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A 34-year-old woman is assaulted and suffers a number of stab wounds to her abdomen. Bystanders call paramedics and she is subsequently taken to the nearest hospital. On arrival to the emergency department, her vitals are T: 36 deg C, HR: 110 bpm, BP: 100/60, RR: 12, SaO2: 99%. A FAST and abdominal CT are promptly obtained which are demonstrated in Figures A and B, respectively. Her chart demonstrates no other medical problems and vaccinations/boosters up to date. The patient is diagnosed with a Grade V splenic laceration and is immediately brought to the OR for emergent splenectomy. The splenectomy is successfully performed with removal of the damaged spleen (Figure C). Following the operation, the patient should receive which of the following vaccines: (I) H. influenzae (II) Tetanus (III) N. meningitidis (IV) S. pneumoniae (V) Hepatitis B
I, III, IV
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A 68-year-old woman with chronic idiopathic thrombocytopenic purpura (ITP) presents to her hematologist for routine follow-up. She has been on chronic corticosteroids for her ITP, in addition to several treatments with intravenous immunoglobulin (IVIG) and rituximab. Her labs today reveal a white blood cell count of 8, hematocrit of 35, and platelet count of 14. Given her refractory ITP with persistent thrombocytopenia, her hematologist recommends that she undergo splenectomy. What is the timeline for vaccination against encapsulated organisms and initiation of penicillin prophylaxis for this patient?
Vaccinate: 2 weeks prior to surgery; Penicillin: 2 weeks prior to surgery for an indefinite course
Vaccinate: 2 weeks prior to surgery; Penicillin: at time of surgery for an indefinite course
Vaccinate: 2 weeks prior to surgery; Penicillin: at time of surgery for 5 years
Vaccinate: at the time of surgery; Penicillin: 2 weeks prior to surgery for an indefinite course
Vaccinate: at the time of surgery; Penicillin: at time of surgery for 5 years
A 1-year-old boy presents to his pediatrician for episodes of crying and being hunched over. He has also had decreased oral intake during this time. He is generally healthy and has no medical issues. His temperature is 97.0°F (36.1°C), blood pressure is 94/54 mmHg, pulse is 100/min, respirations are 22/min, and oxygen saturation is 99% on room air. The child appears well and is playing; however, while in the office he has another spell of crying and being hunched over. An ultrasound is performed as seen in Figure A. Which of the following vaccines is associated with this patient's most likely diagnosis?