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CIC Exam > Bioterrorism and IVDA BSIs > Flashcards

Bioterrorism and IVDA BSIs Flashcards

1
Q

What is an infectious disease disaster?

A

events that involve a biological agent/disease and result in mass casualties, such as a bioterrorism attack, pandemic, or outbreak of an emerging disease

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2
Q

what are some common characteristics of bioterrorism agents?

A

-dispersed in aerosols 1 to 5 micron sized particles that can penetrate the distal bronchioles
-deliver aerosols with simple technology
-feasability of these agents if delivered from a line source (airplane) upwind from the target, it can infect large numbers of the population
- ability to spread infection, disease, panic, and fear

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3
Q

why are infectious disease disasters different from other types of disasters?

A

they increase the risk of communicable disease spread during and after the incident

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4
Q

what is the most likely route of dissemination of bioterrorism agents?

A

aerosolized release of 1 to 5 micron particles

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5
Q

what are some other methods of dissemination of bioterrorism agents?

A

-oral (contamiante food/water)
-percutaenous
-infected animal vector (fleas)
-human to human spread (infected individual walking around a group of healthy people)

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6
Q

what is the difference between bioterrorism and biological warfare?

A

bioterrorism: the intentional use of a biological agent or derivative of such an agent to inflict harm or death onto a civilian population.
biological warfare: target of attack is military personnel.

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7
Q

bioterrorism preparedness is required as part of what?

A

a comprehensive emergency management program.

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8
Q

The potential impact of bioterrorism depends on what?

A

-agent used
-amount disseminated
-dispersal method
-weather/release conditions
-preexisting immunity of the exposed population
-how quickly the attack is identified

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9
Q

define category A bioterrorism

A

poses the highest risk to national security because they:
-can be easily dissemianted or transmitted person to person
-high mortality
-potential to cause public panic
-require special preparedness actions

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10
Q

What are examples of category A infectious agents?

A

-anthrax
-botulism
-plague
-smallpox
-tularemia
-viral hemmoragic fevers

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11
Q

Define category B bioterrorism

A

poses the second highest risk because they:
-moderately easy to disseminate
-low mortality rates
-require enhancement of diagnostic and surveillance capability

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12
Q

what are examples of category B infectious bioterrorism agents?

A

-west nile viruses
-calciviruses
-Hep A
-ricin toxin
-salmonella
-darrheagenic E. coli
-brucellosis
-epsilon toxin of c. perfringens
-pstittacosis
-meliodosis (Burkholderia pseudomallei)
-glanders (burkholderia mallei)
Q fever (coxella burnetti)
-staph entertoxin B
-Typhus fever (Rickettsia prowazekki)
-water safety threats (cholera, cryptosporidium)
-viral encephalitis (eastern, venezualian, western equine)

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13
Q

define cateogry C bioterrorism

A

emerging pathogens that could be engineered for mass dissemination because they:
-are available
-are easily produced and dissimenated
-potential for high mortality rates

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14
Q

what are examples of category C bioterrorism agents?

A

-Influenza
-SARs
-Rabies
-MDRO TB
-Yellow fever
-tickborne hemorrhagic fever
-emergeing IDs like Nipah virus and hantavirus

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15
Q

what are the 6 phases of pandemic?

A
  1. low risk of human cases
  2. higher risk of human cases
  3. no or very limited human to human transmission
  4. evidence of increased human to human transmission
  5. evidence of significant human to human transmission
  6. efficient and sustained human to human transmission
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16
Q

Of all infectious disease disasters, which poses the biggest threat to the public’s health in terms of morbidity and mortality?

A

pandemics

17
Q

what are the 2 major sources of intravascular device-associated bloodstream infection?

A
  1. colonization of the intravenous device, or catheter-associated infection
  2. contamination of the fluid administered through the device, or infusate associated infection. Contaminated infusate is the cause of most epidemic intravascular device-associate bloodstream infections. In contrast, catheter associated infections are responsible for most endemic intravascular device-associated bloodstream infections.
18
Q

What are the 3 mechanisms microorganisms use to gain access to the bloodstream?

A
  1. skin organisms invade the percutaneous tract, probably facilitated by capillary action, at the time of insertion or days following
  2. microorganisms contaminate the catheter hub (and lumen) when the catheter is inserted over a percutaneous guidewire or later manipulated.
  3. organisms are carried hemtogenously to the implanted IVD from remote sources of local infection (i.e., pneumonia).
19
Q

describe short term IVDs

A

-in place less than 10 days
-peripheral IV catheters, arterial catheters, and noncuffed, nontunnelled CVCs
-most device associated BSIs are of cutaenous origin, from the insertion site, and gain access extraluminally.

20
Q

describe long term IVDs

A

-in place more than 10 days
-Hickman and Broviac type catheters, subcutaenous, central ports, and PICCs
-contamination of catheter hub and luminal fluid is predominant mode of BSI

21
Q

what are examples of infusate?

A

-parenteral fluid
-blood products
-IV medications

22
Q

true or false. Infusate administered through an IVD can become contaminated and produce device-associated BSI?

A

True

23
Q

true or false. Contaminated fluid is a common cause of endemic infusion associated infection with short term IVDs

A

false

24
Q

most healthcare epidemics of infusion associated BSI have been traced to contamination of infusate by what?

A

gram negative bacilli

25
Q

True or false. Skin microorganisms account for the largest proportion of IVDA BSIs

A

True

26
Q

how does infusate become contaminated?

A

-extrinsic (fluid medication)
-intrinsic (manufacturer)

27
Q

how does the catheter hub become contaminated?

A

-endogenous (skin flora)
-extrinsic (HCW hands)

28
Q

how do skin organisms results in catheter contamination?

A

-endogenous (skin flora)
-extrinsic (HCW hands, contaminated disinfectant)

29
Q

how often does a central venous catheter need replacing?

A

-when indicated
-remove when no longer necessary
-inspect daily at insertion site for infection
-change or remove when infection is suspected

30
Q

recovery of which microorganisms in multiple blood cultures strongly suggests infection of the IVD?

A

-staphyloocci
-Corynebacterium
-Bacillus
-Candida
-Malassezia

31
Q

Blood cultures should be obtained from ___ separate sites

A

two (you want two sites in case one is contaminated)

32
Q

at least one of two blood cultures should be drawn from what?

A

a peripheral vein by percutaneous venipuncture.

33
Q

What are 4 strategies to prevent IVDA BSIs?

A
  1. choice of catheter and site of device insertion
  2. barrier precautions
  3. intravenous teams
  4. cutaneous antisepsis
34
Q

which insertions are associated with the highest, lowest, and intermediate level risk of IVDA BSI?

A

lowest: subclavian vein insertion
highest: femoral vein insertion
intermediate: jugular vein insertion

CIC Exam (9 decks)

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