Immunisation: varicella exposure in leukaemia: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Immunisation: varicella exposure in leukaemia

Sample item

A 6-year-old on chemotherapy for acute lymphoblastic leukaemia has never had chickenpox or varicella vaccine. His classmate was diagnosed with chickenpox yesterday. What is the most appropriate measure?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Varicella-zoster immunoglobulin as soon as possible

A non-immune child receiving chemotherapy is at risk of severe disseminated varicella after a significant exposure. Varicella-zoster immunoglobulin should be given as early as possible, ideally within 96 hours and not later than 10 days. Live vaccine is contraindicated during chemotherapy, and aciclovir is started if disease develops.

Option by option

  • A. Oral penicillin for 10 days

    Penicillin has no role against a viral infection.

  • B. Varicella-zoster immunoglobulin as soon as possible (correct)

    Correct. VZIG gives passive protection to non-immune immunocompromised contacts.

  • C. No action unless lesions appear

    Waiting for lesions risks severe disease in an immunocompromised child.

  • D. Live attenuated varicella vaccine now

    Live varicella vaccine is contraindicated during chemotherapy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Varicella-zoster immunoglobulin as soon as possible. A non-immune child receiving chemotherapy is at risk of severe disseminated varicella after a significant exposure.

Why is "Oral penicillin for 10 days" not the answer?

Penicillin has no role against a viral infection.

Why is "No action unless lesions appear" not the answer?

Waiting for lesions risks severe disease in an immunocompromised child.

Why is "Live attenuated varicella vaccine now" not the answer?

Live varicella vaccine is contraindicated during chemotherapy.

What concept does this question test?

It tests Immunisation: varicella exposure in leukaemia in Pediatrics. Varicella-zoster immunoglobulin should be given as early as possible, ideally within 96 hours and not later than 10 days. Live vaccine is contraindicated during chemotherapy, and aciclovir is started if disease develops.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunisation: varicella exposure in leukaemia?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.