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MRT Year 1 Semester 3 > Infection Prevention and Control Midterm > Flashcards

Infection Prevention and Control Midterm Flashcards

1
Q

Microorganism characteristics

A
  • too small to be seen without a microscope
  • less than 0.1mm
  • usually unicellular
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2
Q

Another name for microorganisms?

A
  • germs
  • microbes
  • bugs
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3
Q

Groups of microorganisms? (Largest to smallest)

A
  • Protozoa
  • Fungi
  • Bacteria
  • Viruses
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4
Q

What are protozoa?

A

Unicellular animals, move with flagella or ameboid motion

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5
Q

What are fungi? Types?

A

Primitive plants

  • Yeasts: unicellular (yeast infections)
  • Molds: multicellular (ringworm, athletes foot)
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6
Q

What is bacteria?

A
  • unicellular
  • no organized nucleus wall
  • cause strep throat, staph infections, salmonella
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7
Q

What are viruses?

A

A bit of DNA or RNA surrounded by protein coat and sometimes lipid coat.

  • grow only in other living cells
  • influenza virus, mumps, measles, rubella
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8
Q

How are microbes measured?

A

Micrometer = 1/1000mm

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9
Q

Shapes of bacteria?

A
  • round = cocci (coccus)
  • rectangular = rod/bacilli (bacillus)
  • spiral/curved = spirilla (spirillum)
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10
Q

Gram positive bacteria appear ?

A

Dark blue

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11
Q

Gram negative bacteria appear?

A

Red

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12
Q

Why is the gram reaction important?

A
  • 1st step in identifying bacteria (look at shape and gram reaction)
  • determines effectiveness of antibiotics
  • determines effectiveness of disinfectants
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13
Q

How does bacteria reproduce?

A

Binary fusion: 1 splits into 2

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14
Q

Why are endospores bad?

A

They resist drying, head, and disinfectant (hard to kill)

  • may take 121C to kill
  • high level disinfectant and long exposure time
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15
Q

4 phases of bacteria growth curve?

A
  1. Lag: adapting to new environment (no symptoms, incubation)
  2. Log: max reproduction (full-blown symptoms, acute)
  3. Stationary: no change in #, decrease food, increase waste (no better, no worse)
  4. Death: spores may form (on the mend, covalence)
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16
Q

Distinctive features of viruses

A
  • metabolically inert: can multiply only in living host cells
  • contain DNA or RNA, not both
  • have protein coat that surrounds nucleic acid +/- lipid envelope
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17
Q

are lipid or protein viruses more easy to destroy?

A

Lipid, except Hep B

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18
Q

Multiplication of animal viruses

A
  1. Attachment to complementary site on host cell membrane
  2. Penetration
  3. Viral nucleic acid: takes control of hose cell, direct synthesis
  4. Synthesis of viral components
  5. Assembly of viral components
  6. Release from host cell
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19
Q

2 effects of viruses on host cell

A
  1. Host cell dies (lysis, destroyed by hosts own lymphcytes)

2. Host cell may be transformed into tumour cell

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20
Q

How to control viruses?

A
  • antiviral drugs: acyclovir, ZDV

- have to develop drugs that will destroy the viruses in host cells without destroying host cells

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21
Q

What are normal flora? Where are they found?

A

Microbes living in/on body, cause no harm as long as they stay in expected site
-found on skin and mucous membranes

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22
Q

Where in the body has the most normal flora?

A

Large intestine

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23
Q

Factors that affect NF?

A
  • excessive moisture on skin = increased staphylococci (ring, watch, gloves
  • antibiotic therapy: kills sensitive microbes, resistant microbes take over
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24
Q

Normally sterile areas in the body?

A
  • blood
  • CSF
  • tissue
  • fluids that surround organs
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25
Q

What is contamination?

A

-unexpected microbes at body site, do not grow, no harm (ex. Mouth bacteria on hands)

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26
Q

What is colonization?

A

Unexpected microbes at body site, DO grow, no harm initially, but maybe later

  • if they go away = end of story
  • if they dont go away = may cause disease
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27
Q

What is infection/disease?

A

Unexpected microbes, DO grow, DO cause harm

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28
Q

What is the difference between an infection and a disease?

A

Infection: host has pathogen, no symptoms
Disease: host had pathogen and symptoms

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29
Q

What is an exotoxin?

A

G+ bacteria released from intact bacteria and carried away from and infection site
-attack target tissue

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30
Q

What is an endotoxin?

A

G- bacteria, part of a cell wall and released when cell in interrupted, carries away from infection site

  • nonspecific, effect more generalized
  • can lead to destruction of organs and fatal shock
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31
Q

Chain of infection?

A
  • reservoir
  • means of transmission
  • susceptible host
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32
Q

Reservoirs of infectious microorganisms?

A
  1. Humans: with infections or carriers, main reservoir for human infections
  2. Animals
  3. Nonliving: soil, H20,
  4. Carrier: person who harbors pathogenic microbes but show NO SIGNS of infection, can pass microbes on to others
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33
Q

Types of carriers?

A
  • convalescent carrier: person had disease, symptoms now gone, microbes still in body
  • chronic carrier: 6 months after symptoms gone, microbes still in body
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34
Q

Types of contact transmission?

A
  1. Direct: host (person to person) “touch”
  2. Indirect: reservoir-inanimate objects (fomite)-host
  3. Droplet: large “globs” of mucous that contains microorganisms
35
Q

What is vehicle transmission?

A

Reservoir (air, food, H20, blood) hosts (usually more that one)

36
Q

Types of vehicle transmission?

A
  • food, H20: salmonella food poisoning
  • droplet nuclei: very small, travel long way
  • injected solutions: Hep C or AIDS from contaminated blood products used for transfusion in the past
37
Q

What is vector transmission?

A

Reservoir to insect to host

38
Q

Factors that influence host susceptibility to infectious diseases?

A
  • age
  • general health
  • chemotherapy, radiation, antibiotics alter immune status
  • surgery, anaesthesia, insertion of catheters
39
Q

Portals of entry of infectious microorganisms?

A
  1. Skin: sweat glands, moist skin, broken skin
  2. Mucous membranes
  3. Placenta: fetus protected from moms bugs
  4. Parenteral: IV
40
Q

Signs and symptoms of infection?

A
  • fever: bacteria cant multiply under high temps, white blood cells more active
  • lymph node swelling: traps microbes, infection causes lymphocytes to multiply, can be felt (cervical, axillary, inguinal)
  • inflammation: histamine release, vasodilation, increased permeability, fluid leaks into tissues, increased phagocytes, leukocytes
41
Q

4 signs of inflammation?

A
  • heat
  • redness
  • pain
  • swelling
42
Q

What is a nosocomial infection?

A

Infection acquired as a result of stay in hospital or institution
5-15%

43
Q

Contributing factors of nosocomial infections

A
  • hospital microbes
  • compromised patients
  • transmission of microbes facilitated: patient in close proximity, catheters, incisions
44
Q

Top 3 nosocomial infections in order of occurrence?

A
  1. Urinary tract infection
  2. Surgical wound infections
  3. Pneumonia
45
Q

Surgical would are often infected with _________?

A

Staphylococcus aureus

46
Q

What is an antibiotic?

A

Substance produced by a microorganism (often a fungus) that inhibits the growth of, or kills another microorganism (bacteria)

47
Q

Current superbugs?

A
  • MRSA
  • VRE
  • Clostridium difficle
48
Q

Methods of controlling infection?

A
  • silver impregnated bandages

- phages (viruses that infect specific bacterial cells and destroy them)

49
Q

What do infection prevention and control practitioners do?

A
  • specially trained staff
  • develop policies and procedures both nationally and provincially
  • implement policies and preventative measures
  • determine patient placement
  • educate staff
  • monitor and report outbreaks
50
Q

What is epidemiology?

A

The study of incidence, source, and spread of disease

51
Q

What is immunization?

A

The process by which resistance to an infection in induced or augmented. Allows us to develop immunity without having the disease

52
Q

What is immunity?

A

Resistance to a specific disease

53
Q

What is an antigen?

A

A substance that indicated the immune response

54
Q

What is an antibody?

A

Products of an immune response

55
Q

Types of antibodies?

A
  • IgM: first produced in an immune response

- IgG: second antibody produced in the immune response

56
Q

What do IgM and IgG indicated?

A

IgM: current or recent infection or exposure to antigen
IgG: past infection (when IgM absent)

57
Q

Antibody production?

A
  1. Antigenic stimulation of B lymphocytes: clone of antibody, clone of memory cell
  2. Immune response after primary immunization: no detectable antibodies for a week or longer, small burst of IgM then IgG
  3. Immune response after 2nd and 3rd booster: almost immediate` response, small burst of IgM, large burst of IgG provides protection
58
Q

Amount of antibodies present in expressed as a _______?

A

Titer

59
Q

Factors affecting response to immunization?

A
  1. Differences in immune response by host: inheritance, diseases, general health
  2. Site of injection: type of tissue, fat may absorb antigen
  3. Immunization product
  4. Product failure: bad batch, improper storage
60
Q

Products used for immunization?

A
  1. Vaccine: suspension of bacteria or virus altered so not able to cause disease, but still antigenic
  2. Toxoid: bacterial exotoxin treated so no longer toxigenic, but still antigenic
61
Q

Types of immunity?

A
  1. Artificially acquired: product given for the purpose of providing immunity
  2. Naturally acquired: such as having disease of antibodies transferred from mom to baby
  3. Passive immunity: host given preformed antibodies, immediate protection, used for treatment or short term prevention
  4. Active immunity: host makes own antibodies, used for prevention
62
Q

Routine immunization schedule (after 2 months)

A
  • DPT
  • Polio
  • Hib type B
  • MMR
  • Chicken pox
  • Meningococcal conjugate
  • pneumococcal conjugate
  • hep B
  • yearly infuenzae
  • booster shots: diphtheria and tetanus every 10 yrs
63
Q

Rubella symptoms

A
  • mild infection
  • rash
  • or no symptoms
64
Q

Danger of rubella during pregnancy?

A
  • virus can cross placenta to infect fetus
  • fetus may be aborted or stillborn
  • may have defects if carried to term
65
Q

Immunization for rubella

A
  • vaccine contains MMR
  • part of childhood series, before puberty
  • do not immunize if pregnant of expecting to become pregnant within 3 months
  • immunize males and females to eliminate viral reservoir
66
Q

Who should be immunized against Hep B?

A

All health care workers at risk of exposure to blood or fluids capable of transmitting infection or who are at risk of sharps injuries

67
Q

Hep B immunization schedule?

A
  • 3 shots

- first two are a month apart, third six months after

68
Q

What is the hepatitis immune globulin (HBIG)?

A
  • passive immunization product with preformed antibodies
  • given after a blood or mucous membrane exposure to hep B when there is no evidence of anti-HBs in health care worker
  • short term protection, must be given within 24hrs
69
Q

What are chicken pox (varicella-zoster)?

A

Generalized infection characterized by fever, malaise, and vesicular eruptions, spread by respiratory secretions or contact with vesicular fluid, 2-3 weeks incubation period, more sever in adults than children

70
Q

What are shingles?

A

Reactivation of the latent virus in older and immunocompromised patients, cant get shingles without having had chicken pox

71
Q

How to reduce risk of chicken pox?

A
  • determine immune status
  • immunization of non-immune healthcare workers
  • non-immune healthcare workers exposed to chicken pox should not be around immunocompromised patients from day 10-21 following exposure
72
Q

How is TB spread?

A
  • direct contract with respiratory secretions

- droplet nuclei: greatest danger because they remain suspended in the air

73
Q

Sequence of events following inhalation of TB?

A
  • bacteria multiply slowly in lungs for 3-6 weeks
  • cellular immune system become activated
  • spread of bacteria inhaled-walled off by group of cells-granulonmata
  • person infected but does not get disease and is not contagious
74
Q

Symptoms of TB?

A
  • initially vague: persistent cough, fever of unknown origin

- later: bloody sputum, organ dysfunction

75
Q

When is the TB skin test performed?

A
  • at start of employment
  • on a regular basis following initial testing
  • following a known exposure
76
Q

Blood borne pathogens of greatest concern?

A

HIV: 0.3%
HCV: 3%
HBV: 30%

77
Q

How do gloves reduce risk of infection from needle stick by 50%?

A

Blood wiped off outside glove as needle passes through it

78
Q

Hepatitis A

A
  • Previously called: infectious hepatitis, short incubation hepatitis
  • Naked HAV
  • typical symptoms, no permanent liver damage, no death
  • no chronic carriers
  • transmitted via food of H20 contaminated with feces or saliva
  • keep stool and drool out of food
79
Q

Hepatitis B

A
  • Previously called: serum hepatitis, long incubation hepatitis
  • HBV enveloped
  • transmitted by blood or mucous membrane, replicated in liver, HBV in blood, semen, vaginal secretions, CSF…
  • 5-10% chronic carriers even if asymptomatic
  • increase chance of liver cancer, infectious for several years, serve as reservoir
  • can survive for 1 week outside the body
  • prevented by HBV vaccine, HBIG if exposed, passive immunity
80
Q

Hepatitis C

A
  • transmitted via blood, but poor sexual transmission
  • chronic carriers common, high risk or liver cirrhosis
  • no vaccine
  • interferon and/or combination of new drugs, not suitable for all patients
81
Q

HIV (AIDS)

A
  • HIV enveloped, transmitted by blood, semen, vaginal secretions, mom to baby, not by kissing, touching
  • Viral replication (read sheet)
  • kills helper T lymphocytes, when number is significantly reduces you get clinical symptoms of AIDS
  • testing no routine
  • 4-12 weeks for antibodies to appear
  • can get false positives
  • do western blot to confirm
  • ZDV slows viral replication and prolongs latent period, doesnt kill HIV
  • moral, not legal responsibility to disclose if HIV positive
82
Q

Progression of HIV infection?

A
  1. Contact
  2. Primary infection (1month): flu-like symptoms or no symptoms, HIV test may be negative
  3. Latent period (2yrs): no symptoms, but infectious, destruction of CD4 cells, HIV positive
  4. Clinical AIDS: opportunistic infection, cancers, fungal, shingles, CD4 count below 200, death
83
Q

Viral infections of concern to canadians?

A
  1. SARS
  2. West Nile
  3. H1N1 flu
84
Q

Where to look for information?

A
  • WHO
  • CDC
  • Health canada
  • IPAC Canada
  • Alberta health
  • your professional organization
  • your local IPC departments

MRT Year 1 Semester 3 (3 decks)

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