Vaccines — Prometric Style Questions, Set 2

What this deck covers

Vaccines – Prometric Style Questions, Set 2 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. What the fridge log should read
2. Frozen, or only cold
3. Two doses left in the vial
4. A square darker than its circle
5. Switched off at the wall
6. Old enough for a new site
7. Which one, and at what angle
8. Pulling back on the plunger
9. Plenty of room, wrong place
10. Two into one arm
11. Swallowed, not injected
12. One weak leg, four weeks on
13. Coverage fell, then paralysis
14. Three components, then two
15. Confident it is not polio
16. How many injections in all
17. A vaccine for his son
18. Vaccinated, and invited anyway
19. Back too soon for the second
20. Rising, and not genital
21. His first ever flu season
22. Wheezing on the day, on steroids
23. Hives after scrambled egg
24. Why not once, like measles
25. Two months old, in flu season
26. Sixteen weeks, nothing given
27. The only one with a deadline
28. An air enema at three months
29. Most of it came back out
30. The drops were meant to stop this
31. Her sister had it at the end
32. Waiting for the first birthday
33. Vaccinated, then a positive test
34. No antibody on her booking bloods
35. Exposed before he was born
36. What the border will ask for
37. Two products, one campaign
38. Protected against all of it
39. Six days before the flight
40. Before the first infusion
41. A red arm and a blank form
42. Fever the same afternoon
43. Four abscesses, one session
44. Three days after the visit
45. Twelve reports after a campaign
46. What she read about autism
47. A preservative he read about
48. How much will he get
49. Too many at one visit
50. A gathering to catch it

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Plus two to plus eight degrees, Heat exposure beyond the limit, A 25 mm needle at ninety degrees, At least 2.5 cm apart, Circulating vaccine-derived poliovirus, Two doses, Repeat that dose after the proper interval, The inactivated injected vaccine, He is too young, so vaccinate the household, It is omitted permanently, Between about sixteen and thirty-two weeks, Give the measles, mumps and rubella vaccine now, It reduces carriage in the throat, Meningococcal vaccination and daily antibiotics.

Clinical pearls from this deck

• Colder is not safer. The commonest cold chain failure in a well-run clinic is freezing, not overheating, and the vial looks perfect afterwards.
• A frozen adsorbed vaccine looks perfect and works badly. Shake it against a deliberately frozen vial and the flakes settle out in front of you.
• Write the time on the vial the moment you add the diluent. Nothing about a reconstituted vaccine tells you by eye that it has expired.
• The vial monitor sees every hot hour since the factory; the fridge thermometer sees only the last one. Neither of them sees freezing.
• Do not throw it away and do not give it. Label it, keep it cold, and ring somebody with the maximum and minimum readings in your hand.
• Under a year, thigh. Over a year, deltoid if the muscle is there. The rule is about how much muscle exists, not about the birthday.

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.