NORCET 3 - 2022 (Shift-2)
Pharmacology
Easy
In which of the following disease condition live vaccines should not be administered?
Appeared in: NORCET 3 - 2022 (Shift-2)
Explanation
- Leukaemia is a cancer of blood-forming tissues, which results in a severely compromised immune system (immunodeficiency).
- Treatments for leukaemia, such as chemotherapy and radiation, further suppress the patient's immune response.
- Live vaccines contain weakened pathogens that can multiply and cause a serious, potentially fatal disease in individuals who cannot mount an effective immune response.
- Therefore, administering a live vaccine to a patient with leukaemia is a significant safety risk and is strictly contraindicated.
Why Other Options Were Wrong
- Option B: Multiple sclerosis (MS) is an autoimmune disease, not a primary immunodeficiency. The disease itself does not contraindicate the use of live vaccines.
- Option C: Hypertension (high blood pressure) is a cardiovascular condition. It does not affect the immune system in a way that would make live vaccines unsafe.
- Option D: Diabetes is a metabolic disorder. While poorly controlled diabetes can impair immune function, it is not an absolute contraindication for live vaccines. In fact, vaccination is generally encouraged for people with diabetes.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Contraindications for live vaccine administration helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- A nurse's primary responsibility during vaccination is to ensure patient safety by conducting a thorough screening for contraindications and precautions.
- Failure to identify an immunocompromised patient before administering a live vaccine can result in a vaccine-induced disease, which is a serious and preventable adverse event.
- What if? If a patient had leukaemia as a child but has been in remission and off all therapy for over 5 years? In this case, after consultation with their oncologist, they may be considered to have a reconstituted immune system and could potentially receive live vaccines safely.
How to Approach the Question
- First, identify the core concepts of the question: 'live vaccines' and a condition where they should 'not be administered' (a contraindication).
- Recall the fundamental principle of live vaccines: they contain a weakened pathogen and require a competent immune system to be safe and effective.
- Analyze each option based on its primary effect on the body, specifically the immune system.
- Evaluate 'Leukaemia': This is a cancer of the immune system, causing profound immunodeficiency. This is a direct and absolute contraindication.
- Evaluate 'Multiple sclerosis', 'Hypertension', and 'Diabetes': These are autoimmune, cardiovascular, and metabolic conditions, respectively. They do not inherently cause the severe immunodeficiency that contraindicates live vaccines, although treatments for MS might.
- Conclude that Leukaemia is the only condition listed that is a direct and absolute contraindication for live vaccines.
Concept Tested & Keywords
- Concept Tested: Contraindications for live vaccine administration
- Stem keywords: live vaccines, disease condition, not be administered
- Lead-in keywords: not
- Negative lead-in flag: The question asks to identify the condition where live vaccines are contraindicated.
Question ID
QrRO645WJTNBFLo4idFp1i
Reference Book
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) p. 96-98
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1610-1612
Practise the full NORCET 3 - 2022 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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