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1109 Preclinic > Chpt 19- Disease Transmission and Infection Prevention > Flashcards

Chpt 19- Disease Transmission and Infection Prevention Flashcards

1
Q

Define Acquired Immunity

A

Immunity that is developed during a persons life time

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2
Q

Define Acute Infection

A

Infection of short duration that is often severe

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3
Q

Define Anaphylaxis

A

Extreme hypersensitivity to a substance that can lead to shock and life threatening respiratory collapse

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4
Q

define artificially acquired immunity

A

immunity that results from a vaccination

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5
Q

Define blood borne disease

A

disease that is caused by microorganisms such as viruses or bacteria that are carried in blood

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6
Q

define blood borne pathogens

A

disease causing organisms transferred through contact with blood and other body fluids

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7
Q

define chain of infection

A

conditions that all must be present for infection to occur

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8
Q

define chronic infection

A

an infection for a long period of time

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9
Q

define communicable disease

A

condition caused by an infection that can spread from person to person or through contact with body fluids

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10
Q

define contaminated waste

A

items such as gloves and patient napkins that may contain potentially infectious body fluids of patients

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11
Q

define direct contact

A

touching or contact with a patients blood or saliva

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12
Q

define droplet infection

A

infection that occurs through mucosal surfaces of the eyes, mouth and nose.

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13
Q

define epidemilogic studies

A

studies of the patterns and causes of diseases

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14
Q

define hazardous waste

A

waste that poses a danger to humans or to the environment

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15
Q

define immunity

A

ability of the body to resist disease

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16
Q

define indirect contact

A

touching or contact with contaminated surface or instrument

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17
Q

define infection control

A

policies and practices designed to prevent the spread of infectious agents

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18
Q

define infection preventioin

A

ultimate goal of all infection control procedures and policies

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19
Q

define infectious disease

A

disease that is communicable

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20
Q

define infectious waste

A

waste that is capable of transmitting and infectious disease

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21
Q

Define inherited immunity

A

immunity that is present at birth

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22
Q

define latent

A

persistent infection that has recurrent symptoms that “come and go”

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23
Q

define naturally acquired immunity

A

immunity that occurs when a person has contracted and is recovering from a disease

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24
Q

define occupational exposure

A

any reasonably anticipated skin, eye or mucous membrane contact or percutaneous injury involving blood or any other potentially infectious material

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25
Q

define OSHA blood borne pathogens standard (BBP)

A

guidelines designed to protect employees against occupational exposure to blood borne pathogens

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26
Q

define pathogen

A

disease causing organism

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27
Q

define percutaneous

A

through the skin, such as with a needle stick, cut or human bite

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28
Q

define permucosal

A

contact with mucous membranes, such as eyes or mouth

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29
Q

define person protective equipment (PPE)

A

items such as protective clothing, masks, gloves and eyewear used to protect employees

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30
Q

define sharps

A

pointed or cutting instruments including needles, scalpel blades, orthodontic wire, and endodontic instruments

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31
Q

define standard precautions

A

standard of care designed to protect heath-care providers from pathogens that can be spread by blood or other body fluids via excretion or secretion

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32
Q

define universal precautions

A

guidelines based on treating all human blood and bodily fluids as potentially infectious

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33
Q

define virulence

A

strength of pathogens ability to cause disease

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34
Q

what is another name for virulence

A

pathogenicity

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35
Q

What are the 6 links for the chain of infection?

A
  1. an infectious agent
  2. a reservoir
  3. a portal of exit
  4. a mode of transmission
  5. a portal of entry
  6. a susceptible host

Ronald Plays Terrible Pattycake Sometimes

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36
Q

How do infection control strategies help with the chain of infection

A

they are intended to break one or more links in the imaginary chain. once a link is broken you break the infection process

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37
Q

True or false: A pathogen must be present in sufficient numbers to cause infection

A

True.

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38
Q

How does virulence affect disease

A

if the organism is not very virulent it may be incapable of causing disease
if the organism is very virulent it can cause serious disease

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39
Q

Can the body change the virulence of microorganisms?

A

No the body body cannot, it it left to the bodies defence and to immunizations .

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40
Q

What is a reservoir in the chain of infection

A

a place where microorganisms normally live and reproduce
ex. humans, animals, water and contaminated surfaces

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41
Q

what is bioburden?

A

organic materials such as blood and saliva

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42
Q

what are two pieces of equipment that minimize the number of microorganisms in the aerosol?

A
  1. a dental dam
  2. a HVE (high volume evacuation)
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43
Q

what can we as dental professionals do to minimize reservoirs for micro organisms?

A

maintain proper hand hygiene and through cleaning and disinfection of contaminated surfaces

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44
Q

what is portal of entry in regards of the chain of infection

A

means of entering the body

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45
Q

where is air borne pathogens portal of entry?

A

the mouth adn the nose

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46
Q

where is blood borne pathogens portal of entry?

A

a direct access to the blood supply (break in the skin) or through mucous membranes of nose and mouth

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47
Q

what is a susceptible host in the chain of infection?

A

a person who is unable to resist infection by a particular pathogen. ex. someone who has a weak immune system or in poor health is more likely to be infected

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48
Q

Explain acute infection ( what are symptoms like, how long does it last and an example)

A

symptoms are often severe and usually appear soon after the initial infection occurs.
they are of short duration
examples would be the common cold

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49
Q

Explain chronic infection ( how long does it last and an example)

A

microorganisms is present for a long period of time ( even whole life) the person may be asymptomatic but still may be a carrier of the disease
example would be hepatitis c virus

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50
Q

what is a latent infection ( how are symptoms, what occurs and an example)

A

persistent infection which symptoms come and go
ex. coldsore
the virus enters the body and causes the original lesion, it then lies dormant within a nerve cell, until certain conditions cause the virus to leave the nerve cell and seek the surface again. Once the virus reaches the surface it becomes detectable

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51
Q

what is an opportunistic infection? ( what is it, who does it effect most)

A

caused by normally nonpathogenic organisms it occurs in individuals who resistance is compromised
example: someone who is recovering from the flu may develop another virus
common in autoimmune disease, diabetic and elderly patients

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52
Q

what is direct transmission of a disease? and two ways it spreads

A

occurs through person to person contact
- droplets spread through sneezing or coughing
- also through unprotected contact with an infectious lesion or body fluids (blood, saliva, semen, vaginal fluids)
ex. hepatitis, HIV and Tv are all spread through direct contact

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53
Q

Explain indirect transmission of disease (define and example)

A

occurs when microorganisms first are transmitted to an object or surface and then are transferred to another person who touches those objects or surfaces

ex. a dental chart is touched with contaminated hands and then is passed to the receptionist with bare hands she is now at risk

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54
Q

what is airborne transmission? (what is it and how is it spread)

A

spread of disease through droplets of moisture that contain bacteria or viruses

this is how most contagious respiratory diseases are caused. also may be caused by coughs or sneezes

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55
Q

what is another name for airborne transmission of disease?

A

droplet infection

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56
Q

what do aerosols sprays and splatter generate during dental treatment?

A

blood, saliva and nasopharyngeal secretions

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57
Q

what is the difference between aerosols, sprays and splatter?

A

the size of the particles

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58
Q

what has the finest mist? aerosol, spray or splatter?

A

aerosol

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59
Q

Are aerosols typically visible to the human eye?

A

not always no

60
Q

true or false: aerosol can remain airborne for extended periods of time?

A

true

61
Q

What dental tools create aerosols? (2)

A

High-speed hand pieces and ultrasonic scalers

62
Q

Fun fact: Inhaling the bacteria in the aerosol w out a face mask is comparable to what?

A

having someone sneeze in your face twice a minute at a distance of one foot away

63
Q

true or false: aerosols can transmit respiratory infections?

A

true

64
Q

true or false: aerosols can transmit HBV or HIV

A

false. despite the face they are inhaled

65
Q

Define spatter

A

consists of larger droplet particles that are contaminates by blood, saliva and other debris

66
Q

how are sprays and spatter created? (3)

A

the use of hand pieces, ultrasonic scaler and the air water syringe

67
Q

which travels farther aerosol mist or sprays or spatter droplets?

A

spray and spatter droplets travel farther

68
Q

What is intact skin and how does it aid in infection control?

A

intact skin is not broken in any way and acts as a natural protective barrier

69
Q

what is non-intact skin and how does it affect the risk of infection?

A

skin in which a cut, scrape or needle stick injury has occurred
it provides a means of entrance for pathogens to enter the body

70
Q

What is parenteral transmission of diseases? (what is it? how is it caused?)`

A

means through the skin, as with cuts or punctures
disease causing organisms transferred through contact with blood or other body fluids
this is caused by needle stick injures, human bites, cuts or any break in the skin

71
Q

Explain Blood-Borne Transmissions (what are they? what contacts are they delivered with?)

A

carried in the blood and body fluids of infected individuals and can be transmitted to others
they can be transmitted through direct and indirect contact

72
Q

what is the most common concern for dental professionals in regards to blood borne transmissions?

A

saliva

73
Q

true or false: you can always see blood in saliva if it is present?

A

false: blood may not always be visible in saliva but can still be present

74
Q

how can blood borne diseases be commonly spread in the dental clinic and whats a prime example outside of the dental clinic?

A

improper sterilized instruments can transfer all blood borne disease

individuals who share needles while using drugs and unprotected sex

75
Q

3 major blood borne disease in dentistry

A

HCV- Hepatitis C
HBV- Hepatitis B
HIV- Human immunodeficiency virus

76
Q

What is food and water transmission? ( how is it caused and examples of how and diseases it may cause)

A

contaminated food or water
food- uncooked or un unfrigerated food
water- contaminated with decal matter for ex

medical ex. tuberculosis, botulism and staphylococcal

77
Q

Explain Fecal- Oral Transmission (what is it and what types of contact can cause it)

A

many pathogens are present in fecal mater if proper sanitation (hand-washing) procedures are not used after the toilet the pathogens can be transmitted directly or indirectly.

78
Q

Explain Naturally Acquired Immunity (what is it and how is it done?)

A

it occurs when a person has previously contracted a disease and recovered, when the body was fighting the invading pathogens it formed antibodies that provide future resistance against that particular pathogen

79
Q

what type of immunity is naturally acquired immunity?

A

active immunity- because the body of the host is actively involved in the process

80
Q

Explain Passive immunity (what is it ? and what makes it passive?)

A

It is a naturally acquired immunity that occurs during pregnancy and while breastfeeding, the baby receives antibodies from the mother’s placenta and breast milk

its called passive immunity because the antibodies are acquired from an outside source

81
Q

Explain artificially acquired immunity (what is it and how does it work?)

A

when the human body has not been exposed to a disease it has not developed antibodies and is defenceless, these antibodies are introduced into the body by immunizations or vaccines

82
Q

how do vaccines work in artificially acquired immunity?

A

it contains the weakend disease causing organism and is injected into the body. the harmful characteristics of the disease are eliminated from the vaccine to make them less likely to cause disease. the body then forms antibodies in response to the vaccine

83
Q

3 mains ways disease transmits to the dental office

A
  1. direct contact- patients blood or saliva touching open skin
  2. droplet infection- inhaling contaminated aerosol
  3. indirect contact- dental team member touches a contaminated surface or a contaminated surface comes in contact w broken skin
84
Q

tip 5 infection control measures that help prevent disease transmission from patient to dental member

A
  1. gloves
  2. masks
  3. rubber damns
  4. hand-washing
  5. patient mouth rinses
85
Q

common ways team to patient spread of disease happens

A
  1. if the dental team member has a cut while in the patients mouth
  2. if the dental team member has a cold and droplets get on to patient
86
Q

how does patient to patient disease transmission occur?

A

contamination from instruments used on one patient would need to be transferred to another patient

87
Q

how to avoid patient to patient disease transmission (5 things)

A
  1. instrument sterilization
  2. surface barriers
  3. hand-washing
  4. glove
  5. use of sterile instruments
88
Q

how does dental office to community disease transmission occur?

A

if a contaminated object/ thing leave the dental office
this can be:
- contaminated impression
- equipment being sent out for repair
or - if members of the dental office transport microorganisms out of the office by their hair or clothing

89
Q

How does Community to Dental Office to Patient disease transmission occur?

A

microorganisms enter the dental office through municipal water that supplies the dental unit water borne organisms colonize inside of dental unit waterlines and form BIOFILM. as water flows through the hand piece, air water syringe and ultrasonic scaler the patient can swallow contaminated water

90
Q

Explain the CDC ( is it a regulatory agency and what is their role?)

A

CDC is NOT a regulatory agency
its role is to issue specific recommendations that are based on sound scientific evidence

91
Q

Explain OSHA (is it a regulatory agency? what is their role?)

A

It IS a regulatory agency, its role is to issue specific standards that must be used to protect employees

92
Q

Who do the guidelines of CDC apply to?

A

All paid and unpaid dental health professionals who might be exposed to blood and bodily fluid

93
Q

CDS Rankings: Category IA

A

strongly recommended for implementation and strongly supported by well designed experimental, clinical or epidemiologic studies

94
Q

CDS Rankings: Category IB

A

strongly recommended for implementation and supported by experimental, clinic, or epidemiologic studies and strong theoretical rationale

95
Q

CDS Rankings: Category IC

A

Requires from implementation, as mandated by federal or state regulation

96
Q

CDS Rankings: Category II

A

Suggested for implementation and supported by suggestive clinical or epidemilogic studies or a theoretical rationale

97
Q

CDS Rankings: Unresolved issue

A

no recommendation- practices for which insufficient evidence or no consensus regarding efficacy exists

98
Q

What does OPIM stand for?

A

other potentially infectious material

99
Q

What is the most important infection control law in dentistry ?

A

OSHAS Blood Borne Pathogens Standard

100
Q

What is the purpose of OSHA’s BBP standard?

A

its designed to protect employees against occupational exposure to blood borne disease causing organisms, it requires employers to protect their employees

101
Q

What is an exposure control plan?

A

Every dental office must have a written exposure control plan, that clearly describes how the office complies with the BBP Standard.

must be reviewed and updated annually and and each employee must have access to have a copy

102
Q

Explain Universal Precautions? why is it used?

A

OSHA BBP- they’re used based on the concept that all human blood and bodily fluids are to be treated as if known to be infected with a blood-borne disease (HCV OR HIV)

It is impossible to identify those who are infectious so universal precautions are used for all healthcare personnel

103
Q

Categories of Occupational Exposure Determination: Category I

A

Routinely exposed to blood, saliva or both
example: dentist, DA, DH

104
Q

Categories of Occupational Exposure Determination: Category II

A

May on occasion be exposed to blood, saliva or both
ex. receptionist or office manager who may occasionally clean a treatment room

105
Q

Categories of Occupational Exposure Determination: Category III

A

Never exposed to blood, saliva or both
ex. financial manager, insurance clerk

106
Q

Post exposure Management: what happens when an accident does happen?

A

the BBP standard requires the employer to have a written plan this plan explains exactly what steps the employee must follow after the exposure incident occurs and the type of medical followup that will be provided to the employee at no charge

107
Q

true or false: the dentist must provide training in infection control procedures and safety issues to all personnel who may come in contact with blood, saliva or contaminated instruments

A

true

108
Q

How do we manage contaminated sharps?

A

contaminated needles and other disposable sharps but must place into a sharps container, it must be located as close as possible to the place of immediate disposal

109
Q

true or false: you should always bend or break needles before disposal

A

false, never cut bend or break the needles before disposable

110
Q

what the safest way to re cap needle sticks?

A

the single- handed scoop technique

111
Q

When do you perform proper hand washing in regards to wearing gloves?

A

before you put gloves on and after you remove gloves

112
Q

which is better liquid or bar soap in regards to hand washing?

A

liquid soap should always be used as bar soap harbours bacteria

113
Q

what is more effective hand washing or hand rubs

A

hand rubs are more effective

114
Q

what are alchohol based hand rubs

A

water antiseptic agents, ethier gel, foams or rinses that do not require water. They are very effective

115
Q

True or False: When looking at alcohol based hand rubs high concentration of alcohol is more effective

A

false: higher concentrations are less effective

116
Q

When is it not acceptable to just use a alcohol based rub?

A

When you have visible soiled or contaminated. you must first use proper hand washing hygiene.

117
Q

True or false: according to OSHA’s BBP Standard requires the employer to provide employees with proper PPE with out charge to the employee

A

True

118
Q

Why are patients supplied with eye wear as well?

A

may be subject to 1. hand piece spatter 2. spilled or splashed dental materials 3. air-borne bits of acrylic or tooth fragment

119
Q

who regulates gloves?

A

The FDA

120
Q

What do you do if your glove puntures?

A

Remove the gloves, perform hand hygiene and re glove

121
Q

are examination gloves sterile?

A

they are considered non sterile and simply act as a barrier

122
Q

what are over-gloves?

A

also known as food handlers gloves made of lightweight inexpensive clear plastic, they may be worn over contaminated treatment gloves to prevent contamination of clean item during treatment

123
Q

whats the term used for wearing over gloves over contaminated treatment gloves?

A

over gloving

124
Q

what are sterile surgical gloves? when are they used?

A

supplied in pre packaged units to maintain sterility before use, worn for invasive procedure involving the cutting of bone or significant amounts of blood or saliva

125
Q

what are utility gloves? what are they used for? disposable or reusable?

A

are not used in direct patient care they are worn when the treatment room is cleaned and disinfected between patients or while contaminated instruments are being cleaned or handles also for surface cleaning and disinfecting.
Utility gloves must be sterilized

126
Q

how do you limit cross contamination while gloved

A

make sure you have everything ready before the treatment starts this minimized opening the drawers and cabinets
keep a pair of clean forceps to open and grab items with, this will keep bacteria out of cupboards

127
Q

how do you limit cross contamination while opening containers during treatment? how do you remove the item from inside the container?

A

open the container with over gloves, a paper towel or sterile gauze, use sterile cotton pliers to to remove items from the container. if other parts of the container are touched it must be sterlized

128
Q

what is irritant dermatitis? ( causes)

A

its a non immunologic process that does not involve the body’s immune system it is caused by contact with a substance that produces a chemical irritation to the skin.
causes: frequent hand washing, not getting all the soap odd excessive sweating while wearing gloves

129
Q

Type IV Allergic Reaction (where does it affect and how long until it shows)

A

most common type of latex allergy and is a delayed reaction that involves the immune system, it shows as a red itchy rash reactions are limited to the area of contact and do not spread across entire body. it may take 48-72 hours for symptoms to set in

130
Q

Type I Allergic reaction (what is it and what occurs)

A

its the most serious type of latex reaction and can result in death, can take as little as 2 minutes to show
symptoms- coughing, sneezing, shortness of breath and respiratory distress

131
Q

what is anaphylaxis in terms of type 1 latex allergy reaction? what happens

A

most serve form of allergic reaction, death results from closure of the airways

132
Q

what is the treatment of a latex allergy

A

there is no specific cure but option for prevention an treatment of symptoms

133
Q

why should saliva be considered potentially infectious waste?

A

because blood may not always be visible

134
Q

what is general waste?

A

all non hazardous and non regulated waste
example paper towels, paper mixing pads

135
Q

what is contaminated waste (examples)

A

waste that has been in contact with blood or other body fluids
examples- barriers and patient napkins

136
Q

what is hazardous waste (examples)

A

poses a risk to humans and to the environment
examples- amalgam and lead foil from x rays

137
Q

what is infectious waste (disposal and examples)

A

contaminated waste that is able to transmit infectious diseases. must be disposed of diffrently

examples blood or saliva soaked items, pathologic waste (soft tissue and extracted teeth), sharps

138
Q

what are extracted teeth classified as in terms of disposing of them

A

they are classified as medical waste

139
Q

what do you do with extracted teeth that contain amlgam?

A

do not include in medical waste bin as amalgam as it contains mercury and medical wastes are incinerated

140
Q

how does back flow occur in saliva ejectors? why is this a concern?

A

it occurs when the pressure in the patients mouth is less than that in the evacuator. this back flow can create a source of cross-contamination

141
Q

what are pre-procedural mouth rinses and why are they used?

A

its an anti-microbial rinse that patients do before the procedure, it reduces the amount of micro-organisms released in the form of aerosol and spatter

it also cleans the patients mouth before an invasive procedure to prevent the micro organisms from reading the patients blood stream

142
Q

What is M. Tuberculosis? ( how is it spread and how)

A

a bacterium that is spread by airborne infective particles (when the patient sneezes, coughs or even talks) they can remain airborne for several hours. infection occurs when the host inhales the bacteria

143
Q

What is latent TB Infection? (what is it, how does it present)

A

tb bacteria can remain alive in the lungs for years. a person with latent tb will have a reactive tb test but show no symptoms and are not infectious. Active symptoms can show later in life

144
Q

What is Creutzfeldt- Jakob Disease? (what is it and what does the outcome look like?)

A

its a progressive, fatal degenerative neurologic disorder, that is thought to be caused by prion infection . there is a incubation between time between infection and signs of disease of years but once diagnosed its usually fatal within a year

145
Q

infection control concerns with laser and electrosurgery plumes or surgical smoke

A

may expose aerosol infectious materials CDS has no input on the issue as of right now

1109 Preclinic (4 decks)

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