APhA Immunization Self-Study Evaluation
If a vial of influenza vaccine is left out of the refrigerator on the pharmacy counter overnight, what should be done with the vaccine? - ANSWER LO 5.4; Module 5— Vaccine Storage and Handling. If a vaccine has been exposed to temperatures outside the recommended range, the vaccine should be quarantined and stored in the refrigerator or freezer (as appropriate based on where the vaccine should usually be stored). In the case, the IIV should be placed back in the refrigerator. This quarantined vaccine should be clearly marked "do not use" and the manufacturer should be contacted for further guidance. Pharmacists should document each of these steps any time there is a break in the cold chain. The presence of fever, diffuse maculopapular rash, and Koplik spots are characteristic of which of the following diseases? - ANSWER Module 3—Measles, Mumps, Rubella. Measles The classic symptoms of measles include fever, cough, coryza (runny nose), conjunctivitis, Koplik spots (a bluish-white rash on mucous membranes, especially the mouth), followed by the development of a maculopapular rash approximately 14 days after exposure. Individuals infected with mumps may not have symptoms. Others may have nonspecific symptoms, such as headache, fever, myalgia, and malaise. About 30% to 40% of individuals may experience inflammation of the parotid glands. Rubella symptoms tend to be relatively mild and may present as a maculopapular rash that occurs approximately 14 days after exposure. Others may experience arthritis and arthralgia. Varicella presents as a generalized vesicular rash. What is the type of immunity that occurs when a pregnant woman is vaccinated with Tdap to protect the infant from pertussis after birth? - ANSWER LO2. 1; Module 2—Passive vs. Active Immunity Acquired immunity involves immunological memory. It is something the body develops upon exposure to pathogens or antigens and results in antigen-antibody complex formation. Cell-mediated immunity is a component of acquired immunity and destroys pathogens that have entered cells. Acquired immunity can be active or passive. Active immunity occurs when an antigen from an invading pathogen or a vaccine triggers the immune system to respond. Passive immunity happens when antibodies are provided from another source, such as or upon receipt of blood products or immunoglobulin when maternal antibodies are transferred to the fetus. This is the reason Tdap is given with every pregnancy—the maternal antibodies passed to the fetus protect the newborn from pertussis. Which of the following is recognized by sociologists as a factor in a patient's decision whether to be vaccinated? - ANSWER Module 4—Educating Patients About Vaccines. Sociologists have identified five key factors in a person's decision to be vaccinated: 1) perceived susceptibility to a disease, 2) perceived seriousness of a disease, 3) perceived vaccine benefits, 4) perceived vaccine barriers (e.g., adverse effects, access), and 5) social influence (e.g., recommendation from a health care provider) What is the most common complication of pertussis? - ANSWER Module 3 - Pertussis Pertussis, which is is caused by Bordetella pertussis, infects the respiratory tract and produces toxins that interfere with the function of the respiratory tract, ultimately causing the characteristic symptoms of pertussis. Symptoms begin as they would for the common cold but then transition to the paroxysmal (whooping) cough. Given the impact on the respiratory tract, pneumonia is the most common complication. Poor oxygenation during the coughing episodes can lead to hypoxemia and seizures, but these are less common. Colic is inconsolable crying, which has been attributed to abdominal pain. This is unrelated to pertussis. Which type of vaccine involves stimulation of B cells without the assistance of T helper cells? - ANSWER Module 2—Polysaccharide and Conjugated Vaccines A pure polysaccharide vaccine does not require T-helper cells to produce an immune response. It is mediated solely through B cells. As such, they are T cell-independent. The immune systems in children younger than 2 years of age are too immature to mount an immune response by this method. In addition, there is no booster effect and any immunity developed is relatively short-lived. When a polysaccharide vaccine is altered by adding a protein, it is considered conjugated. The immune response changes to one that is T cell-mediated. This mechanism allows children younger than 2 years of age to form an immune response. Conjugated vaccines provide longer-lasting protection. A recombinant vaccine is made by using recombinant DNA technology. Both live attenuated vaccines and recombinant vaccines mimic natural infection and involve T cells in the immune response. HZV should not be administered to a patient with a history of anaphylaxis to: - ANSWER LO 3.3; Module 3— Herpes Zoster, Contraindications and Precautions Gelatin can be found in the MMR vaccine, rabies vaccine, typhoid vaccine, varicella vaccine, yellow fever vaccine, herpes zoster vaccine (HZV), and any combination vaccines that include these. A patient with a severe allergy to gelatin would have a contraindication to receiving these vaccines. HZV also contains neomycin, but does not contain egg protein, latex, or tree nuts. A health care provider who has not been vaccinated against hepatitis B is stuck by a contaminated needle after administering an immunization to a hepatitis B-positive patient. In addition to hepatitis B vaccine, the health care provider also should receive hepatitis B Immunoglobulin (HBIG) as postexposure prophylaxis because the HBIG provides: - ANSWER LO 2.1; Module 2—Passive and Active Immunity Can Be Complementary Giving both the hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) allows for active and passive immunity. Active immunity occurs when the antigen from the vaccine triggers the immune system to respond. The vaccine will provide long-term protection but it takes the body about two weeks to develop immunity. Passive immunity happens when antibodies are provided from another source, such as immunoglobulin. Passive immunity is short-live, but it provides protection right away. Which of the following diseases are transmitted through mosquito bites? - ANSWER Module 3—Vaccines for International Travel Mosquito-borne infections for which vaccines are available include yellow fever and Japanese encephalitis. Typhoid fever is spread by Salmonella typhi in food and water. Hepatitis A is
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