Practice Tests Flashcards by Brie Z

Ebola

Standard, Contact, Droplet (N95 for AGP)
Incubation period: 2-21 days post exposure
- PPE, use EPA disinfectant for non-enveloped viruses, clean hard surfaces of patient room and doffing area, dispose of linen and materials
Severe often fatal disease

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Measles

airborne
sx generally in 2 stages:
-stage 1= 2-4 days of runny nose, cough, fever, Koplik spots, red eyes and sensitivity to light
-stage 2= day 3-7 and red blotchy rash begins on face and spreads down and outward

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Smallpox

-Airborne & Contact
-Serious, contagious and sometimes fatal
-no specific tx, only prevention= vax
-spread by direct contact with body fluids of contaminated objects/clothing

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West Nile

Standard Precautions
Mosquitos
Transmission: spread through blood transfusions, organ transplant, mother to baby during pregnancy or delivery or breastfeeding
- infectious 6-7 days before sx onset- stops shortly after onset sx. Incubation 2-14 days.

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Cytomegalovirus (CMV)

Standard Precautions
no vaccine available and for most people wont cause serious health problem

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Often relates to invasive procedures or underlying or debilitating condition

Acinetobacter baumanni

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whirlpool outbreak

pseudomonas aeruginosa

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most commonly associated with outbreaks related to contaminated equipment

pseudomonas aeriginosa and non-TB mycobacteria

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MERS

Standard, Airborne, Contact

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Sterilization method cleared by FDA

Ozone

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air sampling useful for detecting low # fungal spores in highly filtered area

sieve impactor sampler

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CSF shoes gram + cocci in pairs and chains

No PEP needed because its strep pneumo

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coag-neg staph and 2 + BC from 2 or more sets, 2 days apart, without Sx

BC potential contaminate.

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bacterial meningitis

WBC > 1000, increase protein, decrease glucose, gram statin + may show GPC or GNC/GNR, cloudy

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Bordatella pertusis Dx

DFA= very specific but not sensitive so culture must be performed to confirm DFA.
If culture positive then 100% pt has it. If negative then cannot rule it out because of low sensitivity,

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causes cutaneous lesions after exposure to swimming pools, fish tanks or other water sources

mycobaterium marium

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most common org associated with pna in school aged children and young adults

mycoplasma pneumoniae

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susceptible HCW with measles exposure

furlough from 5th-21st day after exposure- regardless of measles vax or immunoglobulin
- if convert: should be furloughed until they have had their rash for 4 days

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Category 1A (CDC amt of data to support reccomendation)

strongly supported epi clinical data or experimental data from well-designed study
ex: sterilization of medical instruments that will come in contact with sterile tissue or vascular system

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BC grew aerobic, gram neg bacili

Acinetobacter baumanii

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safe temp range for cold food storage

41 F (5 C) or lower

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fungemia most often associated with lipid infusions

malassezia furfur

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improved hydrogen peroxide contains

anionic and/or nonionic surfactants

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acceptable contamination level for BC

less than 3%

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potential source of bronchoscopes, hydrotherapy pool

mycobacterium chelonae (NTM)

air filtration method that has the highest filtering efficiency

diffusion

acceptable upper limit for relative humidity to prevent fungal growth

60%

best choice for cleaning blood and body fluids

bleach nonporous: 1:100 porous, large surface: 1:10

short term central lines associated with higher risk of infection

femoral and jugular

graph that will identify a pattern of observation points above and below the mean

run chart identify how a process changes over time- look at trends and avg useful for identifying variation and trends, monitoring effectiveness after implementing improvement process

only agency that has regulatory authority over any aspect of healthcare facility design, construction and renovation

OSHA

meningococcal meningitis incubation period

2-10 days

calculate mortality rate

X/Y x K K= crude= 1,000 cause- specific = 100,000

if CJD developed as a result of medical treatment

iatrogenic

resistance from high to low for: polio, c diff, CJD, staph

(High) -CJD -C diff (spore forming) -Polio (non-lipid virus- intermediate level disinfection) -staph aureus (vegetative bacteria) (low)

Most regulations related to handling or disposal of infectious or regulated medical waste are defined at the

State level, usually by the state health department

when a test has a higher specificity than sensitivity:

a negative result will be more accurate than a positive. sensitivity = true positive rate specificity= true negative rate

regulates blood safety, medical devices and chemical germicides, antiseptics

FDA

epi curve that rises slowly and then plateaus over extended period

continuous ongoing spread of infection

MERS

SP, Airborne, Contact

transmission difference for Hep B and HIV through needle puncture

HBV conversion is higher at 23-64 % HCV 1.8% HIV 0.3%

pneumonic plague

-Iso = droplet, can d/c after 48 hours AND improving sx - surgical mask worn within 3 feet of pt, door can be open -in bioterrorism: most likely to occue from inhalation of aerosolized -incubation 1-6 days (common 2-4)

surgical risk index and amt of time for Colon resection, CABG, spinal fusion, Ab hyst/hip prosthetic

CABG= about 5 hours spinal fusion = about 4 hours colon resection= about 3 hours Ab hyst, hip prosthesis = about 2 hours

box car shaped gram + bacilli

Anthrax caused by bacillus anthracis CXR: mediastinal widening and pleural effusion

advantages of OPA over glutarledhyde

doesn't require activation, is stable over a range of pH, doesn't irritate eyes/nose

heat temp for treatment of bed bugs

118 F for one hour

outbreak and want to isolate as quickly as possible

use test with highest sensitivity

when a test has a higher specificity than sensitivity

a negative result will be more accurate than pos sensitivity= true pos rate specificity= true neg rate

bleach stored in open container is good for

24 hours closed container= 30 days

post varicella (chickenpox) exposure

10-21 days, ut if give VZIG then off through day 28

p value of 0.05

probability that the observation occurred by chance alone is 1 in 20

measure of dispersion to consider for surveillance reporting include

range and standard deviation

CDC lists as "urgent" drug resistant threats

Neisseria gonorrhea, c diff and CRE

"modifying factors" based on Health Belilef Model

age, gender, race, socioeconomic status, rural or urban, religion, etc

CRE outbreak response

screen/ surveillance testing on patients admitted to high risk setting (ex. ICU or LTC) or from a high risk setting

cases of staph epi and want to determine if all isolated were from a single source

pulsed- field gel electrophoresis (PFGE)

biological indicator is positive, first step

retrieve (recall) unused items from load

discrete data

whole number, can be categorial or noncategorical

noncategorical

only counting events (infections) NOT non-events (ex of discrete and nocategorical is # of BSI per central line days in ICU)

requirements for AFB testing

must be 8-24 hours apart and one sample must be in the early morning

what is the IP targeting when reviewing pre-op CHG bathing instructions

inoculum of bacteria - CHG inhibits/ skills skin colonizing flora

structured communication method that solicits opinions from a panel of experts who answer questionnaires in 2 or more rounds

delphi technique

vax of school aged kids to decrease cases in community is an example of

herd immunity

Community associated MRSA

pt with severe CAP plus hemoptysis, multilobar or cavitary infiltrate on CXR or neutropenia

Case fatality rate (CFR)

X/Y x K K=100, expressed as a %

Preparing cost benefit analysis (CBA)

ALL measures expressed in monetary (US $) terms

Which agency regulates medical waste and incinerators

EPA Also does disinfectants