Deck 19: Drugs Affecting the Immune System

Question 1

If the measles, mumps, rubella, and varicella (MMRV) combined vaccine is ordered to be given as the first MMR and varicella dose to a child the CDC recommends:

A) Parents be informed of the increased risk of fever and febrile seizures over the MMR plus varicella two-shot regimen.
B) Patients must also receive MMRV as the second dose of MMR and varicella in order to build adequate immunity.
C) Patients be premedicated with acetaminophen 15 minutes before the vaccine is given.
D) Patients should not be around pregnant women for the first 48 hours after the vaccine is given.

Answer 1

Patients should not be around pregnant women for the first 48 hours after the vaccine is given.

Question 2

Rh_o(D) immune globulin (RhoGAM) is given to:

A) Infants born to women who are Rh positive
B) Sexual partners of Rh-positive women
C) Rh-negative women after a birth, miscarriage, or abortion
D) Rh-negative women at 36 weeks gestation

Answer 2

Rh-negative women after a birth, miscarriage, or abortion

Question 3

Hepatitis B vaccine is contraindicated in patients who:

A) Were born after less than 32 weeks gestation (give first dose at age 6 months)
B) Are pregnant
C) Are on hemodialysis
D) Are allergic to yeast

Answer 3

Are allergic to yeast

Question 4

Diane may benefit from cyclosporine (Sandimmune). Cyclosporin may be prescribed to:

A) Treat rheumatoid arthritis
B) Treat patients with corn allergy
C) Pregnant patients
D) Treat patients with liver dysfunction

Question 5

Pregnant women should receive the Tdap vaccine:

A) In the first trimester
B) Once every 10 years
C) In the third trimester of every pregnancy
D) Tdap is contraindicated in pregnancy

Question 6

Tuberculin purified protein derivative:

A) Is administered to patients who are known tuberculin-positive reactors
B) May be administered to patients who are on immunosuppressives
C) May be administered 2 to 3 weeks after an MMR or varicella vaccine
D) May be administered the same day as the MMR and/or varicella vaccine

Question 7

True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:

A) Fever up to 104^oF (40.5^oC) after previous DTaP vaccine
B) Family history of seizures after DTaP vaccine
C) Adolescent pregnancy
D) Anaphylactic reaction with a previous dose

Question 8

The MMR vaccine is not recommended for pregnant women because:

A) Pregnant women do not build adequate immunity to the vaccine.
B) There is a risk of the pregnant women developing measles encephalopathy.
C) There is a risk of the fetus developing congenital rubella syndrome.
D) Pregnant women can receive the MMR vaccine.

Question 9

Human papillomavirus (HPV) vaccine (Gardasil, Cervarix):

A) Is a live virus vaccine that provides immunity to six strains of HPV virus
B) Has a common adverse effect of syncope within 15 minutes of giving the vaccine
C) Should not be given to males younger than age 12 years
D) May be given to pregnant women

Question 10

The reason that two MMR vaccines at least a month apart are recommended is:

A) The second dose of MMR "boosts" the immunity built from the first dose.
B) Two vaccines 1 month apart is the standard dosing for all live virus vaccines.
C) If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine.
D) Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR.

Question 11

The rotavirus vaccine (RotaTeq, Rotarix):

A) Is a live vaccine that replicates in the small intestine, providing active immunity against rotavirus
B) Should not be administered to infants who are or may be potentially immunocompromised
C) Is not given to an infant who has a febrile illness (temperature greater than 100.5^oF)
D) All of the above

Question 12

Zoster vaccine (Zostavax) is:

A) A live varicella zoster vaccine from the same strain used to develop the varicella vaccine
B) Effective in preventing varicella zoster in patients of all ages
C) Recommended for patients age 40 to 80 who have had chickenpox
D) Administered at the same time as other live vaccines, as long as they are given the same day

Question 13

Immune globulin serums:

A) Provide active immunity against infectious diseases
B) Are contraindicated during pregnancy
C) Are heated to above body temperature to kill most hepatitis, HIV, and other viruses such as parvovirus
D) Are derived from pooled plasma of adults and contain specific antibodies in proportion to the donor population

Question 14

Children who should receive meningococcal conjugate vaccine (Hib-MenCY, MenHibrix) include:

A) Children traveling to the Haj
B) Infants, routinely at 2, 4, 6, and 12 to 15 months
C) Infants with functional asplenia (including sickle cell disease)
D) Two year olds with complement deficiencies

Question 15

Varicella vaccine is recommended to be given to patients who are:

A) HIV positive with a CD4+ T-lymphocyte percentage less than 15%
B) Taking corticosteroids (up to 2 mg/kg/day or less than 20 mg/day)
C) Pregnant
D) Immunocompromised

Question 16

Hepatitis B immune globulin is administered to provide passive immunity to:

A) Infants born to HBsAg-positive mothers
B) Household contacts of hepatitis-B virus infected people
C) Persons exposed to blood containing hepatitis B virus
D) All of the above

Question 17

Live attenuated influenza vaccine (FluMist) may be administered to:

A) All patients over 6 months of age
B) Patients between ages 2 and 49 with no risk factors
C) Patients with an upper respiratory infection (URI) or asthma
D) Pregnant women

Question 18

Attenuated vaccines are also known as:

A) Killed vaccines
B) Booster vaccines
C) Inactivated vaccines
D) Live vaccines

Question 19

Azathioprine has significant adverse drug effects, including:

A) Hypertension
B) Hirsutism
C) Risk of cancer
D) Gingival hyperplasia

Question 20

Influenza vaccine may be administered annually to:

A) Patients with an egg allergy
B) Pregnant patients
C) Patients age 6 weeks or older
D) Patients with acute febrile illness