sterilization, disinfection, and antisepsis- Exam IV Flashcards

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1
Q

transmission of infectious agents among patients and staff in a clinical environment:

A

cross-infection

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2
Q

management strategies for risk control:

A

cross-infection control

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3
Q

Possible sources of infection in the dental care setting includes:

A
  1. patients with infectious disease
  2. patients in the prodromal or convalescent stage of infection
  3. healthy (or asymptomatic) carriers of disease-causing organisms
  4. Environmental sources
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4
Q

Environmental sources of infection in the dental care setting include:

A

airborne organisms or biofilms in waterlines or on equipment or instruments

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5
Q

All patients are treated as though they are a potential source of infectious pathogens:

A

universal precautions

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6
Q

Routes of spread of cross infection includes:

A
  1. airborne routes
  2. contact routes
  3. parental spread of cross-infection
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7
Q

Airborne routes of spread of cross infection include:

A

dust-borne routes and aerosol routes

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8
Q

Examples of dust-borne routes include:

____ from skin scales
___ from environmental dust

A

staph aureus; clostridium tetani

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9
Q

sources of dust-borne routes include:

A

skin scales, wound dressings, & solid surfaces

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10
Q

Examples of aerosol routes include:

A

large droplets and droplet nuclei

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11
Q

large droplets are classified as:

A

contact

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12
Q

Sources of aerosol routes include:

A

speaking, sneezing, and all intraoral procedures

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13
Q

In what situations is there a massive increase of aerosol routes of cross-infection?

A

when using ultrasonic scaling, air-rotor, and air/water syringe

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14
Q

aerosols can occur with or without:

A

aspiration

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15
Q

Prevention of aerosol transmission includes:

A
  1. elimination or limitation of organisms at source
  2. interruption of transmission
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16
Q

Contact routes of spread of cross-infection include:

A
  1. person-to-person
  2. equipment
  3. fluids
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17
Q

Direct spread by hands and clothes or fomites; large droplets

A

person-to-person

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18
Q

Person-to-person transmission is a ___ route of transmission

A

contact

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19
Q

Person-to-person contact route of transmission is:

A

direct

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20
Q

prevention of person to person contact spread =

A

hand washing, gloves, and protective clothing

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21
Q

the contact route “equipment” route of spread of cross infection includes:

A

chairs, instruments, impression materials

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22
Q

Prevention of equipment route of spread of cross infection includes:

A
  • sterilization of instruments
  • use of disposals
  • disinfection of dental instruments
  • environmental hygiene
  • defining zones in the dental operatory
  • disposal of infected waste
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23
Q

the contact route “fluids” route of spread of cross infection includes:

A

dental water supplies

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24
Q

Prevention of fluid route of spread of cross infection includes:

A

flushing water supply lines, using sterile water and using biocide in water

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25
Q

Sources of parenteral spread of cross-infection include:

A

blood, saliva, secretions

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26
Q

Inoculation of parenteral spread of cross infection is via:

A

eye, skin breach, mucous membrane, & sharps injury

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27
Q

A sharps injury would be what form of spread of cross infection?

A

parenteral

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28
Q

Prevention of parenteral spread of cross infection includes:

A

training in use and disposal of sharps, Hep B vaccine, wearing gloves, dressing wounds

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29
Q

The risk of infection following a needlestick from a seropositive HIV patient:

A

0.3%

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30
Q

The risk of infection following a needlestick from a seropositive HBV patient:

A

7-30%

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31
Q

Destruction of all microbial forms (including bacterial spores):

A

sterilization

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32
Q

Destruction of most microbial forms:

A

disinfection

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33
Q

What agents are typically used as disinfections:

A

usually chemical agents

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34
Q

Disinfectants are typically used on:

A

inanimate objects

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35
Q

List the categories of disinfectants:

A
  1. high-level
  2. intermediate level
  3. low-level
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36
Q

Inhibition or elimination of microbes on living tissue:

A

antisepsis

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37
Q

Chemical agents that kill or inhibit growth of microorganisms when applied to tissue:

A

antiseptics

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38
Q

Reduction of microbial population to levels deemed safe (based on public health standards):

A

sanitization

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39
Q

Agents that kill microorganisms or inhibit their growth:

A

antimicrobial agents

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40
Q

“-cidal” refers to agents that:

A

kill

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41
Q

“-static” refers to agents that:

A

inhibit growth

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42
Q

Microorganisms are not killed:

A

instantly

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43
Q

The population of microbial death usually occurs:

A

exponentially

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44
Q

Microorganisms are considered to be dead when:

A

they are unable to reproduce in conditions that normally support their reproduction

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45
Q

When looking at an exponential plot of microbial survivors versus the minutes of exposure to heating t 121 degrees Celsius, once the population has been greatly reduced, the rate of killing may:

A

slow due to resistant individuals

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46
Q

Conditions influencing the effectiveness of antimicrobial agent activity include: (6)

A
  1. population size
  2. population composition
  3. concentration or intensity of an antimicrobial agent
  4. duration of exposure
  5. temperature
  6. local environment (pH, viscosity, etc.)
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47
Q

The use of physical methods in control of microbial agents include:

A

heat, low temps, filtration, and radiation

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48
Q

heat type that is effective against all types of microorganisms:

A

moist heat

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49
Q

Moist heat works by degrading ____, denaturing ____, and disrupting ___.

A

nucleic acids; proteins; membranes

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50
Q

an example of moist heat use in a dental practice:

A

autoclave

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51
Q

Heat type that is less effective, requiring higher temps and longer exposure times:

A

dry heat sterilization

52
Q

How does dry heat sterilization work?

A

by oxidizing cell constituents and denaturing proteins

53
Q

When measuring heat-killing efficiency what two values are we looking for?

A
  1. Thermal death time (TDT)
  2. Decimal reduction time (D or D-value)
54
Q

TDT=

A

thermal death time

55
Q

D or D-value=

A

decimal reduction time

56
Q

The shortest time needed to kill all microorganisms in suspension at a specific temp under defined conditions:

A

Thermal death time

57
Q

The time required to kill 90% of microorganisms or spores in a sample at a specific temperature:

A

Decimal reduction time

58
Q

Thermal death time is the shortest time needed to kill all microorganisms in a suspension at a ____ and under ____.

A

specific temperature; defined conditions

59
Q

The decimal reduction time (D or D-value) is the time required to kill ____ or ___ in a sample at a specific temperature

A

90% of microorganisms or spores

60
Q

The increase in temperature required to reduce D to 10% of original value:

A

Z value

61
Q

Used to kill endospores efficiently:

A

autoclaves

62
Q

Autoclaves use ____ to reach temps above boiling

A

saturated steam under pressure

63
Q

A moist heat process that involves controlled heating at temperatures well below boiling:

A

pasteurization

64
Q

What type of heat process is pasteurization?

A

moist heat

65
Q

Reduces the total microbial population and thereby increases the shelf life of treated material:

A

pasteurization

66
Q

Pasteurization of milk includes:

A
  1. flash pasteurization (high temp short-term: HTST)
  2. ultrahigh-temperature (UHT) sterilization
67
Q

Describe flash pasteurization:

A

High temp short term (HTST)
72 degrees Celsius for 15 seconds and then rapid cooling

68
Q

Describe ultra-high temperature (UHT) sterilization:

A

140-150 degrees Celsius for 1 to 3 seconds

69
Q

Low temperature processes include:

A

freezing & refridgeration

70
Q

stops microbial reproduction due to lack of liquid water:

A

freezing

71
Q

In freezing, some microorganisms are killed by:

A

ice crystal disruption of cell membranes

72
Q

How does freezing stop microbial reproduction?

A

due to lack of liquid water

73
Q

A low temperature method that involves the slowing of microbial growth and reproduction:

A

refigeration

74
Q

reduces microbial population or sterilizes solutions of heat-sensitive materials by removing microorganisms; also used to reduce microbial populations in air:

A

filtration

75
Q

What types of filters are available for filtering liquids?

A
  1. depth filters
  2. membrane filters
76
Q

thick fibrous or granular filters that remove microorganisms by physical screening, entrapment, and/or adsorption:

A

depth filters

77
Q

pours membranes with defined pore size that remove microorganisms primary by physical screening:

A

membrane filters

78
Q

What are two modes of filtering air?

A
  1. surgical masks
  2. high-efficiency particulate air (HEPA) filters
79
Q

HEPA:

A

High-efficiency particulate air filters

80
Q

What are two types of radiation?

A
  1. ultraviolet (UV) radiation
  2. ionizing radiation
81
Q

UV radiation is limited to ____ because it does not penetrate ____.

A

surfaces; glass, dirt films, water, and other substances

82
Q

Radiation that penetrates deep into objects:

A

ionizing radiation

83
Q

Type of radiation that destroys bacterial endospores, but is not always effective against viruses

A

ionizing radiation

84
Q

Used for sterilization and pasteurization of antibiotics, hormones, sutures, plastic disposable supplies, and food:

A

ionizing radiation

85
Q

Phenolics include:

A

phenol & hexachlorophene

86
Q

Commonly used as laboratory and hospital disinfectants:

A

phenolics

87
Q

____ is a mixture of phenolics

A

lysol

88
Q

How do phenolics work?

A

by disrupting cell membranes

89
Q

Tuberculocidal, effective presence of organic material, and long lasting:

A

phenolics

90
Q

What are the downfalls of phenolics?

A

disagreeable odor and can cause skin irritation

91
Q

What are two examples of alcohols used as chemical for microbial control?

A

ethanol & isopropanol

92
Q

Alcohols can be describe as ___ & ____ but not ___

A

bactericidal & fungicidal; sporicidal

93
Q

Do alcohols work against viruses?

A

may inactivate SOME viruses

94
Q

What is the mechanism of action for alcohols?

A

denature proteins and possible dissolve membrane lipids

95
Q

alcohols are ___ % in water (cidal activity drops sharply when diluted below ___ concentration)

A

60-90%; 50%

96
Q

Contain fluorine, chlorine, bromine, and iodine :

A

halogens

97
Q

skin antiseptic

A

iodine

98
Q

How does iodine work:

A

oxidizes cell constituents and iodinates proteins

99
Q

Can iodine kill spores?

A

yes at high concentrations

100
Q

What are the downfalls with iodine?

A
  1. skin damage
  2. staining
  3. allergies
101
Q

Iodine complexed with organic carrier:

A

iodophore

102
Q

How does chlorine work?

A

oxidizes cell constituents

103
Q

Important in disinfection of water supplies and swimming pools, used in dairy and food industries, effective household disinfectant:

A

chlorine

104
Q

What is chlorine able to destroy? What can it not destroy?

A

vegetative bacteria and fungi but NOT spores

105
Q

What can form when chlorine reacts with organic matter?

A

carcinogenic compounds

106
Q

Ions of mercury, silver, arsenic, zinc and copper are all examples of:

A

heavy metals

107
Q

Heavy metals can be described as ___ but ___

A

effective but usually toxic

108
Q

Heavy metals combine with and inactivate ___ but also may precipitate ___.

A

proteins; proteins

109
Q

Cetylpyridinium chloride and benzalkonium chloride are examples of:

A

quaternary ammonium compounds

110
Q

organic molecules with hydrophilic and hydrophobic ends:

A

quaternary ammonium detergents

111
Q

Quaternary ammonium compound detergents can act as ___ & ___.

A

wetting agents & emulsifiers

112
Q

What type of detergents are effective disinfectants?

A

cationic detergents

113
Q

Cationic detergents kill most ____ but not ___ or ___

A

bacteria; mycobacterium tuberculosis or endospores

114
Q

What is the advantage of cationic detergents? what is the disadvantage of cationic detergents?

A

advantage: safe & easy to use
disadvantage: inactivated by hard water & soap

115
Q
  • highly reactive molecules
  • sporicidal and can be used as chemical sterilants
  • combine with and inactivate nucleic acids and proteins
A

aldehydes

116
Q

Ethylene oxide and betapropriolactone are both examples of:

A

sterilizing gases

117
Q

Sterilizing gases are used to sterilize:

A

heat-sensitive materials

118
Q

Sterilizing gases can be described as ___ & ___

A

microbicidal and sporicidal

119
Q

How doe sterilizing gases work?

A

combine with and inactivate proteins

120
Q

Spaulding inanimate objects classification is used for:

A

instruments or objects used in dentistry

121
Q

Classify the following objects: category, level and risk:

-touch bone or penetrate tissue
-blood present (scalpels, forceps, scalers, probes, and implants)

A

category: critical
level: heat sterilization
risk: very high

122
Q

Classify the following objects: category, level and risk:

-touch mucous membrane but not penetrate
-no blood (mirrors, burnishers, amalgam carriers, etc.)

A

category: semi-critical
level: sterilization, high-level disinfection
risk: moderate

123
Q

Classify the following objects: category, level and risk:

  • unbroken skin contact
    -no blood (masks, clothing, BP cuffs)
A

category: non-critical
level: intermediate level
risk: low

124
Q

Classify the following objects: category, level and risk:

-no direct patient contact
-no blood (door knobs, floors, walls, counters, mops, and other housekeeping equipment)

A

category: environmental surfaces
level: low level disinfection; sanitation
risk: minimal

125
Q
A