Perhaps
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A healthy 55-year-old man comes for an initial health maintenance examination. His last visit to a physician was over 10 years ago. He does not smoke and drinks only on social occasions. Examination shows no abnormalities. Which of the following immunizations should be administered?
A) Hepatitis A vaccine
B) Influenza virus vaccine
C) Measles-mumps-rubella vaccine
D) Pneumococcal vaccine
E) Diphtheria-tetanus toxoid
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| shumaila
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E
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| humbty
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I would say B and E are recommended but E is more urgent and we dont know if its influenza vaccine season so E
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| GDS2008
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E. DT toxoid seems likely. (On a different note, Influenza vaccine si recommended to all healthy individuals >/= 55 years)
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| humbty
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In Harrisons it is >50years for influenza
And I think I also read that in UW but not sure.
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| HighHopes
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over 50 -> Influenza vaccine as far as I remember
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| achilles
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i'll go for E-dt vaccine.
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| usmle262005
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influenza vaccine
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| GDS2008
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can someone point out the indications for influenza vaccine??
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| achilles
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influenza vaccine is indicated in-
1) adults and children with debilitating cardiopulmonary disease or other chronic conditions(renal,hemoglobinopathies, or on immunosuppressive drugs)
2) residents of nursing home and other chronic care facilities
3)healthy adults >50yrs of age
4)pregnant women who will be in influenza season in their 2nd or 3rd trimester.
i choose tetanus vaccine as according to the information given in the question, both influenza and tetanus are indicated but the question specifically mentions that the pt has not seen a doc for 10 yrs, which is time needed before we give the booster dose for tetanus. i was also confused between influenza and tetanus. but as the question specifically gives information about the pt not having seen in last 10 yrs, i choose E
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" it's not whether you get knocked down, it's whether you get up"
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| Perhaps
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Thanks everyone.
I agree with Td also
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| frank100
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E is a nice bet
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| webjeee
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I think its Influenza virus vaccine
more chance to get it
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| usmle12
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well there ar 2 conflicting sources..
i read in usme world its more than 65 in kaplan its more than 50 years....but stilll i dont know its influenza seson so td would be my optin...
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| ram3
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Its influenza vaccine
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| prathapdoctor
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its confusing, but i would go for influenza vaccine.
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| young_doc
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The answer is E.
Tetanus is MUCH more severe in a 55 year old healthy male, than Influenza. So if your patient hasn't seen a Dr in 10 years, give him Tetanus vaccine.
And in fact, Influenza is CURRENTLY indicated in those >65 years (it's only "recommended" in those >50):
Indications for influenza vaccine
- Persons older than 65 years (and recommended for those aged 50-64 y)
- Residents of nursing homes and other long-term–care facilities
- Patients with chronic pulmonary (eg, asthma) or cardiac disorders
- Patients with chronic metabolic disease (eg, diabetes), renal dysfunction, hemoglobinopathies, or immunosuppression
- Children and teenagers with long-term use of aspirin
- Pregnant women who will be in their second or third trimester during influenza season
- Physicians, nurses, and other health care providers
- Employees of nursing homes and long-term care facilities
- Providers of home care to persons at high risk
- Household members (eg, children) of persons at high risk
- Providers of essential community services (eg, police, fire)
- International travelers
- Students and dormitory residents
- Anyone wishing to reduce risk of influenza
http://209.85.165.104/search?q=cache:KzVn2GkOgvsJ...
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| doc_clotaire
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E would be my best bet too
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| prathapdoctor
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young doc, thanks for your update
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| krsna
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E
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