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Dental Hygiene > Chapter 5 > Flashcards

Chapter 5 Flashcards

1
Q

Infection and communicable disease can lead to?

A

Illness, disability, and loss of work time.

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2
Q

Aside from the clinician, infection and communicable disease can also lead to?

A

Patients and family members also become exposed, become ill, lose productive time, and suffer permanent aftereffects.

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3
Q

(DHCP) stands for?

A

Dental healthcare personnel.

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4
Q

For training of DHCP, facilities/healthcare offices must?

A

Operate under an organized system for training of DHCP.

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5
Q

For training of DHCP, facilities/healthcare offices training must have strict adherence to?

A

Standard precautions, transmission-based precautions, safe injection practices, and sharp safety.

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6
Q

All DHCP are responsible for?

A

Preventing direct and indirect cross-contamination and preventing disease transmission between DHCP and patients and patient to patient.

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7
Q

What are infectious agents?

A

Infectious agents are organisms that are capable of producing infection and/or infectious diseases.

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8
Q

Each infectious agent has?

A

Specific characteristics that make specific reactions in an infected individual and can be pathogenic.

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9
Q

Nonpathogenic agents may have pathogenic outcomes in?

A

Susceptible individuals.

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10
Q

Humans’ response to infectious agents varies with?

A

The status of the host immune system and the pathogenicity of the invading agent.

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11
Q

Infectious agents include?

A

Bacteria, virus, fungi, protozoa, helminths, and prions.

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12
Q

List four characteristics of bacteria.

A

Microscopic, living organisms, single-celled, and found in every habitat and environment.

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13
Q

Some diseases caused by bacteria can be treated by or with?

A

Antibiotics.

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14
Q

Other diseases caused by bacteria can be prevented with?

A

Vaccines.

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15
Q

List characteristics of viruses.

A

Microscopic, non-living, subcellular, capable of gaining entrance into a limited range of living cells, use host mechanisms to reproduce/replicate inside of a host cell, and only contains DNA or RNA, not both.

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16
Q

Some diseases caused by viruses can be treated with?

A

Antiviral medication.

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17
Q

Some diseases caused by viruses can be prevented through?

A

Vaccinations.

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18
Q

List two characteristics of fungi.

A

Living organisms and single-celled or multicellular.

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19
Q

Diseases caused by fungi can be treated with?

A

Antifungal agents.

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20
Q

Diseases caused by fungi can/cannot be prevented with vaccinations?

A

Cannot.

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21
Q

List two characteristics of protozoa.

A

Single-celled and cause parasitic infections.

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22
Q

An example of a disease-causing protozoa would be?

A

Plasmodium that is transmitted by mosquitoes to humans causing malaria.

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23
Q

Three characteristics of helminths?

A

Multicellular, invertebrates, and cause parasitic infections.

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24
Q

An example of a helminth that causes disease?

A

The roundworm Trichinella spiralis is transmitted to humans causing trichinosis.

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25
Q

What are prions?

A

Misfolding proteins transmitted to humans by infected meat products that prompt normal proteins to misfold, causing neurodegenerative diseases.

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26
Q

Example of prions causing diseases?

A

Creutzfeldt-Jakob disease (CJD) and bovine spongiform encephalitis (BSE).

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27
Q

What is immunity?

A

Resistance that a person has against disease; it may be natural or acquired.

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28
Q

Immunity to a disease occurs when?

A

The immune system develops antibodies in order to eliminate the infectious agent.

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29
Q

What are antibodies?

A

A soluble protein molecule produced and secreted by body cells in response to an antigen is capable of binding to that specific antigen.

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30
Q

What are antigens?

A

A toxin or other foreign substance capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that specific antibody.

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31
Q

What is immunity?

A

The resistance that a person has against a disease. It may be natural or acquired. Occurs when the immune system develops antibodies in order to eliminate the infectious agent.

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32
Q

What is passive immunity?

A

Protection transferred from one animal or person to another.

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33
Q

How long does passive immunity last?

A

Provides immediate but temporary immunity.

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34
Q

An example of passive immunity?

A

Antibodies passed from a mother to her infant; intravenous transfusion of immunoglobulin IgG to prevent hepatitis B after exposure.

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35
Q

What is active immunity?

A

Protection acquired in the body by having the disease and recovering, or by vaccination.

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36
Q

How long does active immunity last?

A

Protection takes time to develop but can provide lifelong immunity.

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37
Q

An example of active immunity?

A

A child who contracts measles and recovers, or a child who receives the measles vaccination and does not suffer the disease symptoms.

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38
Q

What are vaccines?

A

Products that provide immunity by stimulating the immune system to produce antibodies to a specific infectious agent.

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39
Q

How are the vaccines administered?

A

Vaccines can be administered enterally (oral) or parenterally (injection or nasal).

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40
Q

The more similar a vaccine is to the infectious agent?

A

The better the immune response to the vaccine.

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41
Q

What do live attenuated vaccines contain?

A

A weakened form of the infectious agent that can provide lifelong immunity.

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42
Q

Example of a live attenuated vaccine?

A

Measles, mumps and rubella (MMR) and varicella vaccines.

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43
Q

What do inactivated vaccines contain?

A

Whole or partial inactive infectious agents manipulated to elicit an immune response.

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44
Q

Immunity from inactivated vaccines may not last?

A

Multiple doses, and booster vaccines may be necessary.

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45
Q

An example of an inactivated vaccine?

A

Poliomyelitis and hepatitis A virus vaccines.

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46
Q

What are messenger RNA vaccines?

A

Vaccines that use messenger ribonucleic acid inside of live attenuated or inactivated virus.

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47
Q

How do mRNA vaccines work?

A

They take a message to cells that prompts them to make a specific protein, which is then recognized by the immune system as an antigen.

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48
Q

How does the immune system respond to mRNA vaccines?

A

It makes antibodies against the specific protein that the mRNA vaccine made the cells make.

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49
Q

Why do the mRNA vaccines work?

A

When the specific virus finally enters the body, the immune system recognizes the protein and sends antibodies to destroy the protein, which in turn destroys the virus.

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50
Q

Messenger RNA vaccines only?

A

Deliver the message to make the protein. They cannot enter the cell nucleus or interact with, alter or damage DNA.

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51
Q

List 3 significances with vaccinations?

A

The World Health Organization lists 27 vaccine preventable diseases, of which 20 can be life threatening, and diseases that were once common are now at an all-time low after extensive and decades long vaccination programs.

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52
Q

All microorganisms are capable of?

A

Replicating and evolving to survive.

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53
Q

When infectious agents replicate, they can develop?

A

Mutations.

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54
Q

What are mutations?

A

Change in a gene because of alteration of units of the DNA or RNA.

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55
Q

What causes mutations in infectious agents?

A

Errors in replication, stress from the immune system, vaccines, and medications.

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56
Q

Mutations allow the infectious agents to?

A

Develop mechanisms that can evade the immune system and vaccines and develop resistance to drugs used to treat the disease they cause.

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57
Q

When enough mutations of an infectious agent have occurred, a new?

A

Variant of the infectious agent emerges that can be more infectious, drug resistant, and difficult to treat.

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58
Q

When a variant has developed distinct biologic characteristics that differ from the original version, it is called a new?

A

Strain.

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59
Q

In utero, the oral cavity is?

A

Sterile.

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60
Q

After birth, microorganisms are transmitted to the infant from?

A

The mother, other family members, and caretakers.

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61
Q

As the infant grows, there is continuing introduction of diverse microorganisms that colonize the oral cavity forming complex?

A

Oral biofilms.

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62
Q

The microbiota of the average adult harbors?

A

50 to 100 billion bacteria, represented by over 700 different organisms.

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63
Q

What is the correlation between Infection Potential and dentistry?

A

Pathogenic, potentially pathogenic, or non-pathogenic microorganisms may be permanently or transitorily present in the oral cavity of each patient.

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64
Q

Intact mucous membranes of the oral cavity provide some protection against infection and?

A

Decrease infection potential.

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65
Q

What is cross contamination?

A

The spread of microorganisms from one source to another: person to person or person to an inanimate object and then to another person.

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66
Q

Recognition of possible transfer of transmissible diseases provides the basis for?

A

Planning a system of disinfection, sterilization, and management of instruments, equipment and environment.

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67
Q

Disease transmission within a dental facility may occur because of inappropriate work practices such as?

A

Careless hand washing and/or unhygienic personal habits, inadequate sterilization and handling of sterile instruments and materials, and inadequate or inappropriate personal protective equipment, ventilation and overall infection control practices.

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68
Q

What are standard precautions?

A

Standard precautions represent a minimum standard care to both protect DHCP and prevent the HCP from transmitting infectious agents among themselves and their patients.

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69
Q

Standard precautions apply to?

A

All patients and procedures.

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70
Q

Which bodily fluids apply to standard precautions?

A

Blood, saliva, nonintact or broken skin, mucous membranes, and all body fluids secretions and excretions, except for sweat, regardless of whether they contain blood.

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71
Q

What are transmission based precautions?

A

Transmission-based precautions are to be used in addition to standard precautions when a patient has or is suspected of having a disease that can spread through contact, droplet, or airborne routes.

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72
Q

List the four precautions under transmission-based precautions.

A

Droplet precautions, contact precautions, airborne precautions, and sharps precautions.

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73
Q

Transmission based precautions must be used in addition to?

A

Standard precautions when a patient has or may have a disease that could be transmitted via contact, droplet, or airborne routes.

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74
Q

What is the purpose of Droplet precautions?

A

They are intended to prevent disease transmission from close (short distance) respiratory or mucous membrane contact with respiratory secretions transmitted through airborne droplets (sneezing, coughing, talking).

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75
Q

What is the purpose of contact precautions?

A

Intended to prevent disease transmission from direct or indirect contact with the patient or patient’s environment.

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76
Q

What is the purpose of airborne precautions?

A

Intended to prevent transmission of diseases that remain infectious while suspended in the air over long distances.

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77
Q

In accordance with Airborne precautions, dental facilities must have?

A

Special air handling and ventilation.

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78
Q

What is the purpose of sharps precautions?

A

Intended to prevent bloodborne pathogen transmitted by percutaneous sharps injury.

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79
Q

What does percutaneous mean?

A

Passing through the skin.

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80
Q

A chain of events is required for the spread of an infectious agent?

A

True.

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81
Q

What are the six essential links for the spread of an infectious agent?

A
  1. Infectious agent. 2. A reservoir. 3. Portal of exit. 4. Mode of transmission. 5. Port of entry. 6. Susceptible host.
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82
Q

All 6 links need to be present for the infectious agent to spread?

A

True.

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83
Q

Chain of infection can be broken with?

A

Standard precautions, infection control plan, sterilization, disinfection and more.

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84
Q

A break in the chain of one or more of the six major links in the chain of disease transmission is required to stop the spread of an infectious agent?

A

True.

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85
Q

What can be applied at every link of the chain of disease transmission to interrupt the chain?

A

Standard precautions and transmission-based precautions.

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86
Q

List just some examples of infectious agents.

A

Bacteria, viruses, fungi, protozoa.

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87
Q

Each infectious agent has its own?

A

Specific reaction in an infectious host.

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88
Q

What is a reservoir?

A

Where the infectious agents are found in their own essential environment.

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89
Q

List out 4 examples of reservoirs of disease.

A

People: lungs are reservoirs for M tuberculosis; equipment; instruments; dental unit waterlines: potential reservoir of L. pneumophila.

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90
Q

What is a port of exit?

A

Mode of escape from the reservoir.

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91
Q

Infectious agents exit from their reservoirs through various modes, such as?

A

Coughing, sneezing, speaking, bleeding periodontium, sharps use or in water from a contaminated water line.

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92
Q

Aerosol generating procedures (AGPs) facilitate the aerosolization of infectious agents from their respective reservoirs?

A

True.

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93
Q

List out 4 examples of ports of exit.

A

Body fluids, skin and mucous membrane, droplets and spatter, aerosols.

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94
Q

What is a mode of transmission?

A

The way the infectious agent moves from the reservoir and is transmitted to the susceptible host.

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95
Q

List out 6 examples of transmission.

A

Direct contact: person to person by respiratory aerosols; indirect contact: person with contaminated hands to object, percutaneous sharps injury; aerosols: direct from person respiratory to person oral cavity via coughing, sneezing, speaking; indirect by aerosol to hands or instruments then to receiving host.

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96
Q

What is a port of entry?

A

Mode of entry of the infectious agent into the new host.

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97
Q

List out 6 examples of transmission.

A
  1. Direct contact: person to person by respiratory aerosols
  2. Indirect contact: person w/ contaminated hands to object, percutaneous sharps injury
  3. Aerosols: direct from person respiratory to person oral cavity via coughing, sneezing, speaking; indirect by aerosol to hands or instruments then to receiving host.
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98
Q

List out some ports of entry.

A

The respiratory tract, eyes, mucous membranes, non intact periodontium or skin or percutaneous sharps injury.

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99
Q

What is a susceptible host?

A

Person or animal that does not have immunity or defense to the invading infectious agent.

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100
Q

Example of a susceptible host.

A

A patient taking an immunosuppressant drug to control autoimmune diseases, prevent solid organ transplant rejection and as cancer chemotherapy.

A patient who has not had or has not maintained recommended vaccinations or does not seroconvert after vaccination. A patient who is medically compromised, elderly, or has pre-existing transmissible disease.

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101
Q

What is included under airborne transmission of infectious diseases?

A

Aerosol, droplets and splatter.

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102
Q

What is an aerosol?

A

An aerosol is a solid or liquid particles suspended in the air.

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103
Q

All dental procedures produce contamination in the form of ___ that become airborne with the potential to transmit infectious disease.

A

Aerosols.

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104
Q

Aerosol particles range in size from

A

1 to 100 um.

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105
Q

List the different aerosol sizes from smallest to largest.

A

Droplet nuclei <5um, Droplets 5-100 um, Spatter >100 um

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106
Q

Particles up to what size are capable of being inhaled?

A

200 um

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107
Q

What can be inhaled deep into the lungs?

A

Aerosolized droplet nuclei

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108
Q

What can be inhaled into the upper respiratory tract?

A

Droplets

109
Q

Where can spatter be inhaled?

A

Oropharynx and may come in direct contact with mucous membranes of the eyes, nose and mouth

110
Q

How far can particles <100 um travel when produced by coughing?

A

Up to 4 m

111
Q

How far can particles <100 um travel when produced by speaking?

A

Up to 2 m

112
Q

Why does spatter remain airborne for a relatively short time?

A

Due to size and weight

113
Q

What happens to splatter?

A

Drops or spatters in a ballistic pattern where it may be visible, particularly after it has landed on skin, hair, clothing or environmental surfaces.

114
Q

What may spatter come in direct contact with?

A

Mucous membranes of the eyes, nose and mouth.

115
Q

Where can larger spatter particles be trapped?

A

Higher in the respiratory tract and may be coughed or sneezed out

116
Q

What do all dental procedures produce?

A

Aerosols directly through AGPs and indirectly, when the patient coughs, sneezes and speaks.

117
Q

What do AGPs include?

A

Sonic and ultrasonic scalers, air polishing, high and low speed handpieces, and air water syringes.

118
Q

What can almost any dental procedure result in?

A

The production of aerosolized particles

119
Q

What may aerosols and spatter contain?

A

Single or clumps of infectious agents, tooth and restoration fragments, tissue, saliva, biofilm, blood, sputum, oil from handpieces and water from dental unit water lines.

120
Q

Where are aerosols in greater concentration?

A

Close to the site of instrumentation

121
Q

How do aerosols travel?

A

With air currents and move from room to room

122
Q

What influences the distribution of aerosols?

A

Temperature, humidity, and ventilation.

123
Q

How can spatter be transferred to all areas of the dental office?

A

Contact transfer and result in self inoculation if patient or DHCP touches their own eyes or mucous membranes with contaminated hands

124
Q

Where can aerosols and spatter settle?

A

Dust particles, which can then be sources of contamination

125
Q

What happens when doors are opened and closed and people pass in and out?

A

Dust is set into motion and can settle on instruments, working surfaces and equipment or people

126
Q

What are among the infectious agents that may travel in dust and around dental treatment areas?

A

C. tetani and enteric bacteria

127
Q

What are bloodborne pathogens?

A

Microorganisms that can be transmitted to anyone exposed to contaminated body fluids

128
Q

In dentistry, exposure to bloodborne pathogens is considered what?

A

An occupational hazard

129
Q

What dental procedures expose DHCP to potentially infectious body fluids?

A

ALL

130
Q

Is blood always visible in saliva?

A

No

131
Q

Which three bloodborne pathogens are most common to DHCP?

A

HBV, HCV, HIV

132
Q

Which bloodborne pathogen has a vaccine recommended for all healthcare workers?

A

HBV

133
Q

How can bloodborne pathogens be transmitted?

A

Accidental percutaneous injury, contact with cuts, abrasion or eyes, and mucocutaneous exposure to infected blood.

134
Q

What occurs during percutaneous injury to DHCP?

A

A sharp object pierces the skin.

135
Q

What are examples of dental sharps that can cause injury?

A

Dental anesthetic needles, burs, endodontic files, scalpels, suture needles, scalers, and curettes.

136
Q

When can sharp injury also occur?

A

During instrument processing and sterilization procedures.

137
Q

Do all dental procedures have the potential to transmit infectious diseases?

A

Yes.

138
Q

Must all dental procedures be carefully monitored for all patients?

A

True

139
Q

What must all DHCP adhere to?

A

Standard and transmission based precautions

140
Q

Do dental facilities need to have written infection control and safety protocols?

A

Yes. Dental facilities must have written infection control and safety protocols and provide appropriate training of DHCP.

141
Q

How can a dental facility control the transmission of airborne disease?

A

Installation of air control methods to supply clean air, adequate ventilation, filtration, and relative humidity in the operatory area.

142
Q

What can be used during all procedures to control airborne disease transmission?

A

High volume extraoral suction

143
Q

What should be used with ultrasonic instrumentation and air polishing?

A

High volume intraoral evacuation

144
Q

What should be done for patients with known or suspected infectious disease?

A

Use manual instrumentation as much as possible

145
Q

What should be done prior to beginning a procedure?

A

Oral biofilm removal by patient

146
Q

What can routine pre-procedure rinsing with antiseptic or antimicrobial mouth rinse reduce?

A

The numbers of microorganisms contained in aerosols.

147
Q

How does a dental facility control the transmission of bloodborne diseases?

A

Strict adherence to sharp safety protocols.

148
Q

What should be used when handling contaminated instruments?

A

Puncture resistant gloves

149
Q

What can dental water lines harbor?

A

Microorganisms such as Legionella, Mycobacterium and Pseudomonas species

150
Q

What must be used in dental facilities for water?

A

Water that meets Environmental Protection Agency regulatory standards for drinking water

151
Q

What can reduce cross contamination with planktonic microorganisms in waterlines?

A

Flushing of water lines for at least 20 to 30 seconds between patients

152
Q

What will flushing water lines not affect?

A

Affect or remove bacterial biofilms from the inside of dental water lines

153
Q

What other methods must be used to prevent and treat dental water biofilm?

A

Self-contained water systems with inline water filters and anti-retraction devices to prevent backflow.

154
Q

What are the methods to protect a clinician in a dental office?

A

Use PPE, check and maintain personal immunizations, education and training in the signs, symptoms and transmission of infectious agents, postexposure management for sharps injuries.

155
Q

What methods are used to protect a patient in a dental office?

A

Use protective eyewear to prevent direct spatter and aerosols to face and eyes.

156
Q

How do DHCP and dental facilities maintain and review infection control protocols?

A

Utilize official guidelines from the centers for disease control and prevention (CDC), state public health agencies, and the Occupational Safety and Health Administration (OSHA).

157
Q

What is the procedure when dealing with a patient with an active HHV lesion?

A

Postpone appointment if patient has an active vesicular lesion, explain the contagious nature of the disease, educate patient to limit personal contact, and stress the importance of meticulous hygiene.

158
Q

Which stage of HHV is the most transmissible to other patients and clinicians?

A

Prodromal stage.

159
Q

What can cause autoinoculation of HHV during a dental appointment?

A

Instrumentation that can splash viruses to the patient’s eye or extend the lesion to the nose.

160
Q

What can irritation to HHV lesions do?

A

Prolong the course and increase severity of infection.

161
Q

What is HHV-1 also known as?

A

HSV-1.

162
Q

What percentage of people worldwide are estimated to be affected by HHV-1?

A

Between 50% and 90%.

163
Q

How does primary infection of HSV-1 manifest?

A

As primary herpetic gingivostomatitis, usually occurring in children.

164
Q

Are many cases of primary infection with HSV-1 asymptomatic?

A

Yes, many cases are asymptomatic or mild.

165
Q

What are the most frequent manifestations of HSV-1?

A

Gingivostomatitis and pharyngitis.

166
Q

What are other symptoms or manifestations of HSV-1 aside from gingivostomatitis?

A

Fever, malaise, widespread oral ulcers, severe pain, and lymphadenopathy for 2-7 days.

167
Q

Where does latent infection of HSV-1 occur?

A

In the trigeminal nerve ganglion.

168
Q

How does recurrent infection of HSV-1 manifest?

A

As herpes labialis, herpetic whitlow, and ocular herpes.

169
Q

Where is herpes labialis commonly found?

A

At the vermillion border of the lower lip.

170
Q

What are the characteristics of herpes labialis?

A

Prodromal symptoms occur 6 to 24 hours before the lesion appears, followed by a group of vesicles that coalesce, rupture, and crust over. Healing may take up to 10 days.

171
Q

What causes herpetic whitlow?

A

HSV-1 or HSV-2 entering skin abrasions around a fingernail.

172
Q

What may chronic herpetic whitlow indicate?

A

It may be a manifestation of HIV infection.

173
Q

What causes ocular/ophthalmic herpes?

A

A primary or recurrent infection of HSV-1 or HSV-2.

174
Q

What can ocular/ophthalmic herpes lead to?

A

Blindness.

175
Q

How is ocular/ophthalmic herpes transmitted?

A

From splashing saliva or fluid from a vesicular lesion directly into an unprotected eye.

176
Q

How can ocular/ophthalmic herpes transmission be prevented in a dental facility?

A

By using standard precautions, including eye protection for both clinician and patient.

177
Q

What is HHV-2 also known as?

A

HSV-2.

178
Q

What is a complication of HHV-2 infection during childbirth?

A

Neonatal herpes.

179
Q

What may obstetricians recommend to women with active genital herpes to avoid transmission to the infant?

A

Delivery by cesarean section.

180
Q

Can antiviral therapy suppress HSV-2 lesions?

A

False. Antiviral therapy can suppress HSV-2 lesions.

181
Q

What is HHV-3 also known as?

A

Varicella-zoster virus (VZV).

182
Q

What does primary infection of VZV cause?

A

Varicella (chicken pox) infection.

183
Q

How is VZV primarily transmitted?

A

Via respiratory aerosols and direct or indirect skin contact with discharge from vesicles.

184
Q

Is VZV life-threatening to certain populations?

A

True.

185
Q

When are the two doses of the varicella vaccine recommended?

A

The first dose at 12-15 months old and the second between 4 and 6 years old.

186
Q

What does VZV reactivation cause?

A

Herpes zoster (shingles) infection.

187
Q

How does shingles manifest?

A

As a painful vesicular rash lasting from 2 to 4 weeks.

188
Q

What are risk factors for zoster?

A

Increasing age, HIV infection, physical trauma, cancer, and immunosuppressive medications.

189
Q

Who should receive the shingles vaccine?

A

All adults aged 50 years and older.

190
Q

What is HHV-4 also known as?

A

Epstein-Barr virus (EBV).

191
Q

What does primary infection with EBV cause?

A

Infectious mononucleosis.

192
Q

Who is EBV common among?

A

Teenagers and young adults.

193
Q

How is EBV commonly spread?

A

Through saliva, sexual contact, organ transplants, and blood transfusions.

194
Q

How can EBV be prevented?

A

By minimizing contact with saliva and practicing standard precautions.

195
Q

What does EBV manifest as in those with HIV?

A

Oral hairy leukoplakia.

196
Q

What is HHV-5 also known as?

A

Cytomegalovirus (CMV).

197
Q

How is CMV transmitted?

A

Through direct contact with infected body fluids.

198
Q

Who develops the most severe CMV disease?

A

Infants infected in utero and immunocompromised patients.

199
Q

What are HHV-6A and HHV-6B considered?

A

Distinct viral species.

200
Q

What is HHV-6A acquired after?

A

HHV-6B infection as an asymptomatic primary infection.

201
Q

Is HHV-6A a possible risk factor in accelerating HIV infection?

A

True.

202
Q

What does primary infection with HHV-6B cause?

A

Roseola infantum.

203
Q

Where has HHV-6B been found?

A

In endodontic abscesses and in the adenoids and tonsils of children.

204
Q

What is HHV-7 often found with?

A

HHV-6.

205
Q

Is HHV-7 implicated in a range of diseases?

A

Yes.

206
Q

Is it true that some persons infected with HHV-7 are asymptomatic?

A

True.

207
Q

What is HHV-8 also known as?

A

Kaposi’s sarcoma-associated herpesvirus.

208
Q

Can primary infection of HHV-8 be asymptomatic?

A

True.

209
Q

Does HIV increase the risk of HHV-8 infection?

A

True.

210
Q

How many numbered viruses are considered to be human papillomaviruses (HPVs)?

A

Over 200.

211
Q

Are most HPV infections asymptomatic?

A

Yes, they are mostly asymptomatic.

212
Q

Do some HPV infections persist and are oncogenic?

A

True.

213
Q

What do most types of HPV infect?

A

Epithelial tissues of the skin.

214
Q

What are low-risk HPV types 6 and 11 considered?

A

Non-oncogenic.

215
Q

What do types 6 and 11 HPV infections cause?

A

Recurrent respiratory papillomatosis and anogenital warts.

216
Q

What are oropharyngeal lesions caused by types 6 and 11 HPV infections?

A

Benign squamous cell papillomas.

217
Q

What are high-risk HPV types known to cause?

A

Cervical, vaginal, penile, anal, rectal, and oropharyngeal cancers.

218
Q

Where do HPV-16-associated oropharyngeal cancers typically develop?

A

Near the base of the tongue and in the tonsils.

219
Q

Who does the CDC recommend HPV vaccination for?

A

All children aged 11-12 years and everyone through age 26 years.

220
Q

What does HIV attack in the body?

A

CD4 T lymphocyte cells (T-cells).

221
Q

What signals the last stage of HIV infection?

A

A weakened immune system under attack from opportunistic infections.

222
Q

Is there currently an effective cure for HIV?

A

No effective cure currently exists.

223
Q

What are the two types of HIV?

A

HIV-1 and HIV-2.

224
Q

Which type of HIV causes the majority of infections?

A

HIV-1.

225
Q

Is HIV-1 more infectious than HIV-2?

A

Yes.

226
Q

Where is HIV-2 generally confined to?

A

West Africa.

227
Q

How is HIV transmitted?

A

By direct contact with infected bodily fluids.

228
Q

What increases the likelihood of transmitting HIV?

A

A high viral load.

229
Q

What are common modes of HIV transmission?

A

Parenteral and sexual contact.

230
Q

What are less common modes of HIV transmission?

A

Deep open-mouthed kissing, oral sex, and contact with broken skin.

231
Q

How is HIV not transmitted?

A

By saliva, sweat, tears, insect bites, or social contact.

232
Q

What laboratory tests determine HIV infection?

A

Nucleic acid tests (NATs), antigen/antibody tests, and antibody tests.

233
Q

What does the Home Access HIV-1 Test System® involve?

A

A finger stick to obtain a blood sample that is sent anonymously to a licensed lab.

234
Q

What laboratory tests are used to determine HIV infection?

A

Nucleic acid tests (NATs), antigen/antibody tests, and antibody tests.

235
Q

What does the Home Access HIV-1 Test System® involve?

A

A finger stick to obtain a blood sample sent anonymously to a licensed lab. Results can be obtained as fast as the next day.

236
Q

What does the OraQuick In-Home HIV Test® involve?

A

Obtaining a swab of oral fluids and using the kit to perform the test at home. Results are available in 20 minutes; however, 1 in 12 tests may yield false negatives.

237
Q

What do CD4 T lymphocyte and viral load counts estimate?

A

The health of the immune system and a person’s risk of serious illness from opportunistic infections (OIs).

238
Q

What do the tests mentioned provide data for?

A

They evaluate over time but do not indicate the health of the person, how they feel, or predict the future course of disease.

239
Q

What does the CD4 T lymphocyte count measure?

A

The number of CD4 T lymphocytes in 1 mm of blood, providing data to evaluate the HIV-compromised immune system, progression of infection, and efficacy of HIV medications.

240
Q

What is a normal CD4 T lymphocyte count in a non-HIV-infected adult?

A

500-1,500 cells/mm of blood.

241
Q

What percentage of white blood cells do CD4* T-cells represent in a non-HIV-infected adult?

A

32-68% considered normal.

242
Q

What does a CD4 T lymphocyte count below 200 cells/mm or below 14% indicate?

A

A person is at risk for opportunistic infections.

243
Q

What does the viral load count measure?

A

The amount of HIV in 1 mm of blood, providing data to evaluate potential damage to the immune system, efficacy of HIV medications, and drug resistance.

244
Q

What is viral suppression?

A

When the viral load count is below 200 copies of HIV/mm and the virus can be suppressed to the point where it becomes undetectable.

245
Q

What is required to achieve viral suppression?

A

ART drugs must be taken by strict regimen.

246
Q

What is Stage 1 of HIV?

A

Acute HIV infection.

247
Q

What symptoms may occur within 2-4 weeks after HIV infection?

A

Flu-like symptoms lasting a few weeks; some may be asymptomatic.

248
Q

What is the viral load like during the first two to four weeks after HIV infection?

A

Very high, and the person is highly infectious.

249
Q

Are there AIDS-defining OIs present during Stage 1 of HIV infection?

A

True.

250
Q

What is the CD4 T lymphocyte count during stage 1 of HIV?

A

≥500 cells/mm or ≥29%.

251
Q

What is Stage 2 of HIV?

A

Clinical latency; also known as asymptomatic or chronic infection.

252
Q

How long can clinical latency last?

A

10 years or longer, although some infections will progress to stage 3 faster.

253
Q

What can HIV medications do for an infected person?

A

Maintain them at stage 2 for decades.

254
Q

What is the status of HIV at stage 2?

A

At stage 2 of HIV, HIV is active, replicating at a slow rate, and is still transmissible. However, those with a low viral load are less likely to transmit the virus.

255
Q

Are AIDS-defining Ols present during the second stage of HIV?

A

No, AIDS-defining Ols are not present during the second stage of HIV.

True

256
Q

What are the CD4 T lymphocyte counts at stage 2 of HIV?

A

At stage 2, CD4 T lymphocyte counts are 200-499 cells/mm³ or 14-28%.

257
Q

What is stage 3 of HIV?

A

Stage 3 of HIV is AIDS.

258
Q

What are the CD4 T lymphocyte counts at stage 3 of HIV?

A

At stage 3 of HIV, CD4 T lymphocyte counts are below 200 cells/mm³ or <15%.

259
Q

What is necessary for an AIDS diagnosis at stage 3 of HIV?

A

The emergence of Ols is necessary for an AIDS diagnosis.

260
Q

How is the immune system during stage 3 of HIV?

A

The immune system during stage 3 of HIV is damaged and poorly functioning, which allows Ols to emerge and progress unchecked by the immune system.

261
Q

What is the viral load during AIDS?

A

The viral load during AIDS is very high and without treatment, people may only survive 3 years.

262
Q

What are the symptoms of AIDS?

A

Symptoms of AIDS include fever, sweats, chills, swollen lymph nodes, weight loss, muscle wasting, and weakness.

263
Q

How many different HIV-associated oral lesions are there?

A

There are 24 different HIV-associated oral lesions.

264
Q

Has ART changed the prevalence and pattern of HIV-related oral manifestations?

A

Yes, ART drugs have changed the overall prevalence and pattern of HIV-related oral manifestations.

True

265
Q

What are the consistently encountered HIV-associated oral lesions?

A

Consistently encountered HIV-associated oral lesions include:
- HIV-associated oropharyngeal candidiasis (HIV-OC)
- HIV-associated oral hairy leukoplakia
- Herpes simplex virus
- Kaposi’s sarcoma: HHV-8 (most common)
- HIV-related oral ulcers
- Non-Hodgkin lymphoma: reactivation of latent EBV HHV-4
- Periodontal and gingival manifestations of HIV
- Linear gingival erythema (LGE)
- Necrotizing periodontal diseases (NPDs)

266
Q

What are the less prevalent HIV-associated oral lesions?

A

Less prevalent HIV-associated oral lesions include:
- HHV-3 (herpes zoster; shingles)
- HHV-5 (CMV)
- HPV lesions
- Non-Candida fungal infections
- M. tuberculosis
- M. avium intracellulare infection
- Intramucosal hemorrhages
- Melanotic hyperpigmentation
- Salivary gland disease

267
Q

What impact has ART drugs had on HIV-associated oral lesions?

A

ART has reduced the prevalence of HIV-associated oral lesions, with KS, candidiasis, LGE, and oral hairy leukoplakia being the most responsive.

268
Q

What happens as the viral load declines with ART?

A

As the viral load declines and CD4 T lymphocyte counts improve with ART, there is a corresponding improvement in immune system function, which can prompt a strong inflammatory response resulting in immune reconstitution inflammatory syndrome (IRIS).

Dental Hygiene (8 decks)

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