BCACP Infectious Disease and Immunization Management 1 — Questions and Answers
Question 1: Which vaccine is recommended annually for all adult patients in the ambulatory care setting regardless of age?
- Pneumococcal (PPSV23)
- Tdap
- Influenza (Correct answer)
- Zoster (Shingrix)
Correct answer: Influenza
The CDC recommends annual influenza vaccination for all persons aged 6 months and older, making it the most universally recommended adult vaccine.
Question 2: A 65-year-old immunocompetent patient with no prior pneumococcal vaccine history presents to clinic. Which pneumococcal vaccination sequence is recommended per current ACIP guidelines?
- PPSV23 only
- PCV15 followed by PPSV23 at least 1 year later, or PCV20 alone (Correct answer)
- PCV13 only
- Two doses of PPSV23 one year apart
Correct answer: PCV15 followed by PPSV23 at least 1 year later, or PCV20 alone
Current ACIP guidelines recommend either PCV15 + PPSV23 (≥1 year apart) or PCV20 alone for pneumococcal-naive adults aged ≥65.
Question 3: Which antibiotic class is considered first-line for uncomplicated community-acquired pneumonia (CAP) in an outpatient adult with no comorbidities?
- Fluoroquinolones
- Macrolides (e.g., azithromycin) (Correct answer)
- Beta-lactams
- Tetracyclines
Correct answer: Macrolides (e.g., azithromycin)
Macrolides are first-line for outpatient CAP in otherwise healthy adults without risk factors for drug-resistant S. pneumoniae.
Question 4: A patient is prescribed trimethoprim-sulfamethoxazole for a urinary tract infection. Which monitoring parameter is most important in a patient with chronic kidney disease?
- Liver function tests
- Serum creatinine and potassium (Correct answer)
- CBC only
- Blood glucose
Correct answer: Serum creatinine and potassium
TMP-SMX can increase serum creatinine (by blocking tubular secretion) and potassium, requiring close monitoring in CKD patients.
Question 5: What is the recommended post-exposure prophylaxis (PEP) window for HIV initiation after a high-risk exposure?
- Within 24 hours only
- Within 72 hours (Correct answer)
- Within 1 week
- Within 2 weeks
Correct answer: Within 72 hours
HIV PEP must be initiated within 72 hours of exposure and continued for 28 days to be effective.
Question 6: Which vaccine requires a 2-dose series given 2–6 months apart and is preferred over the older zoster vaccine for shingles prevention in adults ≥50?
- Zostavax (ZVL)
- Varivax
- Shingrix (RZV) (Correct answer)
- Proquad
Correct answer: Shingrix (RZV)
Shingrix (recombinant zoster vaccine) is preferred over Zostavax with >90% efficacy and a 2-dose schedule recommended for adults ≥50.
BCACP Infectious Disease and Immunization Management 1
Which vaccine is recommended annually for all adult patients in the ambulatory care setting regardless of age?