Chapter 24 | Infectious Disease and Sepsis

Question 1

List:

types of infectious disease

2 points

Answer 1

• bacteria
• viruses (and other microbes)

Question 2

Define:

communicable disease

Answer 2

disease which spreads with direct contact or contact with secretions

Question 3

List:

factors causing infection/illness after exposure

4 points

Answer 3

• virulence (strength of virus)
• dose (how much virus)
• route (how virus got in)
• resistance (ability to fight virus)

Question 4

Define:

sepsis

Answer 4

life-threatening condition caused by body’s counterproductive response to an infection

Question 5

Define:

septic shock

Answer 5

shock caused by body’s response to infection

Question 6

List:

3 stages of sepsis

how sepsis progresses

Answer 6

• (local) infection
• (systemic) sepsis
• (systemic) septic shock

Question 7

List:

locations of body associated with sepsis

4 points

Answer 7

• lungs
• GI tract
• genitourinary tract
• skin

Question 8

Describe:

primary cause of sepsis associated with lungs

Answer 8

pneumonia

Question 9

List:

causes of sepsis associated with GI tract

2 points

Answer 9

• abdominal surgery
• pancreatitis

Question 10

List:

causes of sepsis associated with genitourinary tract

4 points

Answer 10

• kidney infections
• prostate infections
• urinary catheter
• UTI

Question 11

List:

causes of sepsis associated with skin

4 points

Answer 11

• long-term IV catheter
• tracheostomy
• gastronomy tube
• pressures sores

Question 12

Define:

SIRS

(abbreviation)

Answer 12

systemic inflammatory response syndrome

Question 13

List:

criteria for SIRS

5 points

Answer 13

• low/high temperature
• high HR
• high RR
• Low BP
• new-onset/worsened mental status

Question 14

Define:

qSOFA

(abbreviation)

Answer 14

quick sepsis-related organ failure assessment

Question 15

Fill in the blank:

qSOFA [DOES/DOESN’T] predict whether someone is septic.

Answer 15

qSOFA does not predict whether someone is septic.

quick sepsis-related organ failure assessment

Question 16

Fill in the blank:

qSOFA predicts [BLANK].

Answer 16

qSOFA predicts whether septic patient will have longer to stay in ICU or be more likely to die.

quick sepsis-related organ failure assessment

Question 17

Fill in the blank:

Chickenpox is caused by the [BLANK] virus.

Answer 17

Chickenpox is caused by the varicella-zoster virus (VZV).

Question 18

Fill in the blank:

[BLANK] is caused by the varicella-zoster virus (VZV).

Answer 18

Chickenpox is caused by the varicella-zoster virus (VZV).

Question 19

Describe:

early signs/symptoms of chickenpox

Answer 19

vague symptoms resembling cold

Question 20

List:

later signs/symptoms of chickenpox

2 points (the ones you expect to see)

Answer 20

• fever
• itchy rash (looks like blisters)

Question 21

Fill in the blank:

Chickenpox [IS/ISN’T] contagious.

Answer 21

Chickenpox is very contagious.

Question 22

List:

ways chickenpox spreads

2 points

Answer 22

• direct person-to-person contact
• airborn from rash

Question 23

Fill in the blank:

Dried scabs [CAN/CAN’T] spread chickenpox.

Answer 23

Dried scabs cannot spread chickenpox.

Question 24

List:

signs/symptoms of measles

5 points

Answer 24

• fever
• cough
• eye irritation
• Koplik spots (white spots inside cheek)
• red and blotchy rash

Question 25

List:

signs/symptoms of mumps

6 points

Answer 25

• swollen parotid glands
• sore throat
• fever
• headache
• aches/tenderness
• fatigue

Question 26

List:

signs/symptoms of hepatitis A

6 points

Answer 26

• fever
• nausea/vomiting
• loss of appetite
• malaise
• abdominal pain
• jaundice

(typically mild but generally worse in older patients)

Question 27

Fill in the blank:

Hepatitis A is spread by [BLANK].

Answer 27

Hepatitis A is spread by fecal-oral route.

Question 28

List:

signs/symptoms of hepatitis B

4 points (basically the same as hepatitis C)

Answer 28

• nausea/vomiting
• loss of appetite
• vague abdominal pain
• (later) jaundice

Question 29

List:

signs/symptoms of hepatitis C

3 points (basically the same as hepatitis B)

Answer 29

• nausea/vomiting
• loss of appetite
• vague abdominal pain

Question 30

Fill in the blank:

Ticks carry [BLANK].

Answer 30

Ticks carry lyme disease.

Question 31

Choose:

The term “severe sepsis” is no longer used because:

A. sepsis is very rarely severe, and typically involves only local responses to infection.

B. it does not differentiate patients or predict who is at higher risk of death.

C. the term “virulent sepsis” is used instead.

D. the word “severe” is considered stigmatizing and insensitive.

Answer 31

B

Question 32

Choose:

A vaccine for a particular disease:

A. increases the severity of the disease when it occurs.

B. may not exist or have been approved.

C. produces greater complications when that disease occurs.

D. always prevents that disease from occurring.

Answer 32

B

Question 33

Choose:

Vasodilation during septic shock is caused by:

A. blood returning to the heart.

B. intravenous fluids.

C. “leaky” capillaries.

D. chemicals produced by the body.

Answer 33

D

Question 34

Choose:

A cause of sepsis involving the central nervous system is:

A. a long-term intravenous catheter.

B. pancreatitis.

C. meningitis.

D. tracheostomy.

Answer 34

C

Question 35

Fill in the blank:

A respiratory rate of [BLANK] is a sign of systemic inflammatory response syndrome.

(greater/less than X)

Answer 35

A respiratory rate of greater than 20 is a sign of systemic inflammatory response syndrome.

Question 36

Choose:

In a patient with a systolic BP below 90, what other sign, using SIRS criteria, would urge you to give the emergency department a sepsis alert?

A. Respiratory rate of 19

B. Temperature of 100.2F

C. Temperature of 95.9F

D. Pulse of 86

Answer 36

C

if patient has systolic BP below 90 and temperature below 96.8 F, then this patient meets two of SIRS criteria (urging a sepsis alert)

Question 37

Choose:

A patient complains of a cough and fever, and she reports recent night sweats and weight loss. You suspect she has TB, and accordingly you and your partner begin using N-95 respirators in addition to the Standard Precautions you had already been taking. She says that the respirators are making her feel judged and insists that you remove them.

What do you do?

A. Ask her if she would prefer you and your partner wear surgical masks.

B. Tell her that if she had received the TB​ vaccine, she would not currently be infected.

C. Tell her that it is standard procedure to wear​ N-95 respirators in response to any suspected infections.

D. Explain that because you suspect an airborne​ disease, the respirators are to prevent the infection from spreading.

Answer 37

D

you should honestly explain the reason you and your partner are wearing the respirators

surgical masks would not be effective against TB and N-95 respirators are not necessary in response to infections that are not airborne

TB vaccine is not very effective and you don’t know for sure that the patient has TB

Question 38

Choose:

Your partner has been exposed to the blood of a trauma patient you suspect of hepatitis B infection. The exposure was from the patient’s coughing blood that splashed your partner’s face around the area of the mouth. Your partner was not wearing a mask, and begins washing the exposed area. The patient complains that your partner should ignore the blood and tend to the patient.

What do you do?

A. Inform your partner later that you thought immediately washing the exposed area was unprofessional.

B. Tell the patient that hepatitis B infection is no small​ concern, and not to worry about your​ partner’s actions.

C. Explain that washing the exposed area in such cases is necessary to do right away.

D. Ask your partner to finish washing the exposed area later.

Answer 38

C

if you sustain significant exposure to blood/fluids, wash site with soap and water (just water for eye exposure) and see healthcare provider right away

telling the patient not to worry about your partner’s actions doesn’t explain them

it is not appropriate to ask your partner to wash the exposed area later or to inform her that her actions were unprofessional

Question 39

Choose:

You are responding to a call at the home of a patient who is experiencing a diabetic emergency. A neighbor approaches you to tell you to be careful because the patient has AIDS.

What do you do?

A. Inform this person that it’s illegal to interfere with an EMT on duty responding to a call.

B. Say that given the infection risk, the neighbor should stay well away from the scene.

C. Briefly explain that the Standard Precautions you would use with any patient are sufficient here as well.

D. Signal to your partner to continue to the patient while you engage the neighbor’s misconceptions.

Answer 39

C

this lets you tell the truth while also not getting bogged down with the neighbor when you need to respond to the patient’s emergency

D is wrong because it’s not appropriate to delay care to engage in a debate with the neighbor

the other answers are wrong because involve spreading or reinforcing misinformation

Question 40

Choose:

You see many people at a facility where several tuberculosis cases have been reported wearing surgical masks to guard against the disease. This solution is:

A. effective as long as these people have been properly vaccinated against TB as well.

B. ineffective, because TB is a bloodborne, not an airborne, illness.

C. ineffective, because these masks do not filter out the particles that cause this disease.

D. effective, because wearing a surgical mask is the minimum acceptable precaution against TB.

Answer 40

C

prevention for TB (airborne illness) consists primarily of having a high index of suspicion in a patient with respiratory symptoms and taking airborne disease precautions (like N-95)

surgical mask does not filter out the small particles that spread the disease

TB vaccine not very effective (only used where disease is very common)

Question 41

True or false:

Chickenpox is not very contagious, and typically only spreads through prolonged exposure.

Answer 41

false

Question 42

True or false:

Chickenpox is very contagious and easily spread by direct person-to-person contact.

Answer 42

true

Question 43

True or false:

Chickenpox is ordinarily only a danger when in contact with contaminated food or feces.

Answer 43

false

Question 44

True or false:

Chickenpox is transmissible only to individuals with a genetic susceptibility to the disease.

Answer 44

false

Question 45

Choose:

How does the dose affect the chances of infection following exposure?

A. A person with a functioning immune system can fight off many infections.

B. Swallowing a virus will not necessarily lead to infection.

C. The number of microbes introduced affects the likelihood of illness.

D. Some viruses that enter through the bloodstream are fatal.

Answer 45

C

Question 46

Choose:

A patient is infected with hepatitis A. She says she is afraid that other people hearing about her infection will think she is unclean. She insists that she observes good personal hygiene.

What is the best response to this patient?

A. You need to make her infection publicly known as a safety measure.

B. The patient needs to wash her hands more carefully.

C. Hepatitis A is a bloodborne illness, and doesn’t have to do with hygiene.

D. The patient could have ingested improperly prepared food.

Answer 46

D

Question 47

Choose:

You are called to the apartment of a person with HIV who had experienced a heat emergency. As you are treating this patient, she tells you that her neighbors avoid her because they think any exposure to her is dangerous.

What should you do?

A. offer to scold these neighbors on her behalf to make them aware that their concerns are foolish.
B. assure her that she​ doesn’t present any health risk to her neighbors from casual contact.
C. make a mental note to complain to the building superintendent about these neighbors.
D. tell her that her neighbors are discriminating against​ her, but you and your partner support her.

Answer 47

B

Question 48

True or false:

Bacteria are living organisms that need to be inside a host to reproduce.

Answer 48

false

bacteria can reproduce independently of a host cell

Question 49

True or false:

Bacteria are living organisms that have a protein coat or shell.

Answer 49

false

only prokaryotes have a cell wall, but many eukaryotes do not

Question 50

True or false:

Bacteria are living organisms that have few if any beneficial uses.

Answer 50

false

bacteria even makes food like cheese, yogurt, soy sauce, and vinegar

Question 51

True or false:

Bacteria are living organisms that consist of a single cell.

Answer 51

true

bacteria are single-celled organisms

Question 52

True or false:

Viruses are microbes that need to be inside a host to reproduce.

Answer 52

true

viruses can only reproduce inside host cells

Question 53

True or false:

Viruses are microbes that cannot survive for long inside a host.

Answer 53

false

yes they can

Question 54

True or false:

Some viruses are necessary for the body’s survival.

Answer 54

false

Question 55

True or false:

Viruses are microbes that need either DNA or RNA to reproduce.

Answer 55

true

viruses depend on host cell’s protein synthesis pathways to reproduce

Question 56

Answer:

A patient presents with new-onset altered mental status and the following vital signs: temperature of 101.3°F, pulse of 90bpm, RR of 20 bpm, and BP of 90/60.

Based on these findings and SIRS criteria, do you give the emergency department a sepsis alert? Why or why not?

Answer 56

yes because temperature and AMS meet SIRS criteria

Question 57

Choose:

Which of the following individuals is likely in the incubation period of chickenpox?

A: A patient who was vaccinated last year, exposed 4 weeks ago, and shows no signs

B: A patient who was exposed 6 days ago but does not yet have a fever or rash

C: A patient whose rash and fever went away a week ago

D: A patient with a fever and a rash on the abdomen and back that began 3 days ago

Answer 57

B

incubation period refers to the period between exposure to an infection and the appearance of the first symptoms

Question 58

Choose:

According to the signs of systemic inflammatory response syndrome (SIRS), which of the following infection patients has an increased risk of sepsis?

A: A patient with a temperature of 95.4°F and a respiratory rate of 28

B: A patient with respiratory rate of 19 and a heart rate of 112

C: A patient with a heart rate of 88 and a temperature of 99.6°

D: A patient with a systolic blood pressure of 75 mmHg and a respiratory rate of 18

Answer 58

A

Question 59

Choose:

What role do health care workers play in handling public crises related to newly recognized infectious diseases?

A: They disseminate information about diseases and their treatment to health care providers and institutions.

B: They implement the steps outlined by the CDC and other agencies to reduce the number of people who become infected.

C: They work closely with local health departments to determine the microbes responsible for the disease and how to treat them.

D: They report information about the outbreaks to the public and share information about the prevalence and spread of the conditions.

Answer 59

B

Question 60

Choose:

Which of the following patients is at the lowest risk of developing sepsis?

A: A pediatric patient who has developed pneumonia in both lungs

B: A college-aged patient who breaks his arm in a skateboard crash

C: A patient with a compromised immune system who has a permanent gastrostomy tube

D: An elderly patient who is recovering from abdominal surgery

Answer 60

B

Question 61

Choose:

Which of the following is the most important thing you can do when treating patients during a public crisis related to a newly recognized infectious disease?

A: Gather data about patient signs and symptoms and report them to the local health department.

B: Share information with patients about the prevalence of the disease.

C: Tell patients not to worry because new reports exaggerate the severity of these diseases.

D: Follow the recommendations of the CDC and your local health department.

Answer 61

D

Question 62

Choose:

Which animal bite-associated infection can lead to bacteremia and fatal sepsis, particularly in individuals without a spleen or those with liver disease?

A. Cat scratch fever

B. Capnocytophaga canimorsus

C. Pasteurella species

D. Streptococcus pyogenes.

Answer 62

B