Green book 4

Question 1

Which of the following is/are true about mumps infection:

a) All patients have bilateral swelling of the parotid glands
b) Asymptomatic infection does not occur
c) It was the commonest cause of viral meningitis in children before 1988
d) Neurological complications can occur without swelling of the salivary glands
e) Mumps is a common cause of sub-fertility

Answer 1

It was the commonest cause of viral meningitis in children before 1988

Neurological complications can occur without swelling of the salivary glands

Question 2

Mumps vaccine:
a) Is available only in the MMR vaccine
b) A single dose of a mumps antigen containing vaccine is around 64% effective
c) Should not be given if there is a history of mumps
d) Can be given at any age
e) Adverse reactions to the mumps containing vaccines may occur up to 6 weeks’ post
vaccination

Answer 2

Is available only in the MMR vaccine

A single dose of a mumps antigen containing vaccine is around 64% effective

Can be given at any age

Adverse reactions to the mumps containing vaccines may occur up to 6 weeks’ post vaccination

Question 3

Which of the following is/are true about MMR vaccines:
a) It is effective prophylaxis if given after exposure to mumps infection
b) Will not exacerbate the symptoms if given to someone who is already incubating
mumps infection
c) A mumps like illness occurring 2 days later MMR vaccine is likely to be due to the
vaccine
d) It is better not to offer MMR if there is uncertainty about an individual’s mumps
vaccination status
e) Contact with suspected mumps infection is a good opportunity to offer MMR to a
previously unvaccinated individual

Answer 3

Will not exacerbate the symptoms if given to someone who is already incubating mumps infection

Contact with suspected mumps infection is a good opportunity to offer MMR to a previously unvaccinated individual

Question 4

The following is/are true about pertussis:
a) The incubation period is between 12 to 20 days
b) Cases are at their most infectious during the early catarrhal phase
c) Cases can be infectious up to 3 weeks after the onset of symptoms
d) In the 2012 Pertussis outbreak the highest incidence of disease was in infants 3 to 6
months of age
e) Pertussis vaccine can also protect against similar illnesses caused by the organism
B. parapertussis

Answer 4

Cases are at their most infectious during the early catarrhal phase

Cases can be infectious up to 3 weeks after the onset of symptoms

Question 5

Which of the following is/are true about the acellular pertussis vaccines (Infanrix
and Pediacel) used in the UK:
a) They are conjugated vaccines
b) They offer equal or better protection than the whole–cell pertussis vaccine
c) They are only given as part of the combined products (DTaP/IPV/Hib) or DTaP/IPV
or dTaP/IPV)
d) They are thiomersal-free
e) They can be given at the same time as other vaccines such as MMR and Hep B (but
in a different site)

Answer 5

They offer equal or better protection than the whole–cell pertussis vaccine

Are only given as part of the combined products (DTaP/IPV/Hib) or DTaP/IPV or dTaP/IPV)

They are thiomersal-free

Can be given at the same time as other vaccines such as MMR and Hep B (but in a different site)

Question 6

Which of the following is/are true? For full protection against pertussis, infants
and children under 10 years of age need:
a) Three doses of a pertussis vaccine–containing product with an interval of one month
between each dose and a booster after 3 years
b) Three doses of DTaP/IPV or DTaP/IPV/Hib and a booster if they have never had
pertussis vaccine, but have received 3 doses of vaccine against diphtheria, tetanus
and polio
c) To repeat the course if the primary course is interrupted
d) Full UK schedule should be followed if no reliable history of previous immunisation is
available
e) No further pertussis containing vaccine if they have had a clinical history of
whooping cough

Answer 6

Three doses of a pertussis vaccine–containing product with an interval of one month between each dose and a booster after 3 years

Three doses of DTaP/IPV or DTaP/IPV/Hib and a booster if they have never had pertussis vaccine, but have received 3 doses of vaccine against diphtheria, tetanus and polio

Full UK schedule should be followed if no reliable history of previous immunisation is available

Question 7

Which of the following is/are true? Pertussis vaccine should not be given to:
a) Those with confirmed anaphylactic reaction to a previous dose of a pertussis-containing
vaccine or to neomycin, streptomycin or polymyxin
b) Pregnant women
c) Premature infants
d) Those with Immunosuppression and HIV infection
e) Those with stable pre-existing neurological condition

Answer 7

Those with confirmed anaphylactic reaction to a previous dose of a pertussis-containing vaccine or to neomycin, streptomycin or polymyxin

Question 8

Which of the following is/are true about prenatal pertussis vaccination:
a) Vaccination should be offered starting from 26 weeks of gestation
b) Vaccine should be offered in every pregnancy
c) It should not be offered after 32 weeks of pregnancy as it is unlikely to offer any
protection
d) Both Boostrix and Repevax are suitable for use in the prenatal programme
e) In exceptional circumstances Infanrix IPV can be given

Answer 8

Vaccine should be offered in every pregnancy

Both Boostrix and Repevax are suitable for use in the prenatal programme

In exceptional circumstances Infanrix IPV can be given

Question 9

Which of the following is/are true regarding pneumococcal infection:

a) The majority of infections in adults and children are caused by up to 10 capsular
(sero) types
b) The incubation period is defined as 7-10 days
c) Transmission commonly occurs after transient contact with a case
d) Infections are at their peak in the winter months
e) In general infections are trivial but irritating

Answer 9

The majority of infections in adults and children are caused by up to 10 capsular (sero)types

Infections are at their peak in the winter months

Question 10

Pneumococcal polysaccharide vaccine:

a) Children under 2 show good antibody responses to this vaccine
b) Covers 23 serotypes
c) Is highly effective at preventing pneumococcal infections, particularly otitis media
d) Is effective at all ages
e) Post immunisation antibodies wane after about 5 years

Answer 10

Covers 23 serotypes

Post immunisation antibodies wane after about 5 years

Question 11

Pneumococcal conjugate vaccine (PCV):

a) Children require more than one dose to produce effective protection
b) Appears to produce “herd immunity”
c) Contains thiomersal
d) Is available which covers 13 serotypes
e) Is conjugated to a Neisseria meningitidis derived carrier protein

Answer 11

Children require more than one dose to produce effective protection

Appears to produce “herd immunity”

Is available which covers 13 serotypes

Question 12

Pneumococcal conjugate vaccine (PCV):
a) Was introduced to the UK in 2000
b) Is given to children born on or after 01/01/2020 at 12 weeks and 1 year in the UK
primary vaccination schedule
c) Should be offered routinely as a single dose to anyone over the age of 2 years who
has not completed the primary childhood schedule
d) If the first dose is given very late then a minimum of 4 weeks should be observed
before the booster to ensure appropriate boosting
e) An unimmunised or partially immunised child aged between one and under 2 years
of age should have 2 doses of PCV13 2 months apart

Answer 12

Is given to children born on or after 01/01/2020 at 12 weeks and 1 year in the UK primary vaccination schedule

If the first dose is given very late then a minimum of 4 weeks should be observed before the booster to ensure appropriate boosting

Question 13

Pneumococcal polysaccharide vaccine:

a) Is recommended for everyone aged 65 years and over
b) Has a primary schedule of 2 doses, given 3 months apart
c) Boosters should be given to all people in clinical risk groups every 5 years
d) Should be given to asplenic children at 1 year
e) Is recommended for all patients with asplenia or splenic dysfunction

Answer 13

Is recommended for everyone aged 65 years and over

Is recommended to all patients with asplenia or splenic dysfunction

Question 14

Which of the following people should receive pneumococcal vaccines:
a) People with chronic respiratory disease
b) Household contacts of a case of pneumococcal meningitis
c) People who have cerebrospinal fluid leaks
d) Anyone who has developed invasive pneumococcal disease and has not been
vaccinated in the past
e) Any child under 2 years of age with an incomplete vaccine history

Answer 14

People with chronic respiratory disease

People who have cerebrospinal fluid leaks

Anyone who has developed invasive pneumococcal disease and has not been vaccinated in the past

Any child under 2 years of age with an incomplete vaccine history

Question 15

Which of the following should receive pneumococcal vaccines:
a) At risk children over 2 years should receive a dose of PPV in addition to their primary
PCV doses
b) People with chronic heart disease
c) Diabetics ‘controlled by diet’
d) People with cochlear implants
e) Those at continuous occupational exposure to metal fumes

Answer 15

At risk children over 2 years should receive a dose of PPV in addition to their primary PCV doses

People with chronic heart disease

People with cochlear implants

Those at continuous occupational exposure to metal fumes

Question 16

Which of the following should not receive pneumococcal vaccines:

a) Pregnant women
b) Premature infants
c) HIV positive people
d) Other people with severe immuno-compromising conditions
e) Breast feeding mothers

Answer 16

There is no correct answer, all the following may receive pneumococcal vaccines

Question 17

Pneumococcal polysaccharide vaccines:

a) Contain purified capsular polysaccharide
b) Do not prevent exacerbation of chronic bronchitis
c) Can provide limited cross protection against non-vaccine serotypes
d) Provide long-lasting immunity i.e. more than 10 years
e) Contain thiomersal

Answer 17

Contain purified capsular polysaccharide

Do not prevent exacerbation of chronic bronchitis

Question 18

Which of the following is/are recognised adverse reactions to pneumococcal
vaccines:
a) Most patients who receive PPV23 develop a mild fever
b) Systemic reactions occur quite often with both pneumococcal vaccines
c) Headache is common after PPV23
d) Diarrhoea is common in infants and toddlers following PCV
e) Pain and induration at the vaccine site can last for 3 days following PPV

Answer 18

Pain and induration at the vaccine site can last for 3 days following PPV

Question 19

Which of the following is/are true:
a) At risk children 12 months to 10 years should also receive one dose of
polysaccharide vaccine after the second birthday
b) Where it is not practical to give pneumococcal vaccine at least 2 weeks before
splenectomy, immunisation should be delayed at least 2 weeks after the operation
c) Children aged between 2 to 10 years who have been fully immunised and then
develop splenic dysfunction should be offered an additional dose of PCV13
d) 13 valent PCV is routinely recommended for all at risk adults
e) Pneumococcal vaccines are contra indicated in pregnant women

Answer 19

At risk children 12 months to 10 years should also receive one dose of polysaccharide vaccine after the second birthday

Where it is not practical to give pneumococcal vaccine at least 2 weeks before splenectomy, immunisation should be delayed at least 2 weeks after the operation

Question 20

Infection with polioviruses:

a) Is most often asymptomatic
b) Children are more likely to have infection without illness than adults
c) Cases are most infectious just before and up to 6 weeks’ post onset of illness
d) Live vaccine strains may rarely cause paralytic disease
e) The last case of natural polio infection in the UK was in 1954

Answer 20

Is most often asymptomatic

Children are more likely to have infection without illness than adults

Live vaccine strains may rarely cause paralytic disease

Question 21

Oral polio vaccine (OPV):

a) May protect contacts of vaccinated people
b) Promotes antibody formation in the gut
c) Reduces the frequency of symptomless excretion of wild viruses
d) May cause vaccine associated paralytic polio
e) Is still used for routine vaccination in the UK

Answer 21

May protect contacts of vaccinated people

Promotes antibody formation in the gut

Reduces the frequency of symptomless excretion of wild viruses

May cause vaccine associated paralytic polio

Question 22

Inactivated polio vaccine (IPV):

a) Is made from 2 polio virus strains
b) Is available in both intramuscular and oral preparations
c) Should not be used if a vaccination course was started with OPV
d) Is recommended as Td/IPV for those over 10 years
e) Is recommended for some laboratory workers

Answer 22

Is recommended as Td/IPV for those over 10 years

Is recommended for some laboratory workers

Question 23

A 21-year-old attends your surgery for travel vaccines. He is backpacking around
the world, his itinerary uncertain but includes India, Thailand, Australia and South
America. He has had a primary course of diphtheria, tetanus and polio vaccines,
but missed his preschool and school leaving booster vaccinations.

So far as protection against polio is concerned:

a) He already has sufficient protection
b) He needs just one dose of Td/IPV to continue his course
c) As he had tetanus vaccine less than 10 years ago the risk of a local reaction means
it is unwise to give him Td/IPV
d) He should be given a dose of Td/IPV, and a further dose of Td/IPV in 10 years’ time
e) He should be given OPV as he may be visiting countries where polio is still a
problem

Answer 23

He needs just one dose of Td/IPV to continue his course, (but a further dose of Td/IPV in 10 years’ time to complete his course)

He should be given a dose of Td/IPV, and a further dose of Td/IPV in 10 years’ time

Question 24

Which of the following statements is/are true about rabies vaccines:
a) There are currently 2 rabies vaccines licensed for use in the UK
b) The vaccines available in the UK are thiomersal free
c) The vaccines are inactivated, do not contain live organisms and cannot cause the
disease against which they protect
d) The vaccines should not be used interchangeably to provide protection both pre- or
post-exposure
e) They can be stored frozen

Answer 24

There are currently 2 rabies vaccines licensed for use in the UK

The vaccines available in the UK are thiomersal free

The vaccines are inactivated, do not contain live organisms and cannot cause the disease against which they protect

Question 25

Which of the following is/are true? Pre-exposure (prophylactic) immunisation with
rabies vaccine should be offered in the UK to:
a) Laboratory workers handling the virus
b) Those working in DEFRA authorised quarantine premises
c) Those who regularly handle bats
d) Those living in or travelling for more than one month to rabies-enzootic areas
e) Anyone travelling abroad with a dog

Answer 25

Laboratory workers handling the virus

Those working in DEFRA authorised quarantine premises

Those who regularly handle bats

Those living in or travelling for more than one month to rabies-enzootic areas

Question 26

Which of the following is/are true about rabies vaccine:
a) Pre-exposure rabies vaccine should not be given to those who have had a confirmed
anaphylactic reaction to a previous dose of rabies vaccine
b) Post exposure vaccine should be given via the intradermal route
c) Pregnant and breast-feeding mothers should only receive pre-exposure rabies
vaccine if the risk of exposure is high and rapid access to post-exposure prophylaxis
is limited
d) There are no absolute contraindications to post-exposure rabies vaccine
e) The vaccine should be given to immunosuppressed and HIV patients regardless of
their CD4 count

Answer 26

Pre-exposure rabies vaccine should not be given to those who have had a confirmed anaphylactic reaction to a previous dose of rabies vaccine

Pregnant and breast-feeding mothers should only receive pre-exposure rabies vaccine if the risk of exposure is high and rapid access to post-exposure prophylaxis is limited

There are no absolute contraindications to post-exposure rabies vaccine

The vaccine should be given to immunosuppressed and HIV patients regardless of their CD4 count

Question 27

An immunocompetent previously unimmunised individual at high-risk of rabies
(composite rabies risk red) who sustained an exposure yesterday requires the
following as post-exposure prophylaxis:
a) Two doses of rabies vaccine on days 0 and 3
b) Four doses of rabies vaccines on days 0, 3, 7 and 14
c) Five doses of rabies vaccine on days 0, 3 7, 14 and 30
d) Four doses of rabies vaccine on days 0, 3, 7 and 21, plus Hyper-Immune Rabies
Immunoglobulin (HRIG) on day 0
e) Two doses of rabies vaccine on days 0 and 3, plus HRIG on day 0

Answer 27

Four doses of rabies vaccine on days 0, 3, 7 and 21, plus Hyper-Immune Rabies Immunoglobulin (HRIG) on day 0

Question 28

Respiratory Syncytial Virus (RSV):
a) Causes bronchiolitis in infants
b) Has an incubation period varying from 5 to 10 days
c) Has neuraminidase and haemagglutin surface glycoproteins in common with
influenza virus
d) May infect individuals repeatedly with the same strain
e) The disease severity is influenced by the virus subtype

Answer 28

Causes bronchiolitis in infants

May infect individuals repeatedly with the same strain

Question 29

Infections with RSV:

a) Result in hospitalisation of 10% of infected children
b) Commonly peak in the spring in the UK
c) May cause ear infections
d) May increase risk of developing asthma later in childhood
e) Will have occurred in almost all children at least once by the age of 2 years

Answer 29

May cause ear infections

May increase risk of developing asthma later in childhood

Will have occurred in almost all children at least once by the age of 2 years

Question 30

Palivizumab:

a) Is a conjugated vaccine
b) Targets the F protein of RSV
c) Provides passive immunisation
d) Requires weekly administration during the RSV season
e) Is indicated for high risk adults as well as children

Answer 30

Targets the F protein of RSV

Provides passive immunisation

Question 31

Palivizumab:
a) Is given by IM injection
b) Should not be given at the same time as vaccines administered as part of the
childhood immunisation programme
c) Should preferably be given in the deltoid region
d) Has a recommended dose of 15 mg/kg of body weight given once a month
e) During the RSV season, up to a maximum of 10 doses should be given

Answer 31

Is given by IM injection

Has a recommended dose of 15 mg/kg of body weight given once a month

Question 32

During the RSV season Palivizumab should be considered for the following:
a) Children born at 35 weeks or less and under 1 year of age at the onset of the RSV
season
b) Children under 2 years of age with haemodynamically significant congenital heart
disease
c) Children under the age of 2 years with asthma who are frequently hospitalised
d) Adults undergoing cardiac surgery at the beginning of the RSV season
e) Children under 2 years of age requiring treatment for bronchopulmonary dysplasia in
the previous 6 months

Answer 32

Children under 2 years of age with haemodynamically significant congenital heart disease

Children under 2 years of age requiring treatment for bronchopulmonary dysplasia in the previous 6 months

Question 33

Children with the following underlying history should be considered for treatment
with Palivizumab:
a) Asplenia
b) Severe combined immunodefiency syndrome (SCID)
c) Requiring long term ventilation
d) Acyanotic chronic heart disease
e) HIV infection

Answer 33

Severe combined immunodeficiency syndrome (SCID)

Requiring long term ventilation

Acyanotic chronic heart disease

Question 34

The following is/are true about rotavirus vaccines:
a) The 2 licensed rotavirus vaccines Rotarix® and RotaTeq® are not interchangeable
b) The vaccine is 95% effective at protecting against rotavirus infection in the first 2
years of life
c) It is an inactivated vaccine
d) The vaccine is not injectable
e) The vaccine may be frozen before use

Answer 34

The 2 licensed rotavirus vaccines Rotarix® and RotaTeq® are not interchangeable

The vaccine is not injectable

Question 35

The ideal recommended schedule for Rotarix® is:

a) One dose at the 4-month vaccination visit
b) 2 doses at the 2 and 3-month vaccination visits
c) 2 doses at the 3 and 4-month vaccination visits
d) 2 doses at 15 weeks and 24 weeks
e) One dose given any time before 16 weeks

Answer 35

2 doses at the 2 and 3-month vaccination visits

Question 36

In line with WHO recommendations infants who have not yet received a first dose
of rotavirus vaccine should not be commenced on Rotarix® if they are older than:
a) 10 weeks
b) 12 weeks
c) 24 weeks
d) 20 weeks
e) 15 weeks

Answer 36

15 weeks

Question 37

Rotarix® is contraindicated in:

a) Infants under 12 weeks of age
b) Infants with SCID
c) Infants with fructose intolerance
d) Premature infants
e) Infants who are HIV positive

Answer 37

Infants with SCID

Infants with fructose intolerance

Question 38

Which of the following is/are true:
a) There should be an interval of a month between a dose of rotavirus vaccine and
BCG
b) Rotavirus and BCG can be given at any time before or after each other
c) If the infant spits out the vaccine up to 2 replacement doses may be given at the
same vaccination visit
d) The vaccine needs to be reconstituted from powder before administration
e) Rotarix® vaccine is supplied as an oral suspension of a cloudy fluid

Answer 38

Rotavirus and BCG can be given at any time before or after each other

Question 39

In relation to intussusception:

a) The background risk of intussusception peaks in the UK at 12 months of age
b) Intussusception mainly occurs after surgery to the intestine
c) The annual incidence in the UK is 120 cases per 100,000 children
d) Rotarix® should not be given to infants with a previous history of intussusception
e) Rotarix® may be associated with a small risk of intussusception

Answer 39

The annual incidence in the UK is 120 cases per 100,000 children

Rotarix® should not be given to infants with a previous history of intussusception

Rotarix® may be associated with a small risk of intussusception

Question 40

Which of the following is/are true about Rubella:
a) It is caused by a herpes virus
b) The incubation period is 10-12 days
c) Clinical diagnosis is usually reliable
d) The infectious period is from one week before symptoms to 4 days after the onset of
rash
e) The rash is generally vesicular

Answer 40

The infectious period is from one week before symptoms to 4 days after the onset of rash

Question 41

Recognised complications of Rubella include:

a) Arthralgia
b) Parotid swelling
c) Thrombocytopaenia
d) Ulcerative colitis
e) Post–infectious encephalitis

Answer 41

Arthralgia

Thrombocytopaenia

Post–infectious encephalitis

Question 42

Which of the following is/are true about Congenital Rubella Syndrome (CRS):
a) Infection in the first 8-10 weeks of pregnancy results in damage in 10% of surviving
infants
b) Fetal damage is rare following infection after 16 weeks of pregnancy
c) Is always apparent at birth
d) Has been documented in babies born to women who have inadvertently given MMR
vaccine in pregnancy
e) To prevent the risk of CRS in a subsequent pregnancy, women who are found to be
non-immune in pregnancy should receive MMR vaccine after delivery

Answer 42

Fetal damage is rare following infection after 16 weeks of pregnancy

To prevent the risk of CRS in a subsequent pregnancy women who are found to be non-immune in pregnancy should receive MMR vaccine after delivery

Question 43

Which of the following is/are true about MMR vaccine and Rubella:
a) Children should not receive MMR vaccine if their mothers are in early pregnancy
b) A mild rubella like rash may be seen 2-3 weeks after a dose of MMR vaccine
c) Arthralgia, probably due to the rubella component, is a reported rare occurrence
after MMR.
d) ITP following MMR is more likely to be due to measles than the rubella component
e) Small amounts of rubella vaccine virus have been found in breast milk, but this is not
harmful to the baby nor a contra-indication to MMR immunisation whilst breastfeeding

Answer 43

A mild rubella like rash may be seen 2-3 weeks after a dose of MMR vaccine

Arthralgia, probably due to the rubella component, is a reported rare occurrence after MMR

Small amounts of rubella vaccine virus have been found in breast milk, but this is not harmful to the baby nor a contra-indication to MMR immunisation whilst breast-feeding

Question 44

Which of the following is/are true about MMR vaccine and Rubella:
a) MMR vaccine may occasionally provide effective post exposure prophylaxis
following contact with rubella
b) MMR vaccine should not be given if there is any likelihood a person is already
incubating rubella
c) Termination of pregnancy should not be recommended following inadvertent
administration of MMR to a pregnant woman
d) Where rubella non-immune women have received anti-D immunoglobulin post
partum the dose of MMR vaccine should be deferred.
e) A blood transfusion around the time of delivery may affect the response to MMR
vaccine given post partum

Answer 44

Termination of pregnancy should not be recommended following inadvertent administration of MMR to a pregnant woman

A blood transfusion around the time of delivery may affect the response to MMR vaccine given post-partum

Question 45

Which of the following is/are true:
a) The selective vaccination policy of offering single dose rubella vaccination to
teenage girls in the UK ceased in 1999
b) A single dose of rubella – containing vaccine confers around 85-90% protection
against rubella
c) Satisfactory evidence of rubella protection includes documentation of a positive
antibody result for rubella or having received one dose of rubella containing vaccine
or MMR.
d) Human normal immunoglobulin (HNIG) is not recommended for post-exposure
protection against rubella
e) The diagnosis of rubella con be confirmed non-invasively by testing for specific IgM
in oral fluid (saliva)

Answer 45

Human normal immunoglobulin (HNIG) is not recommended for post-exposure protection against rubella

The diagnosis of rubella con be confirmed non-invasively by testing for specific IgM in oral fluid (saliva)

Question 46

The following is/are true about shingles:
a) The estimated lifetime risk of acquiring shingles is about one in 4
b) It can be acquired from another individual who has chicken pox
c) The rash typically lasts between 2 to 4 weeks
d) Ophthalmic zoster occurs in about 4% of cases
e) Individuals with active lesions can transmit VZV to susceptible individuals to cause
chicken pox

Answer 46

The estimated lifetime risk of acquiring shingles is about one in 4

The rash typically lasts between 2 and 4 weeks

Individuals with active lesions can transmit VZV to susceptible individuals to cause chicken pox

Question 47

The following is/are true:
a) The accepted definition of Post Herpetic Neuralgia (PHN) is pain that persists for 60
days after the onset of rash
b) The risk of Post Herpetic Neuralgia (PHN) decreases after the age of 79
c) Giving Zostavax to a person with symptoms of Post Herpetic Neuralgia (PHN) may
offer some therapeutic benefit
d) “Herpes zoster ophthalmicus” may result in glaucoma
e) Most deaths linked to dissemination of reactivated varicella virus are attributable to
encephalitis

Answer 47

“Herpes zoster ophthalmicus” may result in glaucoma

Question 48

The following is/are true about Zostavax:
a) It contains a strain of varicella zoster virus at significantly higher dose than the
Varivax varicella vaccine
b) It reduces the incidence of shingles in those aged 60 and 70 by over 70%
c) It can be administered simultaneously with oral antiviral agents
d) It can be administered at the same time as inactivated influenza vaccine
e) It should not be administered at the same time as 23 valent pneumococcal vaccine
as it gives an inferior VZV antibody response

Answer 48

It contains a strain of varicella zoster virus at significantly higher dose than the Varivax varicella vaccine

It can be administered at the same time as inactivated influenza vaccine

Question 49

The course of Zostavax consists of:

a) A single dose
b) 2 doses one month apart
c) 3 doses one month apart
d) A single dose with a booster dose one year later
e) A single dose with a booster dose 3 years later

Answer 49

A single dose

Question 50

The administration route for Zostavax is:

a) Intradermal
b) Subcutaneous
c) Intramuscular
d) Intravascular
e) Intranasal

Answer 50

Subcutaneous

Question 51

Zostavax should not be administered to:

a) Patients with a previous history of shingles over a year ago
b) Patients without a previous history of chicken pox
c) Patients with symptoms of Post Herpetic Neuralgia (PHN)
d) Patients using topical acyclovir
e) Patients with symptoms of shingles

Answer 51

Patients with symptoms of Post Herpetic Neuralgia (PHN)

Patients with symptoms of shingles

Question 52

Reported adverse reactions to Zostavax include:

a) Headache
b) Pruritis
c) Fever
d) Idiopathic Thrombocytopaenic purpura (ITP)
e) Myalgia

Answer 52

Headache

Pruritis

Question 53

Contraindications to receiving Zostavax include:

a) Lymphoma
b) Parkinson’s Disease
c) Macular degeneration
d) Inhaled corticosteroids
e) Previous anaphylactic reaction to gelatin

Answer 53

Lymphoma

Previous anaphylactic reaction to gelatin

Question 54

Which of the following is/are true regarding smallpox and smallpox vaccination:
a) The world was declared smallpox free in December 1979
b) Members of smallpox response teams should be vaccinated against smallpox
c) Staff working in laboratories with monkey pox should be considered for vaccination
against smallpox
d) People opening crypts where smallpox cases may have been buried should be
vaccinated against smallpox
e) Smallpox vaccine can be given safely to anyone

Answer 54

The world was declared smallpox free in December 1979

Members of smallpox response teams should be considered for vaccination against smallpox

Staff working in laboratories with monkey pox should be considered for vaccination against smallpox