Bloodborne Pathogens

Question 1

What is hepatitis and what is it caused by?

Answer 1

*Inflammation of the liver *can be caused by viruses *toxic substances (ETOH, meds, industrial solvents)

Question 2

When is hepatitis acute vs. chronic?

Answer 2

Acute if 6 motnths or less, chronic if over 6 months

Question 3

What are the signs and symptoms of hepatitis?

Answer 3

**fatigue, nausea, decreased appetite, mild fever, mild RUQ pain

** later signs include jaundice, dark urine

Question 4

Discuss Hep A. characteristics.

Answer 4

*highly contagious, single stranded RNA *spread fecal-oral incubation is 14-28 days *usually mild, most people don’t know they have

Question 5

What is the clinical presentation of Hep A?

Answer 5

• fever -malaise -decrease appetite -abdominal discomfort

Question 6

What are the risk factors for Hep A?

Answer 6

-poor sanitation -lack of clean water -injecting drugs -health care workers -sex partners -living in house with infected person -not vaccinated

Question 7

What labs do you order for Hep A?

Answer 7

-CBC -LFT -CMP -Hepatitis panel–> if pt has + then: —IgM, IgG for specific A

Question 8

Treatment and prevention for Hep A

Answer 8

-support -avoid meds that are hepatotoxic (acetaminophen) -avoid ETOH -safe drinking water -proper sewage disposal -hand washing -immunize

Question 9

Discuss Hep B characteristics

Answer 9

–double stranded virus -transmitted by infected blood/serum -sex

Question 10

How is Hep B transmitted

Answer 10

-blood, bodily fluids -sharing needles -mom to infant RISK FACTOR BEING HEALTH CARE WORKER

Question 11

What is the clinical presentation of Hep B?

Answer 11

–jaundice, fatigue/malaise, N/V

Question 12

Treatment and prevention for hep B

Answer 12

-treatment aimed at controlling virus and preventing damage to liver -antivirals (benefit most people) -reg blood tests prevention = vaccine

Question 13

Hep C characteristics

Answer 13

-most common cause of chronic hepatitis, cirrhosis and liver cancer –single stranded RNA (2-26wks for incubation) -no vaccine

Question 14

Transmission of Hep C.

Answer 14

-IV drug use -high risk sex -reuse of unsterile medical equiptment (NOT SPREAD BY BREAST MILK, KISSING, HUGGING OR BEING AROUND INFECTED PERSON)

Question 15

Clinical presentation of Hep C

Answer 15

-fever -fatigue -n/v -abd pain, dark urine -80% don’t show sx and those listed above are acute

Question 16

What are tests for Hep c?

Answer 16

1st serological test 2nd nucleic acid test

Question 17

Treatment and prevention for hep c?

Answer 17

-treatment (not all require) -cure with: interferon and ribavirin, direct antiviral agents (DAA)are better tolerated 12 weeks but expensive -prevent by condoms, safe sharp handling, testing donated blood, hand hygiene

Question 18

HIV characteristics

Answer 18

retrovirus attacking CD4

Question 19

Transmission of HIV

Answer 19

-sex (semen, vag secretions) -IV drug use -mothers to infants

Question 20

Risk factors for HIV

Answer 20

-unprotected anal or vaginal sed -IV drug use -accidental needle sticks among health care providers

Question 21

Presentation of HIV

Answer 21

-Acute: fever, HA, rash, sore throat -Later: swollen lymphnodes, weight loss, cough, carps sarcoma, meningitis, TB, lymphomas

Question 22

Diagnosis of HIV

Answer 22

-enzyme immuno assay -western blot -pcr 5 cs: connection, confidential, counsel, correct results, connection

Question 23

treatment of HIV

Answer 23

ART

Question 24

Opportunistic infections seen with AIDS

Answer 24

-pneumonia -brain infections (toxoplasmosis) -MAC = widespread infection= fever, weight loss -yeast inf. of esophagous -histoplasmosis = fever, couch, anemia -lymphoma -kaposis sarcoma -acute necrotizing ulcerative gingivitis (ANUG)

Question 25

What do universal precautions apply to?

Answer 25

-blood -bodily fluids -semen -vag secretions -CSF -synovial, pleural, peritoneal, pericardial, amniotic fluids

Question 26

What do universal precautions NOT apply to ?

Answer 26

-feces -nasal secretions -sputum -sweat -vomitus -urine -saliva -tears

Question 27

What are other exposure causes (other than needle sticks?)

Answer 27

-trauma (bone fragments, bleeding) -childbirth -improper disposal of instruments -improper universal precautions -skin contact -open wound, chapped non-intact skin -mucous membrane -donated blood -airborne