Vaccines Prometric Style Questions – 50 Cases with Answers

What this deck covers

Vaccines — Prometric Style Questions, Set 1 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. A course that was interrupted
2. Timing for a very early baby
3. A child with no paperwork
4. After a blood product
5. How many jabs at once
6. Steroids on the day
7. Allergy to egg
8. A snuffly baby on the day
9. Fits that run in the family
10. A collapse after a jab
11. A pregnant mother in the room
12. Feeding and immunisation
13. A brother on treatment
14. Restarting after treatment
15. Which ones are alive
16. Living with the virus
17. A cousin who cannot fight infection
18. Played with an infected cousin
19. Born to a carrier mother
20. A dirty wound in the farmyard
21. Chickenpox in the classroom
22. Bitten by a stray abroad
23. Collapse in the chair
24. Rash a week after the jab
25. Screaming after the oral drops
26. A whole leg gone red
27. Swelling and stridor after a jab
28. Why sugar needs a protein
29. An outbreak in a vaccinated school
30. A fridge that went too cold
31. Why so many doses
32. Before the spleen comes out
33. Extra protection in chronic lung disease
34. Penicillin every day
35. A child with a shunt
36. Going abroad in three weeks
37. A newborn in a high-risk family
38. A vaccination site that would not heal
39. An oozing spot after BCG
40. No scar and no records
41. What the liver vaccine prevents
42. No antibody afterwards
43. A needle found in the park
44. A parent who says no
45. A teenager asking alone
46. A change of heart at five
47. Why so young for this one
48. Recording a refusal
49. Protecting the baby before birth
50. Bruising a month later

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Restart the whole primary course from the first dose, Give a double dose to overcome the antibody, Yellow fever vaccine, All future vaccines are permanently contraindicated, Measles, mumps and rubella vaccine, It is permanently contraindicated by the diagnosis, Hepatitis B vaccine alone at 8 weeks of age, Observe for symptoms over the next month, Gastro-oesophageal reflux, The conjugate contains a larger dose of antigen, Each dose builds a stronger, longer-lasting response, The penicillin treats the sickling itself, Nothing; BCG is no longer used, A test for tuberculosis infection.

Clinical pearls from this deck

• The rule is one sentence long and it answers a great many questions: never restart, only catch up.
• Chronological age for vaccines, corrected age for development. Mixing the two up leaves the frailest babies unprotected for months.
• No record means no vaccine, as far as the schedule is concerned. An extra dose costs a sore arm; a missed one can cost a life.
• Only the live ones care about a recent blood product. Ask whether the vaccine has to replicate, and the answer follows.
• Same day, or four weeks apart. There is no middle ground for two live injections, and the same day is always the better choice.
• Dose and duration, not the word steroid. Knowing the actual threshold prevents most unnecessary deferrals in clinic.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Vaccines case decks · pediatric reference values.