HPV vaccination — MCQs

A vaccination campaign designed to increase the uptake of HPV vaccine was instituted in chosen counties of a certain state in order to educate parents not only about the disease itself, but also about why children should be vaccinated against this viral sexually transmitted disease. At the end of the campaign, children living in counties in which it was conducted were 3 times more likely to receive the HPV vaccine compared with children living in counties where no campaign was instituted. As well, after evaluating only the counties that were part of the vaccination campaign, the researchers found that families with higher incomes were 2 times more likely to vaccinate their children against HPV compared with families with lower incomes. What conclusion can be drawn from these results?

An 18-year-old woman presents for a routine check-up. She is a college student with no complaints. She has a 2 pack-year history of smoking and consumes alcohol occasionally. Her sexual debut was at 15 years of age and has had 2 sexual partners. She takes oral contraceptives and uses barrier contraception. Her family history is significant for cervical cancer in her aunt. Which of the following statements regarding cervical cancer screening in this patient is correct?

A 12-year-old girl presents to her primary care physician for a well-child visit. She has a history of asthma and uses her inhaler 1-2 times per week when she exercises. She does not smoke and is not currently sexually active; however, she does have a boyfriend. She lives with her mother in an apartment and is doing well in school. Her temperature is 97.6°F (36.4°C), blood pressure is 124/75 mmHg, pulse is 80/min, respirations are 12/min, and oxygen saturation is 98% on room air. Physical exam is notable for a healthy young girl with no findings. Which of the following is most appropriate for this patient at this time?

A 16-year-old girl comes to her primary care physician for an annual check-up. She has no specific complaints. Her medical history is significant for asthma. She uses an albuterol inhaler as needed. She has no notable surgical history. Her mom had breast cancer and her grandfather died of colon cancer. She received all her childhood scheduled vaccinations up to age 8. She reports that she is doing well in school but hates math. She is sexually active with her boyfriend. They use condoms consistently, and they both tested negative recently for gonorrhea, chlamydia, syphilis and human immunodeficiency virus. She asks about birth control. In addition to educating the patient on her options for contraception, which of the following is the best next step in management?

A 2-year-old boy presents to the pediatrician for evaluation of an elevated temperature, sore throat, runny nose, and lacrimation for the past week, and a rash which he developed yesterday. The rash began on the patient’s face and spread down to the trunk, hands, and feet. The patient’s mother gave him ibuprofen to control the fever. The child has not received mumps, measles, and rubella vaccinations because he was ill when the vaccine was scheduled and was later lost to follow-up. The vital signs include blood pressure 90/50 mm Hg, heart rate 110/min, respiratory rate 22/min, and temperature 37.8°C (100.0℉). On physical examination, the child was drowsy. His face, trunk, and extremities were covered with a maculopapular erythematous rash. Two irregularly-shaped red dots were also noted on the mucosa of the lower lip. The remainder of the physical examination was within normal limits. What is the probable causative agent for this child’s condition?

Two viruses, X and Y, infect the same cell and begin to reproduce within the cell. As a result of the co-infection, some viruses are produced where the genome of Y is surrounded by the nucleocapsid of X and vice versa with the genome of X and nucleocapsid of Y. When the virus containing genome X surrounded by the nucleocapsid of Y infects another cell, what is the most likely outcome?

A 32-year-old pregnant woman at 32 weeks gestation presents with a 2-day history of low-grade fever, headache, and myalgias. She works at a daycare where several children recently had 'slapped cheek' rash. Laboratory studies show hemoglobin 8.5 g/dL (baseline 12 g/dL), reticulocyte count 0.1%, and positive parvovirus B19 IgM. Fetal ultrasound shows hydrops fetalis with ascites, pleural effusions, and severe anemia on cordocentesis. Evaluate the pathophysiologic mechanism and management approach that best addresses both maternal and fetal complications.

A public health official must design a vaccination strategy for a refugee camp with 10,000 children under 5 years old. Resources allow for only one vaccine initially. Current diseases in the camp include measles (15 cases/week), diphtheria (5 cases/week), pertussis (20 cases/week), and rotavirus diarrhea (100 cases/week). Three children have died from measles, two from pertussis, and ten from dehydration due to diarrhea. Evaluate which vaccine should be prioritized and justify the decision.

A hospital infection control committee reviews a cluster of 5 cases of invasive pneumococcal disease over 6 months, all caused by serotype 19A, in vaccinated children aged 3-5 years who received all recommended doses of PCV13. All isolates show resistance to penicillin and macrolides. The committee must evaluate the outbreak and recommend interventions. Which factor most likely explains this outbreak despite appropriate vaccination?

A 65-year-old man with diabetes mellitus and chronic kidney disease presents with sudden onset right-sided facial weakness, inability to close his right eye, and loss of taste on the anterior two-thirds of his tongue. He has vesicular lesions in his right external auditory canal. He received varicella vaccine 20 years ago and had shingles on his trunk 5 years ago. Analyze the relationship between his current presentation and his varicella vaccination history.