MSRA MCQs: Vaccines, BCG, and UK Immunisation Schedule
- examiner mla
- 3 days ago
- 3 min read
Q1. A 24-year-old healthcare worker is new to the UK and is undergoing pre-employment screening. She has no history of BCG vaccination. Her tuberculin skin test (Mantoux) is positive. What is the most appropriate next step?
Choose the correct answer
A. Give BCG vaccine
B. Repeat Mantoux in 1 week
C. Do IGRA and chest X-ray
D. Start latent TB treatment immediately
✅ Answer: C
Explanation: A positive Mantoux test before BCG indicates potential TB exposure. BCG is contraindicated. Further testing is required to exclude latent or active TB.
IGRA (Interferon-Gamma Release Assay): Confirms TB infection, especially helpful in BCG-vaccinated individuals (not applicable here but still more specific).
Chest X-ray: Rules out active pulmonary TB.
Q2. Which of the following is a contraindication to receiving the BCG vaccine?
Choose the correct answer
A. Asplenia
B. Age 1 month
C. Negative Mantoux
D. Severe combined immunodeficiency (SCID)
✅ Answer: D
Explanation: SCID is an absolute contraindication to all live vaccines including BCG.
Q3. A 30-year-old woman, 10 weeks pregnant, requests BCG vaccination due to recent travel to a high-risk TB area. What should you advise?
Choose the correct answer
A. Give BCG now
B. Give inactivated TB vaccine
C. Postpone until after delivery
D. Give Mantoux and then BCG
✅ Answer: C
Explanation: Live vaccines, including BCG, are contraindicated in pregnancy.
Q4. A 12-week-old infant presents for routine immunisation. Which combination of vaccines is scheduled at this visit?
Choose the correct answer
A. 6-in-1 (2), MenB (1), Rotavirus (1)
B. 6-in-1 (2), MenB (2), Rotavirus (2), PCV (1)
C. 6-in-1 (3), MenB (3), PCV (2)
D. MMR, Hib/MenC, MenB booster
✅ Answer: B
Explanation: 12-week schedule includes 6-in-1 (2nd dose), MenB (2nd dose), Rotavirus (2nd dose), and PCV (1st dose).
Q5. Which of the following children is eligible to receive the nasal flu (LAIV) vaccine?
Choose the correct answer
A. 13-year-old on methotrexate
B. 10-year-old healthy child
C. 6-month-old with asthma
D. 3-year-old with egg allergy
✅ Answer: B
Explanation: Healthy children aged 2–15 are routinely offered annual LAIV. LAIV is contraindicated in immunosuppressed, aspirin use, and severe egg allergy.
Q6. Which of the following vaccines is a live attenuated vaccine?
Choose the correct answer
A. Rabies
B. HPV
C. BCG
D. Hepatitis A (UK)
✅ Answer: C
Explanation: BCG is a live attenuated vaccine. Rabies and Hep A are inactivated. Diphtheria is a toxoid.
Q7. A 65-year-old asplenic patient is reviewing vaccines. Which of the following is most accurate regarding their eligibility?
Choose the correct answer
A.Cannot receive live vaccines
B.Should avoid polysaccharide vaccines
C.Can receive all routine and travel vaccines including live
D.Needs only inactivated vaccines
✅ Answer: C
Explanation: Asplenic individuals can receive all vaccines, including live ones (e.g., BCG, MMR, Yellow Fever), unless otherwise contraindicated.
Q8. Which of the following travel vaccines is a whole killed vaccine used in the UK?
Choose the correct answer
A. Yellow Fever
B. Oral Typhoid
C. Rabies
D. MMR
✅ Answer: C
Explanation: Rabies is a whole inactivated vaccine. Yellow Fever, Oral Typhoid, MMR, and BCG are live.
Q9. What is the primary reason conjugate vaccines are used in infants rather than plain polysaccharide vaccines?
Choose the correct answer
A. They require fewer doses
B. They are cheaper and widely available
C. They generate stronger immune memory in infants
D. They contain live components
✅ Answer: C
Explanation: Conjugating polysaccharides to protein carriers enhances immune memory, especially in infants under 2 years old.
Q10. A 1-year-old child is attending for routine vaccinations. Which of the following vaccines is not typically administered at this age?
Choose the correct answer
A. MMR dose 1
B. Hib/MenC
C. MenB booster
D. 6-in-1 dose 4
✅ Answer: D
Explanation: The 4th dose of 6-in-1 is given at 18 months, not at 1 year.
Q11. A child born on 1 August 2024 is now 18 months old. According to the updated UK schedule, which of the following applies?
Choose the correct answer
A. MMR dose 2 is not yet due
B. MMR dose 2 and 6-in-1 dose 4 are both due now
C. Only nasal flu vaccine is needed
D. 6-in-1 dose 4 is skipped in this cohort
✅ Answer: B
Explanation: Children born on or after 1 July 2024 receive MMR dose 2 and 6-in-1 dose 4 at 18 months.
Q12. Which vaccine is made by recombinant DNA technology?
Choose the correct answer
A. Rotavirus
B. Hepatitis B
C. MMR
D. Rabies
✅ Answer: B
Explanation: Hepatitis B vaccine is made by inserting a gene into yeast cells to produce surface antigen → recombinant subunit vaccine.
Q13. A 9-year-old has severe asthma and is on daily oral steroids. Which is the best approach for annual flu vaccination?
Choose the correct answer
A. Give LAIV nasal spray as usual
B. LAIV is contraindicated; give inactivated flu vaccine
C. No flu vaccine is recommended
D. Delay flu vaccine until asthma improves
✅ Answer: B
Explanation: LAIV is contraindicated in children on systemic steroids or with severe asthma → use inactivated flu vaccine instead.
Q14. What is the mechanism of action of toxoid vaccines?
Choose the correct answer
A. Activate immune cells via DNA fragments
B. Trigger immune response to protein subunits
C. Create antibodies against inactivated toxins
D. Create memory B-cells against entire virus
✅ Answer: C
Explanation: Toxoid vaccines (e.g., tetanus, diphtheria) use inactivated bacterial toxins to provoke an immune response against the toxin, not the organism.
Q15. Which of the following is true about MenB vaccine in the updated UK schedule?
Choose the correct answer
A. Administered at 8 weeks and 16 weeks
B. Now given at 12 weeks with booster at 1 year
C. Replaced by MenACWY at age 1
D. Contraindicated under 6 months of age
✅ Answer: B
Explanation: MenB is now given at 12 weeks and booster at 1 year in the updated UK infant schedule.
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