| A |
DrVirgo, vibrio, nyimalay, CocaCola, drshvetasm, lq2006, Drtweetie, inkspot, kpmle2 |
9 |
64% |
| B |
|
0 |
0% |
| C |
khiladi, Jcala, Markus2009, peter90036, Justice |
5 |
36% |
| D |
|
0 |
0% |
| E |
|
0 |
0% |
| Author | 15 Posts |
Justice
Forum Fanatic
Topics: 101
Posts: 1,973
|
In January, a 56-year-old woman with chronic obstructive pulmonary disease and type 2 diabetes mellitus comes for a routine office visit. She is currently clinically stable and has no new or acute symptoms. An outbreak of influenza A is occurring in your community, but the patient failed to receive an influenza vaccination last fall.
Which of the following is most appropriate for preventing influenza in this patient?
A. Administer influenza vaccine and prescribe no new drugs
B. Obtain a nasopharyngeal culture for influenza and treat only if the result is positive
C. Administer influenza vaccine and prescribe amantadine, rimantadine, or oseltamivir for 2 weeks
D. Administer influenza vaccine and prescribe amantadine, rimantadine, or oseltamivir for 6 weeks
E. Tell the patient that it is too late for an influenza vaccination but prescribe amantadine, rimantadine, or oseltamivir for 2 weeks
___________________
Don't live in a town where there are no doctors
|
| peter90036
Forum Elite
Topics: 28
Posts: 315
|
the heck  ?
treat, i'd pick 6weeks, so its probably 2 weeks 
|
| CocaCola
Forum Guru
Topics: 35
Posts: 908
|
not sure how long the vaccine takes to kick in but i choose A... i see no reason to treat
___________________
There is one thing we can do, and the happiest people are those who can do it to the limit of their ability. We can be completely present. We can be all here. We can give all our attention to the opportunity before us!!!
|
| guangyu
Forum Elite
Topics: 29
Posts: 308
|
I think is A, pt did not have flu, so only give vaccine
|
| Jcala
Forum Junior
Topics: 10
Posts: 44
|
C
|
| Markus2009
Forum Senior
Topics: 9
Posts: 189
|
This patient belongs to "People at High Risk Who Are Vaccinated After Influenza Activity Has Begun" then------------------->C
Two weeks is the time needed to develop antibodies after vaccination.
|
| inkspot
Forum Guru
Topics: 26
Posts: 559
|
giving prophylactic anti virals wont be justified. I think she should only be vaccinated as long as she is asymptomatic
___________________
Aagae Aagae Dekho hota hai kiya !!!
|
| aspire
Forum Senior
Topics: 24
Posts: 158
|
A?
|
| Markus2009
Forum Senior
Topics: 9
Posts: 189
|
But is it worth to risk 2 weeks (window period of developing antibodies after vaccination) in a patient with these comorbidities during a current outbreak?
They develop severe influenza infection...
|
| inkspot
Forum Guru
Topics: 26
Posts: 559
|
markus do we have any specific recommendations or guidlines for COPD patients who are at increased risk?
___________________
Aagae Aagae Dekho hota hai kiya !!!
|
| Markus2009
Forum Senior
Topics: 9
Posts: 189
|
CDC Recommends Antivirals for Persons at High Risk for Influenza
Development of an optimal immune response to influenza vaccination takes about 2 weeks. During a confirmed influenza institutional outbreak, use of neuraminidase inhibitors to prevent influenza should therefore be considered for persons at higher risk for influenza complications who were vaccinated within the previous 2 weeks. Immunosuppressed persons who were vaccinated more than 2 weeks before a suspected influenza virus exposure may also be considered for antiviral chemoprophylaxis when local influenza surveillance data indicate high local activity.
Let's see the official explanation by justice but you can take a look the CDC webpage.
|
| inkspot
Forum Guru
Topics: 26
Posts: 559
|
thanks - now it makes lots of sense . waiting for the correct answer by justice
___________________
Aagae Aagae Dekho hota hai kiya !!!
|
| Justice
Forum Fanatic
Topics: 101
Posts: 1,973
|
The correct answer is C
Vaccination is the primary way to prevent influenza. However, after influenza has been documented in a community, unvaccinated individuals at high risk for complications of influenza or those who are caring for high-risk persons can begin chemoprophylaxis. If concomitant vaccination is performed, chemoprophylaxis need only be continued for 2 weeks, by which time adults are presumed to have developed protective antibody levels. The U.S. Food and Drug Administration has approved amantadine and rimantadine for prophylaxis of influenza A, and oseltamivir (but not zanamivir at the time of this writing) for prophylaxis of influenza A and B.
Administration of vaccine alone is not sufficient if influenza is already occurring in the community. This patient is at risk for acquiring influenza virus, developing influenza, and dying—all before immunity develops from the vaccine. There is no role for surveillance influenza cultures in deciding how to manage such a patient. If vaccine is administered, chemoprophylaxis is given for 2 weeks rather than 6 weeks. However, if vaccination is not possible or if the vaccine is not expected to protect against the current virus strain, chemoprophylaxis can be used for a longer course (that is, for the duration of influenza activity in the community). Because influenza can persist in an area for several weeks, vaccination is useful even after influenza has been documented in a community.
___________________
Don't live in a town where there are no doctors
|
| inkspot
Forum Guru
Topics: 26
Posts: 559
|
thanks
___________________
Aagae Aagae Dekho hota hai kiya !!!
|
| aspire
Forum Senior
Topics: 24
Posts: 158
|
Thank you.
|
|
| |
| | | | | | | | | | | | | | | |
You don't have permission to post.
|
