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PHP303: Quiz 3

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Section 1

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Target groups for Hep B

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6 years ago

Date created

Mar 14, 2020

Cards (49)

Section 1

(49 cards)

Target groups for Hep B

Front

infants receive 1st dose before discharge (protect against maternal transmission), all susceptible children not prvsly vaccinated, adults at risk by sexual exposure, healthcare workers, pts w diabetes, chronic liver or renal disease, pts w HIV, international travelers

Back

Hepatitis A

Front

picornavirus, spread by fecal-oral route and by consuming contaminated food/water, replicates in liver ppl at risk; international travelers, homosexual men, illegal drug users incubation: 15-50 days

Back

9vHPV storage and administration

Front

refrigerator at 2°C to 8°C (36°F to 46°F), protect from light\ shake vial before administration, 0.5mL IM

Back

Dosing for adults w/ indication for Hep B

Front

3 dose series w/ Recombivax HB or Engerix-B (0,1,6mths)

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Hep A vaccine schedule

Front

2 doses 1st- 1 yo 2nd- 6mths-12mths later adults should receive initial dose followed by booster dose 6-18mths later travelers receive at least 2 wks before travel

Back

What does HPV preferentially infect?

Front

epithelial cells; cervical, vulvar, vaginal, anal, penile, oral, pharyngeal cancers, genital warts and other diseases

Back

Hep B

Front

bloodborne pathogen transmitted by exposure to infected blood or body fluids, replicates in liver; causes acute hepatitis, chronic hepatitis, cirrhosis, liver cancer, death

Back

Hep A target group

Front

Children 12-23 mths, any person at inc risk of infection, people traveling internationally (except Canada, West Europe, Japan, NZ, Australia), homosexuals, drug users, lab works, chronic liver disease r clotting disorders, sanitation workers, food handlers post-exposure prophylaxis

Back

Measles complications

Front

diarrhea, otitis media, pneumonia, encephalitis, and death

Back

HPV Clinical features

Front

asymptomatic

Back

Hep B protection in immunocompromised pts

Front

persists after 3 doses even if anti-Hbs antibodies fall to undetectable levels b/c T-lymphocytes develop after vaccination and persist

Back

Twinrix (GlaxoSmithKline Biologicals), Comvax (Merck & Co.), and Pediarix (GlaxoSmithKline Biologicals)

Front

combination vaccines w/ Hep B

Back

Recommended groups for HepB immunity testing

Front

1. Health care workers at risk of exposure to blood or body fluids in the workplace. 2. Infants born to HBsAg-positive mothers. 3. Immunocompromised individuals (e.g., patients on dialysis, people with HIV). 4. Sex partners of people with chronic hepatitis B virus infection. people who initially achieve an anti-HBs antibody titer of 10 mIU/mL after immunization have responded to the vaccine and are considered protected

Back

HPV Risk factors

Front

older age, infection w/ multiple HPV types

Back

ACIP recommendation for Hep B vaccine w/ diabetes pts?

Front

adults aged 19 to 59 years with diabetes type 1 or type 2 should be vaccinated against hepatitis B as soon as possible after a diagnosis of diabetes is made >60 vaccinated at HCP discretion

Back

Hep B incubation and symptoms

Front

incubation = 2-5 mths sx: half are asymptomatic, those who are symptomatic are contagious 1-2 mths after symptom onset fever, malaise, headache, n/v, RUQ pain, myalgias, jaundice causes up to 80% hepatocellular cancers

Back

MMR and pregnancy

Front

women of childbearing age should have immunity to all 3 (if not, receive vaccine 4 wks before becoming pregnant) if pregnant and not immune to rubella, receive MMR after completion of pregnancy

Back

Twinrix-GlaxoSmithKline

Front

used for individuals who require both Hep A and B vaccine

Back

Rubella

Front

togavirus, transmitted via resp route and communicable from 7 days before until 5-7 days after rash onset sx: maculopapular rash for 2 weeks, arthralgia, arthritis

Back

Hep B vaccine dosing

Front

1st- after birth before discharge 2nd- 1-2 mths after 3rd- 6mths age start series ASAP for infants who did not initially receive, if infant falls behind schedule 2nd dose given after 4 wks, 3rd dose 2 mths after 2nd and at least 4mths after 1st --> 3rd dose should not be administered before 24 wks of age

Back

9vHPV counseling key points

Front

does not replace the need for routine cervical cancer screening, sexually active pts be educated on protection

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MMR dosing

Front

1st dose - 12-15 mths, 2nd dose - 4-6 yrs 12 mths <18 yrs should have 2 doses of MMR, if no documentation: administer 2 doses of MMR 4 wks apart adults born in 1957 or later: 1 dose MMR or lab evidence for immunity --> second dose rec for pts who have been exposed, are students, work in healthcare, plan to travel internationally

Back

Mumps complications

Front

aseptic meningitis, orchitis (inflammation of the testicles) in postpubertal males, and permanent deafness

Back

Hep B dosing

Front

at birth, 1-2 mths, 6-18 mths older pts: 0, 1, 6 mths

Back

Hep A symptoms

Front

fever, n/v, liver inflammation, jaundice, dark urine lasts 1-2 mths, can persist up to 6 mths complications = liver failure, death

Back

Measles (onset, transmission, symptoms)

Front

paramyxovirus, spread via resp transmission, communicable from 4 days before onset until 4 days after rash onset sx: fever, cough, coryza (runny nose), conjunctivitis, Koplik spots, maculopapular rash lasting 14 days

Back

Hep A storage and administration

Front

fridge, shake before given children/adolescents <18: 0.5mL IM adults >19: 1mL IM

Back

9vHPV contraindications

Front

severe allergic reaction to a previous vaccine dose or to a vaccine component, pregnant women should not be vaccinated

Back

MMR contraindications

Front

hx of hypersensitivity to prior dose/vaccine component, anaphylaxis to neomycin or gelatin, pregnant women, caution to persons w severe egg allergy, immunosuppression

Back

HPV4 (Gardasil-Merck)

Front

1st HPV vaccine, inactivated, recombinant quadrivalent prepared from highly purified virus-like particles of HPV types 6,11,16,18 NO LONGER AVAILABLE

Back

MMR dosing if immune?

Front

adults born before 1957 are immune to measles and mumps HCP must get MMR if born before 1957 and no evidence of immunity (2 doses separated by 28 days if no immunity to MM, 1 dose if no immunity to rubella)

Back

Mumps

Front

paramyxovirus, spread via resp route, communicable 3 days before onset until 4 days after sx: some asymptomatic, some have headache, fever, myalgia, malaise, parotitis (30-40%)

Back

MMR 2- Merck

Front

live virus vaccine, protects 95% after single dose --> second dose (99% protected)

Back

Human Papillomavirus

Front

most common STI in US, half in 15-24 yrs; sexual activity at an early age w/ multiple partners, nearly 100 HPV types (40 infect genital mucosa, 16 considered high risk carcinogens)

Back

Congenital Rubella Syndrome

Front

if pregnant woman is infected with rubella, fetus can become infected leading to spontaneous abortion, fetal death, premature delivery complications: deafness, cataracts, heart defects, mental retardation

Back

When is catch-up vaccination recommended?

Front

up until 26 yrs, vaccine can be given as early as 9 yrs at HCP discretion if series has been interrupted, it does not need to be restarted

Back

MMR storage and administration

Front

protect from light, keep in refrigeration or in freezer as cold as -50C diluent should not be frozen 0.5mL SC immediately after reconstitution

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9vHPV (Gardasil 9)

Front

provides protection against four HPV types included in HPV4 + HPV 31,33,45,52,58

Back

A dose of 9vHPV was given to a pt at 14, the pt is now 16... what should the pt receive?

Front

1 more dose of 9vHPV

Back

Adolescents w/out Hep B documentation

Front

1. 3 dose series (0,1,6 mths) of Engerix-B or Recombivax HB (5ug/mL) 2. adult Recombivax HB (10ug/mL) in 2 dose series for 11-15 yrs --> initial at 11-12, second dose 4-6mths after

Back

Havrix-GlaxoSmithKline and Vaqta-Merck

Front

both inactivated vaccines for Hep A pediatric formulation- 12mths-18yrs adult- >18yrs

Back

Target groups for 9vHPV

Front

girls and women 9-26 for prevention of cervical vulvar, vagina, and anal cancers, precancerous or dysplastic lesions, genital warts boys and men 9-26 for prevention of anal cancer, precancerous, dysplastic lesions, genital warts

Back

When to measure anti-HBs antigen antibody titers?

Front

after the third dose to determine whether the person has seroconverted infants born to positive mothers should be tested 3-12 mths after last dose

Back

Third dose of MMR criteria

Front

must have 2 high dose MMR coverage, intense exposure setting (college campus), and high attack rate

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HPV2 (Cervarix-GlaxoSmithKline)

Front

licensed for use in women in 2009; inactivated, recombinant bivalent vaccine that contains virus-like particles from HPV types 16 and 18 NO LONGER AVAILABLE

Back

ACIP 9vHPV dosing

Front

boys and girls aged 11-12 with 2 dose series of 9vHPV vaccine (0 and 6-12 months) if pts do not receive vaccine before 15 yrs, receive 3 dose series (0, 1-2 months, 6 mths) immunocompromised males/homosexual: 3 dose series regardless of age A series that was initiated with HPV2 or HPV4 may be completed with 9vHPV --> no guidelines

Back

Recombivax HB-Merck and EngerixB-GlaxoSmithKline

Front

both inactivated containing HBsAg (antigen on outer viral coat) Both of these vaccines reduce the risk of disease by 80% to 100% after 3 doses

Back

What do infants born to positive mothers for HBsAg need?

Front

hepatitis B vaccine and hepatitis B immune globulin (HBIG) promptly at birth, ideally within 12 hours of birth

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MMR ADRs

Front

fever, rash, arthralgia, arthritis parotitis and deafness, encephalopathy, thrombocytopenia (rare)

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