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Board Review > Immunizations > Flashcards

Immunizations Flashcards

1
Q

what must you give before any vaccine?

A

the most up-to-date Vaccine Information Statement

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2
Q

what is active immunity

A

when a person builds their own immune response because they survived an infection or received a vaccination

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3
Q

what is passive immunity

A

when a person is immune because they transferred someone else’s immune system as in giving antibodies from a mother to child

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4
Q

how long after you give a live vaccine should you wait to give any antibodies?

A

at least 2 weeks

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5
Q

how long do you wait between giving a antibody product and MMR or varicella vaccines? (except zoster)

A

at least 3 months or up to 11 months (see the PINK book)

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6
Q

why are live vaccines started 12 months after birth?

A

cuz baby has circulated vaccines

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7
Q

which vaccine can be started at birth?

A

hep b

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8
Q

when to start inactivated vaccines?

A

2 months

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9
Q

can you give more than one vaccine at a time ?

A

YES as many as possible at one time. no contraindications in the US

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10
Q

in the case where you have multiple doses that need to be given for a vaccine at certain intervals, what happens if you delay the interval a little

A

you are just delaying more protection, but you can vaccinate them after the recommended interval.

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11
Q

can you decrease the time interval of multi dose vaccines?

A

no usually not. For high risk exposure, you may do so but usually decreasing interval doesn’t allow enough time for immune system to respond

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12
Q

can you give live vaccines on the same day sat the PPD test?

A

yes inf efact its recommended on the same day because you avoid false negatives

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13
Q

what if a person already got a live vaccine and you want to give them the PPD test?

A

you have to wait 4 weeks in order to avoid false negatives of the PPD test

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14
Q

what if a person already got the PPD but not the live vaccine yet?

A

wait 48-72 hours after until the person gets the results and then given them the live vaccine

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15
Q

what are the most common local SE of vaccines?

A

pain
swelling
redness at site injection

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16
Q

what are systemic adverse reactions to vaccines?

A 
fever
malaise
myalgias
headache
loss of appetite
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17
Q

what is the incidence of an anaphylactic reaction to a vaccine?

A

1 in 500,000

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18
Q

what are anaphylactic reactions usually mediated by?

A

IgE

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19
Q

what to administer in case of a anaphylactic reaction

A

epinphrine 1:1000 IM 0.01mg/kg/dose max 0.5mg/dose

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20
Q

who should your report an adverse reaction for vaccines?

A

FDA

Vaccine Adverse Event Reporting System (VAERS)

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21
Q

which are contraindications to vaccination with live vaccines?

A

pregnancy and immunosupression

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22
Q

define immunosuppression

A

20mg daily prednisone daily for at least 14 days

or 2mg/kg x 14 days or longer

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23
Q

when are live vaccines contraindicated for HIV patients?

A

only if CD4 < 200

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24
Q

when can a pregnant women receive a live vaccine?

A

never, even 1 month before pregnancy

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25
Q

when can a pregnant women receive an inactivated vaccine?

A

whenever

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26
Q

what about HPV vaccine and pregnancy?

A

defer

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27
Q

what about the flu vaccine and pregnacy

A

yes as long as its not the live vaccine

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28
Q

when should a pregnant woman get her TdAP?

A

> 2 weeks of gestation and has not had her Tdap booster (Q 10 years)

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29
Q

what if you are allergic to eggs, which vaccines can you not get?

A

influenza
yellow fervor
if anaphylactic allergy to eggs

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30
Q

what if a person can eat lightly cooked eggs or only gets hives from eating egg containing foods?

A

can give them the Inactivated form and watch the patient for 30 minutes

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31
Q

is allergy to eggs contraindication to MMR vaccine

A

no, no logner

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32
Q

Which vaccines can you not get if you are allergic to gelatin or neomycin?

A

varicella (zostavax & varivax)

MMR

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33
Q

what vaccines can you not give if streptomycin , polymyxin B or neomycin allergies?

A

inactivated polio vaccine

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34
Q

who should receive the DTaP vaccine?

A

< 7 yo

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35
Q

Havrix

A

HepA vaccine

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36
Q

Vaqta

A

HepA vaccine

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37
Q

two brands of HepA vaccine

A

Havrix/ Vaqta

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38
Q

engerix-B

A

hepatitis b vaccine

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39
Q

Recombivax HB

A

hep B vaccine

40
Q

Twinrix

A

Hep A/B vaccien

41
Q

who gets the Hep A vaccien

A

> 1 yo

  • MSM
  • IVDU
  • Chronic disease
  • travelers
42
Q

who get the hep B vaccine?

A

HC workers

  • MSM
  • multiple partners
  • IVDU
  • ESRD/ chronic liver disease
43
Q

dosing schedule for hep b?

A

0, 1 , 6 months

44
Q

accelerated twinrix dosing schedule?

A

days 0, 7, 21, 30 and booster at month 12

45
Q

for HepA dose given?

A

1ml if >18yo , if less, see package

46
Q

for hepB dose given

A

1ml if > 20yo , if <20, see package

47
Q

who is indicated for HPV vaccine?

A

females 9-26 years old, recommend 11-12yo before sexual activity
-males 9-26

48
Q

dosing schedule for HPV vaccine

A

0, 1-2 months, 6 months

49
Q

which is the only HPV vaccine for males?

A

HPV 4: gardasil

50
Q

which HPV vaccine for females?

A

HPV2: Cervarix

51
Q

afluria

A

TIV

52
Q

Flumist

A

LAIV

53
Q

agriflu

A

TIV

54
Q

fluarix

A

TIV

55
Q

flulaval

A

tiv

56
Q

fluvirin

A

TIV

57
Q

fluzone

A

TIV

58
Q

whats the diff between normal flu vaccine and flu zone (high dose)

A

in 2010 licencse for >= 65 yo but ctaonains 60mcg of each strain instead of 15mcg like the others

59
Q

what is the diff between normal flu and flu zone intradermal vaccine?

A

uses a small needle to reduce pain but causes more redness, swelling, itching.
Preg B

60
Q

who should receive a flu vaccine?

A

everyone > 6months old

61
Q

who can get the nasal spray?

A

2-49 yearls old , healthy, not pregnant, w/o high risk medical conditions

62
Q

what are the age limits of AFLURIA?

A

> 9 yo patent only due to report of febrile illness in young children

63
Q

if < 3 yo , which is the only vaccine you can give?

A

Fluzone

64
Q

when is flu season?

A

60% of peaks occur in february or later

65
Q

for MMR who is considered generally already immune to it?

A

people born < 1957

66
Q

storage of MMRV

A

freezer

67
Q

proquad

A

MMRV

68
Q

M-M-RII

A

MMR

69
Q

menomune

A

MPS4 meningiococcal

70
Q

menactra

A

MCV 4 meningiococcal

71
Q

menveo

A

MCV4 meningiococcal

72
Q

indications for meningiococal vaccine

A 
1 dose age 11-12 and booster at 16-18
1 dose if 13-18 yo
2-55 yo if: 
-college freshman in dormitories 
-asplenia
-military
-traveler
-immunodeficiency
-lab workders w/ n. meningidits exposure
73
Q

age restriction menomune?

A

> 56 yo pts

74
Q

menactra age?

A

9months to 55yo

75
Q

menveo age?

A

2-55 years old

76
Q

menomune IM or Sc

A

SC

77
Q

mcv 4 IM OR Sc

A

IM

78
Q

pneumococcal conjugate

A

PREVNAR 13

79
Q

pneumococcal polysaccharide

A

Pneumovax 23

80
Q

age limit prevnar

A

> 6 weeks

81
Q

age limit pneumovax

A

> 2 years old

82
Q

prevnar 13 indications

A

children younger than 2
50 + adults
19 + if immunocompromised

83
Q

pneumovax inidcations

A

65+
19-64 if smoke or asthma
2-64 w/ chronic disease

84
Q

vivotif special storage

A

MUST REFRIGERATE CAPSULES

85
Q

vivotif berna

A

Typhoid

86
Q

for what age group DTaP?

A

6 weeks to 6 years old

87
Q

for what age group the Tdap?

A

patients 7-10 who didn’t ge tteh full dose of the Dtap series (give a single dose)
11-64: one dose of Tdap
then Q 10 years a dose of Td
>65: vaccinate if in proximity w/ <12month olds, otherwise optional

88
Q

pregnancy and TDAP

A

> 20 weeks gestation get the shot if booster is need

89
Q

in patients who have never gotten the vaccine, what should you do?

A

start w/ the TDAP as first dose then the boosters as necessary

90
Q

when children get varicella vaccine?

A

12 months and 4 years

91
Q

varivax

A

varicella vaccine

92
Q

zostavax

A

zoster vaccine

93
Q

adults that get varivax?

A

2 doses 4 weeks apart

94
Q

IM or SC varivax/zostavax?

A

SC

95
Q

storage of varivax/zostavx

A

frozen at -15 degrees: the vaccine

store diluent in the fridge

96
Q

where do you inject the varivax/zostavax?

A

SC tissue behind triceps

97
Q

how much time after reconstituting varivax/zostavax should you inject it?

A

30 min otherwise discard

Board Review (65 decks)

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