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ELCS > Bloodborne Pathogens > Flashcards

Bloodborne Pathogens Flashcards

1
Q

What are bloodborne Pathogens?

A

Pathogenic microorganisms in blood or OPIM (tears,feces (hep. A/E transmission- fecal oral route) ,urine,sweat,vomit,blood contaminated bodily fluids) that cause disease in humans

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2
Q

Are tears, feces, urine, sweat, vomit, saliva, sputum (phlegm), or nasal secretions considered sources of BBP’s?

A

Not unless contaminated with blood but we assume saliva is contaminated with blood

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3
Q

What are the 4 steps of inflammation?

A
  1. Vasodilation and increased blood supply (redness/heat)
  2. Vessels leak and fluid escapes with immune cells in that fluid (lymphocytes travel/swelling)
  3. Leaky vessels allow WBC to flow to area. Phagocytes attack pathogen.
  4. The inflammation causes pain and loss of f(x)n
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4
Q

What are the 5 cardinal signs of inflammation?

A

Pain (tissue pressure/inflammatory mediators)
Redness(vasodilation)
Immobility(b/c of pain and swelling)
Swelling(fluid escapes from vessels to site of injury or concern)
Heat(vasodilation/ hypothalamus activation/ increased blood supply to infected area)

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5
Q

What are the big 3 known examples of viral blood borne pathogens in dentistry? How are they transferred? What kind of infxn do they produce?

A

Hepatitis B/ Hep. C/HIV
Transferred via blood in healthcare settings
They produce chronic infxn- people could be seemingly fine but they’re carriers.

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6
Q

What are the 3 ways BBP’s can be transmitted at work?

A
  1. Cuts or punctures w/sharp objects (new cuts)
  2. Splashes to permeable mucous membranes of the eyes,nose, and mouth allowing pathogens to pass through
  3. Contamination of broken skin (wounds, chapped skin, and rashes are exposed)
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7
Q

Who’s Kim Bergalis?

A

A pt caught HIV from her dentist (David Acer). He transmitted HIV to 6 pt. He wore PPE during her extractions. Kim then died after developing flu like symptoms -> thrush (oral infxn).-> pneumonia->

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8
Q

What’s the standard precautions for BBP’s? What are the 3 tenants of standard precautions ?Who’s it mandated by?

A

Treat all human blood/OPIM as infectious.

  1. Use PPE
  2. Work practice controls - safe practices- perform tasks in the safest manner possible
  3. Engineering ctrls - you should isolate or remove any hazardous infection that could be near to limit harm to yourself, staff, or fellow patients.

OSHA.

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9
Q

What effect does drinking and taking Tylenol have on the body?

A

Damage to the liver is likely, especially if the pt is taking more than 4 grams.

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10
Q

What does hepatitis mean?

A

Liver inflammation.

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11
Q

Why is the fxn of the liver important?

A

Filters bodily fluids. The liver regulates most chemical levels in the blood and excretes a product called bile (help to transport fats around body) This helps carry away waste products from the liver. All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood and breaks down, balances, and creates the nutrients and also metabolizes drugs into forms that are easier to use for the rest of the body or that are nontoxic. Converts glucose to glycogen for storage

Missing Clotting elements and accumulation of bile make you yellow (jaundice)

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12
Q

How is Hep A transferred? B?C?D?E?

A

A/E- fecal/oral

B/C/D- Blood/bodily fluids -> skin/mucous membranes

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13
Q

What hepatitis versions have vaccines?

A

A/B. You can only get Hep D if you have Hep B, so if you’re vaccinated against Hep B you wont get Hep D.

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14
Q

When do babies get hep B vaccine?

A

As soon as they’re born because HEP B/C/D can be transmitted perinatally

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15
Q

What is the most transmissible BBP?

A

Hep B

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16
Q

What are symptoms of Hep B/Hep C?

A

Flu like symptoms (nausea, fever, fatigue, appetite loss, diarrhea, vomiting)
Jaundice (yellow eyes/skin)
Abdominal pain (near liver)
Enlarged liver

17
Q

What is ANti-HBsAg?

A

Hep B surface antigen on the Hep B virus

18
Q

Do detergents kill germs?

A

No, they clean basic surfaces like floors, walls, sinks. You can just scrub anti microbes off surface, but it’s not disinfected,

19
Q

What 3 factors influence your occupational risk of being infected by a BBP?

A
  1. How many pt are infected ?
  2. How easily can you transmit infection after blood exposure ? (Varies by virus- is it alive for 5 seconds or 5 minutes)
  3. What kinds of dental procedures are you doing that could potentially lead to more or less blood contact ?
20
Q

What does the 95 in N95 mask stand for?

A

It protects against 95% of organisms that are a few microns or less.

21
Q

What are the 9 things that OSHA targets when considering the BBP standard ?

A
  1. Implement the use of the Universal precautions (treat everyone as infected)
  2. Identify and use engineering Ctrls (devices that isolate or remove BBP hazards from the workplace- sharps Ctrls and devices with injury protection features)
  3. Identify and ensure the use of work practice Ctrls (reduce BBP exposure by changing how a procedure is performed- handling waste material, cleaning surfaces, handling specimens, use instruments instead of fingers to retract tissue)
  4. Provide PPE to workers for free
  5. Make HEP B vaccines available to workers at no cost
  6. Make available post exposure evaluations and Follow up for free to workers but they must document the route of exposure and how it happened
  7. use labels and signs or red bags to communicate hazards
  8. Provide info and training to workers
  9. Maintain worker medical and training records and a sharps injury log
22
Q

What does it mean to be a chronic carrier of a disease?

A

It means that your body’s immune system is incapable of clearing the virus out of your body. So you’re susceptible to passing on the disease

23
Q

About how many chronic carriers of Hep B are in the US?

A

About 1 million

24
Q

What are some possible occupational exposures to Hep B?

A

You could be infected with hep b via needlestick b/c it has a 30% infection rate for needlesticks

Also since hep b can live OVER 1 WEEK on surfaces , you could be infected by having contact with a surface that has dried blood or OPIM on it

25
Q

About how many chronic carriers of the Hep C virus are there in the US?

A

About 3.5 million , most are baby boomers born bw (1945-1965)

26
Q

What’s the tx for hep C being that there’s no vaccine for it?

A

SVR- sustained virologic response

27
Q

How does HIV attack the immune system ?

A

It destroys white blood cells (immune defender cells) therefore leaving the pt immune system suppressed and susceptible to infections and certain tumors

  • CD4+lymphocyte
  • T4 cells
  • T helper cells
28
Q

What’s the fxn of a Cd4+ lymphocyte ?

A

CD4 T lymphocytes (CD4 cells) help coordinate the immune response by stimulating other immune cells, such as macrophages, B lymphocytes (B cells), and CD8 T lymphocytes (CD8 cells), to fight infection.

29
Q

What’s the fxn of a T4 cell?

A

The primary role of T4-lymphocytes is to regulate the body’s immune responses through the production of cytokines.T4-lymphocytes display CD4 molecules and T-cell receptors (TCRs) on their surface.
The TCR on T4-lymphocytes, in cooperation with CD4, typically bind peptides from exogenous antigens bound to MHC-II molecules. After activation, the dendritic cell produces cytokines that contribute to proliferation of the T4-lymphocytes and their differentiation into effector T4-lymphocytes, the cells the body uses to regulate both humoral immunity and cell-mediated immunity through the cytokines they produce.

A type of T cell that has CD4 markers on its surface and participates in the immune response by recognizing foreign antigens and secreting substances called cytokines that activate T and B cells. T-helper cells fall into two main classes: those that activate other T cells to achieve cellular inflammatory responses; and those that drive B cells to produce antibodies in the humoral immune response

30
Q

What are some symptoms of HIV?

A 
Fever lasting over a month
Diarrhea over a month
Severe unexplained weight loss
Pneumonia
Constant cough
Enlarged lymph nodes
Fatigue
31
Q

What’s the most affected region with HIV?

A

Sub Saharan Africa

32
Q

What’s the purpose of receiving antiretroviral therapy if there’s no cure for HIV?

A

It’s to lower the amount of virus that’s in the blood. It’s a kind of post exposure prophylaxis (PEP) given within 72 hours of HIV exposure to prevent infection. PEP includes counseling , first aid , HIV testing , if needed administering a 28 day course of antiretroviral drugs

33
Q

Besides being spread via needlestick exposure or mucous membrane exposure (very low transmission rate for these), Can HIV be spread from blood on a surface ?

A

No it’s not transmitted via dried blood because HIV can’t survive on surfaces outside of the body

34
Q

If HIV is so low risk, why are we worried about it ?

A

There’s no vaccine for the disease, some HIV strains can be resistant of antiretroviral therapy and the therapy can be very expensive and have side effects

35
Q

What are the risks of becoming infected from a needlestick accident from the 3 diseases: Hep B, Hep C, and HIV?

A 
Hep B (30%, 3 out of 10 needlesticks)
Hep C (2%, .2 out of 10 needlesticks)
HIV (.3%, .03 out of 10 needlesticks)

ELCS (4 decks)

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