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Question Bank > Green book > Flashcards

Green book Flashcards

1
Q

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

A

Hepatitis B immunoglobulin

Cross placental transfer of maternal antibodies

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2
Q

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

A

From the pooled plasma of blood donors

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3
Q

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

A

B lymphocytes secrete antibodies

Cell-mediated immunity is controlled by T lymphocytes

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4
Q
  1. 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
A

Hib vaccine is an example of a conjugated vaccine

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5
Q

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

A

Herd immunity reduces the risk of unvaccinated individuals being exposed to infection

BCG is a live vaccine

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6
Q

Specific immunoglobulins are available for:

a) Rabies
b) Pertussis
c) Tetanus
d) Rubella
e) Varicella Zoster

A

Rabies

Tetanus

Varicella Zoster

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7
Q

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

A

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

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8
Q 
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
A

+2 - +8 oC

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9
Q

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

A

Should be lockable or in a lockable room

Should be away from radiators

Are best plugged into a switchless socket

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10
Q

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

A

Protected from light during storage

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11
Q

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

A

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

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12
Q

Which of the following vaccines is/are given by the intramuscular route:

a) Influenza
b) BCG
c) Cholera
d) MMR
e) Varicella

A

Influenza

MMR

Varicella (but only with Varivax, not Varilix)

BCG is intradermal/ subcutaneous
Cholera is oral

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13
Q

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

A

Anterolateral aspect of the thigh

Deltoid area of the upper arm

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14
Q

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

A

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

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15
Q

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

A

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

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16
Q

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

A 25mm needle length is suitable for all age groups

A 16mm needle length is only recommended for pre-term or very small infants

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17
Q 
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
A

2.5cm

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18
Q

What is a Patient Group Direction with regards to vaccination?

A

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

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19
Q

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

A

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

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20
Q

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

A senior doctor and a senior pharmacist

21
Q

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

A

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

22
Q

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

A

The patient has received immunoglobulin in the past 3 months

The patient is receiving systemic high-dose steroids

23
Q

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

A

None of the above are true

24
Q

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

A

Asthma

Low birth weight

A patient with G6PD deficiency

A history of jaundice at birth

25
Q

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

A

Diphtheria/tetanus/inactivated polio combined Td/IPV

Pneumococcal conjugate

Hepatitis B

Hib/Men C combined

26
Q

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

A

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

27
Q

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

A

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

28
Q

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

A

Hib/Men C vaccine

Men B vaccine

Meningococcal ACWY conjugate vaccine

Pneumococcal vaccine

29
Q

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

A

Hib/Men C booster, PPV 23 and Men B vaccines followed by a second dose of Men B and Men ACWY 2 months later

30
Q

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

A

2 months from the actual date of delivery

31
Q

Influenza vaccine is specifically indicated in individuals with:

a) Diabetes
b) Cochlear implants
c) Complement disorders
d) Haemophilia
e) Chronic kidney conditions (including haemodialysis)

A

Diabetes

Chronic kidney conditions (including haemodialysis)

32
Q

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

A

Influenza vaccine

Two doses of Men B vaccine at least 2 months apart

2 doses of Men ACWY vaccine at least one month apart

33
Q

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

A

Chickenpox

Measles

34
Q

Signs of anaphylaxis include:

a) Angioedema
b) Tachycardia
c) Wheeze
d) Hypertension
e) Urticaria

A

Angioedema

Tachycardia

Wheeze

Urticaria

35
Q

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

A

Cardiovascular collapse and other anaphylactic reactions

36
Q

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

A

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

37
Q 
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
A

Intramuscularly (IM)

38
Q 
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
A

None of the answers is correct since the revision of the Resuscitation Council Guidelines 2008.

39
Q

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

A

All suspected reactions (serious and non-serious must be reported)

40
Q

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

A

Allows patients to report suspected adverse reactions

41
Q

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

A

To a report centre of the Medicines and Healthcare products Regulatory Agency (MHRA)

42
Q

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

A

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

43
Q

Vaccines covered by the Vaccine Payment Damages Scheme include:

a) Diphtheria
b) Hepatitis A
c) Rubella
d) Hepatitis B
e) Yellow fever

A

Diphtheria

Rubella

44
Q

Vaccines covered by the Vaccine Payment Damages Scheme include:

a) Typhoid
b) Measles
c) Tick-borne encephalitis
d) Haemophilus influenzae type B
e) Influenza

A

Measles

Haemophilus influenzae type B

45
Q

Vaccines covered by the Vaccine Payment Damages Scheme include:

a) Japanese Encephalitis vaccine
b) HPV vaccine
c) Cholera vaccine
d) Pertussis
e) BCG vaccine

A

HPV vaccine

Pertussis

BCG vaccine

46
Q

. 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

A

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

47
Q

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

A

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

48
Q

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

A

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

Question Bank (33 decks)

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