Prevention of Herpes Zoster

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Which of the following statements about herpes zoster is true?

a) It most frequently manifests in a sacral nerve dermatomal distribution.
b) It most frequently manifests in a thoracic, cervical, or ophthalmic dermatomal distribution.
c) It most frequently presents as a disseminated rash.

2. The diagnosis of herpes zoster…

a) Can usually be made on clinical grounds alone.
b) Is made on the basis of testing antibody to varicella zoster virus.
c) Neither A nor B.

3. Which of the following statements is true regarding the epidemiology of herpes zoster?

a) Approximately one in 10 persons acquire zoster during their lifetime.
b) After adjusting for changes in age and other factors in the population, the rate for zoster in the United States has been stable in recent decades.
c) Recent data suggest approximately 1 million cases of zoster occur annually in the United States.
d) Exposure to varicella has been demonstrated to have major influence on the rate for zoster in the population.
e) All of the above.

4. Which of the following groups are at increased risk for herpes zoster?

a) Persons at advanced age.
b) Patients with atopic dermatitis.
c) Blacks.
d) Persons that have been vaccinated with varicella vaccine.
e) All of the above.

5. The most significant burden from zoster in the U.S. population is caused by…

a) A high number of hospitalizations.
b) A high number of deaths.
c) Blindness caused by ophthalmic zoster.
d) Impact on quality of life attributed to pain and suffering.

6. Which of the following is true regarding zoster vaccine?

a) It must be refrigerated before reconstitution.
b) It is made from a different strain of varicella zoster virus than used in varicella vaccine.
c) It should not be administered within 28 days of inactivated influenza vaccine.
d) It contains thimerosol.
e) None of the above.

7. Which of the following is true regarding the efficacy of zoster vaccine in the Shingles Prevention Study?

a) The vaccine reduced overall incidence of zoster by approximtaely 51%.
b) The vaccine was most effective at preventing the post-herpatic neuralgia (PHN) of the longest duration.
c) The vaccine was not very effective at preventing zoster in persons aged >80 years but was much more effective at preventing PHN in these persons.
d) Efficacy of the vaccine at preventing zoster was fairly stable over a period of 6 years.
e) A, B, and C.

8. The Advisory Committee for Immunization Practices (ACIP) recommends zoster vaccine for which of the following?

a) Adults aged >50 years about to undergo kidney transplantation.
b) Adults aged >60 years, with 1 booster dose 10 years later.
c) Adults aged >60 years irrespective of prior history of varicella or zoster.
d) Adults aged >60 who are experiencing zoster to prevent PHN.
e) B, C, and D.

9. Zoster vaccine is contraindicated by ACIP for which of the following persons?

a) Persons with insulin-dependent diabetes mellitus.
b) Persons infected with human immunodeficiency virus before progression to acquired immunodeficiency syndrome.
c) Persons that received chemotherapy for leukemia during the preceding 3 months.
d) A, B, and C.
e) B and C.

10. In the Shingles Prevention Study, which of the following adverse reactions occurred with significantly greater frequency in the zoster vaccine recipients as compared with controls?

a) A generalized varicella-like rash.
b) Injection site reactions.
c) Fever.
d) All of the above.