxis
Stay with the patient all the time
Send the patient to a nearest hospital
In a suspected anaphylactic reaction adrenaline (epinephrine) 1:1,000 should be given: a) Intradermally b) Subcutaneously c) Intramuscularly (IM) d) Intravenously (IV) e) Any of the above
Intramuscularly (IM)
In case of anaphylaxis, half of the usual adrenaline dose should be given to those taking: a) Beta blockers b) Tricyclic antidepressants c) Monoamine oxidase inhibitors d) Cocaine e) All the above
None of the answers is correct since the revision of the Resuscitation Council Guidelines 2008.
If a vaccine carries the Black Triangle symbol this indicates:
a) It is a vaccine which must be administered under hospital supervision
b) The vaccine is not yet licensed in the UK
c) All suspected reactions (serious and non-serious must be reported)
d) The vaccine can only be used on a named-patient basis
e) Only reactions in children need to be reported
All suspected reactions (serious and non-serious must be reported)
he Yellow Card Scheme:
a) Reports submitted to the Yellow Card Scheme are entered on a database operated
by the Health and Safety Executive (HSE)
b) Is not applicable to vaccines given Black Triangle status
c) Allows patients to report suspected adverse reactions
d) Only serious adverse reactions should be reported for vaccines that have been
marketed for 6 months or more
e) Is a compulsory reporting system for suspected adverse reactions
Allows patients to report suspected adverse reactions
A defect in a vaccine product should be reported:
a) Using the Yellow Card Scheme
b) Using the Black Triangle Scheme
c) To a report centre of the Medicines and Healthcare products Regulatory Agency
(MHRA)
d) Only to the vaccine manufacturer
e) Only if it has caused an adverse reaction in a patient
To a report centre of the Medicines and Healthcare products Regulatory Agency (MHRA)
The Vaccine Damage Payment Scheme:
a) Provides a single tax-free payment to successful claimants
b) Is provided to people/families of someone suffering severe mental disablement as a
result of immunisation against specified diseases
c) Does not cover severely disabled children born to mothers vaccinated against
specified diseases in pregnancy
d) Does not cover severe disablement in a person in close contact with someone
immunised with oral polio vaccine
e) Is provided to people/families of someone suffering severe physical disablement as
a result of immunisation against specified diseases
Provides a single tax-free payment to successful claimants
Is provided to people/families of someone suffering severe mental disablement as a result of immunisation against specified diseases
Is provided to people/families of someone suffering severe physical disablement as a result of immunisation against specified diseases
Vaccines covered by the Vaccine Payment Damages Scheme include:
a) Diphtheria
b) Hepatitis A
c) Rubella
d) Hepatitis B
e) Yellow fever
Diphtheria
Rubella
Vaccines covered by the Vaccine Payment Damages Scheme include:
a) Typhoid
b) Measles
c) Tick-borne encephalitis
d) Haemophilus influenzae type B
e) Influenza
Measles
Haemophilus influenzae type B
Vaccines covered by the Vaccine Payment Damages Scheme include:
a) Japanese Encephalitis vaccine
b) HPV vaccine
c) Cholera vaccine
d) Pertussis
e) BCG vaccine
HPV vaccine
Pertussis
BCG vaccine
. To be successful claims must meet the following criteria:
a) The disabled person can be of any age
b) The disabled person can have been vaccinated in any country in the European
Union
c) The disabled person must have been immunised before their 18th birthday if the
claim is for polio vaccine
d) If the disabled person is deceased, the claim must be made before they would have
reached their 21st birthday
e) Claimant must have been assessed by a doctor
If the disabled person is deceased, the claim must be made before they would have reached their 21st birthday
Claimant must have been assessed by a doctor
To be successful claims must meet the following criteria:
a) Claims must be made on or before the disabled person’s 21st birthday
b) Disability is assessed using a percentage disability test similar to that used for
assessing industrial injuries
c) The disabled person can have been immunised at any age against a specified
disease, provided this was undertaken during an outbreak in the UK or Isle of Man
d) Any immunisations given by HM Armed Forces should be clearly identified, as these
are excluded from the scheme
e) Claims must be made within 6 years of the date of vaccination, or before the
disabled person’s 16th birthday, whichever is the later
Claims must be made on or before the disabled person’s 21st birthday
Disability is assessed using a percentage disability test similar to that used for assessing industrial injuries
The disabled person can have been immunised at any age against a specified disease, provided this was undertaken during an outbreak in the UK or Isle of Man
Under the claims procedure:
a) All decisions are made by the Secretary of State for Work & Pensions
b) An assessment is made on the balance of probability that disability is the result of
immunisation with the percentage level of disablement attributable
c) There is no appeal
d) The independent Vaccine Damage Tribunal decision is final
e) A request for the reversal of the claim decision can be made in writing providing an
explanation of why it is believed the decision given is wrong
An assessment is made on the balance of probability that disability is the result of immunisation with the percentage level of disablement attributable
A request for the reversal of the claim decision can be made in writing providing an explanation of why it is believed the decision given is wrong
