VACCINES

Question 1

What vaccines are required for a child to enter kindergarten in Maine?

Answer 1

5DTP, 4 polio, 2 MMR, and 1 varicella

Question 2

What part of the immune system is involved in vaccines?

Answer 2

Adaptive (memory) – why you need repeat exposure

Question 3

How do we measure the effectiveness of a vaccine, what are the downfalls of that?

Answer 3

Antibody levels – only correlates somewhat

We need LARGE field trials to measure effectiveness

Question 4

What disorder causes flaccid paralysis? Spread via poor sanitation

Answer 4

Polio – via the anterior horn damage

Question 5

What preventable disease presents with a prodrome period including a fever of >103, cough, coryza, conjunctivitis, and koplik spots (white spots in the mouth)?

Answer 5

Measles

Question 6

How is measles spread?

Answer 6

Respiratory

Question 7

What does the rash period of measles look like?

Answer 7

Maculopapular begins at the hairline, lasts 5-6 days, infectious period is 4 days before & after

Question 8

What is the schedule of the measles (MMR) vaccine for children?

Answer 8

1st @ 12-15 months of age

2nd @ 4-6 years of age (at least 28 days after 1st dose)

Can be given to a child after 6 months of age if traveling outside the US

Question 9

What disease causes sterility in males and causes parotid gland swelling?

Answer 9

Mumps

Question 10

What disease can a pregnant woman not be exposed to in the first 20 weeks of pregnancy due to genetic malformation?

Answer 10

Rubella

Question 11

What is the technical name for whooping cough and what is the bacteria that causes it?

Answer 11

pertussis & Bordetella pertussis

Question 12

what are the 3 stages of pertussis?

Answer 12

Catarrhal (watery eyes, low grade fever)

Paroxysmal (cough during exhalation with an inspiratory whoop, post-tussive cyanosis, and vomiting)

Convalescent (gradual improvement, recur with respiratory infections)

Question 13

How do you diagnose & treat pertussis?

Answer 13

PCR to diagnose & Abx if onset 21 days

Question 14

What is considered a close contact for a child with pertussis?

Answer 14

Had face-to-face exposure within 3 feet; had direct contact with respiratory or nasal secretions; shared same confined space for >1 hour.

Question 15

How would you treat a close contact of a pertussis child?

Answer 15

If symptomatic treat the same

If not symptomatic – consider chemoprophylaxis x 5 days

Question 16

How do you prevent pertussis?

Answer 16

Universal childhood vaccination with Tdap

DTaP = 2,4,6, 15-18 months & 4-6 years. Tdap = adult booster

Question 17

What disease involved a thick grey coating on the back of the throat and a “bullneck” appearance, that if left untreated can cause a child to suffocate?

Answer 17

Diptheria

Question 18

Can diphtheria just effect the throat?

Answer 18

No (but throat is most common), it can involve any mucous membrane

Question 19

Besides suffocation, what are the most common complications of diphtheria?

Answer 19

myocarditis & neuritis (5-10% death rate)

Question 20

What do we have to do as soon as we suspect diphtheria in a child? Where does the vaccine come from?

Answer 20

Consult the CDC ASAP

Vaccine comes from horses

Question 21

IF a child presents with an abrupt onset of fever, hypotension, with a rash, and stiff neck – what diagnosis? What bacteria?

Answer 21

Meningococcal disease (either meningitis or meningococcemia)
Neisseria meninitidis

Question 22

If meningococcal infection gets into the blood stream, what does it present with and what is it called?

Answer 22

Presents with fever, hypotension, purpuric rash, and multiorgan failure

Known as Meningococcemia

Question 23

How do you diagnose Meningococcal disease?

Answer 23

Bacterial culture, gram stain, non-culture (antigen detection in CSF and serology)

Question 24

When do you give the meninfococcal vaccine?

Answer 24

All children aged 11-12 with booster at 16

Question 25

How many chicken pox vaccines do you need for immunity?

Answer 25

2 – but you only need one to go to school…

Question 26

Would you use acyclovir in a child with chicken pox?

Answer 26

Not routinely recommended

Question 27

At what age do you need to get a zoster vaccine?

Answer 27

60! Whether or not they’ve ever reported a case of shingles

Question 28

If you see a side effect of a vaccine, where do you report it to?

Answer 28

VAERS