Chapter 3 CIC Identification of infectious disease processes Flashcards
Get my CIC from APIC
A patient was just admitted to a long-term care facility from the local hospital. The patient is being treated for psoriasis. The psoriasis does not appear to be responding to treatment, and 48 hours later, the Infection Preventionist (IP) receives a report that a Certified Nursing Assistant has developed an itchy rash. The patient’s physician visits and determines that the patient has crusted scabies and not psoriasis. Another name for crusted scabies is:
a. American scabies
b. Norwegian scabies
c. Canadian scabies
d. English scabies
B - Norwegian scabies is a severe form of scabies that can occur in individuals who may be immunocompromised, elderly, disabled, or debilitated.
APIC Parasites.
Guidelines for transporting specimens include
- ) Transport within 2 hours of collecting a specimen.
2) Transport in leakproof specimen containers and sealable leakproof bags.
3) Transport specimen in the syringe used to collect it.
4) Refrigerate all specimens prior to transport.
a) 1,4. b) 2,3. c) 1,2. d) 3,4
c. 1,2The appropriate selection, collection, and transport of specimens to the diagnostic microbiology laboratory are essential parts in the accurate identification of microorganisms that cause infections that affect patient care and infection prevention.
See Answers and Rationale page 53.
This is not from APIC
Which is True about a tuberculin skin test (TST):
a. Positive TST indicates active tuberculosis infection.
b. Negative TST rules out active TB infection.
c. Positive TST indicates past exposure to TB.
d. Negative TST indicates past exposure to TB.
c. Positive TST indicates past exposure to TB. TST involves injection of purified protein derived from the mycobacterial cell wall.
Tuberculosis and Other Mycobacteria
The optimal time to collect a sputum specimen for acid-fast bacilli (AFB) testing to rule out TB would be:
a. First thing in the morning.
b. After a respiratory treatment.
c. Prior to the patient going to bed.
d. Prior to a respiratory treatment.
a. First thing in the morning. Because pulmonary disease is the most common form of TB, patients with suspected TB should have a chest radiograph.
APIC Tuberculosis and Other Mycobacteria
A hospital has hired a new manager of the Microbiology section of the laboratory. During the initial discussion with the manager about the Infection prevention and control program, the IP stresses the importance of collaboration between the departments in reducing healthcare-associated infections (HAIs). Of the choices below, which activity will best meet this goal?
a. The Microbiology staff’s compliance with the annual flu vaccination program and tuberculosis skin testing.
b. The Microbiology staff’s participation in the periodic infection prevention educational sessions for hospital staff.
c. Microbiology’s prompt notification to the Infection prevention and control department of any organism’s unusual resistance pattern.
d. The Microbiology manager’s attendance at local, state and / or national infection prevention and control educational conferences.
c. Microbiology’s prompt notification to the Infection prevention and control department of any organism’s unusual resistance pattern.
APIC Hepatitis
The primary immune response after exposure to a communicable disease pathogen or vaccine is production of:
a. Immunoglobulin G (IgG)
b. Immunoglobulin M (IgM)
c. Immunoglobulin A (IgA)
d. Immunoglobulin C (IgC)
b. Immunoglobulin M (IgM) During the primary immune response that occurs after a communicable disease pathogen or vaccine is encountered, the class of antibody that is produced first is IgM. IgG develop a few weeks later and are a good indication of the convalescence period and generally mark the establishment of long-term immunity to the pathogen.
Infection Preventionists’ guide to the Lab
See the Answers and Rational pg 54
When are IgM antibodies to Hepatitis A virus (HAV detectable in the blood?
a. 30 days after exposure.
b. 5 to 10 days after exposure.
c. 1 to 4 days after exposure.
d. 15 - 20 days after exposure.
b. 5 to 10 days after exposure.Hepatitis A is an acute liver disease caused by HAV. Clinical features of acute hepatitis are not specific for HAV infection, so serological diagnosis is necessary. IgM antibodies to HAV (IgM anti-HAV), which are used to diagnose acute HAV infection are detectable with in 3 weeks of exposure and are present a the onset of jaundice.
See Answers and Rationale pg 55
The incubation period for pertussis in immunocompetent persons is usually:
a. 7 to 10 days.
b. 3 to 5 days.
c. 1 to 2 days.
d. 2 to 4 days.
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a. 7 to 10 days.
Pertussis is a highly communicable, acute infectious respiratory disease caused by Bordetella pertussis. The incubation period in immunocompromised patients is usually 7 to 10 days, with a range of 6 to 21 days. In rare cases, the incubation period may be as long as 42 days.
APIC Bordetella pertussis
A patient who was hospitalized for 2 days calls 3 days after discharge complaining that he has developed healthcare-associated scabies due to his recent inpatient stay. The IP know that his scabies infestation is not healthcare-associated because:
a. Scabies is only transmitted through contaminated linens.
b. The incubation period for scabies is longer than 5 days.
c. The incubation period for scabies is shorter than 3 days.
d. Scabies is only transmitted through direct contact and none of the healthcare personnel who cared for the patient are infested.
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b. The incubation period for scabies is longer than 5 days. It may be as short as 10 days but is typically between 4 to 6 weeks. Therefore, the patient could not have acquired scabies during the hospital stay because, based on the incubation period, he would need to have been exposed at least 5 days before he was admitted.
APIC parasites
A nurse is concerned that a patient in the neurology ward has a prion disease after receiving a lab report stating that the patient had a positive nucleic acid test for John Cunningham virus (JCV) in the cerebrospinal fluid. What is the best response to give this nurse?
a. The test is positive for Creutzfeldt-Jakob disease, which is a prion disease.
b. The test is positive for Camphlobactor jejuni, which is not a prion disease.
c. The test is positive for JCV (a polyomavirus, which is not a prion disease.
d. the test is positie for JCV ( a polyomavirus), which is a prion disease.
The test is positive for JCV (a polyomavirus), which is not a prion disease.
JCV is a polyomavirus that can cause a demyelinating disease called progressive multifocal leukoencephalopathy in immunocompromised patients. Because the name and some presenting symptoms, JCV is sometimes confused with CJD, which is a prion disease.
APIC Prion disease
- An IP is conducting an educational session to help the nursing staff understand infectious disease transmission. She explains that the initial element in virulence is the ability of an organism to survive in the external environment during transit between hosts. What is the second element of virulence?
a. Secretion of enzymes that enhance spread through tissues.
b. A mechanism for transmission to a new host.
c. invasion and dissemination in the host.
d. Avoidance of host resistance.
11.
b. A mechanism for transmission to a new host.The second element in virulence is a mechanism for transmission to a new host.
APIC Microbial pathogenicity and host response
- The Management of an infected surgical site includes the following foundational principles:
1) Open and drain the incision
2) Debride fibrous debris and necrotic soft tissue
3) Replace hardware
4) Implement antimicrobial management as needed
5) Manage the open wound
a. 1,2,3,4 b. 2,3,4,5 c. 1,3,4,5 d. 1,2,4,5
- D - 1,2,4,5
1) Open and drain the incision
2) Debride fibrous debris and necrotic soft tissue
4) Implement antimicrobial management as needed
5) Manage the open wound
APIC surgical site infection
- During annual TST, an employee’s test result was read as 10mm induration. The employee’s last TST was negative. This initial result indicates a:
a. Positive test.
b. False positive.
c. Negative test.
d. False negative
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A - positive test is determined by the number of mm of induration (Not erythema) caused by the reaction to the tuberculin.
See Answers and rationals pg 56
- A microbe that can grow in the absence of oxygen but is also able to utilize oxygen for growth is a/an:
a. Aerobe.
b. Obligate anaerobe.
c. Facultative anaerobe.
d. Microaerophilic aerobe
14.
C - Facultative anaerobe will utilize oxygen if it is present but are still able to grow in the absence of oxygen.
APIC chapter Microbiology Basics
- Western blot testing for human immunodeficiency virus (HIV) is used to detect:
a. HIV DNA in a serum sample.
b. HIV RNA in a serum sample.
c. HIV antibodies in a serum sample.
d. HIV proteins in a serum sample
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C - antibodies in a serum sample. Western blot is a confirmatory test that is performed on all samples that have tested positive for HIV on enzyme immunoabsorbent assay (EIA).
APIC text HIV/AIDS
- An infection preventionist (IP) is reviewing the cerebrospinal fluid (CSF) results from a patient admitted the previous night. The CSF is cloudy and has an elevated WBC, markedly increased neutrophils, low glucose level and elevated protein concentration. What type of meningitis should she suspect?
a. Bacterial.
b. Viral.
c. Fungal.
d. Aseptic
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a - BacterialThe diagnosis of bacterial meningitis rests on examination of the CSF.
APIC Laboratory Testing and diagnosis
- Which of the following statements about influenza is false?
a. Influenza is primarily spread between individuals via respiratory secretions (droplets)
b. Viral shedding starts 48 to 72 hours after infection and typically 48 hours before the onset of symptoms.
c. Viral shedding normally persists for less than 5 days but can be longer in children and in immunocompromised persons.
d. The typical influenza symptomology is not always predictive of influenza in elderly or immunocompromised persons.
17.
b. - Viral shedding starts 48 to 72 hours after infection and typically 48 hours before the onset of symptoms.
Influenza viruses are spread from person to person primarily through large-particles respiratory droplet transmission.
APIC text Influenza
- Which of the following statements is false regarding influenza viruses?
a. They are divided into three categories: A, B, and C
b. Influenza A strains have been the predominant cause of worldwide epidemics (pandemics)
c. Influenza A and B strains have been named according to the city or state and year of their initial isolation.
d. Influenza B strains have not been associated with large epidemics.
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d. Influenza B strains have not been associated with large epidemics.
APIC Influenza
- Which factor is commonly associated with Clostridium difficile infections? (CDI).
a. Chemotherapeutic agents
b. ACE inhibitors
c. Prophylactic antibiotics or antibiotic to treat a primary bacterial infection.
d. Antiviral medication to treat a primary viral infection
19.
c - Prophylactic antibiotics or antibiotic to treat a primary bacterial infection. C-diff is a spore-forming, Gram-positive anaerobic bacillus that produces two exotoxins: toxin A and toxin B. It is a common cause of antibiotic-associated diarrhea (AAD). It accounts for 15-25 percent of all episodes of AAD.
APIC text Clostridium difficile infection and Pseudomembranous Colitis
- The IP is reviewing the history of a patient who has been in the facility on a ventilator for a week. All of the following are risk factors for colonization and infection with multidrug-resistant pathogens except:
a. Antimicrobial therapy in preceding 90 days.
b. Current hospitalization of 5 days or more.
c. Immunosuppressive state or therapy.
d. Low frequency of antibiotic resistance in the facility.
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d - Low frequency of antibiotic resistance in the facility.Pneumonia may be caused by a wide variety of pathogens, but multidrug-resistant organisms (MDRO) are becoming more relevant as etiologic agents.
APIC text Pneumonia
