Term
| The primary antibody response to vaccination usually produces detectable circulating antibody (initially IgM) in _________, and peaks in ____________ |
|
Definition
|
|
Term
| Live vaccines, although productive of a long-lasting immune response, should generally be avoided in __________ or __________ |
|
Definition
immunocompromised
pregnant patients. |
|
|
Term
| Killed vaccines also induce a protective immune response, but often require __________ to induce and maintain adequate immunity |
|
Definition
|
|
Term
| What is passive immunization? |
|
Definition
| occurs when antibodies are directly injected into the blood stream to grant immediate immunity. Done with immunocompromised pts |
|
|
Term
| Most cases of GBS are provoked by ________ |
|
Definition
| infectious illnes themselves (as opposed to vaccines) |
|
|
Term
|
Definition
| mercury-containing organic compound that is added in small amounts to certain vaccines as a preservative |
|
|
Term
| Egg allergy, previously a contraindication to influenza vaccine, is now only a contraindication if eggs include __________ |
|
Definition
|
|
Term
| If a person has a mild egg allergy, do you still administer influenza vaccine? |
|
Definition
YES! (live attenuated virus should still be avoided)
(mild allergy implies a rash) |
|
|
Term
| Should you administer vaccinations to individuals with MODERATE or SEVERE illness? |
|
Definition
| NO, delay vaccinations until their condition improves |
|
|
Term
| What is the optimal time for giving the flu vaccine? |
|
Definition
|
|
Term
| Flu season can begin as early as ________ and last until _______ |
|
Definition
|
|
Term
| How many different type of flu are there? |
|
Definition
|
|
Term
| Of the different subtypes of the flu, which is the most dangerous to humans? |
|
Definition
|
|
Term
| Which subtype of flu is the least dangerous? |
|
Definition
| C (does not infect humans) |
|
|
Term
| Even when the predominant strain of influenza is miscalculated, the vaccine _______________ |
|
Definition
|
|
Term
| What age group is the Live Attenuated Influenza Vaccine administerd? |
|
Definition
| healthy individuals ages 2-49 |
|
|
Term
| If a person sneezes after receiving an INTRANASAL dose of flu vaccine, should they get a repeat dose? |
|
Definition
|
|
Term
| If a person has a mild egg allergy (skin rash) can you still use LAIV? |
|
Definition
| No, LAIV is contraindicated even with mild egg allergy |
|
|
Term
| All chronic medical conditions (i.e., heart disease, lung disease, hemoglobinopathies, diabetes, renal dysfunction, and immunodeficiency) are contraindications to _________ |
|
Definition
|
|
Term
| Children or adolescents receiving aspirin or other salicylates should not receive __________ |
|
Definition
| LAIV (to prevent the potential of Reye's syndrome). |
|
|
Term
| A history of Guillain-Barre syndrome is a contraindication to _________ |
|
Definition
|
|
Term
| Pregnant pts should not receive which flu vaccination? |
|
Definition
|
|
Term
| Is nasal congestion a contraindication to LAIV? |
|
Definition
|
|
Term
| Can LAIV be given in conjunction with antiviral medications? |
|
Definition
|
|
Term
| What are the antiinfluenza agents licensed in the US? |
|
Definition
| the ADAMANTANES (amantadine and rimantadine, effective against influenza A), and the neuraminidase inhibitors (oseltamivir and zanamivir, effective against influenza A and influenza B). |
|
|
Term
| The polysaccharide coat of the pneumococcus determines its __________ |
|
Definition
|
|
Term
| Since the first pneumococci to be described were those that cause significant human disease, the most virulent strains typically have ___________ |
|
Definition
|
|
Term
| The most widely-used adult pneumococcal vaccine consists of capsular polysaccharides from the ____________ of pneumococcus that most commonly cause disease in humans, and is known as the ____________, or _______ |
|
Definition
23 serotypes
pneumococcal polysaccharide vaccine
PPSV23 |
|
|
Term
| A new formulation of the 13 most virulent strains of pneumococcus has been developed, and is known as the _________________, or _______ |
|
Definition
pneumococcal conjugate vaccine
PCV13 |
|
|
Term
| PCV13 may be ___________ than PPSV23. Because of this, _________ is now the recommended initial vaccine in those with certain risk factors for invasive pneumococcal disease |
|
Definition
|
|
Term
| Because the pneumococcal vaccine is polysaccharide based, it evokes a _____________. Therefore, immunity tends to _________ |
|
Definition
T-cell independent response
wane with time |
|
|
Term
| ___________ is recommended for persons with specific clinical conditions that predispose them to pneumococcal disease, as long as they are less than ___ |
|
Definition
|
|
Term
| final revaccination of these high-risk individuals should be given at age ___ or _______________, whichever comes later |
|
Definition
65
five years after their one-time revaccination |
|
|
Term
| High risk conditions for which revaccination (if age<65) is recommended are. . . (9) |
|
Definition
Aslepnia (sickle cell)
HIV
Malignancy
CKD
Organ Transplant
Nephrotic Syndrome
Chemotherapy
Corticosteroid Therapy
Cochlear Implant |
|
|
Term
| What is the sequence of pneumococcus vaccinations used in high risk individuals? |
|
Definition
PCV13 first
followed by PPSV23 8 weeks later
then REVACCINATED in 5 years with PPSV23 |
|
|
Term
| Pneumococcal vaccine may be co-administered with other vaccines, with the notable exception of the _________ |
|
Definition
|
|
Term
| Co-administration of the pneumococcal vaccine and the zoster vaccine results in decreased immunogenicity of ____________; thus they should not be given together. |
|
Definition
|
|
Term
| The polysaccharide coat of the pneumococcus determines its __________ |
|
Definition
|
|
Term
| Since the first pneumococci to be described were those that cause significant human disease, the most virulent strains typically have ___________ |
|
Definition
|
|
Term
| The most widely-used adult pneumococcal vaccine consists of capsular polysaccharides from the ____________ of pneumococcus that most commonly cause disease in humans, and is known as the ____________, or _______ |
|
Definition
23 serotypes
pneumococcal polysaccharide vaccine
PPSV23 |
|
|
Term
| A new formulation of the 13 most virulent strains of pneumococcus has been developed, and is known as the _________________, or _______ |
|
Definition
pneumococcal conjugate vaccine
PCV13 |
|
|
Term
| PCV13 may be ___________ than PPSV23. Because of this, _________ is now the recommended initial vaccine in those with certain risk factors for invasive pneumococcal disease |
|
Definition
|
|
Term
| Because the pneumococcal vaccine is polysaccharide based, it evokes a _____________. Therefore, immunity tends to _________ |
|
Definition
T-cell independent response
wane with time |
|
|
Term
| ___________ is recommended for persons with specific clinical conditions that predispose them to pneumococcal disease, as long as they are less than ___ |
|
Definition
|
|
Term
| final revaccination of these high-risk individuals should be given at age ___ or _______________, whichever comes later |
|
Definition
65
five years after their one-time revaccination |
|
|
Term
| High risk conditions for which revaccination (if age<65) is recommended are. . . (9) |
|
Definition
Aslepnia (sickle cell)
HIV
Malignancy
CKD
Organ Transplant
Nephrotic Syndrome
Chemotherapy
Corticosteroid Therapy
Cochlear Implant |
|
|
Term
| What is the sequence of pneumococcus vaccinations used in high risk individuals? |
|
Definition
PCV13 first
followed by PPSV23 8 weeks later
then REVACCINATED in 5 years with PPSV23 |
|
|
Term
| Pneumococcal vaccine may be co-administered with other vaccines, with the notable exception of the _________ |
|
Definition
|
|
Term
| Co-administration of the pneumococcal vaccine and the zoster vaccine results in decreased immunogenicity of ____________; thus they should not be given together. |
|
Definition
|
|
Term
| Tetanus infection is most commonly confused with what other two diagnoses? |
|
Definition
strychnine poisoning
dystonic reaction |
|
|
Term
| Clostridial spores, which are exceptionally stable, are typically inoculated during injury, and are more likely if the injury is contaminated with (3) ______________ |
|
Definition
|
|
Term
| Puncture wounds (including ____________ in injection drug users), __________ and ___________ are among the high-risk injuries leading to clostridial infection |
|
Definition
needle injuries
crush injuries
frostbite |
|
|
Term
| Does the tetanus vaccine protect against infection from the bacteria or the toxin? |
|
Definition
| TOXIN (there is no immunity against the bacteria) |
|
|
Term
| The isolated tetanus toxoid vaccine should be used only when ___________ |
|
Definition
|
|
Term
| What is the difference between TD and Td? |
|
Definition
| The abbreviation for the vaccine, Td, indicates that a low dose of diphtheria toxoid is used, in contrast to TD, which has a higher dose of diphtheria toxoid. Td is favored over TD in adults because the high dose of diphtheria toxoid found in TD is more likely to cause side effects |
|
|
Term
|
Definition
Tetanus toxoid vaccine
diptheria toxoid vaccine
acellular pertussis vaccine |
|
|
Term
| Tdap should be considered for pregnant woman after |
|
Definition
|
|
Term
| What other adults except pregnant pts should receive Tdap? |
|
Definition
postpartum women,
close contacts of infants aged less than 12 months,
all health-care personnel with direct patient contact |
|
|
Term
| Tetanus immune globulin is used for passive immunization of those who have not received their ___________ |
|
Definition
| primary series (or those with humoral immunodeficiency) |
|
|
Term
| How many doses are required for the PRIMARY series of TETANUS? |
|
Definition
|
|
Term
| What is the timeline for Tetanus vaccination? |
|
Definition
•Dose 1: Time zero
•Dose 2: 4 weeks later
•Dose 3: 6-12 months after dose 2 |
|
|
Term
| When administering the primary series, which is used Td or Tdap? |
|
Definition
| Td is used for two of the doses, and Tdap is used for one when administering the primary vaccination series. |
|
|
Term
| What is the only significant contraindication to tetanus toxoid vaccination? |
|
Definition
| recent immunization with tetanus vaccine (an Arthus-like reaction may develop) |
|
|
Term
| How often does one receive Td? |
|
Definition
every ten years
OR
if an at risk injury occurs and it has been more than five years since their last Td |
|
|
Term
| When does an adult receive Tdap? |
|
Definition
| If they're up for their Td dose OR they are working with at risk people (regardless of their last Td) |
|
|
Term
| Which serotype of neirsseria meningitidis is there no vaccine? |
|
Definition
|
|
Term
| What is the name of the meningitis vaccine given to people less than 55? |
|
Definition
|
|
Term
| What is the meningitis vaccine that is given to adults > 55? |
|
Definition
|
|
Term
| Who should receive the meningitis vaccine? |
|
Definition
College freshman living in dorms
Complement deficiency
asplenia
US military recruits
exposed to meningitis outbreaks
travel to high risk country
Microbiologists working with N. men. |
|
|
Term
| What is the dosing series for HIV, complement deficiency, and asplenia? |
|
Definition
Give two doses primary series two months apart
Repeat the vaccination every five years |
|
|
Term
| How frequently is meningitis vaccination repeated? |
|
Definition
|
|
Term
| Is HIV an indication for N. meningitidis vaccination? |
|
Definition
| No, but if they receive the vaccination they should be given two doses |
|
|
Term
| MMR vaccination should NOT be administerd on the same day as . . . |
|
Definition
| PPD (it interferes with the skin test) |
|
|
Term
| How many doses of MMR are typically given? |
|
Definition
2 during childhood if born after 1957
1 if low risk adult (2 for high risk adults) |
|
|
Term
| Who are considered high risk pts for MMR and should therefore receive two doses? |
|
Definition
healthcare workers
international travelers
exposed to measles or mumps outbreak
post-highschool education |
|
|
Term
| The MMR vaccine is a live attenuated virus vaccine. It is therefore contraindicated in __________ |
|
Definition
pregnant women
those with cancer
those receiving high doses of corticosteroids (>20 mg of prednisone daily). |
|
|
Term
| Can MMR be given to pts with HIV? |
|
Definition
| YES, but only if their CD4 count is greater than 200 |
|
|
Term
| If two doses of MMR are required how far apart is the dosing? |
|
Definition
|
|
Term
| Regarding immunization recommendations, adults can be divided into three age groups: |
|
Definition
| 18-49, 50-64, and 65 and older. |
|
|
Term
| What vaccinations should be routinely administered in ages 18-49? |
|
Definition
◦Td every 10 years for all persons in this age group (Tdap once in adult life)
◦Influenza annually
◦MMR and varicella for those without documentation of vaccination or evidence of immunity
◦Pneumococcal, hepatitis A, hepatitis B, and meningococcal vaccine for those at risk
◦Repeat pneumococcal vaccine once for those at high risk
◦Repeat meningococcal vaccine every 5 years for those at risk
◦HPV vaccine for individuals aged 9-26 |
|
|
Term
| What vaccinations should be routinely administerd in ages 50-64? |
|
Definition
◦Td every 10 years for all persons in this age group (Tdap once in adult life)
◦Varicella for those without documentation of vaccination or evidence of immunity
◦Influenza annually
◦Pneumococcal, hepatitis A, hepatitis B, and meningococcal vaccine for those at risk
◦Repeat pneumococcal vaccine once for those at high risk and again at age 65 if >5 years since last vaccination
◦Repeat meningococcal vaccine every 5 years for those at risk
◦(Zoster vaccine is FDA-approved for this age group, but not recommended by the Advisory Committee on Immunization Practices until age 60) |
|
|
Term
| What vaccinations should be given to those 65 years or older? |
|
Definition
◦Td (Tdap once in adult life)every 10 years for all persons in this age group
◦Influenza annually
◦Pneumococcal vaccine once or repeat dose at age 65 or 5 years after initial dose, whichever is later
◦Hepatitis A, hepatitis B and meningococcal vaccine for those at risk
◦Zoster vaccine once (ages 60 and older, if not given prior) |
|
|
Term
| In addition to typical vaccination contraindications, varicella vaccine is contraindicated in . . . |
|
Definition
| those with neomycin or gelatin allergy |
|
|
Term
| What are the contraindications LIVE attenuated FLU vaccine? |
|
Definition
◦Pregnant women
◦People 50 years old and older
◦People with chronic pulmonary disease
◦People with chronic cardiovascular disease
◦People with chronic metabolic disease (e.g., DM, chronic renal disease)
◦Immunocompromised patients (e.g., malignancy, chemotherapy, immune deficiency)
◦People with a history of Guillain-Barre syndrome
◦People with egg allergy |
|
|
Term
| What is the most common mode of transmission of Hep A? |
|
Definition
| fecal-oral route (household or sexual contact) |
|
|
Term
| How long from infection of Hep do symptoms manifest? |
|
Definition
| Incubation until clinical manifestations is 28 days |
|
|
Term
| When are individuals most infectious? |
|
Definition
prior to clinical manifestation
shedding in stool is highest 2 weeks prior to liver enzyme elevation or jaundice. |
|
|
Term
| What groups are the highest risk of Hep A? |
|
Definition
men who have sex with men;
travelers to endemic regions; injection drug users;
recipients of clotting factors |
|
|
Term
| When do you vaccinate children for Hep A? |
|
Definition
|
|
Term
| What is the dosing schedule for Hep A? |
|
Definition
1st dose day zero
2nd dose in six months |
|
|
Term
| In adults, HBV transmission occurs primarily among unvaccinated persons with _______________ |
|
Definition
behavioral risks (specifically heterosexuals with multiple sex partners,
injection drug users,
men who have sex with men,
household contacts
sexual partners of those with chronic HBV |
|
|
Term
| Eighty percent of new cases of HBV are associated with _____________ or ____________. |
|
Definition
high-risk sexual activity (the most common risk factor seen)
injection drug use |
|
|
Term
| How long of an incubation period with HBV is there until you a see an elevation of ALT? |
|
Definition
|
|
Term
| How long of an incubation period with HBV is there until JAUNDICE is seen? |
|
Definition
|
|
Term
| Chronic infection in healthy adults is ________ |
|
Definition
| uncommon (<5%), but much higher in the immunosuppressed and in those with diabetes |
|
|
Term
| Chronic infection is much higher when young |
|
Definition
| children are infected, and nearly universal in infants. |
|
|
Term
| The dosing schedule for the hepatitis B vaccine is at _____________ |
|
Definition
|
|
Term
| Adults receiving hemodialysis or other immunocompromised adults (e.g., HIV-infected persons, hematopoietic stem-cell transplant recipients, and patients undergoing chemotherapy) should receive ________________ |
|
Definition
| double the amount (40 micrograms) per vaccine dose |
|
|
Term
| What is the most common STD in the US? |
|
Definition
|
|
Term
| Which HPV serotype is the most common cause of genital warts? |
|
Definition
|
|
Term
| Which HPV serotype is carcinogenic? |
|
Definition
|
|
