Mening

Question 1

Meningococcal disease symptoms

Answer 1

• Meningitis
• Bacteremia
• Bacteremic pneumonia

Question 2

Meningitis symptoms

Answer 2

pain, headache, neck stiffness

Question 3

Bacteremia symptoms

Answer 3

sepsis and rash

Question 4

Meningococcal Vaccines

Answer 4

A, C, Y, W-135
Polysaccharide (MPSV4) - removed from market
and
Conjugate (MCV4)

Question 5

dosing is different for

Answer 5

adolescents and adults with certain med conditions

Question 6

all adolescents

Answer 6

2 and 4 dose options for babies

1 dose of MCV4 at age 11-12
1 booster of MCV4 at age 16

only 1 dose if 1st dose after age 16 yrs - not routinely recomm after 19 yrs

Question 7

adults with certain med conditions

Answer 7

2 doses at least 8 weeks apart

Question 8

children at cont’d risk for mening disease who were prev vacc with MCV4

Answer 8

additional dose after 3 yrs if 1st was admin at age 2 to 6

Question 9

persons who have completed the 2-dose primary series and remain at continued risk for meningococcal disease

Answer 9

revaccinate every 5 yrs after the last dose of the primary series

Question 10

Persons with persistent complement component deficiency or anatomic or functional asplenia

Answer 10

1 dose every 5 yrs after completing 2-dose primary series

Question 11

HIV patients over the age of 2 mo

Answer 11

Men ACYW-135

Question 12

two new mening B vaccs licensed by FDA for ages

Answer 12

10-25

2-dose and 3-dose options

Question 13

ACIP recommends routine use of MenB vaccines

Answer 13

during outbreaks

college campuses that have recently experienced an outbreak of serogroup B meningococcal

Question 14

Notes about meningococcal b vacc

Answer 14

• must complete series with same vacc
• can be given at same time with other vaccs, diff sites
• both men B vaccs recommended for high-risk patients > 10 yrs

Question 15

Men B not routinely recommended for

Answer 15

travelers, HIV patients, revaccination

Question 16

CDC recommendations for Men B in an outbreak

Answer 16

no upper age limit

Question 17

Measles

Answer 17

Paramyxovirus

Question 18

Clinical features

Answer 18

respiratory transmission

highly contagious 4 days b4 to 4 days after rash onset

Question 19

incubation

Answer 19

10-12 days

Question 20

Early signs

Answer 20

(2-4 days) fever 103 or higher,

followed by cough, runny nose, swelling around eye

Question 21

Other sign

Answer 21

Rash - first appears in mouth (koplik spots)

Question 22

measles complications

Answer 22

diarrhea
otitis media
pneumonia
encephalitis
death 
hospitalization

Question 23

Mumps

Answer 23

Paramyxovirus

Question 24

Clinical feat

Answer 24

respiratory transmission

contagious 3 days before to 4 days after onset

Question 25

incubation

Answer 25

14-18 days

Question 26

prodrome

Answer 26

myalgias, anorexia, headache low-grade fever

Question 27

in first 2 days

Answer 27

parotitis

Question 28

20%

Answer 28

asymptomatic

Question 29

mumps complications

Answer 29

``` cns involvement orchitis oophoritis deafness myocarditis death ```

Question 30

Rubella

Answer 30

Togavirus (german measles, 3-day measles)

Question 31

clinical features

Answer 31

resp transmission (contagious 7 days before rash and 5-7 days after onset

Question 32

incubation

Answer 32

14 days (12-23 range)

Question 33

Prodrome

Answer 33

rare in children | ow-grade fecer, malaise, URI symptoms

Question 34

Rash

Answer 34

musculopapular starts on face then spreads from head to foot duration 3 days

Question 35

rubella complications

Answer 35

arthralgia or arthritis in adult women | congenital rubella syndrome (cataracts, heart defects, deafness, mental retardation, miscarriage)

Question 36

MMR vaccine

Answer 36

(merck) live-attenuated

Question 37

dose

Answer 37

2 dose series for children at 12-15mo then 4-6 yrs of age second dose not a booster, but to revaccinate non-responders adults born before 1957 immune born later must have documentation of 1 or more doses of MMR

Question 38

Contraindications

Answer 38

allergy to gelatin or neomycin, pregnancy, immunosuppression, receipt of blood products

Question 39

what are the target groups for MMR vaccination

Answer 39

all children all susceptible people at high risk (e.g. health care personnel, college students, travelers, patients with HIV if cd4 count adeq) adults born n 1957 or later who have never been vacc

Question 40

should a patient with provider-diagnosed measles, mumps, or rubella be considered immune

Answer 40

adults born before 1957 considered immune adults born in 1957 or later lab evidence or documentation is required, provider diagnosis not adeq.

Question 41

all children

Answer 41

2 doses

Question 42

all susceptible patients at high risk for disease

Answer 42

2 doses

Question 43

health care personnel born before 1957

Answer 43

consider 2 doses

Question 44

adults born in 1957 or later who have not been vacc with MMR

Answer 44

at least 1 dose recommended | 2nd dose if a risk factor is present

Question 45

recc dose and route of admin for MMR

Answer 45

0.5 ml SC