Aseptic Technique

Question 1

Chlorhexidine gluconte and PI, but not parachlorometaxylenol cover gram negative organisms

Answer 1

F - all do

Question 2

For surgical procedures, the contact and airborne routes are the most likely means of contamination.

Answer 2

T

Question 3

Autoclaving generates pressures of 2 Pascals and temperatures of 121C that must be maintained for 15-30 mins.

Answer 3

T

Question 4

Povidone-iodine is most active against Gram positive bacteria, but also active against Gram negative bacteria, M.tuberculosis, fungi and enveloped viruses.

Answer 4

T

Question 5

Repeated use of povidone-iodine has a additive effect.

Answer 5

F

Question 6

Contaminated wounds are those with frank purulent fluid such as an abscess, or perforation of a viscus or faecal contamination.

Answer 6

F This is a dirty wound.

Question 7

Longer procedures carry a greater risk of contamination than brief procedures.

Answer 7

T

Question 8

Alcohols (60-90%) may be used as an antiseptic and have the fastest onset of action.

Answer 8

T Need to use liberal amount and allow to dry.

Question 9

On the night before surgery, a preoperative shower with chlorhexidine gluconate or povidone-iodine has been shown to decrease wound infection rates.

Answer 9

T

Question 10

Alcohol is rapidly germicidal but once evaporated it does not have significant residual activity

Answer 10

T

Question 11

Chlorhexidine glucondate has the fastest onset

Answer 11

F 60-95% alcohols do

Question 12

If repeated application of antiseptic preparations is expected (eg. during Mohs), it is not necessary to use the same agent for each consecutive application.

Answer 12

F Should try to use the same, since some antiseptic agents are mutually inactivating.

Question 13

There is conflicting data regarding the ability of face masks to reduce infection

Answer 13

T

Question 14

Biopsies performed in a hospital ward, as opposed to an outpatient setting, have a higher risk for infection.

Answer 14

T

Question 15

Should it be necessary to cough or sneeze while wearing a face mask, you should step backwards and turn away from the surgical field

Answer 15

F Should face the surgical field

Question 16

Hair removal is indicated for all surgical procedures.

Answer 16

F Only if it will obscure field or hinder technique.

Question 17

Wounds are defined as clean if they are elective incisions carried out on non-inflammed tissues under strict aseptic technique and if there is no entry into the GI, respiratory or GU tracts.

Answer 17

T

Question 18

The majority of post-operative wound infections are due to transient micro-organisms that contaminate the wound after surgery.

Answer 18

T Mostly due to endogenous flora from patient’s nose, throat, or skin.

Question 19

CHG and alcohol containing preparations should be avoided in the periocular area

Answer 19

T

Question 20

The patient’s normal flora is the most common reservoir for contamination during surgical procedures.

Answer 20

T

Question 21

Hands should always be washed after removing surgical gloves.

Answer 21

T Surgeon only notices 17% glove perforations.

Question 22

Chlorhexidine gluconate binds to the stratum corneum and maintains residual activity in excess of 6 hours, even when wiped from the field.

Answer 22

T

Question 23

The surgical hand scrub should be at least 2 minutes.

Answer 23

T

Question 24

Gram-negative bacteria are mostly limited to the humid intertriginous areas, with Enterobacter, Klebsiella, E.coli and Proteus spp being the predominant organisms.

Answer 24

T

Question 25

PI is safe to use in the periocular area

Answer 25

F Must be half strength (5%)

Question 26

A caution of 60-95% alcohols is their flammability

Answer 26

T

Question 27

Hair should always be removed before surgical procedures

Answer 27

F Only if it will obscure the surgical field or hinder properly surgical technique

Question 28

In dermatologic surgery, gloves become perforated in approximately 1% of procedures.

Answer 28

F 11%.

Question 29

The most common resident organisms are coagulase-negative staphylococci, with Staph epidermidis accounting for 60% of resident microbes.

Answer 29

F Over 90%. Rest is true

Question 30

Both chlorhexidine and povidone-iodine have relatively slow onset of action.

Answer 30

F Both fast.

Question 31

Repeated use of chlorhexidine gluconate has an additive effect.

Answer 31

T

Question 32

Anaerobic diphtheroids such as Proprionibacterium acnes are common in lipid-rich locations, such as the pilosebaceous unit.

Answer 32

T

Question 33

Chlorhexidine gluconate is most active against Gram positive bacteria, but also active against Gram negatives and enveloped viruses.

Answer 33

T Poor activity against M.tuberculosis, fair activity against fungi.

Question 34

Chronic maternal use of povidone –iodine have been associated with hyperthyroidism in newborns

Answer 34

F Hypothyroidism

Question 35

Chlorhexidine gluconate should not be allowed to contact the eye or middle ear.

Answer 35

T

Question 36

Fingernails should be kept short to facilitate cleaning

Answer 36

T

Question 37

Excessive thermal destruction of tissue is not associated with an increased risk for infection.

Answer 37

F

Question 38

Surgical site infection is defined by the CDC as any surgical wound that produces pus within 10 days of the procedure.

Answer 38

F 30 days.

Question 39

Povidone-iodine is quickly inactivated in the presence of blood or sputum.

Answer 39

T

Question 40

A sterild dressing must be left undisturbed for at least 72hours to permit a degree of epithelialization to take place and seal the wound edges from bacterial contamination

Answer 40

F 48 hours

Question 41

A potential limitation to autoclave sterilisation is that repeated exposures to high humidity may dull sharp cutting surfaces.

Answer 41

T

Question 42

Chlorhexidine gluconate is quickly inactivated in the presence of blood or sputum.

Answer 42

F

Question 43

Povidone-iodine has excellent sustained activity, even after wiped from the skin

Answer 43

F Intermediate to minimal if wiped from skin

Question 44

Dirty wounds include those where major breaks in aseptic technique have occurred, or there is inflammation, but no frank purulence encountered.

Answer 44

F This is a contaminated wound.

Question 45

Studies have shown a clear relationship between bacterial contamination of the surgical field and the volume at which the surgeon speaks.

Answer 45

T

Question 46

For most dermatological surgery a formal surgical scrub is not generally considered necessary

Answer 46

T

Question 47

Povidone-iodine must remain on the skin to be effective.

Answer 47

T

Question 48

The mixture of alcohol and chlorhexidine gluconate achieves better antiseptic than either agent alone.

Answer 48

T

Question 49

S.aureus is the most frequent cause of surgical site infection, followed by coagulase-negative staph, Enterococcus spp., group A strep, and P.aeruginosa.

Answer 49

T

Question 50

The surgical scrub, if performed correctly, can reduce the microbial load by 80% and maintain this reduction for several hours.

Answer 50

F 90-95%. Everything else is true.

Question 51

There is convincing scientific data to show that wearing scrubs rather than street clothes affects the incidence of infection

Answer 51

F There is no data