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Absolute contraindications for hormone replacement
therapy - ANSWER-
Estrogen-dependent malignancies, unexplained uterine
bleeding, hx of
VTE/CVA, CAD, active
liver dz.
Genitourinary Syndrome - ANSWER-Vulvar/vaginal atrophy.
Topical estrogen therapy (ET) - ANSWER-Reverses vaginal
atrophy, enhances
blood flow, and
reduces UTI.
Ospemifene 60mg PO qd - ANSWER-SERM for
moderate to severe
dyspareunia.
,Estrogen alone - ANSWER-Determined by hx of
hysterectomy - if no uterus
they do not need progesterone to offset effects
of estrogen.
Vaccinations - ANSWER-Should not be delayed due to minor
illnesses, even if
they illicit low-grade fever. However, for moderate to
severe infections,
vaccinations could be
postponed.
Premature infants immunization schedule - ANSWER-Should
follow a schedule
for immunizations based on their chronological age, not their
gestational age.
Vaccine dose adjustment for premature or low-birthweight
patients - ANSWER-
Vaccine doses should not be adjusted (reduced) for
these patients.
Chronic diseases and vaccinations - ANSWER-Chronic
diseases are not outright contra-indications; however,
,vaccination with DTaP should be deferred until the neurologic
condition has been clarified and/or is stable.
Rotarix vaccine schedule - ANSWER-Doses should be given 28
days apart - for
infants, given at age 2 mo and 4 mo, completed
by 24 weeks.
Rotateq vaccine schedule - ANSWER-3 doses completed by 32
weeks of age.
Immunodeficient children and live-virus vaccines -
ANSWER-Should not be
given live-virus
vaccines.
Examples of live-virus vaccines - ANSWER-Oral polio vaccine
[OPV, not available in the United States], Rotavirus, MMR, VAR,
MMRV, yellow fever, LAIV (live attenuated), Live-bacteria
vaccines (BCG or live typhoid fever vaccine).
Live virus vaccine eligibility for children with malignancy -
ANSWER-If malignancy is in remission or chemo hasn't been
administered within 90 days they can receive live virus vaccine.
, Known allergies and vaccines - ANSWER-MMR, IPV,
and VAR contain
microgram quantities of neomycin, and IPV also contains
trace amounts of
streptomycin and polymyxin B; children with known
anaphylactic responses to
these antibiotics should not be given
these vaccines.
Egg antigens in vaccines - ANSWER-Trace quantities of egg
antigens may be
present in both inactivated and live influenza and yellow
fever vaccines.
Influenza vaccination guidelines for children with egg allergies
– ANSWER-Guidelines for influenza vaccination in children with
egg allergies have recently changed.
Hormonal contraceptives - ANSWER-Affect ovulation (via
altering production of
LH and FSH) and endometrial lining as well as
cervical mucus.
Implants (IUD) - ANSWER-Will need to have pelvic exam, for
insertion.