Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

General Pediatrics Certifying Exam > Vaccines/Immunizations > Flashcards

Vaccines/Immunizations Flashcards

1
Q

Steroids and live immunizations

A

Delay all live vaccines for ONE MONTH after steroid treatment if:
- >20 mg/day OR >2 mg/kg/day
AND
- >14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Live vaccines

A
  • MMR
  • “Sabin”/oral polio
  • Varicella/VZV
  • Adenovirus (for military only)
  • Yellow Fever
  • Inhaled influenza
  • Rotavirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Patient populations that should not receive live vaccines

A
  • Pregnant teen
  • Severe immunocompromise (including patients with HIV and CD4 < 200 cells/microL
  • *If patient has HIV and is generally healthy (CD4 >200), DO NOT withhold vaccines!**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Are lives vaccines contraindicated in patients with family members who are immunocompromised or pregnant?

A

NO!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MMR and PPD

A
  • PPD can be placed on the same day that MMR is given

- HOWEVER, if MMR was given < 6 weeks ago, DO NOT place PPD!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Side effects of MMR

A
  • Fever 7-10 days after vaccine given
  • Rash 7-10 days after vaccine given
  • Joint pain of hands and knees for up to 1 month after vaccine given
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rotavirus vaccine

A
  • DO NOT give at < 6 weeks or > 15 weeks of age
  • 2 dose regimen: 2 & 4 months
  • 3 dose regimen: 2, 4 and 6 months (max for 3 dose series is 8 months)
  • DO NOT give to patients in the hospital
  • Can be administered to patients with an immunocompromised family member
  • Shed in stool
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Influenza vaccine

A
  • FluMist (currently off market) can be given to children >2 years of age, healthy, NOT pregnant, NOT immunocompromised, NOT asthmatic
  • Children 6 months - 8 years receiving influenza vaccine for the first time should receive 2 doses (1 month apart)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hepatitis A Vaccine

A
  • Everyone receives Hep A vaccine
  • First dose at 1 year. Second dose given at least 6 months later.
  • Typically 12 and 18/24 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hepatitis B vaccination for infants >2000 g at birth

A
  • Maternal Hep B negative = vaccine @ birth, then 2 additional doses given at 1-2 months, 4 months and 6 months. If combination vaccines are used -> birth, 2, 4 and 6 months.
  • Maternal Hep B unknown = give vaccine within 12 hours of birth and test Mom. If Mom later found to be Hep B +, give HBIG within 7 days.
  • Maternal Hep B positive = give Hep B and HBIG at birth, then complete series.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hepatitis B vaccination for infants < 2000 g at birth

A
  • Maternal positive OR unknown = vaccine AND HBIG at birth. THEN give normal 3 dose series as recommended.
  • Maternal Hep B negative = delay first dose until age 1 month OR hospital discharge and complete series as usual.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Human Papilloma Virus (HPV) Vaccine

A
  • Recommended for males and females
  • Can be given as early as 9 years of age
  • If < 15 years of age when first vaccine is given, give 2 doses (at least 6 months apart) starting at 11-12 years.
  • If > 15 years of age when first vaccine given, give 3 doses on a 0, 1-2 month and 6 month schedule.
  • Dose #3 has to be given at least 6 months after dose #1
  • If dosing schedule is not followed, may continue dosing without having to restart series
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Meningococcal Vaccine

A
  • Give to ALL children at 11 years of age + booster at 16 years of age. Otherwise, give second dose about 3 years after first dose.
  • For unimmunized college students living in a dorm, give ONE SHOT and NO BOOSTER
  • Minimum age is 2 months.
  • Children < 1 1 years may receive vaccine if at high risk (asplenic, having complement deficiency, generally immunocompromised, traveling to an endemic area)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Meningogoccal Subtype B vaccine

A
  • Low risk patients -> given between 16-23 years old)
  • High risk -> >10 years old after an outbreak, spleen damage or removal, compliment immune deficiency, taking eculizumab, microbiologists routinely working with N. meningitides
  • ## Booster required
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Postexposure prophylaxis of meningitis

A
  • Only 1 case of exposure required for prophylaxis (in contrast, TWO documented cases are required to give prophylaxis for H. flu).
  • If CLOSE INTIMATE contact of patient diagnosed with meningitis, give rifampin or ceftriaxone within 24 HOURS of diagnosis
  • *Close, intimated contacts = person living in same home/roommate, nursery school, close contact with secretions (i.e. boy/girlfriend), HCPs who cam in contact w/ secretions (provided mouth-to-mouth, performed intubation or managed ETT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Immunizations and pregnancy

A
  • Tdap and inactivated influenza vaccine recommended in pregnancy
  • Live vaccines are contraindicated
  • HPV is not recommended
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Postexposure prophylaxis of H. influenzae B

A
  • TWO documented cases are required
  • Treat with rifampin
  • If immunization status unknown, also give Hib vaccine.
  • If patient is FIRST PATIENT to be diagnosed, make sure to immunize household members
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Postexposure prophylaxis of Pertussis

A
  • Give macrolide to all household contacts, all high-risk contacts (infants, pregnant women in 3rd trimester, those with pre-existing illness and those with contact with infants and pregnant women).
  • If unimmunized, give vaccine
  • If < 6 weeks, give azithromycin
  • If > 6 weeks, give erythromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Postexposure prophylaxis of Hepatitis A

A
  • Give Hep A immunoglobulin to unimmunized family members
20
Q

Postexposure prophylaxis to Hepatitis B following needle stick

A
  • If immunizations UTD by titers, no prophylaxis is indicated.
  • If uncertain immunization status, check for antibody. If NEGATIVE, give HBIG AND start FULL vaccination series. If antibody POSITIVE, no prophylaxis indicated.
  • Unimmunized, give HBIG AND full vaccine series
21
Q

Postexposure prophylaxis for VZV

A
  • Give immunoglobulin for patients at HIGH RISK for complications (including pregnant, immunocompromised and some infants
22
Q

Postexposure prophylaxis for measles

A
  • If severely immunocompromised, give MIG regardless of immunization status.
  • If < 6 months, give measles immunoglobulin (MIG)
  • If >/= 6 months AND exposure < 72 hours prior AND unimmunized, give vaccine OR MIG.
  • For >/= 6 months AND exposure from 72 hours - 6 days, give MIG.
  • NO prophylaxis indicated after 6 days.
  • If < 12 months and receives vaccine due to exposure, continue with full vaccine schedule.
  • *DO NOT give MMR and MIG at the same time. DO NOT give MMR for at least 5 MONTHS after MIG**
23
Q

Tetanus booster

A
  • DTaP and DT for children < 7 years of age
  • If booster required for children < 7, only DT portion needs to be given.
  • If booster given for possible exposure or routine booster after age 7, give Tdap.
  • Boosters of Tdap given ever 10 years (unless otherwise required due to exposure)
24
Q

DTaP and Tdap recommended schedule

A
  • Given at 2 months, 4 months, 6 months, 15 months and 5 years.
  • Tdap booster given around 11-12 years of age
25
Q

Tetanus booster for clean wounds

A
  • If last vaccine given < 10 years ago, NO booster required.
  • If vaccine given >10 years ago, give Tdap.
26
Q

Tetanus booster for dirty wounds

A
  • If patient has received at least 3 doses of DTaP and last shot was >5 years ago, give booster.
  • If patient unimmunized, immunizations incomplete (i.e. < 3 doses) or immunization status unknown, give tetatus immunoglobulin + booster
27
Q

Vaccines given within the first year of life

A
  • DTaP, IPV, Hepatitis B, Hib, PCV-13 and rotavirus given at 2, 4 and 6 months
  • Hep B not required at 4 months if newborn dose was given, though may be given for simplification (due to combination vaccines)
28
Q

Vaccines given between 12-15 months

A
  • 12 months = Hep A, MMR and Varicella
29
Q

Vaccines given at 18 months

A
  • Hepatitis A #2
30
Q

Vaccines given around 24 months

A
  • DTaP #4, Hib #3, PCV #4 (all first year shots with exception of Hep B and rotavirus)
31
Q

Vaccines given at 4-5 years

A
  • DTaP #5, IPV #4, MMR #2 and VZV #2
  • *Remember, Hib and pneumococcus are not important threats for immune competent children >5 years, so no further doses are needed**
32
Q

Vaccines given at 11-12 years

A
  • Tdap, HPV, meningococcus
33
Q

Vaccines given at 16-18 years

A
  • Meningococcus #2
34
Q

Mnemonic for general immunization schedule

A
  • SIX shots at SIX months
  • 12-24 months = 6 shots (i.e. 6 x 2 = 12 months)
  • ## FOUR shots at FOUR years
35
Q

Mnemonic for remembering # of doses given of each vaccine

A
  • 5-4-3-2-1
  • 5 = DTaP (last dose at 5 years)
  • 4 = PCV, IPV and HiB (4eumococcal, I4P and 4ib)
  • 3 = Hep B
  • 2 = MMR, VZV, Hep A
  • 1 = NONE
36
Q

Which vaccines should NOT be given to children with severe allergic reactions to eggs, chicken or gelatin?

A
  • Live-attenuated influenza vaccine
  • Yellow Fever
  • *One FLU over the YELLOW cuckoo’s next of EGGS**
  • *Inactivated influenza vaccine may be given as long as precautions are taken (i.e. 30 minute monitoring following immunization and in setting with ability to diagnose/manage anaphylaxis)
37
Q

DTaP contraindications

A
  • Encephalopathy or “prolonged seizure” within 1 week of receiving DTaP. In the future, only give DT.
  • *DO NOT order allergy testing due to concern for inducing a seizure**
  • Relative contraindication if child has a progressive neurologic disorder, uncontrolled seizure disorder, BRIEF seizure within 3 days of vaccination, high fever (>105F) or shock-like state within 48 hours of vaccination.
  • *If neurologic disorder has been stabilized or no longer progressive, MAY give DTaP!**
38
Q

Vaccines contraindicated in patients with gelatin allergy

A
  • MMR
  • Varicella
  • Yellow Fever
  • Influenza
  • *If has true allergy that has not been cleared by an allergist**
39
Q

Vaccines contraindicated in patients with neomycin, streptomycin or polymyxin allergies

A
  • VZV (includes neo and poly)
  • IPV (includes traces of streptomycin)
  • MMR (includes neo and poly)
  • *Must be cleared by allergist before receiving these vaccines**
40
Q

Allergic contraindications for MMR

A
  • Gelatin

- Neomycin/Polymyxin/Streptomycin

41
Q

Allergic contraindications to Yellow Fever vaccine

A
  • Gelatin

- Chicken/egg

42
Q

Allergic contraindications to IPV vaccine

A
  • Neomycin/Polymyxin/Streptomycin
43
Q

Allergic contraindications to VZV vaccine

A
  • Neomycin/Polymyxin/Streptomycin

- Gelatin

44
Q

Allergic contraindications to IPV

A
  • Neomycin/Polymyxin/Streptomycin
45
Q

Allergic contraindications to influenza vaccine

A
  • Gelatin
  • Chicken/egg (may be given, though must be monitored for at least 30 minutes and diagnosis/management of anaphylaxis available

General Pediatrics Certifying Exam (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions