Determine the most appropriate post-exposure prophylaxis for each of the following patients presenting with a recent infectious exposure.
- A 30-year-old healthcare worker with no prior immunizations who sustained a needlestick injury from a Hepatitis B surface antigen-positive patient.Administer hepatitis B immune globulin (HBIG) and the hepatitis B vaccine
- A 45-year-old immigrant with an unknown immunization history who sustained a deep, dirt-contaminated puncture wound.Administer the Tdap vaccine alongside tetanus immune globulin (TIG)
- A healthy 10-month-old infant brought to the clinic 48 hours after prolonged close contact with a child diagnosed with measles.Administer the live-attenuated MMR vaccine
- A susceptible 25-year-old woman at 28 weeks gestation who was exposed to varicella two days ago.Administer varicella-zoster immune globulin (VZIG)
Cevap
The healthcare worker receives HBIG and the hepatitis B vaccine. The patient with the dirty wound receives the Tdap vaccine and TIG. The 10-month-old infant receives the MMR vaccine. The pregnant woman receives VZIG.
Each matching pair accurately identifies the post-exposure prophylaxis protocol established by guidelines: HBIG plus vaccine for unvaccinated high-risk hepatitis B exposures, TIG plus vaccine for dirty wounds in unimmunized individuals, the MMR vaccine for 6 to 11 month-old infants exposed to measles within a 72-hour window, and VZIG for susceptible pregnant women exposed to varicella.
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Anahtar Kavram
Appropriate post-exposure prophylaxis for vaccine-preventable diseases requires careful assessment of the patient's underlying immune status, the exact nature of the exposure, and absolute contraindications to active vaccines (such as age or pregnancy).