MIDTERM Flashcards
1
Q
ORDER OF CHAIN OF INFECTION
A
INFECTIOUS AGENT, RESERVOIR, PORTAL OF EXIT, MODE OF TRANSMISSION, PORTAL OF ENTRY, SUSCEPTIBLE HOST
2
Q
- Causative agent.
- Can be any disease causing microorganism or pathogen.
- Can be bacteria, virus, fungi or parasite
- It is located in the reservoir
A
INFECTIOUS AGENT
3
Q
- Where microorganism normally lives and reproduces
- Habitat where reagent commonly lives, grows and multiplies
- May/may not be source from which reagent is transferred to a host
A
RESERVOIR
4
Q
- Route of escape of the pathogen coming from reservoir
- Path na tutunguhin to leave its host
A
PORTAL OF EXIT
5
Q
T OR F. portal of exit corresponds with side opposite of where pathogen is glutanized
A
FALSE.- Usually corresponds with the side where pathogen is glutanized
6
Q
Once the organism/infectious agent is liberated from reservoir towards the portal of exit, it can now be transmitted by
A
way of route of transmission
7
Q
MODES OF TRANSMISSION
A
- Can be: direct and indirect
- Direct
Direct contact
droplet spread - Indirect
Airborne
Vehicle borne
Vector borne
8
Q
- In direct transmission, an infectious agent is transferred from a reservoir to a susceptible host by direct contact or droplet spread.
A
DIRECT
9
Q
- occurs through skin to skin contact, kissing and sexual intercourse
- also direct contact with soil or vegetation harbouring organisms
A
DIRECT CONTACT
10
Q
- refers to spray with relatively large, short-range aerosols produced by sneezing, couging or even talking
- b
A
DROPLET SPREAD
11
Q
SIZE NG DROPLET
A
- More than 5 microns size of droplet
12
Q
close contact with infected person (atleast 3 ft) droplets will land directly in mucous membrane (eyes, nose. mouth) of susceptible person
A
o Grounded transmission
13
Q
- Transfer of infectious agent from reservoir to host through suspended air particles, inanimate object (food or water) , animate intermediary fly vectors
A
INDIRECT
14
Q
- occurs when infectious agents are carried by dust or droplet nuclei suspended in air
A
AIRBORNE
15
Q
- includes material that has settled on surfaces and becomes resuspended in aircurrents as well as infectious particles blown from the soil by the wind
A
airborne dusts
16
Q
- dried droplet residue SIZE
A
<5 microns in size
17
Q
- may remain suspended in the air for long periods of time and may be blown over great distances.
A
AIRBORNE
18
Q
- yung mga airborne dust particles or airborne droplet to kaya magaan meaning pwede siya long distance.
A
Dehydrated particles
19
Q
- through food, waterm biologic products(blood), fomites (inanimate objects)
A
VEHICLEBORNE
20
Q
- through food, waterm biologic products(blood), fomites (inanimate objects)
A
VEHICLEBORNE
21
Q
- pwedeng magprovide siya ng environment in which agent grows, multiplies or produces toxins
- may passively carry a pathogen
- purely mechanical because food/water may not support growth and changes in the agent
A
VEHICLE-BORNE
22
Q
- Mosquitos, fleas or ticks
A
VECTOR BORNE
23
Q
2 TYPE OF VECTOR
A
Can be mechanical or biological vectors
24
Q
dadalin bacteria from one host to infected to tas dadalin niya lang agent. No changes in agent.
A
o Mechanical vectors
25
o = causative agent undergoes maturation in intermediate host/in mosquito before it can be transmitted to another susceptible host
Biological vector
26
- Route through which pathogen can enter new host
PORTAL OF EXIT
27
- Must provide access to tissues in which pathogen can multiply and toxins to release
PORTAL OF EXIT
28
- Person who cen get sick when they are exposed to a disease causing pathogen
SUSCEPTIBLE HOST
29
WHAT TYPE OF PRECAUTION?
- PATIENT PLACEMENT
- PPE (MASK N95)
- LIMIT TRANSPORT AND MOVEMENT OF PATIENT
- USE DISPOSABLE EQUIPMENT
- PRIORITISE CLEANING AND DISINFECTION OF THE ROOM
- NO NEED FOR MASK
DIRECT
30
WHAT TYPE OF PRECAUTION?
- PATIENT PLACEMENT
- PPE (MASK N95)
- LIMIT TRANSPORT AND MOVEMENT OF PATIENT
- USE DISPOSABLE EQUIPMENT
- PRIORITISE CLEANING AND DISINFECTION OF THE ROOM
- NO NEED FOR MASK
DIRECT
31
- Mask
- Proper patient placement
- Limit transoport and movement of pateint
DROPLET PRECAUTION
32
- Halos kapareho ng sa droplet pero need ng isolation room
- Proper patient placement in a proper airborne isolation room
- Suscpetible heathcare personnel restricted
AIRBORNE PRECAUTION
33
starts when doctor
asks for a test and ends when
testing begins.
PREANALYTICAL
34
n factors that will
be important in interpretation of
lab results
REFERENCE RANGE
35
Lab results should be interpreted
using
reference intervals
36
REFERENCE RANGE IS BASED ON
Most often based on healthy
people, sometimes considering
fasting state
37
PRE COLLECTION VARIABLES
AGE, GENDER, DIURNAL VARIATION, FASTING STATE, VIGOROUS EXERCISSE, DIET, ALCOHOL, POSTURE,DRUG INTAKE/MEDICATION, ALTITUDEFEVER, JAUNDICE, PREGNANCY TBN, TEMP AND HUMIDITY
38
day to day
variation
DIURNAL VARIATION
39
Drug intake/medication =
nakkaaaffect lalo na pag
anticholesterol recreation
40
* Four components, present at the same time, are necessary for fire to occur.
FUEL (COMBUSTIBLE MATERIAL)
HEAT
OXYGEN
CHEMICAL REACTION
41
fires occur with ordinary combustible materials, such as wood, papers, or clothing, and require water or water-based solutions to cool or quench the fire to extinguish it.
CLASS A
42
fires occur with flammable liquids and vapors, such as paint, oil, grease, or gasoline, and require blocking the source of oxygen or smothering the fuel to extinguish.
Class B
43
fires occur with electrical equipment and require non conducting agents to extinguish
CLASS C
44
fires occur with combustible or reactive metals, such as sodium, potassium, magnesium, and lithium, and require dry powder agents or sand to extinguish (they are the most difficult fires to control and frequently lead to explosions).
Class D
45
* fires occur with high-temperature cooking oils, grease, or fats and require agents that prevent
Class K
46
FIRE EXTINGUISHER THAT IS BEST LEFT TO FIREFIGHTERS
CLASS D
47
* are the type most frequently used in healthcare institutions.
Multipurpose FIRE extinguishers
48
extinguishers use soda and acid or water to cool the fire.
class a
49
extinguishers use foam, dry chemical, or carbon dioxide to smother the fire.
class b
50
extinguishers use dry chemical, carbon dioxide, halon, or other nonconducting agents to smother the fire.
Class C
51
(multipurpose) extinguishers use dry chemical reagents to smother the fire. They can be used on class A, B, and C fires.
Class ABC
52
extinguishers use a potassium-based alkaline liquid specifically formulated to fight high-temperature grease, oil, or fat fires by cooling and smothering them without splashing. Some class K extinguishers can also be used on class A, B, and C fires
class k
53
order of action for fire
R-ESCUE
A-LARM
C-ONFINE
E-XTINGUISH
54
CIRC SYSTEM CONSISTS OF
- Consists of blood vascular and lymphatic vascular
54
CIRC SYSTEM CONSISTS OF
- Consists of blood vascular and lymphatic vascular
55
returns tissue fluid spaces to the blood.
LYMPHATIC VASCULAR
56
Blood vascular consists of:
HEART AND BLOOD VESSELS
57
BLOOD VESSEL CONSISTS OF
- Capillary, vein, artery
58
= The smallest blood vessel that branches profusely.
CAPILLARY
59
ROUTE OF BLOOD
HACVB
59
ROUTE OF BLOOD
HACVB
60
vessels are more than 0.1 milimeter in diameter
macrovessel
61
Example: Capillary, arterioles, venules
macrovessel
61
Example: Capillary, arterioles, venules
macrovessel
62
- Carries blood away from the heart
arteries
63
oxy o deoxy pag artery?
oxy
64
to stretching of arteries after the heart pumps, creating blood pressure kase nagpump ng blood yung heart
pulse
65
o Stretching of arteries also cause
blood pressure.
66
= Stretching phase (top number)
= nadederive when our heart contracts and blood pressure rises and blood moves out along the vessels
systolic pressure
67
= relaxation phase (bottom number)
= Heart relaxes, blood pressure falls and blood fills the heart
DIASTOLIC PRESSURE
68
- Average young person has a blood pressure of
120/80
69
- Carries blood from arterioles to venules
CAPILLARIES
70
- When arterioles get small enough they turn into
capillaries
71
where nutrients and oxygen leave the blood and wastes (like co2) enter the blood.
CAPILLARY
72
- CARRIES deoxygenated blood to the heart.
VEIN
73
HAS VALVES
VEIN
74
that allows blood to flow forward. HOLDS BLOOD FROM SECTION TO SECTION
valves
75
= 1 layer of epithelial cell. Has loose CT. Konting smooth muscle cells
TUNICA INTIMA
76
= thick smooth muscle cells.
= many elastic fibers, lamellae, collagen
TUNICA MEDIA
77
= pag turbulent blood flow, eto nagcocontain ng internal elastic composed of elastic fibers
TUNICA MEDIA
78
= consists of type 1 collagen fiber. Some elastic fibers.
3. TUNICA ADVENTITA/EXTERNA
79
“vessel of vessels”. Consists of arterioles, capillaries and venules.it provides nourishment for cells found in tunica externa
VASOGASORA
80
separates tunica media and adventitia
External elastic lamina
81
= separates tunica intima and media
Internal elastic lamina
82
COMPONENTS OF EACH LAYER IN BLOOD VESSEL
-
Flat cells (simple squamous endo)
= acts as semi permeable membrane
= carries blood, plasma and interstitial fluid
- Smooth muscles
- Cappilaries
- CT primarily collagen
- Elastic material for resiliency
83
- System of thin walled endo channels that collects excess interstitial fluid(lymph) from tissue spaces and returns it to blood.
LYMPHAT8IC VASCUOLAR
84
- Collects fluid in between tissues except nervous, tissue, bone marrow and heart
Tissue
LYMPHATIC VASCULAR
85
lvs Consists of
lymphatic capillaries, lymphatic vessels and lymphatic ducts
85
lvs Consists of
lymphatic capillaries, lymphatic vessels and lymphatic ducts
86
- Specialized CT. A fluid CT made up of cells that are in a suspended material called plasma
blood
87
- 91.5% water the rest are proteins and other solutes
plasma
88
proteins in plasma most to least
Proteins = (most to least) albumin, globulin, fibrinogen(7%)
89
solute in plasma
Solutes = hormones, waste,gas, nutrient, electrolyte vitamins
90
how many percent formed element of blood
45
91
= 99%. 4.8-5.4 millions per um. 7-8 um diameter
= biconcave (may depression) pag bilog yan may sphigocytosis which is hereditary)
= mature rbc has no nucleus
= mas malaki wbc
= life span is 100 – 120 days develops in 2wks/3days
rbc
92
5 to 10k per um. Spherical shape. Has nucleus
wbc
93
agranalucytes
A. Agranulocyte = lymphocyte and monocyte
94
= longest life span in bc hours to yrs
lymphocte
95
remembers encountered pathogen magiging mabilis response
memory t cell
96
= proliferates/tataas in case of viral infection
lymphocyte
97
= kidney shape. 1 nucleus. Has indentation. Biggest
monocyte
98
= came from bone marrow
monocyte
99
paglabas sa circulation pag traverse sa tissue, it becomes macrophage which phagocytizees causative agent. Itim loob neto
monocyte
100
= bluish granule natatakpan nucleus niya. 1 nucleus.bilobe
basophil
101
= 1 nucleus. Bilobe. Red granule
eosino
102
kills parasitic worm in allergy asthma, hypersensitivity
eosino
103
laman ng granule may heparin, histamine and serum protease and mediators of inflammation
Hypotactic factors send signals to ask for help
eosino
104
= granules released= dadating na kakain sa causative agent
eosino
105
= mataas no. nito = bacterial infection
neutrophil
106
= phagocytizes bacteria
neutrophil
107
= Sticky fragment containing granules
= develops in 4-5 ls:5-10 days
platelet
108
PHYSICAL CHARACTERISTICS OF BLOOD
- Viscosity (thickness) = 4.5 (sa tubig 1)
- Salinity = 0.85%
- pH = 0.4
- Range = 7.33-7.4
- 8% of uor total weight
- Osmolality = 300 mOsm or 3.0 osm (concentration of solute in plasma)
- Temp = 38C (slightly higer than normal body temp which is 37)
- Blood vol. in ave. male = 1-6L
- Blood volume in ave. fem = 4-5
109
FUNCTIONS OF BLOOD
1. SUBSTANCE DISTRIBUTION
2. REGUALTION OF BLOOD LEVELS OF PARTICULAR SUBSTANCES
3. BODY PROTECTION
110
has proteins that allows us to shell off complement proteins and antibodies (Ex. Lymphocytes can shell off antibodies so ti becomes plasma cells)
plasma
111
oposite of omoestasis
hemorrhage
112
3 STEPS IN HOMOESTASIS
1. Vasoconstriction
2. Formation of platelet plug (primary homoestasis)
3. Formation of fibrin clot or blood coagulation (secondary homoetasis
113
initiates maintenance of homoestasis after injury.. it is the blood vessel’s first response to injury
Von willebrand factor (bwf factor) =
114
= formation of fibrin mesh
Coagulation cascade
115
vein pattern of 70% of population
h
116
Typically larger, closer to the surface, better anchored, more stationary than others
median cubital
117
Often harder to palpate than median cubital
Fairly well-anchored and often the only vein that can be palpated in obese patient
median cephalic
118
More painful. Not anchored well
median basilic
119
vein patetrn - 20-28% of the population
m pattern
120
Malayo sa nerves
median cephalic
121
order of vein kung san kukuha
1. Antecubital fossa = select big vein at di nagroroll
2. Forearm and hand vein
Above knuckles. Yung prominent and straight vein piliin
3. Ankle, leg/foot
Need dr. permission
4. Singit
Dr or nurse lang pwede kumuha dito
122
yung gamot na tinatake, may time kung kelan siya nagpepeak at pagtapos ng ilang oras may lowest level den called “trough”
* Therapeutic blood monitoring (TBN)
123
= catheter na nakakabit sa radial artery
arterial line
124
provides for continues BP monitoring, and for infusing medication
arterial line
125
= permanent surgical fusion of an artery and vein
atriventricular shunt / fistula
126
USE: to provide access for dialysis
atriventricular shunt / fistula
127
=kinakabit sa patient pagkaadmit palang sa ward
heparin or saline lock
128
= catheter or canula connected to a stopcock/cap with diaphragm
heparin or saline lock
129
USE: provides access for administering medications and drawing blood
heparin / saline lock
130
= a catheter inserted in vein to administer fluids
iv line
131
= known as indwelling lines na asa gitna ng katawan
central vascular access device (CVAD)
132
TYPES OF CVAD
= has many types: peripheral inserted center catheter (picc),implanted peripheral port, implanted chest port
133
= inserted into large vein (subclavian);
CENTRAL VENOUS CATHETER
134
= inserted into large vein (subclavian);
CENTRAL VENOUS CATHETER
135
CENTRAL VENOUS CATHETER ADVANCE INTO
IMPLANTED PORT
135
CENTRAL VENOUS CATHETER ADVANCE INTO
IMPLANTED PORT
136
small chamber attached to a indwelling line, surgically implanted under skin usually in upper arm or chest
IMPLANETED PORT
137
inserted in veins
or extrimities papunta sa gitna sa puso sa central vein. It is threaded into central vein
Peripherally inserted central catheter (PICC) =
138
SITE SELECTION AREAS TO BE AVOIDED
Yunng may line (arterial, picc, etc.)
Extensive scarfrom burns and surgery = pagka makapal na peklat, mahirap matarget vein kase natatakpan siya ng peklat
Upper extremity on side of previous mastectomy = yung other breast nalang
Mastectomy = inalis breast
Intravenous therapy/blood transfusion
139
= missed vein; needle goes through vein or just partially in the vein
HEMATOMA
140
happens pag ang tagal linapply tourniquet.
HEMOCONCENTRATION
141
pag pull ng plunger ng syringe forcefully kase manipis lang vein
COLLAPSE OF SMALL VEIN
142
* Puncture only the uppermost wall of the vein
* Remove tourniquet before removing needle = baka magsquirt blood pag hindi tinanggal
* Use major superficial vein = mas malaki diameter. Mas well anchored
* Alisin tourniquet, tas needle tas apply pressure to venepuncture site.straighten arms
* Avoid probing `
PREVENT HEMATOMA
143
PROLONGED TORNIQUET APPLICATION RISKS
* Total protein, iron, total lipids and cholesterol increase from 5-7%, bilirubin increases 8% and AST aka sgot 9%,lactate, ph, blood potassium
144
* Happens due to too much probing
NERVE INJURY
145
* Sign:rapidly forming hematoma blood filling tube quickly
Inadvertent arterial puncture
146
* Collect only the min. required specimen volume
IATROGENIC ANEMIA
147
* Don’t open bandage ahead of time
* Don’t preload needle onto tube holders ahead of time. Sa harap ng patient buksan yung syringe
* Don’t TOUCH needle insertion site after disinfecting it.
* Minimize time between needle cap removal and venepuncture
* keep bandage on atleast 15 minutes or pag di na nagdudugo
INFECTION
148
* yung tube na may anticoagulant bumabalik dugo sa vein
* It can cause adverse reaction
* dapat arm is in downward position below venepuncture site
REFLUC OF ANTICOAGULANT
149
* avoid numerous venepuncture in same area over time
* avoid blind probing and improper technique
VEIN DAMAGE
150
* use larger bore needle (21G which is used for standard phlebotomy) lalo na pag malaki vein, kung maliit vein or domavle vein g23
- * draw slowly
* size of needle should depend on size of vein na ipupuncture.
TO PREVENT HEMOLYSIS
151
* Primary cause of is vigorous mixing dat figure of 8 pag ikot niya
hemolysis
152
* Yung gloves with powder – pwede mangcontaminate ng powder yung sample
* Madalas macontaminate neto blood film
* Dripping perspiration into capillary specimens – pag pawis.
* Using improper and wrong antiseptic procedure
* Alcohol residue
SPECIES CONTAMINATION
153
* Check date before using baka expired na
* Pag expired nabaka wala na vacuum sa loob.
* Pag walang vacuum yung papalit dun is yung amount of blood
Ex. Di mapuupuno ng dugo yung ets holder kase walang vacuum.
WRONG OR EXPIRED COLLECTION TUBE
154
3 ways to get blood
VEIN, ARTERY, CAPILLARY
155
3 WAYS OF VENIPUNCTURE
3 ways of venepuncture
Syringe
ETS holder
Butterfly
156
= end of needle. Andito pore.allows needle to easily slip in skin
BEVEL
157
= long cylindrical portion of needle. Usually 1” to 1.5”
SHAFT
158
= end of blood collecting. where needle is connected. Both ets and butterfly meron den
HUB
159
Bevel = end of needle. Andito pore.allows needle to easily slip in skin
Shaft = long cylindrical portion of needle. Usually 1” to 1.5”
Hub = end of blood collecting. where needle is connected. Both ets and butterfly meron den
Gauge number
Parts of a needle
160
Parts of a syringe
Tip = minsan may screw na iikot needle
Plunger tip = yung dulo itim ng plunger tawag plunder tip.
Volume markings
Barrel = pag inalis number makikita volume marking. May nakasuksok na plunger
Plunger = eto yung pinupull pag kukuha ng dugo .
Flange = nakausli sa dulo ng barrel. Gamit pag iniinject eto hinahawakpara maganda paghawak
161
- is a special type of ETS needle na may hub na nakattach.
Flashback needle
162
- Bd designed blood collection needle that’s safety and clear for multisample collection
eclipse needle
163
- offers simple way of collecting blood reducing risk of needlestick injury kase di na magrerestick ng needle.
eclipse
164
parts of lancing device
- lancet nakatusok sa carrier
- setting= tinuturn depending kung gano kakalain na dugo
- release button = pangtusok
- barrel = minsan may clip minsan wala
- lancet needle
165
BLOOD COLLECTION ADDITIVES
- anticoagulant
- special-used anticoagulant
- anti-glycolytic agents
- clot activators
- thixotropic gel separator
- trace element-free tubes
* non-trace element royal blue.trace element free siya
166
- 3 principles kung bat di makukuha dugo:
1. Binds or relation calcium
2. Precipitation of calcium
3. Thrombine inhibition (
167
thrombin inhibition
para kase magkathrombine need ng calcium pag may thrombine siya mag coconvert ng fibrinogen to fibrin)
168
anticoagulant ex
3 green(ammonium, na heparin, li heparin), gold, violet (edta (k2 and k3 type ng edta meron pang edta na white and pink yung pink for blood banking)
169
SPECIAL USED ANTICOAGULANT
1. acid citrate dextrose
2. citrate phosphate dextrose
3.sodium polyanethol sulfonate
170
= has 2 formulations: yellow tap, asa blood bag pag nagcocollect ng blood
ACID CITRATE DEXTROSE
171
No. of mixing
-
3 to 4 citrate
- 5-6 gold and spt
- 8-10the rest 8-10
172
WHAT HAZARD
-Microwaves, infra-red, ultraviolet, lasers, X-rays and gamma
rays.
RADIATION
