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1. Which of the following are indicators that influenza is epidemic in the 2017-2018 influenza season?

A. Persistent drugs shortages of the antiviral neuramidase inhibitors B. School closings (by percent of all schools) and visits to pediatricians per 100,000 population C. Identification of the A(H3N2) and A(H1N1)pdm09 viruses as prevalent circulating strains D. Deaths (by percent of all deaths) and hospitalization per 100,000 population

2. As of February 16, 2018, what was the 2017-2018 influenza vaccine's overall adjusted vaccine effectiveness against influenza A and influenza B virus infection?

A. 10% B. 36% C. 43% D. 63%

3. Mrs. Ellison, who is 83, comes to the pharmacy and tells you that she thinks she has the flu. She says she doesn't think she has been exposed, but on questioning, you find that she has gone about her activities as usual lately. Her symptoms are dry cough, sore throat, runny or stuffy nose, muscle or body aches, and fatigue. She has no fever. Might this be the flu?

A. No, influenza usually presents with fever B. No, she doesn't report an exposure C. Yes, fever is often absent in older adults D. Yes, almost all older people get the flu

4. What is a possible explanation for severe, progressive influenza requiring hospitalization for tissue inflammation and damage in a 39 year old, health physical education teacher?

A. Cytokine storm B. Concurrent extreme fatigue C. Exposure students with virulent strains D. Over-reaction on the patient's part

5. The Miller family has five very young children who cannot swallow capsules or tablets, three of whom have hereditary fructose intolerance. One of the children develops influenza, and Mrs. Miller calls to say she is going to call their physician and ask for medication to shorten the flu's duration in the sick child, and to prevent the others from getting the flu. What is the best choice for this family if she wants one medication for all?

A. amantidine B. oseltamivir C. peramivir D. zanamivir

6. Select the statement that is TRUE.

A. Oral and inhaled work antivirals work best when initiated within 48 hours of symptom onset B. Clinicians should wait for influenza testing results before staring neuraminidase inhibitors C. Patients should continue oseltamivir and zanamivir until the CDC gives the "all clear" signal D. Patients who receive oseltamivir and zanamivir are less likely to contract influenza

7. What should you tell patients who have household members who have the flu and ask about treating the family with antiviral drugs?

A. Antiviral medications can be used to treat influenza and can shorten illness duration and prevent complications from influenza B. Antiviral medications are 50% effective in preventing influenza following exposure in specific populations C. Antiviral medications can be used to treat influenza, and do not shorten illness duration but prevent complications from influenza D. Antiviral medications are used to treat the flu, but are never used to prevent it following exposure in specific populations

8. The phone is ringing off the hook with calls from patients who want a neuraminidase inhibitor although they have no symptoms, have not been exposed, and are not in high-risk groups. What do you tell them?

A. I'll call the physician for you and ask for a prescription since others also want these drugs B. CDC does not recommend widespread, routine prophylactic use of antiviral medications C. The nation is experiencing shortages of these drugs, so you have to wait D. The neuraminidase inhibitors don't really help prevent the flu, they only treat it

9. Mr. Davison asks about preventive measures to keep influenza from spreading in his household. His 8 year old currently has the flu. After seeing a recommendation for frequent handwashing with soap, he tells you that he and his daughter have eczema and avoid soap. What do you recommend?

A. Having all family members wear face masks at all times B. Starting family members who have eczema on rimantadine C. Using an alcohol-based hand rub with at least 60% alcohol D. Rinsing with 1/4 cup bleach in 1 gallon hot water

10. You have several prescriptions for oseltamivir, and none on your shelf. You look at the order that arrived today, and your supplier indicates it is out of stock, and more will arrive Friday (today is Sunday). What is the first step to resolving this issue?

A. Hold the prescriptions until your supplier is replenished B. Switch these patients to peramivir C. Contact multiple alternative distributors or manufacturers D. Explain to the patients that there is a nation-wide shortage