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pharmacy 358 > Immunizations > Flashcards

Immunizations Flashcards

1
Q

What is the adaptive immune system?

A

defends a specific pathogen and is memory based

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2
Q

Innate immune system?

A

physical barrier

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3
Q

If a disease is highly transmissible what is the percentage needed for herd immunity?

A

HIGH

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4
Q

What are the live vaccines?

A

MMRV, varicella, rotavirus, typhoid (oral)

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5
Q

What else is in a vaccine?

A

antigen
suspending fluid- sterile h20
stabilizers- gelatin
preservatives
antibiotic-neomycin
adjuvant

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6
Q

What adjutant commonly causes more pain?

A

Aluminum salts

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7
Q

Why do you need a Ha booster if twinrix?

A

because too low of dose

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8
Q

What routes are most common for vaccines?

A

IM>SQ>oral

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9
Q

How long must you wait between live vaccines if not a combo?

A

> 4 weeks

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10
Q

Who is contraindicated for live vaccines?

A

immunocompromised or pregnant

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11
Q

What vaccine should be done last? What is an example?

A

The most painful one- pneumococcal

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12
Q

How much vaccine can usually be put in one arm?

A

1 ml

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13
Q

AT what age can multiple vaccines be given (Not combo)?

A

> 6 months

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14
Q

What vaccines are not interchangeable?

A

pneumococcal and some meningococcal
HB and HB dialysis

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15
Q

Do you need to restart a schedule if a long time between doses?

A

NO

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16
Q

Is an egg allergy an issue?

A

No

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17
Q

Can you give vaccine if mild URTI?

A

Yeds

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18
Q

Is GBS a good contraindication to vaccine?

A

NO

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19
Q

Must you report a common side effect of a vaccine?

A

No

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20
Q

What is special about rotavirus administration?

A

Oral and it is sweet

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21
Q

Pain management strategies?

A

move arm, numb cream, skin to skin or hold child, sucrose for babies

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22
Q

When can you give ibuprofen and acet?

A

> 6-8 hours after

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23
Q

What is Diphtheria?

A

bacteria that makes toxin that stops protein synthesis

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24
Q

What does Capital letters mean on vaccine name?

A

paediatric dose

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25
Q

How does diphtheria transmit and present?

A

respiratory droplets and URTI, grey membrane on throat

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26
Q

Complicaitions of diphtheria?

A

resp issues and myocarditis

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27
Q

what form of vaccine is diphtheria?

A

detoxified toxin

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28
Q

How frequent should Tdap be?

A

every 10 years or 5 if a serious cut or each pregnancy

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29
Q

Explain tetanus.

A

bacteria found in soil and faces, painful spasms and lockjaw

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30
Q

Transmission of tetanus?

A

wound contamination

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31
Q

complications of tetanus?

A

seizures and resp failure

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32
Q

What is form of vaccine for tetanus?

A

detoxified toxin

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33
Q

What is pertussis/

A

contagious early and whooping cough

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34
Q

Complications of pertussis?

A

pneumonia, seizures and encephalopathy

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35
Q

Why did we switch to acellular version of pertussis vaccine?

A

because other one caused seizures and hyperresponse

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36
Q

True or false, do you NEED a pertussis booster in adulthood?

A

YESSSSS

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37
Q

What in name of vaccine means polio?

A

IPV

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38
Q

Explain polio?

A

viral and mostly asymptomatic but can be flulike

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39
Q

Complications of polio?

A

meningitis, paralysis, limp

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40
Q

Transmission of polio?

A

fecal oral

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41
Q

Form of vaccine for polio?

A

inactivated and is trivalent

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42
Q

Why don’t we use live attenuated polio vaccine?

A

can cause the paralysis

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43
Q

When would you give adult a booster for polio?

A

if travelling to are with outbreak

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44
Q

Explain Hib?

A

bacteria and B is the most pathogenic

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45
Q

How does Hib spread?

A

resp droplets

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46
Q

Complications of Hib?

A

ear infection, meningitis, pneumonia, deaf, death

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47
Q

Who mostly gets Hib?

A

<5 yrs

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48
Q

What condition would you want to give a dose of Hib vaccine?

A

HIV

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49
Q

Of Tdap-IPV-Hib which don’t need adult boosters/

A

IPV and Hib

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50
Q

How does rotavirus transmit?

A

fecal oral

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51
Q

Sx of rotavirus?

A

diarrhea, stomach pain, vomitting

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52
Q

What form of vaccine is rotavirus?

A

live oral

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53
Q

If a baby spits up rotavirus vaccine what do we do?

A

Nothing

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54
Q

Caution with rotavirus vaccine?

A

sheds in faces so wash hands and caution for immunocompromised

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55
Q

S/e of rotavirus vaccine?

A

fever, diarrhea, bowel obstruction

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56
Q

Explain meningococcus disease?

A

bacterial, causes bacteria and meningtisi

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57
Q

Transmission of meningococcus?

A

resp droplets so crowded is an issue

58
Q

Complications of meningococcus?

A

amputations, deaf, seizures, brain damage

59
Q

What serotype of meningococcal do we NOT routinely give?

A

serotype B

60
Q

Are meningococcal vaccines interchangeable?

A

Fuh no

61
Q

What serotypes of meningococcal are given?

A

C, A, W, Y

62
Q

Explain measles.

A

viral transmitted by resp droplets

63
Q

Complication of measles?

A

ear infection, pneumonia, seizure, deaf, encephalitis

64
Q

Explain mumps. include complications and transmission.

A

viral by resp droplets
complications of meningitis and encephalitis, swollen gonads, abortion

65
Q

Explain rubella. include complications and transmission.

A

viral, resp droplets
causes rash, flu like, miscarriage

66
Q

Explain varicella. include complications and transmission.

A

viral by resp droplets OR blister fluid
causes rash, SSTI and pneumonia

67
Q

What form of vaccine is MMR-V

A

live attenuated

68
Q

What allergy is an issue with MMRV?

A

to gelatin or neomycin

69
Q

What does rubella part of the vaccine cause?

A

joint pain

70
Q

What can the varicella part of the vaccine cause?

A

blisters

71
Q

What is herpes zoster?

A

reactivation of varicella

72
Q

Who gets herpes zoster?

A

> 65 or immunocomp, stress

73
Q

If never got varicella or vaccine are adults at risk of herpes zoster?

A

No

74
Q

signs of herpes zoster?

A

prodromal pain before rash unilateral

75
Q

Complications of herpes zoster?

A

postherpetic neualrhia, opthalmic, pulmonary and hepatic issues

76
Q

Who is recommended to get shingrix?

A

> 50 years old
previously got Zostavax 2 or shingles epsiode

77
Q

Why was Zostavax discontinued?

A

live version. and could cause it and issues for children in close contact with patient

78
Q

How well does shingles vaccine work?

A

Lowers rate of shingles by 90% and NNT of 32 also decreases risk of PHN

79
Q

If immunocompromised, when should you get shingles vaccine?

A

> 18 years old

80
Q

How many doses of shingles needed?

A

2

81
Q

Up to what age can you get varicella vaccine?

A

50

82
Q

WHat should be done if a patient has the zoster rash?

A

Wait after rash to 1 year after

83
Q

Transmission of hep B?

A

bodily fluids

84
Q

Sx of Hep B infection?

A

usually asymptomatic but usual flue like and jaundice

85
Q

Complications of Hep B?

A

cirrhosis, liver cancer and death

86
Q

Who should get high dose Hep B vaccine?

A

renal disease, HIV,

87
Q

What does the following blood work mean/ All hepatitis B work is negative?

A

susceptible to infection

88
Q

What does the following blood work mean?
HBsAg negative
anti-HBc negative
anti-HBs- positive >10

A

immune from vaccine

89
Q

What does the following blood work mean?
HBsAg negative
anti-HBc positive
anti-HBs- positive >10

A

immune from infection

90
Q

If you do serum testing and it is below 10 what should you do for Hep B?

A

nothing UNLESS CKD and immunocompromised may need another dose

91
Q

Transmission of Hep A?

A

fecal oral

92
Q

Sx of Hep A infection?

A

asymptomatic or flu like

93
Q

True or false: Hep A causes chronic hepatitis and carrier state?

A

False- That’s Hep B

94
Q

Who is recommended for Hep A?

A

Only if travelling or at risk of infections!

95
Q

Which Hepatitis is vaccinated in kids?

A

Hep B

96
Q

Transmission of HPV?

A

skin to skin, verticle

97
Q

Sx of HPV?

A

Asymptomatic, cancer, warts

98
Q

Which HPV vaccine is only for females?

A

CERVARIX

99
Q

What’s the benefit of HPV vaccine?

A

stops warts and cancer

100
Q

Can you give HPV vaccine in pregnancy?

A

YES

101
Q

What about patient education is important about HPV vaccine?

A

Painful and does not protect against other STI

102
Q

Up to what age is HPV vaccine indicated?

A

45

103
Q

If I am a gay man that is in a relationship with only one person am I at risk of mpox?

A

No- not risky behaviour

104
Q

Explain mpox. Transmission?

A

viral by skin to skin, animals to humans, resp droplets, low risk with contaminated objects

105
Q

sx of Mpox?

A

flu like and rash, lesions on places for sex

106
Q

How long are you contagious with Mpox?

A

until lesion scabs fall off

107
Q

What vaccine for mpox and what type is it?

A

small pox vaccine
live attenuated

108
Q

Can you get mpox from small pox vaccine?

A

nonreplicating so NOOOO

109
Q

Is the small pox vaccine safe for immunocompromised and pregnant?

A

Yes!!

110
Q

Transmission of pneumococcal?

A

resp droplets

111
Q

Sx of pneumococcal infection?

A

sinusitis, pneumonia, ear infection
can cause bacteria and meningitis

112
Q

What type is the pneumococcal vaccine and what does this mean?

A

conjugate no polysaccharide= more robust immune system response through T cell as well

113
Q

What type of vaccine do infants respond to better?

A

conjugate= better T cell activation

114
Q

Who is indicated for Prevnar?

A

> 65 but maybe eventually >50

115
Q

How long to wait between pneumococcal vaccines?

A

Just don’t do at same time

116
Q

Is Prevnar 20 vaccine interchangeable with pneumovax-23?

A

no because Prevnar is a conjugate vaccine

117
Q

What conditions put you at risk of pneumococcal infections?

A

heart disease, DM, CKD, chronic liver disease, chronic lung disease, immunocompromising conditions, homeless, IVDU, senior home

118
Q

transmission of RSV?

A

resp droplets

119
Q

Who is at high risk of RSV?

A

cardiac, pulmonary issues, DM, immunodeficiency, liver disease, CKD

120
Q

Sx of RSV?

A

URTI- cough, sore throat, headahce

121
Q

What RSV vaccine is indicated in pregnancy?

A

ABRYSVO

122
Q

Who should get RSV vaccine?

A

> 75
60 if at risk

123
Q

Explain key points of AREXVY and ABRYSO RCT?

A

older adults (about 65) compared with placebo,
decreased RSV lower resp tract disease significantly

124
Q

Limitations of AREXVY and ABRYSO study?

A

hospitalizations and mortality were not studied
low event rate in the RCT

125
Q

Do you need a RSV booster?

A

No

126
Q

Potential serious s/e of AREXVY and ABRYSVO?

A

GBS and a fib

127
Q

Can you get covid from the vaccine?

A

No - innactivated

128
Q

Who should get covid vaccine?

A

> 65
6 months if underlying medical conditions

129
Q

How long to wait if COVID infection for vaccine?

A

3-6 months

130
Q

Are the new covid vaccines better?

A

yes better titre

131
Q

Do vaccines protect against post covid?

A

yes

132
Q

If a patient is >18 and doesn’t know if they have had vaccinations what should we do?

A

assume unimmunized and give appropriate

do not need serology

133
Q

IS HIV always immunocompromised?

A

No they can get to a point that they are okay

134
Q

If planning to become pregnant how long should they wait for live vaccine?

A

wait 1 month before conception

135
Q

When does maternal antibodies transfer to fetus?

A

3rd trimester

136
Q

What vaccine must be given each pregnancy?

A

tdap but pertussis is the important one
influenza
COVID
ABRYSVO
NO LIVE VACCINES

137
Q

What vaccines should not be recommended while breastfeeding?

A

some travel vaccines such as yellow fever
mpox

138
Q

What vaccines is a good idea for substance use?

A

ALL
but especially HA, HB, penumooccal, flu, covid, Tdap

139
Q

What is good vaccines to recommend for MSM?

A

ALL
But especially Ha, Hb, maybe mpox if high risk behaviours

140
Q

If cardiac disease/DM/lung disease what vaccine is a must?

A

Pneumococcal

141
Q

What vaccines to recommend if liver disease?

A

HA, HB, Prevnar

142
Q

What vaccines for CKD?

A

Hb, prevnar

pharmacy 358 (16 decks)

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