A 63-year-old female presents for a routine evaluation. She asks if she and her husband, age 69, would benefit from the herpes zoster vaccine.
You advise her that:
Correct Answer D:
The live attenuated varicella-zoster vaccine has been shown to reduce outbreaks of herpes zoster by 51% in vaccinated individuals. The greatest benefit is the reduction in the severity and duration of postherpetic neuralgia. Efficacy does not decrease after age 70, the age group at greatest risk for postherpetic neuralgia. The vaccine is contraindicated in the immunodeficient population.
Mr. and Mrs. Smith, 74 and 72-year-old respectively, come to clinic for herpes zoster (HZ) vaccination. They report that Mrs. Smith had HZ infection 5 years ago and she described the pain as “worse than childbirth.” Mr. Smith's past history of chicken pox is unknown. They know they have to pay out of pocket for the vaccines.
Assuming there are no contradictions for the vaccination, what would be the most appropriate recommendation?
Correct Answer B:
Shingles vaccine is recommended by the Advisory Committee on Immunization Practices (ACIP) to reduce the overall burden and severity of herpes zoster and its associated pain in people 60 years old or older without contraindications. The vaccine reduces the incidence of herpes zoster (HZ) by about 50% and the occurrence of postherpetic neuralgia (PHN) by two-thirds, with vaccinated individuals experiencing attenuated or shortened symptoms.
→ Having an episode of HZ has an immunizing effect, greatly reducing the probability of a second event. That said, patients with a history of severe HZ are often the most insistent on receiving the vaccine, and concerns have been raised about the validity of patient histories of HZ. For these reasons, both the Centers for Disease Control and Prevention and the ACIP recommend that adults be vaccinated whether or not they report a previous episode of HZ.
→ An estimated 90% of Canadian adults have had a previous varicella-zoster virus (VZV) infection. Thus, almost all adults 60 years of age or older have been infected with VZV, regardless of patient-reported history or recall. There is no need to test immunity levels before administering the vaccine.
The herpes zoster (HZ) vaccine is a safe and effective preventive measure for reducing the overall burden and severity of HZ in adults aged 60 years and older.
Which is not associated with occupational asthma?
Numerous substances are associated with occupation asthma including plastic and rubber dusts (polyvinyl chloride), isocyanates and acid anhydrides.
Life expectancy is a comprehensive measure of the health status of a population. This measure is:
Correct Answer A:
Life expectancy is a statistical measure of the average length of survival of a living thing. It is often calculated separately for differing gender and geographic location. Popularly, it is most often construed to mean the life expectancy at birth for a given human population, which is the same as the expected age at death. However, technically, life expectancy means the expected time remaining to live, and it can be calculated for any age.
To promote good dental health among children living in areas with low natural fluoride in the water supply, it is recommended that fluoride supplements be given from:
Correct Answer E: It is suggested that only children living in non-fluoridated areas use dietary fluoride supplements between the ages of six months to 16 years.
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