Preventing/ Controlling Transmission of Infectious Agents (22 questions)

Question 1

Category A

Answer 1

-Highest priority, pose risk to national security
- easy transmission person to person n
High mortality
- might cause public panic, social distuption
-requires special attention for public health preparedness
- Ex: Anthrax, botulism, plague, smallpox, tularemia, viral hemorrhagic fevers

Question 2

Category B

Answer 2

• second highest risk
  -moderately easy to disseminate, mod morbidity
• requires specific enhancements of CDC dx capacity and increased disease surveillance
  -ex: Brucellosis, clostridium perfringes, food safety threat, Glanders, Meloidosis, Psittacosis, Q fever, Ricin toxin, Staph enterotoxin B, Typus fever, Viral encephalitis, water safety threats

Question 3

Category C

Answer 3

3rd highest
-Emerging pathogens that could be engineered for mass dissemination in future
ex: Nipah virus, Hantavirus

Question 4

Anthrax

Answer 4

-Not person to person. SP
-Exposure to dust or powder -CONFIRMED anthrax= tx with abx for 6 weeks or more

Question 5

Brucella

Answer 5

-transmission person to person by contact with draining lesions tissue transplant or sexual contact
- SP, plus appropriate PPE when caring for draining lesions

Question 6

Cholera

Answer 6

-Transmissed through drinking water or food contaminated with feces
-SP

Question 7

Pneumonic Plague

Answer 7

-transmission person to person via resp droplets.
- SP + Droplet until 48 hours of app abx and improvement in sx
- transmission can occur from skin lesions- good HH is a must

Question 8

Smallpox

Answer 8

• Transmitted person to person by resp secretions, aerosols, contact with pox lesions and fomites
• Airborne (N95, neg pressure) + Contact
• Dedicated equipment, autopsy/ post mortem = A + C
• Pt infectious until all scabs have separated

Question 9

Tuleremia

Answer 9

NOT person to person. SP
- Lab must wear: mask, eye protection gown and gloves wen working with culture and do in a closed system- adhere to biosafety level (Category A)

Question 10

Viral Encephalitis (Venezuelan, Eastern, Western)

Answer 10

NOT person to person. SP
Transmitted by inhalation or mosquitoes

Question 11

Viral Hemorrhagic fever

Answer 11

• Person to person by inhalation of aerosols or percutaneous injury
• SP + Contact
• Wear eye protection and mask if risk for aerosol or splash
• Post mortem: mask, eye protection, gown, gloves

Question 12

Primary source of SSI HAI’s

Answer 12

Endogenous bacteria (OR environment, and surgical personnel)

Question 13

OR air quality and ventilation

Answer 13

> 15 ACH (3 must be fresh air)

Question 14

Prevention of Bloodborne Pathogens in Dialysis

Answer 14

HBV*, HDV, HCV, HIV

HBV:
-Anti-HBs = serological marker to look for vaccine or infection related immunity
-Anti-HBc= current or past HBV
-HBV vaccine if susceptible pt or staff
-dedicated equipment, separate room, not in reuse programs

Question 15

Airborne negative pressure room ACH

Answer 15

at least 6-12

Question 16

Notification of a contaminated or defective product, decide or med is suspected to cause outbreak.

Answer 16

notify FDA and CDC

Question 17

c diff

Answer 17

spore forming, Gram- po anerobic bacillus

Question 18

Meningococcal disease

Answer 18

SP plus Droplet isolation for the first 24 hours of antibiotic therapy.

Meningococcal disease is a serious and potentially life-threatening infection caused by the bacterium Neisseria meningitidis. Common symptoms of meningococcal disease include high fever, neck stiffness, confusion, nausea, vomiting, lethargy, and/or petechial or purpuric rash. N. meningitidis is a gram-negative, encapsulated, aerobic diplococcus. The bacteria are transmitted from person-to-person through droplets of respiratory or throat secretions from carriers and require Droplet isolation in addition to standard precautions for the first 24 hours of antibiotic therapy.

Question 19

Which of the following antiseptic solutions does the Centers for Disease Control and Prevention (CDC) recommend as skin prep for central venous catheter insertion and care, unless there is a contraindication?

Answer 19

> 0.5% chlorhexidine preparation with alcohol.

According to the Centers for Disease Control and Prevention (CDC) Guidelines for the Prevention of Intravascular Catheter-Related Infections, clean skin should be prepared with a >0.5% chlorhexidine preparation with alcohol before CVC and peripheral arterial catheter insertion and during dressing changes. If there is a contradiction to chlorhexidine, tincture of iodine, an iodophor, or 70% alcohol can be used as alternatives

Question 20

Precautions for influenza positive mom

Answer 20

Temporarily separate mom and baby after delivery, all feeding by healthy caregiver if possible.
If mom is going to breastfeed, encourage them to express milk

Question 21

Pruritic lesions

Answer 21

Scabies
Contact precautions until 24 hours after Tx

Question 22

___ days USP recommends multidose vials be disposed of after opening

Answer 22

28 days

Question 23

Kills all orgs and spores

Answer 23

Steam sterilization and Ethylene oxide

Steam= items that are tolerant of high temperatures, such as metal surgical
tools.

Ethylene oxide gas = is a low-heat method for items that are
not heat tolerant. Items that are sterilized by ethylene oxide must be allowed
time for aeration before use

Question 24

Have published regulations for infection and medical or regulated waste

Answer 24

EPA (Environment protect), OSHA, DOT (department transportation)

Question 25

Airborne precautions ACH

Answer 25

6-12

Question 26

vein with lower incidence of CLABSI

Answer 26

subclavian

Question 27

CJD is sporadic in what percent of cases

Answer 27

85% cases are sporadic (vs familial/genetic) and occurs at a mean onset of 50 to 70 years of age

Question 28

Epidemiological triangle

Answer 28

Host, agent, environment

-host is the human
ex: HCW vaccination
improved their immunity

-agent may be a bacteria, virus, fungi, etc.
Ex: increasing antimicrobial resistance
represents a change in the agent (or pathogen)

• environment consists of
  all external factors associated with the host
  ex: Improving HCW influenza vaccination rates would be an
  environmental factor change for patients by decreasing their exposure to flu
  ex: A change in cleaning agents

Question 29

UTI risk factors young girl

Answer 29

Risk factors for young girls include:
* History of maternal UTI
* Family history of vesicoureteral reflux
* History of dysfunctional voiding patterns
* Constipation
Although often reported as a cause, direction of wiping with toilet paper is not
a risk factor. Identified risk factors include bubble baths and prolonged soaking
in the bathtub, excessive holding of urine, and delayed bladder emptying

Question 30

infections in which breast milk must be withheld from
the newborn are:

Answer 30

Untreated active TB, HIV, breast abscess, West Nile, HSV

(1) presence of a breast abscess, (2) herpes simplex virus
lesion on breast, and (3) infection with HIV, West Nile virus, or human
T-cell lymphotropic virus type I or II

Women with open, active, untreated
pulmonary TB cannot breast-feed because they are to have no direct
contact with the newborn. However, breast milk can be pumped and given
to the newborn, provided that the treatment the woman is receiving is not a
contraindication for breast-feeding.

Question 31

effective strategies to curb antimicrobial
resistance include

Answer 31

Recommended strategies for antimicrobial stewardship
include formulary restriction, automatic stop orders, and antimicrobial cycling

Question 32

The infection prevention program should include the following
when planning for active surveillance cultures:

Answer 32

providing additional personnel
to obtain cultures and additional laboratory personnel to process these
cultures, ensuring turnaround time for screening results, monitoring adherence
to Contact Precautions, providing a mechanism for communicating results to
healthcare providers, and measuring outcomes to evaluate the effectiveness
of active surveillance cultures and Contact Precautions