Preventative

Question 1

Age to administer DTaP

Answer 1

2 mo
4 mo
6 mo
15-18 mo (or at least 6mo from 3rd dose)
Kindergarten

Question 2

Age to administer Tdap

Answer 2

11-12 yr

Can be given with meningococcal and HPV vaccines

Question 3

Puncture wound with increased risk of infection

Answer 3

Involving forefoot
Puncture through shoes
Diabetes

Question 4

Tetanus and clean wounds

Answer 4

Tetanus IG Not indicated

Tetanus vaccine is immunization status unknown or has received < 3 tetanus vaccines

Booster if > 10 yr since last vaccine

Question 5

Tetanus + dirty wounds

Answer 5

Tetanus vaccine + TIG (or IVIG) if received < 3 tetanus vaccine or immunization status unknown

Booster if > 5 yr since last tetanus vaccine

Question 6

Age to administer Hib

Answer 6

2 mo
4 mo
6 mo

Question 7

Age to administer Hep B

Answer 7

Birth
1-2 mo
6-18 mo after 1st dose

Question 8

Mother with Hep B or unknown hepatitis status

Answer 8

Newborn should receive HBIG in first 12 hours of life in addition to routine immunization

Question 9

Hep B vaccine + preemies

Answer 9

Within 30 days of life if < 2mg

If less than 2 kg, does not count toward completion of series

Question 10

Post-exposure prophylaxis and Hep B

Answer 10

If received full series and Ab neg or unknown immunity or unvaccinated, give HBIG + full series

Question 11

Age to administer Hep A

Answer 11

1 yr
6 mo after 1st dose

Question 12

Hep A + traveling to endemic area

Answer 12

Passive immunization + IG if < 12 mo

Hep A vaccine if > 12 mo (2-4 weeks prior to departure)

Question 13

Age to administer MCV4 (A, C, Y, W-135)

Answer 13

11-12 yr
16 yr (booster)

Question 14

MCV4 administered as early as 2 mo

Answer 14

Immunocompromised
Community outbreak
Traveling to endemic areas

Question 15

Age to administer HPV

Answer 15

11-12 yr
Booster 6 mo after 1st

If starting series < 15 yr, 2 dose series
If starting > 15 yr, 3 dose series

Question 16

Age to administer MMR

Answer 16

12-15 mo
4-6 yr

Question 17

MMR + epidemic/endemic area

Answer 17

Administer between 6-11 mo
Must resume regular immunization schedule

Question 18

Absolute contraindications to MMR and varicella

Answer 18

Severe allergic reaction
Pregnancy
Severely immunocompromised

Question 19

MMRV vs MMR + V

Answer 19

MMRV associated with higher rate of febrile seizures (12-23 mo)

MMRV contraindicated in HIV

Question 20

Age to administer varicella

Answer 20

12-15 mo
4-6 yr

Question 21

Varicella vaccine + ASA

Answer 21

Avoid aspirin for 6 weeks post-vaccination
Risk of Reye Syndrome

Question 22

Age to administer PCV-13

Answer 22

2 mo
4 mo
6 mo
12-15 mo

Question 23

Indications for PPSV23

Answer 23

Immunocompromised (another dose 5 years after 1st)

CSF leaks, cochlear implants

Chronic disorders

Given at 2 yr + 8 weeks after PCV-13

Question 24

Age to administer IPV

Answer 24

2 mo
At least 2 mo after 1st
6-18 mo
> 4 yr (at least 6mo after 3rd)

Question 25

Catch up immunization for Hib

Answer 25

Single dose if 15-59 mo

Question 26

Catch up immunization for PCV13

Answer 26

2 doses (8 wk apart) for health children 12-23 mo

Question 27

Subcutaneous injections of vaccines

Answer 27

MMR Varicella IPV

Question 28

Vaccine associated with syncope

Answer 28

HPV

Question 29

Age of Rotavirus vaccine

Answer 29

RV5 (PO): 2, 4, 6 mo RV1: 2 and 4 mo Complete series by 8 mo

Question 30

Age not to give Rotavirus vaccine

Answer 30

After 15 weeks

Question 31

Contraindications to Rotavirus vaccine

Answer 31

SCID H/o intussusception Latex allergy (Rotatrix. Give RotaTeq instead)

Question 32

Preemies and Rotavirus

Answer 32

At least 6 weeks of age Discharged from nursery Clinically stable

Question 33

Cholesterol screening

Answer 33

5-9 yrs: high risk/family history 9-11 yrs: universal

Question 34

UV A

Answer 34

Constant risk throughout the day Drug induced photosensitivity reactions

Question 35

UV B

Answer 35

Strongest risk between 10a-5p Skin aging Sunburn Skin cancer

Question 36

Contraindications to live influenza vaccine (nasal)

Answer 36

Pregnancy Chronic heart disease Asthma (children 2-4 years) History of wheezing in past 12 mo DM CKD Immunosuppressant Daily salicylate therapy CSF leak Cochlear implant Severe allergy to vaccine

Question 37

Whitish lines running across teeth Chalky-brown enamel discoloration +/- dental pitting

Answer 37

Fluorosis (too much flouride exposure)

Question 38

Elevated BP in 1-13 yo

Answer 38

SBP and/or DBP > 90th perfenctile but < 95th percentile or 120/80 to < 95th percentile (whichever is lower)

Question 39

Stage 1 HTN in 1-13 yo

Answer 39

SBP and/or DBP > 95th perfenctile to < 95th percentile + 12 or 130/80 to 139/89 (whichever is lower)

Question 40

Stage 2 HTN

Answer 40

SBP and/or DBP > 95th perfenctile + 12 or > 140/90 (whichever is lower)

Question 41

Common adverse effect of pertussis-containing vaccine

Answer 41

Prolonged irritability and crying for an extended period of time (> 3 hr)

Question 42

Minimum age that requires only 1 dose of influenza vaccine if never been immunized against influenza

Answer 42

9 yo