Quiz 2 Flashcards

Question

Liver disease

Answer 1

-No viral hepatitis or other liver disease *Need hep A, hep B, annual infuenza, pneumococcal

Answer 2

-Need pneumococcal, MenACWY, no annual activated influenza, Tdap, hep B -Consider MMR or varicella *Avoid live vaccines

Answer 3

-Avoid immunization during chemo -Annual LAIV should not be administered

Answer 4

-Immunize while waiting -Annual LAIV, pneumococcal, Tdap, Hep B (might need booster) vaccine needed

Answer 5

Diabetes: Hep B series (19-59 years), pneumococcal, annual inactivated influenza Renal failure: pneumococcal, hepatitis B series, LAIV, Td/Tdap

Answer 6

-Up to date with adult immunizations -Two doses of MMR -Varicella if not immune (born before 1980 doesn't count as immune) -Hep B -Pertusis -Annual Influenza

Answer 7

-Important access point for many preventative health needs Immunization -11/12 years and 16 years Tdap, MenACWY, MenB, HPV

Answer 8

-Pneumococcal and annual influenza -Tdap -RZV -RSV for >75 years and risk based for 60-74 years -Decreased immune response to Hep B vaccine

Answer 9

-Mild illness not a contraindication -Antibiotic therapy not a contraindication -Wait till after moderate or severe illness is resolved *Well enough to be in the pharmacy, well enough to be immunized

Answer 10

Recommended for immunosuppressed age 19 or older Recommended for normal > 50 years Revaccinate those who receive ZVL

Answer 11

MenB - 16-18 HPV - 27-45 PCV20/21 for >65 years who previously had PCV13 +PPSV23

Answer 12

Uncommon disease Serious disease Availability of vaccines Unknown degree of protection and duration of protection

Answer 13

Very common no consequence Infection most common in adolescents and young adult New Sex partner --> risk

Answer 14

Only if previously received PCV13 and PPSV23 after age 65 If decide to use PCV20/21 administer at least 5 years after last dose

Answer 15

-As a practice group decide which patients you will have convo with -Document the conversation in pharmacy notes

Answer 16

Also called marginalized populations Defined by barriers to vaccination Difficult to vaccinate due to -Distrust -Religious beliefs -Lack of awareness -Poverty or low SES -Lack of time to access vaccine services -Gender based discrimination

Answer 17

Three drivers Complacency Covienience Confidence *Don't disparage patients who are vaccine hesitant; engage with them and answer their questions

Answer 18

Focus on countering arguments Importance of recognizing that the audience is the public who are present not the vaccine denier

Answer 19

Patients medication history -Health status -Medications -Allergies -Vaccine history Patient's itinerary/behavior -duration of travel -rural vs urban -Planned or unplanned activities -Visiting friends or relatives -patient's risk tolerance

Answer 20

Avoid Tap water and anything washed or made from it -Uncooked meat -unpasteurized stuff

Answer 21

Use an EPA approved repellant DEET and Picaridin are safe for children > 2 months of age and for pregnant women Apply sunscreen then repellant

Answer 22

Flavivirus infection transmitted through mosquitoes -Endemic to tropics and subtropics -Acute febrile illness with headache, retro-orbital pain, muscle/joint aches, rash

Answer 23

Dengvaxia For children 9-16 years old living in areas endemic *Not approved for US travelers who are visiting but not living in areas where dengue is endemic

Answer 24

Flavivirus infection from mosquitoes -Intrauterine, perinatal, and sexual transmission Endemic in tropics and subtropics found in rural and urban areas Most infections are asymptomatic or mild

Answer 25

Microcephaly with brain anomalies and fetal loss *Pregnant woman should avoid areas with Zika

Answer 26

Viral infection from mosquitoes Endemic in tropics and subtropics and rural/urban areas Acute febrile illness with headache, muscle/joint aches, conjunctivitis, nausea, vomiting, rash *Joint pain can be severe and last from months to years *New vaccine available in the US

Answer 27

Live attenuated vaccine for adults >18 years of age One dose May be considered to persons traveling to area with Chikungunya virus in last 5 years who are: - above 65 years old with underlying medical conditions - Persons who stayed for longer than 6 months

Answer 28

Immunocompromising condition, history of allergic reaction Precautions: Pregnancy and breast feeding Some side effects are tenderness, fatigue, muscle and joint aches, etc.

Answer 29

An acute bacterial intestinal disease that causes bacteria *Transmitted through ingestion of contaminated water or food in endemic areas Treatable with rehydration +/- antibiotics

Answer 30

Live attenuated single dose oral vaccine Approved for 2-64 years old Vaccine ingested orally by patient

Answer 31

Mosquito borne flavivirus infection Most infections are asymptomatic, but when it fully develops it has high fatality rate Occurs in Asia and parts of Australia

Answer 32

Recommended for long term travelers or for short term travelers Inactivated Vero cell culture-derived vaccine Approved for >2 months 2 dose series on day 0 and 28

Answer 33

Single stranded RNA virus Transmitted to humans through Tick bite or by ingesting unpasteurized dairy products Symptoms range from non-specific febrile illness to acute non-invasive disease

Answer 34

Inactivated whole virus vaccine with formulations for children and adults 3 dose schedule with third dose 5-12 months after 2nd dose Booster >3 years after completion of primary immunization then every 3-5 years

Answer 35

An acute febrile illness caused by bacteria Transmission is through contaminated food and water and person to person contact

Answer 36

Injectable inactivated vaccine 2 years of protection Approved for >2 years of age Oral live attenuated vaccine 4 capsules 1 taken every other day, refrigerate Duration of protection is 5 years Approved for > 6 years *NO LIVE VACCINE TO IMMUNOSUPPRESSED

Answer 37

Single stranded RNA virus transmitted by mosquitoes Symptoms are influenza like syndrome to severe hepatitis, hemorrhagic fever, and death Proof of vaccination required in some African countries

Answer 38

Live attenuated vaccine approved for > 9 months Single dose Prioritize unvaccinated vs. traveler who's there longer but has been previously vaccinated

Answer 39

Travelers diarrhea -OTC meds -Antibiotics Malaria Prophylaxis Altitude illness -acetazolamide Motion sickness -scopolamine patch -OTC medicines (meclizine, dimenhydrinate) Flight anxiety/sleep meds

Answer 40

Caused by parasites in mosquitoes Symptoms include fever, chills, headache, body aches, generalized malaise Severe disease can lead to seizures, mental confusion, kidney failure, acute respiratory distress, coma, death Prevention Avoid Mosquitoes when possible Chemoprophylaxis

Answer 41

Chloroquine: Areas w Chloroquine-Sensitive mosquitoes Doxycycline: All areas Atovaquone-proguanil: All areas Mefloquine: All areas except SE Asia

Answer 42

1. Identify the technique used 2. Disentangle the core points and address each separately 3. Respond with evidence based message

Answer 43

Predictable based on pharmacology of vaccine Unpredictable based on properties of vaccine (alopecia after hep B vax)

Answer 44

Stable controlled seizure disorder no effect on immunization *Caution for MMRV vaccine if have personal or family seizure history

Answer 45

Fever is a common adverse event following immunization *Recent study found lower antibody response to pediatric vaccines in those who received prophylactic acetaminophen Discourage use of prophylactic antipyretics

Answer 46

Reversion of vaccine virus to more neurovirulent phenotypes Very rare in healthy vaccinees or their contacts

Answer 47

-Neurological syndrome characterized by loss of reflexes and symmetric paralysis with recovery -Immune response directed at myelin sheath of peripheral nerves or axon -May be triggering event (acute infection, vaccination)

Answer 48

Common in later adolescents to older adults Seasonally in late summer Associated with campylobacter infection

Answer 49

Tetanus toxoid--> extremely low risk Hepatitis B vaccine and polio vaccine --> no association established Influenza vaccine --> very low RSV vaccine in individuals >60 --> very low risk MenACWY--> no increased risk

Answer 50

FDA Modernization Act of 1997 called for review of mercury containing food and drugs Thimerosal preservative contains very low levels of mercury

Answer 51

Thimerosal free preparations now available in U.S Risk of vaccine preventable disease much higher than the unknown, probably much smaller risk of thimerosal exposure

Answer 52

shoulder injury related to vaccine administration -Injury to musculoskeletal structures of the shoulder -Should pain, limited range of motion -Inflammatory reaction resulting from unintended injection of vaccine or needle trauma

Answer 53

Risk of anaphylaxis following immunization is very low Mediated IgE Occur within minutes to hours of the vaccine Require medical attention

Answer 54

Vaccine antigen Animal or yeast protein Antibiotics Preservatives Stabilizers Packaging

Answer 55

Occurs shortly after exposure Exposed to antigen previously Mediated by IgE IgE antigen complex attach to receptors on basophils and mast cells Basophils and mast cells release mediators

Answer 56

Direct -Upper airway obstruction -bronchial dysfunction -Hypotension Indirect -myocardial infarction -cerebral injury -ischemia, hypoxia -epinephrine use

Answer 57

Indications: bronchospasm, laryngeal edema, urticaria, angioedema, hypotension Goals: maintain airway, reduce fluid, extravasation, reduce pruritis, maintain SBP Complications: Arrythmias, hypertension, nervousness, tremor

Answer 58

Adult dose Epinephrine 1:1000 0.3-0.5 mL sq or im Pediatric dose Epinephrine 1:1000 0.01 mL/kg sq or im May repeat dose in 15 minutes if necessary

Answer 59

Indication: urticaria Goals: reduce pruritis, antagonize H1 effects of histamine Complications: Drowsiness, dry mouth, urniary retention Dose 1-2 mg.kg im or iv Typically 50-100 mg

Answer 60

Make an anaphylaxis kit *Epinephrine auto injector *Diphenhydramine syringe *Alcohol wipes *Tourniquet *Management protocol

Answer 61

Vasovegal reaction consisting of sympathetic nervous system stimulation Often in a setting of fear or emotional distress Sudden onset of hypotension Assist to lying down *don't confuse with stroke

Answer 62

Wisconsin Act 68 and 24: No prescription -Age 6 or older -ACIP recommended vaccine Pharmacy techs may administer vaccines Students must complete course and be supervised by a healthcare provider authorized to administer vaccines Prescription -Any vaccine -Age 0-5 years

Answer 63

Screening Vaccine ordering and storage Record keeping Reimbursement

Answer 64

Beneficiaries must check with their plans to determine if immunization must be obtained within the HMO

Answer 65

Covers vaccines for adults with Medicare Part D plans *Used for zoster and RSV vaccine

Answer 66

Will pay for influenza or pneumococcal vaccines administered in pharmacies

Answer 67

VFC Federal program provides vaccine at no cost to uninsured, underinsured or American Indian or Alaska native children 0-18 years *No charge for vaccine but might have administration fee

Answer 68

simplified billing method for immunization One CMS 1500 submitted with a list of claims Roster billing can be used for mass immunization clinics

Answer 69

Document that contains information about what to do in the case of an exposure Contains: -Facility name -Determination of employee exposure -Implementation of various methods of exposure control *Universal precautions *Engineering and work practice controls *PPE *Housekeeping -Hep B vaccine -Post exposure evaluation and follow-up Communication of hazards to employees and training -Recordkeeping -Procedures for evaluating circumstances surrounding exposure incidents *Person or department responsible for different aspects of program adminsitration

Answer 70

Educate other pharmacist staff to serve as vaccine educators and recommend immunizations -Posters, flyers, bag stuffers -Press release -Local immunization coalition *Immunize patients consider process continue immunization efforts all year long *Share success

Answer 71

covers annual influenza vaccine, pneumococcal vaccine, CMS priority to increase immunization rates *covered in any setting *No deductible

Answer 72

Must charge all patients the same price

Answer 73

Globally eradicated in 1980 Biological warfare -French and Indian wars Storage of virus stocks in Russia and US

Answer 74

Live vaccine Live, non replicating Cross protection for Orthopoxviruses (monkey, cow, variola)

Answer 75

Vaccine vial contains about 100 doses Vaccinator wears gloves Remove aluminum seal and rubber stopper Choose vaccine sit Cleaning site unnecessarily Bifurcated needles supplied with vaccine (scratch surface of skin)

Answer 76

vaccination process that involves scratching the skin Needle at right angle to skin Strokes vigorous enough to cause trace of blood to appear

Answer 77

Primary vaccination -Pustular lesion must be present on day 6-8 Revaccination -Pustular lesion or significant induration surrounding a central lesion on day 7

Answer 78

Mass preexposure not in plan -Risks outweigh benefits (people can die from getting vaccine induced small pox) Surveillance and containment strategy

Answer 79

Ring vaccination Focused contact tracing Deliver vaccine to those who are at highest risk Avoid adverse effects associated with mass immunization Limited vaccine and VIG supplies

Answer 80

vaccine recommended for -People having contact with someone with M. Pox -Sexual partner had M. Pox -Multiple sexual partners in area with M. Pox Vaccine: 2 doses separated by 4 weeks Subcutaneous administration

Answer 81

Cell free filtrate of anthrax culture *No dead or live bacteria Vaccine schedule: -Vaccine doses administered intramuscularly -Primary vaccination at 0,1,6,12, 18 months -Maintain immunity with annual boosters for people at risk

Answer 82

Three doses (0,2,4, weeks) in combo with antimicrobials

Answer 83

History of anthrax infection Anaphylaxis following dose Postpone for moderate to severe illness

Answer 84

Local reactions Systemic symptoms Safety assessed extensively in military populations

Answer 85

Rare deadly viral infection Transmitted through contact with infected body fluids Fever, myalgia, internal hemorrhage, vomiting, or coughing blood -70-90% fatal -Supportive care

Answer 86

Live recombinant prevents infection *not effective in outbreaks -Healthy non pregnant, non lactating adults with occupational exposure Adverse effects (anaphylaxis, arthritis)

Answer 87

Corroborate About Me Science Explain + advise

Answer 88

Report adverse events requiring medical attention occurring within 30 days of getting vaccine Purpose: Designed to generate, not test vaccine safety hypotheses Detect possible signals of adverse events associated with vaccien

Answer 89

Meningococcal vaccine

Answer 90

$1 million per occurrence and $2 million per year

Answer 91

5/8 in and 25-37 gauge needle 1 mL and/or 3 mL syringe 45 degrees

Answer 92

1 to 1 1/2 in with 22-25 gauge needle 1 mL and/or 3 mL syringe 90 degrees

Quiz 2 Flashcards

(116 cards)