Practice Tests Flashcards
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
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
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
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.
Cytomegalovirus (CMV)
Standard Precautions
no vaccine available and for most people wont cause serious health problem
Often relates to invasive procedures or underlying or debilitating condition
Acinetobacter baumanni
whirlpool outbreak
pseudomonas aeruginosa
most commonly associated with outbreaks related to contaminated equipment
pseudomonas aeriginosa and non-TB mycobacteria
MERS
Standard, Airborne, Contact
Sterilization method cleared by FDA
Ozone
air sampling useful for detecting low # fungal spores in highly filtered area
sieve impactor sampler
CSF shoes gram + cocci in pairs and chains
No PEP needed because its strep pneumo
coag-neg staph and 2 + BC from 2 or more sets, 2 days apart, without Sx
BC potential contaminate.
bacterial meningitis
WBC > 1000, increase protein, decrease glucose, gram statin + may show GPC or GNC/GNR, cloudy
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,
causes cutaneous lesions after exposure to swimming pools, fish tanks or other water sources
mycobaterium marium
most common org associated with pna in school aged children and young adults
mycoplasma pneumoniae
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
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
BC grew aerobic, gram neg bacili
Acinetobacter baumanii
safe temp range for cold food storage
41 F (5 C) or lower
fungemia most often associated with lipid infusions
malassezia furfur
improved hydrogen peroxide contains
anionic and/or nonionic surfactants
acceptable contamination level for BC
less than 3%
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
