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NAPLEX > immunizations > Flashcards

immunizations Flashcards

1
Q

live vaccines are CI in

A

pregnant and immunocompromised patients

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2
Q

live vaccines

A 
C cholera
O oral typhoid
Z zostavax
Y yellow fever
I Intranasal flu
V varicella 
R Rotavirus
M MMR
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3
Q

increasing the interval between a vaccine series does what

A

it doesnt diminish the effectiveness of the vaccine but may delay protection

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4
Q

decreasing the interval between a vaccine series does what

A

interferes with antibody response and protection

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5
Q

antibodies/ IVIG can interfered with ___ vaccines

A

live, like MMR usually a waiting period

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6
Q

waiting period for MMR and varicella vaccines such as varivax and MMRV is 3-11 months for ___ vaccines

A

live

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7
Q

vaccine given at birth

A

hep b

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8
Q

most live vaccines witheld until ___ years of age accept

A

1 year, rotavirus

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9
Q

inactivated vaccines are started when a baby is __ onths

A

2, except hep b which is given at birth

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10
Q

tubercullin skin test also called PPD test interaction with ___ vaccines can cause a ___ negative

A

false

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11
Q

how to reduce risk of false negative with TB test and live vaccine

A

give live vaccine on same day as tb test
wait 1 month after live vaccine for tb test
administer skin test first, wait 48- 72 hours to get result then give live vaccine

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12
Q

if live vaccines arent given on the same day, how long apart

A

4 weeks ( 1 month )

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13
Q

if vaccine requires more than one dose series can be ___ but not ___

A

extended but not shortened

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14
Q

if patient has an adverse reaction to a vaccine report it to

A

vaers

fda’s vaccine adverse event reporting system

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15
Q

live vaccines can cause mild systemic reactions that can occur __ - __ days after the vaccine is given

A

3-21 days

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16
Q

minor allergic reaction tx

A

benadryl or hydroxyzine

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17
Q

severe allergic reaction tx

A

anaphylaxis, epinephrine

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18
Q

epi pen is IM or SQ

A

IM

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19
Q

how many 0.3mg auto injectors should be available in the pharmacy

A

3

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20
Q

most adults will require how many doses of epi for severe allergic reaction

A

1-3 doses of 0. 3mg every 5-15 min

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21
Q

can you give a vaccine if the patient has a slight fever

A

yes

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22
Q

can you give a vaccine if the patient is taking antibiotics

A

yes

exceptions :varicella, zoster, oral typhoid

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23
Q

can you give a vaccine if the patient has had a previous local skin reaction

A

yes

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24
Q

can you give a vaccine if the patient has immunosupressed person in the household, recent exposure to the disease or convalesence

A

yes

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25
Q

can you give a vaccine if the patient has a family history of adv events to the vaccine

A

yes

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26
Q

CI for Hep B vaccine (recombivax HB) and HPV (gardisil)

A

yeast!

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27
Q

avoid the live flu vaccine in what patient

A

asthma patients

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28
Q

varicella CI in

A

gelatin or neomycin allergy

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29
Q

what age is flu shot recommended

A

6 months

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30
Q

infants and children vaccines

A

3 dose hep b started at birth

other series started at 2 months: prevnar 13, DTaP, Hib, polio, rotavirus

live vaccine series started at 1 year: MMR and Varicella

no polysaccharide vaccines before age 2

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31
Q

health care professional vaccines

A 
annual flu
Hep B
Tdap
Varicella
MMR
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32
Q

Adolescents and YA

A

Meningococcal (MCV4, Menactra or Menveo)

  • 2 doses: 1 dose at 11-12 yo and 1 dose at 16
  • first year college students (if not previously vaxed): 1 dose)

-HPV vaccine (gardisil)
age 11-12
2-3 doses depending on starting age

Tdap
first dose at age >11

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33
Q

sickle cell disease and other causes of asplenia (damaged or missing spleen) vaccinations

A

H. influenzae type b (Hib) vaccine

Pneumoccocal vaccines (prevnar 13 and 23)

  • before age 65: 1 dose of prevnar 13 (if not received previously) and 2 doses of pneumovax 23
  • give prevnar 13 first then 23 8 weeks later, then 23 again 5 years later

Meningococcal vaccines

  • meningococcal conjugate vaccine (menactra or menveo)
  • serogroup b meningococcal vaccine (bexsero or trumenba)
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34
Q

pregnancy vaccines

A

live vaccines are contraindicated
flu vaccine can be given in any trimester
tdap needs to be given once in every pregnancy (3rd trimester is optimal)

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35
Q

diabetes vaccines

A

pneumococcal vaccine
before age 65: 1 dose of pneumovax 23

hep b: age 19-59 (blood/needle protection vaccine)

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36
Q

causes of immunodeficenicy

A

chemotherapy/bone marrow transplant drugs
strong immunosupressant (etanercept, infliximab)
transplant drugs (tacrolimus, cyclosporine)
hiv w/ cd4 count <200 (aids)
systemic steroids for at least 2 weeks at 20 mg or more or 2 mg/kg prednisone daily/ equivalent
chronic renal failure

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37
Q

steroid dose to be immunosuppressed

A

1) 2 weeks or more

2) 20 mg or 2mg/kg prednisone/ equivalent daily

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38
Q

Tdap starts at what year

A

> 11 years old

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39
Q

shingrix for all adults age

A

50 and older
2 doses
2-6 months apart

wait 8 weeks (2 months) after zostavax

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40
Q

HPV indicated for adults less than ___and up tp ___

A

26 and less

and up to 45

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41
Q

age for pneumovax23

A

65

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42
Q

pneumovax 23 before age 65 (1 dose) if:

A

heart, lung, liver disease, diabetes, alcohol abuse, smoker

43
Q

prevnar 13 is for any patient ___ or older who are immunocompromised/asplenic

A

6 or older

44
Q

meningococcal serogroup b vaccines (bexsero, trumenba) give if

A 
complement component deficiency
raking eculizumab (soliris)
asplenia
microbiologist with exposure to N. Meningitidis
serogroup b outbreak exposure
45
Q

conjugate vaccines for meningococcal (menactra, menveo) give if

A 
HIV
travelers/residents to countries in which the disease is common
military recruits
first year college students in dorms
if not up to date
46
Q

Hep B (engerix B, recombivax HB, heplisav b) who gets

blood virus

twinrix is hep b with hep a

A
  • sexually active adults not in monogomas relationship
  • diabetes age 19-59
  • household contact with infected patient
  • iv drug users
  • HIV or chronic liver disease
47
Q

hep a vaccine who gets it
(havrix, vaqta)

twinrix is hep a and b

virus is fecal oral

A 
adults traveling to undeveloped countries outside of the US
household members and other close contacts of adopted children newly arriving from countries with moderate-high infection risk
liver disease
hemophilia
men who have sex with men
iv drug users
homeless 
HIV
48
Q

HIV hep a b or both

A

both

49
Q

liver disease hep a b or both

A

both

50
Q

diabetes hep a b or both

A

hep b

51
Q

iv drug users hep a b or both

A

both

52
Q

homeless hep a b or both

A

hep a

53
Q

men who have sex with men hep a b or both

A

hep a

54
Q

sexually active not in monogamous relationship hep a b or both

A

hep b

55
Q

Dtap for peds have 3-5 times more __

A

diptheria

56
Q

Dtap is for children younger than ___

A

7

57
Q

dtap-Hepb-IPV:

A

pediarix

58
Q

Dtap is how many doses of childhood vaccine

A

5 doses

59
Q

Dtap series ends at how old

A

6

60
Q

Tdap booster typically given at age

A

11 or greater if not previously received

61
Q

wound prophylaxis with td or tdap

A

for deep dirty wounds

revaccinate with td or tdap if its been more than 5 years since last dose

62
Q

must be how hold to receive a tdap shot

A

7

63
Q

tdap / td boosters given every __ years

A

10

64
Q

haemophilus influenzae type b or Hib vaccine is given to patients with

A

asplenia

65
Q

Hib is also a routine ___ vaccine

A

childhood

66
Q

you can give hep a to anyone who __

A

wants it

67
Q

hep a and b are routine childhood __-

A

vaccines

68
Q

hep b is started

A

within 24 hours after birth

69
Q

patients with ESRD and incarcerated people get ___

A

hep B vaccine

70
Q

heplisav-b is hep b vaccine for what age

A

age 18 or older (2 dose series)

71
Q

recommended age for gardasil 9 (HPV 9)

A

age for gardisil 9-26
recommended 11-12

CI with severe yeast allergy

72
Q

gardisil is fda approved up to age

A

45

73
Q

2 doses of hpv is age

A

9-14

74
Q

3 doses of hpv is age is

A

15 or greater

75
Q

dosing schedule for gardisil

A

2 doses: come back 6-12 months later

3 doses: 2nd dose=1-2months, 3rd dose: 6months

76
Q

patients age 6months to 8 years getting their first flu vaccine are to receive what

A

2 doses 1 month apart

77
Q

flublok is a ___ free product approved for what age

A

egg

18 and older

78
Q

do not administer the live influenzia vaccine (flumist) to a patient with what allergy

A

egg

or pregnant patient

79
Q

flu vaccines indicated for patients 65 or older

A

fluzone HD
fluzone HD QUAD
and
fluad

80
Q

live=

A

SQ

81
Q

not live =

A

IM

82
Q

flumist age

A

2-49

half dose in each nose

83
Q

pcv13

A

prevnar 13 CONJUGATED must know

84
Q

PPSV23

A

pneumovax 23 (polysaccharide) must know

85
Q

heplisav b how many doses

A

2

86
Q

engerix b and recombivax hb how many doses

A

3

87
Q

if patient already has hep b its too late to give them the

A

hep vaccine

88
Q

only vaccine that can be in the freezer or fridge

A

MMR (measles mumps rubella)

89
Q

no mmr for what allergy

A

neomycin or gelatin allergy

90
Q

do not give MMR (live vaccine) in

A

pregnancy or immunocompromised esp HIV patients

91
Q

MMR+varicella is called

A

proquad MMRV

92
Q

Proquad is in the ____

A

freezer

93
Q

when is varicella vaccine given

A

1 year or older , 2 doses

94
Q

shingles occurs on __ side of the body

A

one side, (back moving to front)

95
Q

rotarix is rotavirus vacccine whats special about it

A

live and oral

given in infants

96
Q

typhoid which is live which isnt

only for travelers

A

live is oral (vitotif berna)

not live is IM typhim vi

97
Q

yellow fever is a ___ vaccine

A

live and travelers vaccine
given through mosquitos
use DEET

98
Q

twinrix age

A

greater than 18

99
Q

varicella is in the

A

freezer

100
Q

fridge temps

A

2-8 c.

36-48 f.

101
Q

freezer temp

A
  • 50 to -15 c.

- 58 to 5 f.

102
Q

varivax needs to be given right ___

A

away after reconstituion

103
Q

healthy 66 year old, doctor wants patient to get prevnar 13 and pneumovax 23 whats the squence

A

prevnar 13 first then 23 one year later

104
Q

age for menB vaccine

A

10-25

sickle cells gets menB

NAPLEX (24 decks)

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