PREVMED 2 Final Review Flashcards
How often is the Typhoid booster given if continued exposed to typhi organism?
Every 2 Years
What is distillation?
The total process the distilling plant forms, including evaporation and condensation
Who is responsible for promulgating instructions for ship-to-shore potable water connections?
Naval Facilities Engineering Command (NAVFACENGCOM)
Who is responsible for establishing and promulgating health standards for water quality afloat?
Chief, BUMED
The Engineering Department are responsible for potable water system components that do what?
a. Receive
b. Store
c. Distribute
d. Produce
e. Treat
If the ship is on water hours how many gallons per man per day?
2 gallons
If the ship is NOT on water hours how many gallons per man per day?
50 gallons
Shore-to-Ship delivery is an approved when it comes from what?
EPA (state and territory) approved public water system
We accept water from U.S. Military under the cognizance of?
a. British Royal Navy
b. Canadian Forces
c. Royal Australian Navy
What are the 2 types of Reverse Osmosis?
a. Single Pass – Additional disinfection is required
b. Triple Pass – Additional disinfection is NOT required
What is CHT also known as?
Marine Sanitation Device
Can we use sea water for Marine Sanitation Devices?
Yes
Potable water tanks coating meets what standard?
NSF/ANSI
Connections hose what color for potable water?
Dark Blue
What are the characteristics of Potable Water Hose Lockers?
a. Vermin Proof
b. Locked
c. 18 inches off the decks (when located on weather decks and sponsons)
d. Printed, step by step instructions (water sanitation bill) for disinfection hoses and risers posted (CONSPICUOUSLY) inside the locker
What is the purpose for bacteriological testing?
a. Ensures fitness for human consumption
b. To assess adequacy of disinfection process
What is the minimum halogen residual for water with doubtful quality?
2.0PPM
Where is the water sanitation bill posted?
Posted conspicuously in areas where potable water and associated materials are processed, treated, or stored
What are the two DPD tablets and what do they test for?
a. DPD #1 – tests for FAC or TBR
b. DPD #4 – tests for Chloramines (total chlorine) residual
What is the most important source of contamination?
Cross connections with non-potable systems
What is the least desirable method of water disinfection?
(Batch Method) Manual Chlorine Disinfection
What does HTH stand for?
Calcium Hypochlorite
What are the Halogen Residuals for approved/unapproved sources?
a. Approved – 0.2 PPM FAC/TBR after 30 minute contact time
b. Unapproved – 2.0 PPM FAC/TBR after 30 minute contact time
How long do you hold the solution for disinfection method 1?
Hold solution for 24 hours
Steam method requires approval of from who?
NAVSEASYSCOM
When requesting outside assistance, who do you contact?
NEPMU via TYCOM Medical Officer
What type of container does 65-70% HTH come in?
6 Ounce Bottles
Where can bottles of HTH not be stored for ready to use stock?
a. Machinery spaces
b. Flammable liquid storeroom
c. Berthing space
d. Paint storeroom
e. Oil and water test lab
Where can 65-70% HTH not be stored in storeroom stock?
In area where paints, oils, grease, or other combustible organic materials are stored
Who promulgates the water sanitation bill?
The Commanding Officer promulgates it and is ultimately responsible
What will the water sanitation bill consist of?
a. Sources
b. Connection procedures for:
i. Ship to Shore
ii. Shore to Ship
c. Potable water hoses
d. Storage tanks
e. Disinfection procedures
f. Halogen residual testing
g. Bacteriological testing
h. Temperature, ph and salinity testing
i. Disinfection of tanks and distribution system
j. Distribution system
k. Records
How long does the MDR maintain the potable water surveillance records?
2 years
How often training is conducted concerning the prevention of wastewater hazards?
Periodically
What type of sanitation devices are installed on navy vessels
Type II-B
When NOT able to transfer off-ship immediately out of the CHT where is it stored?
Holding Element
Pump room should have what breathing devices?
2 EEBD
What are we worried about with health hazards associated with CHT Systems?
Explosions
a. Toxic or explosive gases associated with CHT:
i. Hydrogen sulfide – Rotten Egg Smell
ii. Methane
iii. Ammonia
iv. Carbon Dioxide
What is required of CHT workers to prevent transmission of disease?
Personal Hygiene
Spill in medical food service and berthing has to be disinfected with what EPA disinfectant?
a. Germicides:
i. Phenolic Type
ii. Iodine Type
What is the color coding of pipes and valve handles?
Gold
When transferring waste off in port or on the pier?
Transfer to the sewer risers
What is the responsibility of the Engineering Officer?
Construction, operation, and maintenance of all facilities used for collection, treatment, and distribution of potable water
When medical treats and disinfects water what does it become?
Potable
3000 gallon tank
No idea what the question is just know ONION
Two types of tanks with 3,000 gallons?
a. 3,000-gallon tank
b. Semitrailer-Mounted Fabric Tank – 3,000 to 5,000 gallons
When disinfecting natural surface water or well water under the direct influence of surface water for drinking and there is no other treatment available what is the PPM after what contact time
5 PPM FAC after 30 minute contact time
Alternative procedures chlorinate the water to what PPM?
10 PPM FAC
What is a surge?
Personnel embarked for short duration during SPECIAL OPERATIONS
Berthing, messing, normal work spaces and medical shall maintain what minimum dry bulb temperature
65˚F
What type of pillows aren’t authorized?
Polyurethane
How often are trash cans cleaned?
Daily
All berthing spaces, common rooms and head facilities cleaned how often?
Daily
The IDC will ensure inspections are performed how often
At least quarterly
Disinfectant must meet what standard?
An EPA registered product or international equivalent with demonstrated bacterial, virucidal, and fungicidal activity used as outlined in the manufacturer’s instruction
Who must be medically screened to be free of communicable disease prior to initial assignment
Barber Shop Employees
What must be worn over uniform while attending to patrons?
A clean smock or other freshly laundered over garment
Barber shop must include what
Hot and cold running water
What practice is prohibited in barber shops?
Therapeutic practices
a. Treating pimples
b. Removing ingrown hairs
Compressed Air should not exceed what psi?
15 PSI
Laundry facility floor shall be cleaned using what method
Dustless
Any equipment louder than what DB requires hearing protection?
Over 84 Db
Hygienically safe laundry is washed in warm water without bleach at what temperature?
120˚F to 140˚F
When chlorine bleach is not included in formulation what is a necessary step
Heated air dryers
Requirements for handling contaminated laundry?
a. Received in impervious, double sealed bags
b. Outer bag must be red and labeled with:
i. Universal biohazard symbol
ii. The word “Biohazard”
c. The inner bag must be hot water soluble
d. Contaminated linen must NOT be sorted
What bacterium causes Cholera?
Bacterium Vibrio Cholerae
How can a person get Cholera?
By drinking water or eating food contaminated with the cholera bacterium
Where does Cholera live?
The Cholera bacterium may live in brackish rivers and coastal waters
Plague is spread by what flea
Rodent Flea
Methods of control for plague?
a. Education
b. Rat-proofing of buildings and/or ships
c. Storage and disposal of food and garbage
d. Patient isolation and concurrent disinfection
e. Clothing repellants
What mosquito causes yellow fever
Aedes Aegypti
Why do travelers not get yellow fever?
Most countries have regulations and requirements for yellow fever vaccination that must be done prior to entering the country
Small pox is also known as what type of virus
Variola Virus
Skin eruption appears within how many days?
2-4 Days
Stocks of variola virus are held where?
a. CDC Atlanta, Georgia
b. Centre of Biology and Biotechnology, Koltsovo, Russia
What immunization is used for small pox?
Vaccinia Virus
What is OPNAVINST 6210.2?
Quarantine Regulations of the Navy
Within how many hours of entering a port will the CO message/radio the Senior Naval Officer in Command?
12-72 hours prior
What are the 5 Elements of TB program
a. Tuberculosis Screening
b. Preventive Therapy
c. Tuberculosis Case Identification
d. Tuberculosis Patient Management
e. Contact Investigation
What method is used to give the TST?
Mantoux Method
What is preferred product for TST?
Tubersol
What can be used in place of TST
QFT (quantiFERON)
What is BCG and who is it given to?
Bacillus Calmette-Guérin
Often Given to Infants and small children in other countries where TB is common
When are active duty and reserve personnel screened for TB and what document is used?
a. Annual screening during PHA
b. Document on NAVMED 6224/8
If documentation is not provided for previous positive result?
Proceed with skin testing
What are chest x-rays used to rule out
Fibrotic Changes
High Risk TST results
a. High Risk
i. Induration of 5mm or greater is considered positive in.
1. Recent close contacts of active TB disease patients.
2. Persons with fibrotic or other changes on chest radiograph consistent with prior TB.
3. Patients suspected of having active TB disease.
Medium Risk TST result
b. Medium Risk:
i. Induration of 10mm or greater is considered positive in.
1. Recent immigrants (within 5 years) from high TB prevalence countries.
2. Healthcare workers and others at risk of occupational exposure to TB.
3. Persons with clinical conditions that place them at increased risk.
Low Risk TST result
c. Low Risk:
i. Induration of 15mm or greater is considered positive in:
1. Persons with no risk factors for TB.
When placing a TST what is the wheal size?
6-10MM
If the TST wheal is less than 6 mm, what is required?
Test should be administered again
When is a PPD read?
48 to 72 hours
Prior to therapy, the reactor must be evaluated by who to rule out active TB disease?
a. MO
b. NP
c. PA
d. IDC
When are sputum examinations performed?
If radiographic shows signs of active TB
What is the form used for monthly evaluations for INH preventive therapy?
NAVMED 6224/9
Who do you consult for management guidance for Non-Compliance?
NEPMU
What is Direct Observed Therapy?
Tool to ensure compliance
When should you consider withholding INH treatment
a. Transaminase levels exceed 3 times upper limit of normal if symptomatic
b. 5 times the upper limit of normal if asymptomatic
In cases where active TB is suspected or confirmed who does the MDR notify?
a. Cognizant NEPMU
b. Local health department
Personnel who are enrolled in a contact investigation but are separating who will patients follow-up with for follow-up testing and medications?
a. Local public health department – Follow-up testing
b. VA – medications
Who does the cognizant NEPMU provide the contact investigation report to?
a. Members Command
b. Cognizant FLEET/TYCOM surgeon
c. NMCPHC
What are the 4 drugs used for TB treatment?
a. INH – Isoniazed
b. RIF – Rifampin
c. PZA – Purazinamide
d. EMB – Ethambutol
What are RME’s event?
Disease or etiologic agent specific which may pose an inherent , significant threat to public health and military operations
Who is the primary consultant resource as well as where should findings be reported to?
Cognizant NEPMU
What is the official system to capture, store and communicate information related to RME’s?
Disease Reporting System internet (DRSi)
What is NMCPHC-TM 6220.12?
Medical Surveillance and Medical Event Reporting Technical Manual (Only Manual)
What are the two types of reports?
a. Urgent – must be submitted within 24 hours
b. Routine – for non-urgent submitted NLT 7 calendar days after identification
Communicable diseases required to be reported within 24 hours? PT 1
a. Anthrax
b. Botulism
c. Diphtheria
d. Hemorrhagic Fever
e. Influenza A, Novel
f. Malaria (all)
Communicable diseases required to be reported within 24 hours? PT2
g. Measels (Rubeola)
h. Meningococcal Disease
i. Outbreak or Disease Cluster
j. Plague
k. Poliomyelitis
l. Rabies, Human
Communicable diseases required to be reported within 24 hours? PT3
m. Severe Acute Respiratory Distress (SARS)
n. Smallpox
o. Tuberculosis, Pulmonary/Infectious
p. Tularemia
Outbreaks will have what?
A narrative report of what’s going on
If the MER might have an adverse impact on operational unit or national security who should be consulted for classification decision?
a. Information Security Officer
b. Commanding Officer
After Clinical Assessment, Laboratory Studies, and Epidemiological Results, a diagnosis, case or medical-event will be classified into what 3 categories?
a. Suspected
b. Probable
c. Confirmed
What are the temperatures for all refrigerators?
36˚F to 46˚F (2˚C to 8˚C)
What drug must be stored and readily available at all vaccine sites in case of anaphylaxis?
Epinephrine
What must be provided prior to receiving immunizations?
Vaccine Information Sheet (VIS)
Are we performing pregnancy tests when administering live viruses
NO
What is done for short notice deployments?
Administer first dose, than make arrangements to receive additional doses to complete the series as close to schedule as possible
Who prepares the VIS?
Department of Health and Human Services, CDC and Prevention
What instruction states IDC’s on ships cannot give yellow fever?
COMNAVSURFORINST 6000.1
Religious exemptions to immunizations is a command decision made with whose advice?
a. Medical
b. Judge Advocate
c. Chaplain
Who grants waivers for religious exemptions
Chief, Bureau of Medicine and Surgery
What forms are used to document patient immunizations?
a. NAVMED 6230/4 – Adult Health Record Immunization Record
b. CDC 731 – International Certification of Vaccination
c. DD 2766 – Adult Preventive and Chronic Care Flowsheet
