Vaccinations

Question 1

Meningitis vaccination recommendations for adults less than 55

Answer 1

2 doses of meningococal conjugate vaccine quadravalent (MCV4) Menectra

Question 2

Meningitis vaccination recommendations for adults over 55

Answer 2

meningococcal polysaccaride vaccine (MPSV4) Menomune in 5 year intervals

Question 3

which is more immunogenic, PPSV23 or PCV 13?

Answer 3

PCV 13 (conjugated) is more immunogenic than PPSV23 (polysaccharide)

Question 4

If a 19 y/o pt has not received PCV13 or PPSV23, what is the next step?

Answer 4

give a PCV13 first then PPSV23 8 weeks later

Question 5

What if the 19 y/o had one dose of PPSV23, what is the next step?

Answer 5

give a single PCV13 at least one year from his previously received PPSV23

Question 6

A patients blood work returns, they have anti-HBs and anti-HBc. What does this tell you?

Answer 6

They had a natural infection

Question 7

A patients blood work returns, they have Anti-HBs. What does this tell you?

Answer 7

They are immune due to a vaccine

Question 8

A patients blood work returns, they have HBsAg and Anti-HBc. What does this tell you?

Answer 8

They have a chronic infection

Question 9

What is the Hep B vaccine series?

Answer 9

zero, one month and 6 months

Question 10

How well are people protected after each Hep B vaccine?

Answer 10

healthy adults less than 40 are protected 75% after 2nd and 90% after 3rd. by age 60 only 60%

Question 11

Oops that 19 y/o kid missed a dose of Hep B, do we have to restart the series?

Answer 11

Nope, just give him the next dose asap and the third 8 weeks later

Question 12

How soon could you check for protect from the HepB vaccination and what is the minimum concentration?

Answer 12

1-2 months after the 3rd dose and a minimum concentration of 10 mIU/mL is considered protective

Question 13

After doing a Hep Bpost vaccination serological test, the pt is found to be 6 mIU/mL, what is your next step?

Answer 13

revaccinate with three dose series

Question 14

What is the zoster vaccine good for?

Answer 14

it decreases the incidence of zoster and post herpetic neuralgia

Question 15

At what age can we give the zoster vaccine?

Answer 15

current ACIP says wait until 60, FDA approved for 50-59.

Question 16

Can you give the zoster vaccine with an antiviral?

Answer 16

no you should wait at least 24 hours off anti-viral to maximize the effectiveness of the vaccine

Question 17

Which is for kids and which is for adults, TD vs Td?

Answer 17

TD (diphtheria-tetanus toxoid) is for kids and Td (tetanus-diphtheria) is for adults

Question 18

How do you give unvaccinated people over 7 y/o a tetanus vaccination?

Answer 18

This age group uses Td formulation (adults). 1st and 2nd are separated by at least 4 weeks and the third is given 6-12 months after. One them should be Tdap. Td booster every 10 years after

Question 19

According to the ACIP, should we give Td or Tdap to all people over 65?

Answer 19

Tdap

Question 20

Do we give pregnant women tetanus vaccines?

Answer 20

Yes, a Tdap with each pregnancy, more so for the pertussis

Question 21

What are some examples of encapsulated organisms?

Answer 21

pneumococcal, meningococcal, HiB

Question 22

Which vaccinations are contraindicated in pregnancy?

Answer 22

MMR, zoster, varicella

Question 23

What CD4 count do you see multiple painful livid reddish brown plaques papules and nodules of both lower limbs and purplish nodules on the hard palate

Answer 23

Anything 400 or less

Question 24

What CD4 count do you see bacterial skin infections, herpes simplex, zoster, oral skin fungal infections?

Answer 24

500

Question 25

At what CD4 count do you see PCP cryptococcus, toxoplasmosis?

Answer 25

200

Question 26

At what CD4 do you see MAC, CMV, lymphoma?

Answer 26

50

Question 27

At what CD4 do hairy leukoplakia and TB?

Answer 27

300