Vaccines and Screenings

What is the best way to reconcile polypharmacy?

The best way to reconcile polypharmacy is through regular medication reviews to evaluate the necessity and effectiveness of each drug; have the patient bring in their medications

In screening for diabetes, how often is blood pressure and A1C checked?

Blood pressure should be checked at every visit, while A1C is typically checked every 3 months for patients with diabetes and at least twice a year for those without diabetes.

If someone is actively infectious and HIV is suspected, what HIV test is taken?

An HIV RNA test (viral load test) is taken to detect the virus directly.

In a pregnant patient with an unknown immunization history, what vaccines can and should be given?

In a pregnant patient with an unknown immunization history, the Tdap and inactive influenza vaccines can and should be given to protect both the mother and the baby.

In a cut, when should tetanus Ig also be administered with Tdap?

Tetanus Ig should be administered with Tdap if the patient has a dirty or contaminated wound and has not received a tetanus booster in the last 5 years.

When should shingles vaccine be received?

The shingles vaccine should be received by adults aged 50 and older, and it is recommended even if they have had a previous shingles infection or received the earlier zoster vaccine.

When should pneumococcal polysaccharide vaccine be given?

The pneumococcal polysaccharide vaccine should be given to adults aged 50 and older, provided that they received the pneumococcal conjugate vaccine at least one year prior or have certain underlying health conditions.

In patients with chronic hepatitis C, what vaccine should they get to avoid liver failure?

The hepatitis A and B vaccines should be administered to patients with chronic hepatitis C to reduce the risk of liver failure.

For a patient who did not develop antibodies to the 3 series of hepatitis B vaccine and gets a needle stick injury from someone who is hepatitis B positive, what should be given for them?

They should receive hepatitis B immune globulin (HBIG) and the 3 series of the hepatitis B vaccine as soon as possible after the exposure.

In premature infants, what routine vaccines should be delayed until the infant makes weight?

Routine vaccines such as the measles, mumps, rubella (MMR), varicella, and hepatitis B vaccines should be delayed until the premature infant reaches a certain weight, typically around 2 kg (4.4 lbs), to ensure adequate immune response.

What vaccines should pregnant patients receive?

Pregnant patients should receive the Tdap and influenza vaccines to protect both the mother and the baby from preventable diseases.

What kind of vaccine is the meningitis vaccine?

The meningitis vaccine is a conjugate polysaccharide vaccine that protects against Neisseria meningitidis, a bacterium that can cause meningitis and other serious infections.

Which routine vaccine should be given to HIV patients with unknown vaccination history?

The hepatitis B vaccine and MMR vaccine should be given to HIV patients with unknown vaccination history

In a patient who is immunocompetent and underwent splenectomy, when should the vaccines for encapsulated bacteria be administered?

Vaccines for encapsulated bacteria should be administered at least 2 weeks after splenectomy and antibiotic prophylaxis for 1 year

In an HIV patient with CD4 below 200, what vaccines should they get?

They should receive the pneumococcal vaccine, hepatitis A and B vaccine, and the influenza vaccine.

When is the HIV1/HIV2 immunoassay done?

In someone with a positive HIV test

When is it best to get the IGRA TB test over the TST test?

The IGRA TB test is preferred when a patient has a history of prior BCG vaccination, is unable to return for TST reading, or has certain medical conditions that may affect the TST result.

When screening for asymptomatic bacteriuria becomes positive, what are the antibiotics used?

Amoxicillin/clavulanate, nitrofurantoin, or fosfomycin.

What is the test for asymptomatic hematuria after urinalysis?

CT urography, cystoscopy, or ultrasound.

What are screening tests for Down syndrome during pregnancy?

Screening tests for Down syndrome during pregnancy include non-invasive prenatal testing (NIPT), first-trimester screening (combined ultrasound and blood tests), and second-trimester screening (quad screen). These tests assess the risk of the fetus having Down syndrome and other chromosomal conditions.

What screening test is best after 15 weeks gestation for Down syndrome?

Amniocentesis

What condition is PCOS most associated with?

Metabolic syndrome; all PCOS patients should be screened for dyslipidemia

When symptoms of ulcerative colitis are diagnosed, when should screening colonoscopy begin?

Screening colonoscopy should begin 8 years after the diagnosis of ulcerative colitis. Regular screenings are essential to monitor for colorectal cancer risk.

In patients with cirrhosis, how often should screening be done?

Screening for hepatocellular carcinoma should be performed every 6 months using ultrasound and alpha-fetoprotein testing.

When should lipid screening be done?

Lipid screening should be performed at least once in all adults aged 40 to 75 years and may be done earlier or more frequently based on individual risk factors for cardiovascular disease. In patients without significant risk factors for ASCVD, screening is done every 4 to 6 years

When does lung cancer screening begin?

Lung cancer screening should begin at age 50 for individuals with a history of heavy smoking or other risk factors, with annual low-dose CT scans recommended if they smoked for 20 pack-years or more and quit less than 15 years ago.

When should tetanus boosters be administered?

Every 10 years

When should pneumococcal vaccines be administered?

Pneumococcal vaccines should be administered to adults aged 65 and older, and also to younger adults with specific health conditions, such as chronic diseases or weakened immune systems

What specific health conditions warrant early pneumococcal vaccination?

Chronic diseases like diabetes, heart disease, liver disease, or weakened immune systems due to cancer treatment, organ transplants, or HIV.