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Oral Microbiology > Sterilization and Antisepsis > Flashcards

Sterilization and Antisepsis Flashcards

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1
Q

What are the routes of transmission during dental treatment?

A
  1. direct contract with infectious lesions, saliva, or blood
  2. indirect transmission via contaminated intermediate object
  3. spatter of blood, saliva, plaque or nasopharyngeal secretions
  4. Aerosolization of blood, saliva, plaque or nasopharyngeal secretions
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2
Q

What is the fatality rate for Ebola?

A

50%, young and elderly associated with higher fatality rates

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3
Q

T/F. Ebola is highly infectious and takes a large load to infect.

A

False, Ebola is highly infectious BUT a miniscule amount (1 virus particle) may be enough to infect.

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4
Q

T/F. Ebola is only moderately contagious and is transmitted by direct contract with body fluids from infected person or contaminated objects from infected persons (fomites).

A

True

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5
Q

T/F. Ebola is transmitted by air.

A

False, acquired via direct contact through broken skin or mucous membranes

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6
Q

How long is the incubation period for Ebola?

A

2 - 21 days

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7
Q

When does an Ebola patient become contagious?

A

when symptoms develop

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8
Q

The Ebola virus is ___ so it can be killed or inactivated by ___ hand sanitizer.

A

Enveloped; alcohol

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9
Q

Is the risk of transmission of HIV from a health care worker to a patient low or high? What about from a patient to health care provider?

A

low

low occupational risk

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10
Q

T/F. Standard infectious control practices are highly effective against HIV and the risk from percutaneous exposure is 3 to 4 per 1000 exposures.

A

True.

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11
Q

Is immediate post exposure anti-retroviral therapy effective against HIV?

A

yes

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12
Q

Hepatitis B has ____ persons infected each year, ___% of infections that go undiagnosed and ___ million carriers.

A

300,000; 80; 1

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13
Q

T/F. There are a few cases of Hep B transmission from and to health care workers.

A

False, there are MANY documented cases of transmission to and from health care workers.

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14
Q

T/F. Most health care workers are vaccinated against Hep B.

A

True

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15
Q

There is an ___ resurgence of TB and the risk during dental procedures appears to be ___.

A

TB; low

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16
Q

TB patients that ___ produce infective aerosols that are not transmitted by ___ contamination but must be ___.

A

cough; surface; inhaled

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17
Q

Which virus is frequently present in the oral cavity and may be transmitted to health care workers?

A

Herpes I and II

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18
Q

___ herpes may cause blindness and viral ___ is when the herpes lesion appears on the finger.

A

Ocular; whitlow

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19
Q

Which immunizations are recommended for health care providers by the CDC?

A 
Hep B
Influenza
Measles
Mumps
Rubella
Varicella zoster
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20
Q

___ items come into contact with tissue or the vascular system. Give an example.

A

Critical

surgical instruments (needles, dental burs, endo)

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21
Q

___-___ items come into contact with mucous membranes or non-intact skin. Give an example.

A

Semi-critical

curing light

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22
Q

___ items touch intact skin. Give an example.

A

Noncritical

blood pressure cuff

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23
Q

Define sterilization, disinfectants, and antiseptics

A

Sterilization: destruction or removal of all forms of life including spores. Can be heat or chemical. Not used on humans - only inanimate objects.

Disinfectants: Inhibition or destruction of pathogens (spores not killed). Only used on inanimate objects.

Antiseptics: destroy pathogenic microorganisms on living tissues and are safe for use on human tissues (soap)

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24
Q

___ registers environmental surface disinfectants based on the manufacturer’s ___ activity claims when registering its disinfectant.

A

EPA; microbiological

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25
Q

FDA regulates ___ chemical sterilants used on ___ and __-___ devices. EPA regulates ___ used on ___ surfaces and ___ sterilants.

A

liquid; critical; semi-critical; disinfectants; noncritical; gaseous

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26
Q

___-level disinfection destroys all microorganisms, with the exception of bacterial spores.

___-level disinfection inactivates ___ ___, vegetative bacteria, most viruses, and most fungi but it does not kill bacterial spores.

___-level disinfection kills most bacteria, some viruses and some fungi, but it cannot be relied on to kill ___ microorganisms such as ___ ___ or bacterial ___.

A

High

Intermediate; Mycobacterium tuberculosis

Low; resistant; Mycobacterium tuberculosis; spores

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27
Q

Why must critical items be sterilized?

A

because they enter sterile tissue or the vascular system and any microbial contamination could transmit disease

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28
Q

How are semi-critical and noncritical items cleaned?

A

Semi-critical: sterilize if possible, high or intermediate-level disinfection required

Noncritical: low-level disinfectant

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29
Q

Why is heat sterilization the most efficient and reliable method?

A

proteins are denatured by heat, thus killing organisms

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30
Q

What are the autoclave conditions?

A 
steam under pressure
121oC (250oF)
15psi
15-20 minutes
packing material must allow for penetration of steam (paper, plastic cloth - not closed metal or glass containers)
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31
Q

What are the advantages and disadvantages to steam sterilization?

A

advantages: short cycle time, good penetration

disadvantages:
- corrosion (oxidation) of unprotected carbon steel & dulling of cutting edges
- deposits from hard water (use distilled)
- may remain wet at end of cycle
- destruction of heat sensitive materials

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32
Q

How can corrosion and dulling of instruments be prevented when under steam pressure?

A

with 1% sodium nitrite solution

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33
Q

T/F. Flash steam sterilization has a lower temperature and pressure than autoclave.

A

False, Flash steam sterilization has a HIGHER temperature and pressure than autoclave.

34
Q

For dry heat sterilization, ___ proteins are more stable, so ___ temp and ___ time is required. The heat transfer is ___, so oven cannot be overfilled, and packages must be kept small.

A

dehydrated; high; longer; slow

35
Q

Does dry heat sterilization corrode or dull cutting edges?

A

No

36
Q

What are the disadvantages of using dry heat sterilization?

A

long cycle
may discolor or char fabric
destruction of heat sensitive materials (rubber/plastic destroyed) (soldered impression trays melt)
unsuitable for handpieces

37
Q

What is a forced air unit that reduces heat transfer time?

A

rapid heat transfer sterilization

38
Q

What are the advantages and disadvantages to rapid heat transfer sterilization?

A

Advantages:

  1. short cycle
  2. dry at end
  3. does not corrode or dull

Disadvantages

  1. instruments must be dry at start
  2. destruction of health labile items
  3. not suitable for handpieces
  4. unwrapped items not protected after cycle
39
Q

What is used to create the sterilizing vapor for Chemiclave?

A

Depends on heat, water and chemical synergy

Mixture of methyl alcohol, formaldehyde, ketone, acetone and water

40
Q

T/F. Penetration of Chemiclave is as good as steam.

A

False, no it is not so items must be loosely packed and dry.

41
Q

What are the advantages and disadvantages of Chemiclave?

A

Advantages: short cycle time, does not corrode or dull cutting edges

Disadvantages: chemical odor & safety concerns, instruments must be dried before use, chemical solution required, heat-sensitive materials may be destroyed

42
Q

Who monitors sterilization?

A

CDC and Ohio state law

43
Q

Chemical treated ___ and heat sensitive ___ indicate that a package has been heated, but not that sterilization temperatures were reached or held for adequate period of time.

A

tapes; strips

44
Q

T/F. Some indicators change color long before sterilization conditions are met.

A

True, they do not ensure adequacy of sterilization cycle (especially autoclave tape)

45
Q

What provides the best guarantee of sterilization?

A

biological indicators

46
Q

Which two microorganisms contain spores that are more resistant than viruses or vegetative forms of bacteria?

A 
bacillus stearothermophilus (autoclaves and chemiclaves)
bacillus subtilis (dry heat)
47
Q

What are the two forms of biological monitors?

A
  1. glass vials containing suspensions of spores plus pH indicator (if spores germinate or produce acid, color change can be seen)
  2. spore-impregnated strips in glassine envelopes must be sent to service for checking.
48
Q

T/F. It is ok to use chemical sterilants instead of heat.

A

False.

49
Q

Ethylene oxide (ETO) is an ___ agent that irreversibly inactivates nucleic acids and proteins. It is an explosive gas mixed with ___ and will ___ tissue.

A

alkylating; freon; burn

50
Q

T/F. ETO damages heat or moisture labile materials and leaves a residue after adequate aeration.

A

False, ETO DOES NOT damage heat or moisture labile materials and DOES NOT leave a residue after adequate aeration.

51
Q

What are the disadvantages of ETO?

A

slow
hazardous material (toxic, carcinogenic and explosive)
items must be clean and dry
retained in liquid and rubber items for a long time
toxic residue if not well aerated

52
Q

What is the most potent chemical germicide that is active in the presence of organic debris?

A

Glutaraldehydes

53
Q

What are the disadvantages to glutaraldehydes?

A 
long immersion time
rinsing required
severe tissue irritation and toxicity from fumes
allergenic
biologically non-verifiable
cannot package items
corrosive to metals
54
Q

CaviWipes are a combination of ___ and ___ ___ solutions. It is an ___-level disinfectant for __-___ items (in contact with intact mucous membranes)

A

alcohol; quaternary ammonium; intermediate; semi-critical

55
Q

T/F. Accelerated Hydrogen Peroxide (AHP) is a combo of 0.5% hydrogen peroxide surfactants, chelating agents and wetting agents.

A

True

56
Q

Phenols and derivatives are ___ poisons that penetrate and disrupt microbial cell walls and denature intracellular proteins. They are not suitable as ___, and must be used in conjunction with another agent.

A

cytoplasmic; antiseptics

57
Q

T/F. Phenols are EPA registered surface disinfectant with broad spectrum but not sporicidal. They have been replaced by quaternary ammonium-alcohol combo agents.

A

True.

58
Q

What are the two single unit alcohols?

A

70% ethyl alcohol

70% isopropyl alcohol

59
Q

Alcohol solutions containing ___% alcohol are most effective. Higher concentrations of alcohol produced even greater ___ and ___ surface disinfection.

A

60-80; dehydration; poorer

60
Q

What is the antimicrobial effect of alcohols?

A

the effect results from denaturation of proteins and dissolution of lipid membranes.

61
Q

What are the disadvantages of alcohols?

A

alcohol dehydrates proteins, making them insoluble and tenaciously adherent to surfaces. Denatured bioburden can protect contaminant microorganisms

-rapid evaporation results in rapidly diminishing effect

62
Q

What is the antimicrobial effect of detergents?

A

the osmotic barrier is disrupted and microbes explode in hypo-osmotic solution.

63
Q

T/F. Gram positive bacteria are more susceptible than gram negative to detergents.

A

true.

64
Q

T/F. Alone quaternary or cationic ammonium preparations are high-level surface disinfectants suitable for critical items.

A

False, Alone quaternary or cationic preparations are LOW-level surface disinfectants suitable for NONCRITICAL items.

65
Q

T/F. Quaternary ammonium preparations are NOT recommended as single-ingredient surface disinfectants.

A

True.

66
Q

How are cationic agents inactivated?

A
  • by anionic agents, calcium, magnesium, and iron in hard water
  • by organic matter or cotton applicator
67
Q

Iodine and iodophors are ___ handwashing antiseptics and ___ surface intermediate-level disinfectant.

A

good; good

68
Q

___ of iodine (alcohol solution of iodine salts) are good antiseptics but are also irritating and ___, corrodes metal, and stains skin and clothing

A

Tincture; allergenic

69
Q

Define iodophors.

A

Iodine combined with solubilizing agents to stabilize the iodine and slowly release it.

70
Q

Iodophor carriers are ___ that increase tissue ___ and ___ cleaning effectiveness.

A

surfactants; permeability; surface

71
Q

T/F. Iodine and iodophor solutions must be made fresh daily with distilled water.

A

True.

72
Q

What has primary antimicrobial activity by oxidation as hypochlorous acid and rapidly causes unfolding and aggregation of proteins?

A

chlorine-containing compounds

73
Q

For intermediate level disinfection, OSU and NCH use ___ ___/alcohol wipes.

A

quaternary ammonium

74
Q

How long can blood remain under finger nails?

A

5 days

Therefore, protect epithelial integrity, no artificial nails, short nails max 1/4 in, jewerly ?

75
Q

What are the most efficacious agents for reducing the number of bacteria on the hands of personnel?

A

alcohol-based hand rubs

76
Q

What is recommended from visibly soiled hands?

A

soap and water

77
Q

What is recommended for routine decontamination of hands for all clinical indications (except when hands are visibly soiled) and as one of the options for surgical hand hygiene?

A

alcohol based hand rubs

78
Q

Why should one not wash before or after using alcohol based hand rubs?

A

do NOT wash BEFORE because may pre-irritate skin

do NOT wash AFTER because may remove emollients

79
Q

When antiseptic hand cleansers are used repeatedly may accumulate on epithelial tissues providing a residual effect - termed ___.

A

substantivity

80
Q

What hand hygiene technique is recommended if exposure to potential spore-forming pathogens or outbreaks of Clostridium difficile?

A

hand washing with soap and water

81
Q

How long for hand hygiene with alcohol rub? soap and water?

A

alcohol - 20-30 secs

soap - 40-60 secs

Oral Microbiology (11 decks)

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