© I.M.Quizitor Pediatrics Date

SINGLE Quizitor Measles, Mumps, Rubella, & Varicella Hepatitis A Meningococcal Human Papillomavirus General Questions & Pain Management 100 100 100 100 100 200 200 200 200 200 300 300 300 300 300 400 400 400 400 400 500 500 500 500 500

The two doses each of MMR and varicella vaccine are recommended routinely at which ages? Topic I 100 Question

12-15 months and 4-6 years Note: Children who will travel outside of the US follow a different MMR schedule: 1) Infants 6-11 months old receive 1 dose prior to departure then 2 more doses: the 1st at 12-15 months and the 2nd at least 4 weeks later. (The dose given <12 months does not count toward completion of the series because lingering maternal antibodies could inactivate this live virus vaccine.) 2) Children 12 months and older should receive 2 doses prior to departure: the 1st at 12-15 months and the 2nd at least 4 weeks later. Go To Single Quizitor Topic I 100 Answer

The second doses of MMR and varicella vaccine may be administered prior to 4-6 years, provided at least how much time has elapsed since the first dose? Topic I 200 Question

The minimum interval between doses of MMR is 4 weeks The minimum interval between doses of MMR is 4 weeks. For varicella vaccine, it is 3 months for children 12 months to 12 years (if the second dose was administered at least 4 weeks after the first dose, it can be accepted as valid); for persons aged 13 years and older, the minimum interval between doses is 4 weeks. Go To Single Quizitor Topic I 200 Answer

Combination MMRV vaccine (ProQuad) is not recommended in which situations due to increased risk of febrile seizure? Topic I 300 Question

1). First dose (if given at age 12-47 1) First dose (if given at age 12-47 months), unless parents express a preference for MMRV 2) Personal or family history of seizures      Go To Single Quizitor Topic I 300 Answer

A 10 year old received one dose of varicella vaccine at age 1 year A 10 year old received one dose of varicella vaccine at age 1 year. Should this child receive additional varicella vaccine? Why or why not? Topic I 400 Question

All children should receive 2 doses of varicella vaccine All children should receive 2 doses of varicella vaccine. Older children who did not receive the 4-6 year dose should be given a “catch up” dose to prevent entering adulthood susceptible to varicella. (A single dose only protects 70-85%.) Go To Single Quizitor Topic I 400 Answer

A 13-year-old has no history of chickenpox or varicella vaccination A 13-year-old has no history of chickenpox or varicella vaccination. How many varicella vaccine doses does she need and when? Topic I 500 Question

2 doses 4 weeks apart (the interval is 4 weeks between doses starting at 13 years) Go To Single Quizitor Topic I 500 Answer

At what age should the initial dose of Hepatitis A vaccine be given routinely? Topic II 100 Question

12-23 months Go To Single Quizitor Topic II 100 Answer

How many doses of Hepatitis A vaccine are recommended? Topic II 200 Question

2 doses Go To Single Quizitor Topic II 200 Answer

What is the minimum interval between Hepatitis A vaccine doses? Topic II 300 Question

6 months Go To Single Quizitor Topic II 300 Answer

True or False? Household contacts (including babysitters) of children adopted from countries with endemic Hepatitis A should be immunized 2 or more weeks before arrival of the adoptee. Topic II 400 Question

True Go To Single Quizitor Topic II 400 Answer

Hepatitis A vaccine is recommended for post-exposure prophylaxis to incompletely vaccinated children if exposed to Hepatitis A within what time frame? Topic II 500 Question

The past 2 weeks Go To Single Quizitor Topic II 500 Answer

Which two quadrivalent meningococcal vaccines are recommended for routine use in the US and against which serogroups do they protect? Topic III 100 Question

1). Menactra (MCV4-D) 2). Menveo (MCV4-CRM) 1) Menactra (MCV4-D) 2) Menveo (MCV4-CRM) Both protect against serogroups A, C, Y, and W135 Go To Single Quizitor Topic III 100 Answer

At which ages should one of the quadrivalent meningococcal conjugate vaccines (MCV4) be given routinely to healthy adolescents? Topic III 200 Question

1). All teens 11-18 years: give 1st dose at 11-12 1) All teens 11-18 years: give 1st dose at 11-12 years and a booster at 16 years. 2) College entry (if age 19-21 years and not previously immunized); previously unvaccinated older adolescents and college students may also elect to receive the vaccine. Note: Teens 11-18 years old with HIV infection should receive a 2-dose primary series of MCV4 (with at least 8 weeks between doses). Go To Single Quizitor Topic III 200 Answer

To protect teens during the peak meningococcal disease risk (16-21 years), when should you give an MCV booster to patients who did not receive their first dose at 11-12 years? What are the risk factors for meningococcal disease in this age group? Topic III 300 Question

If first dose given at 13-15 years, booster at 16-18 years. If first dose given at 16 years or older, no booster. Give booster at college entry if age <22 years and more than 5 years since first dose; consider booster for existing college students who meet same criteria. Risk factors for meningococcal disease: crowded living conditions, exposure to smoking (active/passive), URIs. Accordingly, college freshmen living in dorms and military recruits are at increased risk. Go To Single Quizitor Topic III 300 Answer

Which new meningococcal vaccines were approved to protect against serogroup B (MenB) and for which age groups? Topic III 400 Question

Go To Single Quizitor Topic III 400 Answer Bexsero (2-dose series, at least 4 weeks apart) and Trumenba (3-dose series at 0, 2, 6 months). The CDC recommends completion of one series (do not mix MenB products) for high risk individuals ages 10 years or older. High risk is defined as children with: Persistent complement component deficiencies Anatomic or functional asplenia, or At increased risk because of a serogroup B meningococcal disease outbreak Given recent outbreaks of MenB on college campuses, the CDC also gave a “permissive” recommendation: MenB may be given, based on individual decision-making, to adolescents and young adults 16-23 years, preferentially 16-18 years. This recommendation allows for coverage by VFC and most insurance companies. Go To Single Quizitor Topic III 400 Answer

Which children should receive meningoccal vaccine before the standard age of 11 years? Topic III 500 Question

Go To Single Quizitor Topic III 500 Answer Infants and children with high-risk conditions: anatomic or functional asplenia (including sickle cell disease), and persistent complement component deficiency. (NOTE: These children should receive a meningococcal conjugate vaccine (Menveo, MenHibrix, or Menactra) series as infants/toddlers and MenB vaccine series starting at age 10 years.) Children who travel to countries in which meningococcal disease is hyperendemic or epidemic, including the sub- Saharan “meningitis belt” or the Hajj. (NOTE: These children should receive either Menactra or Menveo as MenHibrix (Hib-MenCY) does not protect against serogroups A or W.) See Footnote 11 for number and timing of doses. Go To Single Quizitor Topic III 500 Answer

Which HPV vaccines are licensed in the US and for which ages and genders? Topic IV 100 Question

Gardasil, quadrivalent vaccine (4vHPV4) for females and males 9-26 years (No longer covered by VFC) Gardasil 9, 9-valent vaccine (9vHPV) for females and males 9-26 years Cervarix, bivalent vaccine (2vHPV) for females 9- 25 years (No longer covered by VFC) NOTE: The HPV vaccine schedule may change in 2016 or 2017. To review the most recent recommendations, please refer to the CDC website: http://www.cdc.gov/vaccines/hcp/acip-recs/ Go To Single Quizitor Topic IV 100 Answer

Which conditions do these HPV vaccines prevent if administered prior to exposure? Topic IV 200 Question

1) Gardisil (4vHPV4 and 9vHPV) prevents cervical, vaginal, vulvar, and anal cancers and precancerous lesions and genital warts in females, and anal cancer and cancerous lesions and genital warts in males. In addition, although there are no data on the efficacy of HPV vaccine to prevent oropharyngeal and penile cancers, most of these HPV-associated cancers are caused by the HPV types prevented by the vaccines. 2) Cervarix (HPV2) prevents cervical cancers and precancers in females. Go To Single Quizitor Topic IV 200 Answer

How many doses of HPV vaccine are recommended and at what ages and intervals? Topic IV 300 Question

3 doses: 1st dose given at 11-12 years 2nd dose: 1-2 months after 1st dose 3rd dose: 6 months after 1st dose (and at least 12 weeks after the 2nd) Go To Single Quizitor Topic IV 300 Answer

Which children should start the HPV vaccine series before age 11 years Which age should they begin? Topic IV 400 Question

Administer HPV vaccine beginning at age 9 years to children with any history of sexual abuse or assault. Go To Single Quizitor Topic IV 400 Answer

True or False? Females who complete the 3-dose series of Gardasil as recommended do not need routine cervical cancer screening. Topic IV 500 Question

False HPV vaccination does not substitute for routine cervical cancer screening. All women aged 21-65 should continue to undergo cervical cancer screening per standard of care. Go To Single Quizitor Topic IV 500 Answer

True or False? The timing of immunizations for premature infants should be corrected for gestational age. Topic V 100 Question

False. Premature infants should be immunized according to their post-natal (chronological) age. Exception: Hep B vaccine for preterm infants weighing <2000 gm. Go To Single Quizitor Topic V 100 Answer

True or False? Children who are behind on vaccines (time elapsed between vaccines exceed the recommended intervals) must restart the series. Topic V 200 Question

False. Never restart the series. Continue the series from the last administered dose (unless the child is now too old to receive the vaccine (e.g., Rotavirus vaccine for infants older than 8 months or Hib vaccine for low-risk children older than 60 months). Go To Single Quizitor Topic V 200 Answer

True or False? CDC immunization guidelines state that children should be given all vaccines for which they are eligible at the time that they are seen, regardless of the number of injections Topic V 300 Question

There is no maximum number of injections. True. There is no maximum number of injections. Go To Single Quizitor Topic V 300 Answer

True or False? The AAP recommends routine preemptive administration of acetaminophen for managing injection pain. Topic V 400 Question

False. Two large controlled trials showed that infants who received acetaminophen following immunization had significant lower antibody geometric mean concentration compared to infants who did not receive acetaminophen. (See Reference by Prymula et al.) Go To Single Quizitor Topic V 400 Answer

children (4 years and older)? What are the components of effective pain management for immunization injections for: infants children (4 years and older)? Topic V 500 Question

See PCC policies in “Resources” section Infants: Combined oral sucrose, breastfeeding/sucking on bottle or pacifier, and parent holding; Children: Combined topical vapocoolant spray (Pain Ease) and distraction with a party blower or pinwheel. See PCC policies in “Resources” section Go To Single Quizitor Topic V 500 Answer