vaccines & contraindications

Question 1

name the 7 live vaccines

Answer 1

rota
mmr
var
opv
adenovirus
yellow fever
IN flu

Question 2

what steroid dose if given should make you avoid vaccinating a patient for at least 1 month

Answer 2

20mg/day or >2mg/kg/day lasting at least 14 days

Question 3

when should a premie baby get Hep B if their mom is Hep B negative

Answer 3

can delay for 1 month

Question 4

what vaccine should not be given to a premie in hospital becuase it is shed in the stool and infect others

Answer 4

rotavirus

Question 5

how long should you wait to give another live vaccine if the patient recieved 1 today

Answer 5

at least 1 month

Question 6

can you vaccinate a healthy HIV patient with live vaccines

Answer 6

yes, if they are well and disease is under control

Question 7

are live vaccines like mmr and var contraindicated in the family members of an immunocompromised person

Answer 7

no, give them

Question 8

what are the rules for PPD administration and MMr vaccine

Answer 8

they can be done on the same day but if MMR is given prior to PPD you have to wait at least 4 weeks prior to testing PPD

Question 9

1st rota dose should not be given before ___ or after ___?

Answer 9

6 weeks
15 weeks

Question 10

can you give rota to a child who has an immunocompromised family member in the home

Answer 10

yes

Question 11

can you give a baby presenting for vaccines for the first time at 4 months rota

Answer 11

no becuase they are 16 weeks (>15 weeks) old

Question 12

what vaccine should not be given to an asthmatic

Answer 12

IN flu

Question 13

which children require two vaccines for flu if it is their first time

Answer 13

ages 6 mo -8 years

Question 14

last dose of hep b should not be given before what age

Answer 14

6 months

Question 15

ideal regimen for Hep B vaccine is

Answer 15

0 , 1 mo and 6 mo

Question 16

if mom is hep b status unkown what should baby get

Answer 16

hep b vaccine within 12 hours of birth

Question 17

if om is hep b positive when baby is born what do you give

Answer 17

hep B and HBIG no later than day 7 of life

Question 18

if your patient has an intimate contact who has meningitis what do you do

Answer 18

ppx rifampin or rocephin even if they are vaccinated

Question 19

what two vaccines are recommended during pregnancy

Answer 19

tdap and flu

Question 20

what UDE is associated with rifampin

Answer 20

reddish orange tears and urine

Question 21

what is given for H flu ppx

Answer 21

rifampin

Question 22

when to give H flu ppx to a patient

Answer 22

if there are TWO documented cases around them

Question 23

what ppx for pertussis should be given and to who

Answer 23

all householld contacts and all exposed should get a macrolide ( give azithromycin to children 6 weeks or less as erythromycin can cause PS)

Question 24

Hep B needle stick in an uncertain immune status patient

Answer 24

check for antibody, if negative then give HBIG and START full vaccine series
if positive do nothing

Question 25

a child ( < 6 months) exposed to measles 3 days or less ago should get

Answer 25

IFIM or IVIG

Question 26

a child 6-11 months exposed to measles 3 days or less ago should get

Answer 26

MMR

Question 27

a child 6-11 mo who is exposed to measles 4-6 days ago should get

Answer 27

IVIG or IGIM

Question 28

if a child of any age was exposed to measles more than 6 days ago, what ppx do they get

Answer 28

none its to late to prevent the disease

Question 29

can a child go back to daycare if they were exposed 72 hours ago and gets MMR vaccine

Answer 29

yes

Question 30

for tetanus exposure, what vaccine is given for a child < 7, 7-11 and > 11

Answer 30

DT Td Tdap

Question 31

if tetanus exposure in someone who had a shot > 5 years ago and its dirty

Answer 31

give booster

Question 32

patients with severe gelatin allergy shouldnt get what shots

Answer 32

yellow fever

Question 33

if a patient has encephalopathy or prlonged seizure within 1 week of getting DTAP what to do in he future

Answer 33

give DT (likley the reaction was the pertusis componenet)

Question 34

what vaccines have gelatin in them

Answer 34

MMR, varicella, flu and yellow fever

Question 35

which vaccine have traces of neomycin and streptomysin in them

Answer 35

polio, mmr and var

Question 36

how long to wait after 20mg/d o >2mg/kg/day sterid course to vaccinate

Answer 36

one month

Question 37

how long to wait after IVIG to give live vacine

Answer 37

1 month

Question 38

what is the only live vaccine you CANNOT give to a child who lives with an immuno compromised family member

Answer 38

OPV

Question 39

can pregnant mothers let one of their children recieve a live vaccine

Answer 39

yes

Question 40

what does CD4 count have to be in HIV kid to get live vaccine

Answer 40

>15%

Question 41

what sxs are different in kawasaki and adeno from measles

Answer 41

- conjunctivits that is lymbic sparing - exudative pharyngitis

Question 42

what symptoms proceeds the diarrhea of rota

Answer 42

vomiting

Question 43

what age should rota virus vaccination should not be continued in

Answer 43

> 8 months

Question 44

children on what therapy really need flu vaccine and why

Answer 44

salicylate therapy becuase of the risk for reye syndrome if they get flu

Question 45

what is a dx that is contraindicated in giving the flu vaccine

Answer 45

GBS

Question 46

if a mother has an unknown Hep B status and she has a baby <2000g what to give

Answer 46

Hep B and HIBG

Question 47

chidlren with Hep B positive moms should have anti-Hbs and HbsAg checked when

Answer 47

beween 9-12mo, if neg AB then restart 3 dose series

Question 48

what is the most contagious pertussis phase

Answer 48

cattahral stage

Question 49

what are the three pertusis stages

Answer 49

1. cattarahl 2. paroxysmal 3. convalescent

Question 50

what is a contraindication to giving pertusis or DTAP vaccine

Answer 50

encephalopathy or severe anaphylaxis within 7 days of prior dtap vaccine

Question 51

why do we have to give so many pertusis containing shots

Answer 51

becuase of waning vaccine immunity

Question 52

pertusis cough is associated with what lab

Answer 52

leukocytosis with lymphpcytosis (90%)

Question 53

chlamydia cough is associted with what two findings

Answer 53

stacatto cough eosinophilia

Question 54

what tetanus containing vaccine should be given to a child who is > 7 but is not completed vaccinated against tetanus

Answer 54

TDAP

Question 55

if a patient has a hx of anaphylaxisis to a shot, what test should be done

Answer 55

skin prick testing

Question 56

when should Pcv23 be given

Answer 56

in children older than 2 who are HR (give 8 weeks after last PCV 13 and again 5 years later)

Question 57

patients with spinal bifida usually have what allergy ans should avoid what shot

Answer 57

latex allergy rotavirus shot has latex in bottle

Question 58

patients with terminal complement deficiency and properdin deficiency are at high risk for what dx

Answer 58

meningococcal