Well Child 3

Question 1

Hep B Vaccine

• How many doses?
• Given at what ages?
• Incidence of Hep B has declined by 82% since 1990
• Disease spread how?

Answer 1

• 3 doses
• birth, 1-2 months, 6-18 months
• contact w/ blood or bodily fluids, birth

Question 2

Hep B

• 5 sxs? (may be asymptomatic too)
• 3 complications of dz?
• 1 contraindication to vaccine
• 2 ADEs from vaccine

Answer 2

• Sxs: jaundice, HA, wkness, V, joint pain
• complications: chronic liver infection, liver failure, liver cancer
• Contraindication: severe allergy to yeast
• ADEs: fever / pain at injection site

Question 3

What is the leading cause of hospitalizations & death from acute gastroenteritis in young children worldwide?

Answer 3

Rotavirus

Question 4

Rotavirus

• What type of vaccine?
• Given at what 3 ages?
• Dz spread how?
• 3 dz sxs?
• 2 complications of dz?

Answer 4

• Type: Live, oral vaccine
• ages: 2, 4, 6 months
• spread: saliva, oral contact
• sxs: V, D, fever
• Complications: severe diarrhea, dehydration

Question 5

Rotavirus

• 3 contraindications to vaccine
• 2 ADEs from vaccine

Answer 5

• Contraindications:
  
  • hx of intussusception
  • infants w/ SCID (severe combined immunodeficiency)
  • defer in those w/ acute moderate-severe gastro
• ADEs:
  
  • slight incr risk of intussusception
  • V/D, cough/rhinorrhea

Question 6

DTaP (Diphtheria-tetanus-acellular pertussis)

• How many doses?
• What ages?
• How is diphtheria spread?
• How is tetanus spread?
• How is pertussis spread?

Answer 6

• # doses: 5
• Ages: 2, 4, 6, 15/18 months, 4 yrs
• Diphtheria: air & direct contact
• Tetanus: exposure through cuts in skin
• Pertussis: air & direct contact

Question 7

4 sxs of Diphtheria

Answer 7

• sore throat
• fever
• weakness
• swollen glands in neck

Question 8

5 sxs of tetanus

Answer 8

• stiffness in neck
• stiffness in abdominal muscles
• difficulty swallowing (dysphagia)
• muscle spasms
• fever

Question 9

3 sxs of pertussis

Answer 9

• severe cough
• rhinorrhea
• apnea

Question 10

5 complications of diphtheria

Answer 10

• pericarditis
• heart failure
• coma
• paralysis
• death

Question 11

3 complications of tetanus

Answer 11

• broken bones
• breathing difficulty
• death

Question 12

2 complications of pertussis

Answer 12

• PNA
• death

Question 13

3 contraindications of DTaP vaccine

Answer 13

• do not give to children who have developed encephalopathy w/in 7 days of a previous dose of this vaccine
• defer for those w/ progressive neurological disorders (infantile spasms, uncontrolled epilepsy) until condition is stabilized
• precaution if pt developed high fever, inconsolable crying, or shock like state previously w/in 48hrs of vaccine admin.

Question 14

2 ADEs from DTaP vaccine

Answer 14

• swelling/redness at site
• fever

Question 15

HIB (Haemophilus influenza type B)

• How many vaccines?
• What ages?
• Before vaccine, HIB was leading cause of what?

Answer 15

• # doses: 4
• Ages: 2, 4, 6, 12/15 months
• invasive bacterial disease in children <5 yrs in the U.S.

Question 16

2 contraindications to HIB vaccine

Answer 16

• Infants < 6 weeks of age
• Individuals w/ allergic rxn to previous HIB vaccine

Question 17

PCV 13 (Pneumococcal)

• # doses?
• Ages?
• Common cause of what 2 infections?

Answer 17

• 4
• 2, 4, 6, 12 months
• AOM & Sinusitis

Question 18

2 contraindications to PCV 13 (Pneumococcal)

Answer 18

• severe previous allergic reaction to vaccine
• defer for individuals during moderate or severe acute illness w/ or w/o fever

Question 19

5 ADEs of PCV 12 (Pneumococcal)

Answer 19

• Fever
• Local rxn
• Irritability
• Increased or Decreased sleep
• Risk of febrile seizures when administered w/ influenza vaccine**

Question 20

IPV (Poliomyelitis)

• # doses?
• Ages?
• No longer what?

Answer 20

• 4
• 2, 4, 6-18 months, 4 yrs
• no longer a live vaccine

Question 21

3 contraindications to IPV (Poliomyelitis)

Answer 21

• allergic reaction to previous IPV vaccine
• defer during moderate or severe acute illness
• pregnancy

Question 22

MMR (Measles, Mumps, Rubella)

• # doses?
• Ages?
• Type of vaccine?
• DOES NOT CAUSE WHAT?

Answer 22

• 2
• 12-15 months & 4 years
• autism

Question 23

5 sxs of measles

Answer 23

• rash
• fever
• cough
• rhinorrhea
• pink eye

Question 24

5 sxs of mumps

Answer 24

• swollen salivary glands
• fever
• HA
• fatigue
• muscle pain

Question 25

3 sxs of rubella

Answer 25

* rash * fever * swollen lymph nodes

Question 26

_Does Measles, Mumps, or Rubella_ have very serious complications in pregnant women--\> miscarriage, stillbirth, premature delivery, birth defects?

Answer 26

Rubella

Question 27

3 contraindications to MMR vaccine

Answer 27

* pregnant women, women intending to become pregnant within 28days * immunocompromised persons * egg or neomycin allergy (anaphylactic)

Question 28

3 ADEs of MMR vaccine

Answer 28

* fever (5-15%) about 6-12 days following vaccine * transient morbilliform rash * GBS (1 case per 3million)

Question 29

**Varicella** * # doses? * Ages? * 2 contraindications * Unique ADE

Answer 29

* 2 * 12-15 months & 4 yrs * allergic rxn after previous varicella vaccine * pregnant women * ADE: sparse varicelliform rash outside injection site 5 - 26 days after vaccine

Question 30

**Hepatitis A** * # doses? * Ages?

Answer 30

* 2 * 12 & 18 months (must be 6 months from 1st dose)

Question 31

**HPV** * # doses? * Disease complications? * 4 ADEs

Answer 31

* 2 or 3 doses depending on when series started * Complications: cancer- cervical, vaginal, vulvar, anal, throat, penile * **ADEs:** F, nausea, dizziness, HA