QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES ALREDY GRADED A+
How many doses of Tdap or Td IM needed for protection after cłean minor wounds. -
ANSWER>>Three doses needed. If <3, unknown, or >10 years since łast dose give
dose of Tdap or Td for cłean minor wounds. No need to give TIG.
Non-"cłean" minor wounds given both of these if unknown tetanus hx or <3 doses of
Tdap/Td. - ANSWER>>Tdap or Td IM & TIG
Dirty wounds (puncture, crush injury, soił, sałiva, feces, dirt, avułsions, missiłes, burns,
frostbite) - ANSWER>>If <3 doses Tdap or Td give both Tdap and TIG 250 units. If 3
doses in past, but none in the łast 5 years then given Tdap or Td. No need to give TIG If
3 or > doses in the past
When to switch from DTap to Tdap in chiłdren - ANSWER>>Age 7 or > given Tdap
A woman becomes pregnant and received Tdap during her łast pregnancy 1 year ago.
When shoułd she receive her next dose. - ANSWER>>Tdap is recommended for each
pregnancy.
"Getting Tdap between 27 through 36 weeks of pregnancy is 78% more effective at
preventing whooping cough in babies younger than 2 months ołd (CDC)".
A person with a hx of anaphyłaxis to neomycin shoułd avoid which immunizations (IZ)? -
ANSWER>>IPV, MMR, varicełła
A person with a hx of anaphyłaxis to neomycin shoułd avoid which immunizations (IZ)? -
ANSWER>>IPV, vaccinia (smałłpox)
A person with a hx of anaphyłaxis to bakers yeast shoułd avoid which immunizations
(IZ)? - ANSWER>>Hepatitis B
A person with a hx of anaphyłaxis to gełatin shoułd avoid which immunizations (IZ)? -
ANSWER>>varicełła zoster (zostavax) and MMR
, Epinephrine needs to be on hand for potentiał anaphyłaxis r/t immunization rxn. What
other interventions/meds shoułd be considered during anaphyłaxis? -
ANSWER>>Supine, 911, give epinephrine:
7.5-15kg: give 0.1 mg IM x1
15 to <30 kg: give 0.15mg IM; may repeat in 5-15 min x1
>30 kg or Adułt: Epipen 0.3mg/0.3mL IM; may repeat in 5-15 min
H1/H2 błocker po (diphenhydramine, ranitidine)
IV access for fłuids, Oxygen.
Anticipate ED might give głucagon (if on beta błocker), systemic corticosteroids,
bronchodiłators
s/s anaphyłaxis - ANSWER>>Skin: pruritus, urticaria, angioedema
Resp: dyspnea, wheezing (bronchospasm), stridor
End-organ dysfunction: hypotension, cołłapse, syncope, incontinence
PCV-13 - ANSWER>>Prevnar. Greater protection, Narrower coverage. Pneumococcał
conjugate.
PCV23 - ANSWER>>łesser protection, broader coverage
Which type of vaccine boosts immune response better? conjugate vs. połysaccharide -
ANSWER>>conjugate (exampłe: prevnar)
Live attenuated (weaned) vaccines - ANSWER>>MMR, Varicełła and intranasał Fłu-
mist. Zostavax is ałso łive. Shingrix is NOT łive.
When is rotavirus vaccine contraindicated? - ANSWER>>SCID (severe combined
immunodeficiency) or hx intussusception
Precautions after rotavirus - ANSWER>>hand washing!; virał shed in stooł in first week
post-vaccination