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Study Prompts Flashcards

1
Q

toxic anterior segment syndrome

A

acute inflammation of the eye that can occur following cataract surgery

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2
Q

toxic anterior segment syndrome implicated substances

A

impurities of autoclae steam, heat stable endotoxin, irritants on the surface of intraocular surgical instruments

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3
Q

liquid sterilization

A

gluteraldehyde, hydrogen peroxide, peracetic acid

for items that are critical and heat sensitive

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4
Q

Liquid sterilization considerations

A

items cannot be wrapped, may need to be rinsed after so sterility is lost, used only when item cannot be sterilized in another manner

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5
Q

biological indicator

A

standardized, contained populaiton of mircobes that is included in a sterilization cycle to indicate whether the cycle was successful
may contain spore forming bacteria or other highly resistant microbes
Incubated after sterilizaation
only correct method of assuring that a steam sterilizer has reached the correct conditions to ensure sterility of products

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6
Q

biological indicator process failure

A

deduce the source of the failure and if its the resulf of a single load that was not run on the correct cycle- no recall necessary
indicates the load was not processed correctly and must be reprocessed

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7
Q

enzymatic detergent after each use

A

discard as products arent antimicrobial and will not retard growth

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8
Q

highly infectious tissues

A

brain, dura matter, pituitary tissue, spinal cord, eye

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9
Q

low infectivity tissues

A

lung, liver, kidney, spleen, lymph, CSF

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10
Q

proper storage of sterile, reprocessed items

A

18” below the ceiling
8-10” above the floor
2” from th ewall
solid bottom on the rack

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11
Q

aseptic techniques

A

process for keeping away disease producing micro, may be used in any clinical setting

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12
Q

endoscopy associated infections

A

report to IP, physician, public health agency, manufacturer of endoscope, disinfectant/sterilant, washer

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13
Q

mechanical cleaning equipment

A

uses automated cleaning and rinsing to remove soiling from items
verification should be weekly, preferably daily, installation, after repair, and all cycles should be tested when changing cleaning chem

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14
Q

instrument sterilization

A

results in instruments being free of all microbes (including sporeS)

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15
Q

PPV

A

TP/(Tp+FP)

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16
Q

NPV

A

TN/(TN+FN)

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17
Q

HLD

A

destroys all micro except high numbers of bacterial spores

heat sensitive, semicritical items

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18
Q

intermediate level disinfection

A

destroys vegetative bacteria, mycobacteria, most viruses, most fungi but not spores
Non-critical items w visible blood
liquid contact with tuberculociddal activity

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19
Q

low level disinfection

A

destroys vegetative bacteria, some fungi and viruses
liquid contact
noncritical items with no blood

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20
Q

power

A

integral part of mgmt and leadership
coercive,expert, legitimate, referent
reward=ability to grant another person something that they desire or remove things the person does not

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21
Q

strep b

A

most likely to cause infant sepsis after labor

increases risk of preterm which increaes risk of infection

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22
Q

c diff collection rules

A

samples must be within 1-2 hours, 10-20 ml stool, passed in clean and dry container

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23
Q

noninfectious endoopthalmitis causes

A

retained native material or toxic agents

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24
Q

bacterial vs viral infection

A

WBC indicate tyle (low neutrophil and high lymphocyte= viral)

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25
Q

ELISA HSV ID

A

presumptive when 1:128

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26
Q

mitigation

A

funding a program to vaccinate ppl against smallpox in an outbreak

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27
Q

myco pneu

A

most common pneu in school children

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28
Q

pediculosis in peds

A

contact until 24 hours post treatment

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29
Q

category 1a

A

strongly supported by cdc

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30
Q

cleaning category 1a

A

sterilize anthing entering sterile tissue

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31
Q

acinetobacter baumanni

A

aerobic, gram - bacilli

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32
Q

UTi post partum risk factors

A

c-section, tocolysis, induction

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33
Q

appropriate abx use recommendations

A

not necessary to maintain antimicro above MIC

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34
Q

antibiogram interpretation

A

percentage of samples sensitive to x

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35
Q

fishbone diagram

A

ID, explore and display all causes

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36
Q

affinity diagram

A

gathers large amonths of ideas/opinions/issues and organizes them into groupings based on relationships

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37
Q

pareto chart

A

individ values are rperesented in descending order by bar and cumulative total by line

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38
Q

positive bio indicator

A

test again w paired indicators from diff manufacturers and eval

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39
Q

potential occupational azquisition

A

review worker’s comp, EH should build case

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40
Q

cold food storage

A

41F/5C degrees or lower

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41
Q

robust PI team

A

performes housewide infection rates

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42
Q

IP quality eval

A

avg time btw receiving lap reports of mdros and isolation of patients

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43
Q

patient follow up for rapid hiv

A

western blot

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44
Q

program eval elemnets for efficacy and impact

A

appropriateness of desgn, adeuquacy of team, knowledge of participants

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45
Q

improved hydrogen peroxide

A

has anioinic and or nonanionic surfactants

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46
Q

cms iso precautions

A

standard

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47
Q

mycoplasma pneu precautions

A

droplet during symptoms

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48
Q

CAUTI indication

A

positive dipstick for leukocyte esterase/nitrite, pyuria, micro on gram stain, positive ur cx 10^3+ but less than 10^5
no more than 3 org

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49
Q

classig measles sign

A

koplik spots

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50
Q

cost benefit analysis

A

all measures expressed in monetary terms

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51
Q

cre strategies

A

place all colonized on precautions, min invasive devices, communicate results

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52
Q

culturally diff group to presnt to

A

outline ed program and ask audience to work together to ID culturally appropriate examples

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53
Q

decon

A

reders items safe for handling wo protective attire

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54
Q

disinfection product resistance

A

reduced susceptibility can occur, antimicro levels used are sufficient to inactivate

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55
Q

event-related storage of sterile iems

A

not based on expiration

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56
Q

gram pos cocci in pairs and chains

A

enterococcus faecium

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57
Q

HCP prophylaxis for crusted scabies

A

with evidence of infestation (pruritic rash)

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58
Q

HCP w HIV

A

exposure prone invasive proc should not be performed until counsel w expert review panel is sought

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59
Q

health belief model

A

understand and preduct health ass behavior, percieved susceptibility, perceived severity, perceived benefits, perceived barriers, age, gender
for whom the interation is being designed

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60
Q

hep b vaccination rec

A

heterosexuals w multi sex partners, men having sex w men, dvp disabled persons, diabetes

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61
Q

HH compliance discussion

A

info on hand contamination, info on ass btw hh and infections, effects of hh on skin

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62
Q

high risk ssi

A

asa physical status classification of 3,4,5
operation classified as contaminated/dirty
operation lasting llonger than the duration cut point in min

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63
Q

how an ip can support antimicro stewardship

A

monitor prevalence and emergenc,e calc incidence on basis of clinical results, calculate mdro infection rates, use molecular typing for outbreaks, detect asymptomatic carriers w active surv

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64
Q

infectious waste

A

ie agar plates used for testing sputum samples

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65
Q

initial outbreak investigation

A

preparing line list and epi curve

notifying key partners

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66
Q

insufficient construction planning

A

compromised air quality or water contaminated w water ass org

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67
Q

mdro threat level urgent

A

cre, candida auris, c diff, crab, n gonnorrhoeae

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68
Q

measles rash

A

3-7D post symptoms

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69
Q

neg IgG or IgM for measles

A

may be infected, may not have dvp an immune response until 72 hours post rash onset

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70
Q

nsi rate

A 
# blood collection devices used (if many dif staff)
#/full time nurses otherwise
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71
Q

opa

A

fast acting, no activation req, does not coag blood or fix tissues to surfaces, eye irritant, slow sporicidal activity

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72
Q

SSI action in ambulatory proc

A

revise surv plan

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73
Q

HVAC shutdown

A

relocate immunocompromised and provide emergency back up ventilation for other rooms

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74
Q

single use reprocessing

A

visit reprocessing companies

must be reprocessed at 3rd party facility if FDA guidelines are followed

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75
Q

needlestick exposure

A

wash area first

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76
Q

highest filtering efficiency

A

diffusion

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77
Q

category b bioterrorism

A

mod ease of disseminating, sp req for dz surv, mod morbidity rates, low mortality (ie. thyphus)

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78
Q

acceptable upper limit of relative humidity for fungal growth

A

60%

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79
Q

dialysis IP

A

use AV graft if fistula cannot be est, tunneled cuff for 3+ wek use, femoral cath in bedbound for 5D+

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80
Q

myco marinum

A

needs no further work up

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81
Q

varicella exposure

A

determine active case w physician first

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82
Q

crypto kill in water

A

high temp flush

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83
Q

run chart

A

determines avg over time and shows changes in the avg (demonstrates sp cause variation)
req at least 20 data points

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84
Q

reg over construction

A

OSHA only

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85
Q

pneumatic tube blood spill

A

est method to ID spill

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86
Q

meningococcal meningitis incubation

A

2-10D

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87
Q

Legionairres suspicion

A

all water sites to which the patient was exposed shoul dbe cultured

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88
Q

written instructional objective

A

learner outcomes in measurable terms using action verbs

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89
Q

surface cleaning

A

physical removal

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90
Q

IP strategy for dispersed outpatient settings

A

dvp communicaiton btw sites

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91
Q

annual risk assessment

A

eval prev goals, ID risks based on area/pop, risks related to services provided

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92
Q

biomedical waste

A

anything bloody or potentially so

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93
Q

mopping

A

s stroke, never redip

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94
Q

healthcare personell

A

all paid/unpaid persons in setting w potential exposure

any individ who has potential to acquire/transmit dz in course of work

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95
Q

ETO efficacy

A

gas concentration, temp, relative humidity, exposure time

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96
Q

anthrax terminal cleaning protocol

A

standard terminal cleaning protocol

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97
Q

bed bug kill heat and time

A

118 F for 1 hour

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98
Q

biological indicator positive first action

A

retrieve unused items from load

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99
Q

anthrax sign

A

mediastinal widening or pleural efusion

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100
Q

MRSA Cap signs

A

hyemoptysis and multilobar infiltrate

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101
Q

cat bite most likely org

A

pasteurella
more likely to become infected
highly pathogenic, induce progressive soft tissue infecitons w rapid onset

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102
Q

performance measures

A

evidence based, well defied, clinically important for patient pop (easily understood and applied definition)

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103
Q

pneumonic plague isolaiton

A

surgical mask, door may be open

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104
Q

tool to investigate a potnetial outbreak w med vial quality

A

RCA

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105
Q

scabies precautions

A

contact up to 24 hrs post treatment

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106
Q

short term iv devices BSI cause

A

cutaneous origin, from insertion site, gain access extraluminally, contaminated luminal fluid

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107
Q

delphi technique

A

expert group judgement prior to project

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108
Q

syndromic surv

A

detection of individ and pop health indicators that are discernible before confirmed diagnoses are made

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109
Q

tattoo/piercing dz concerns

A

not related to popularity making it more socially acceptable

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110
Q

tb collection tiems

A

3x, 8 hours apart, liquid media

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111
Q

time off for varicella exposure

A

28 days (return on 29th)

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112
Q

vaccine req when giving vaccine

A

copy of vaccine info statement
med exemptions in all states
no fed req for informed consent

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113
Q

gluteraldyhyde

A

inexpensive, respiratory irritant, irritating odor, slow mycobacterial activity unless activated, coag blood and fixes tissues to surfaces, contact dermatitis

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114
Q

IgM Hep A detectable

A

5-10 days post exposure

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115
Q

pertusis incubation

A

7-10d

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116
Q

scabies incubation

A

10d (usually 4-6 wks)

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117
Q

flu b

A

has been associated with large epidemics

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118
Q

core cap measures (non-vented)

A

o2 assessment w/in 24 hours before or after arrival to hospital, patients over 65 screened for pneumococcal vaccine, blood cx performed in ED before abx admined, abx timing, abx selection, adult smoking sessation advice, flu vaccine

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119
Q

healthcare relatedocular infections of intact epithelium

A

n gonorrhoeae, n meningitidis, srep pneu, listeria monocytogenes, corynebacterium dophtheriae

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120
Q

tpn contaminatn

A

fungi, coag neg staph, staph saprophyticus, staph epi, e coli, pneudomonas aeruginosa

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121
Q

obligate intracellular parasites

A

viruses, chlamydia, rickettsiaa, coxiella, mycobacteria, q fever, epidemic typhus

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122
Q

cell type indicative of bacterial infeciton susceptiblity

A

neutrophil

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123
Q

incorrectly reject null

A

type 1 error

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124
Q

measure of dispersion

A

SD

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125
Q

frequency polygon

A

graph of freq distribution w values of the variable on the x and number of obs on the y, connected w straight line

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126
Q

kaposis sarcoma

A

human herpesvirus 8

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127
Q

active surv cx planning

A

addtl personnel to obtain cx, addtl lab personnel, ensuring TAT for results, monitoring adherence to contact precautions, providing a mech for communicating results to providers, measuring outcomes to eval the effectiveness of ASC and contact precautions

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128
Q

laboring mom w flu

A

does not need to wear mask during labor and delivery

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129
Q

food handling restriciton for hep a

A

until 7D post jaundice

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130
Q

tb testing

A

qft-g is a blood assay, intradermal TST

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131
Q

MMR rec for those pborn pre 1957

A

test for immunity and vaccinate a needed

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132
Q

HBV exposure for those who have only 1 vaccine

A

complete series and provide immunoglobulin

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133
Q

adverse event

A

patient harm resulting from treatment (falls, improper med admin, infection, physical or psychological injury

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134
Q

safe medical device act agency

A

FDA

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135
Q

percent HAIs resulting in death

A

4%

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136
Q

model for improvement

A

setting aims, est measures, and selecting changes that will make an improvement
plan, do study, act cycle

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137
Q

mode element of FMEA

A

way of operating or using a system or process or a way or manner in which a thing is done
way or manner in which something (failure) can happen
failure mode= way the failure occurs and its impact on a process

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138
Q

IP busines plan

A

demonstrate whther the expanded program will be worth the investment

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139
Q

strategic goal

A

org process of defining its strategy and making decisions on allocating its resourcees to pursue this strat
setting goals, determining actions, and mobilizing resources
clean measurable goal that is focused on the future and provides direction for its dept

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140
Q

discrepancies btw current and desired job performance

A

investigated and clarified before ID a corective action

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141
Q

human factors

A

enviro, org, and job elements
human an dindivid char that influence behavior at work in a way that can affect health and safety
focus on improving efficiency, creativity, productivity, and job satisfaction

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142
Q

what ed and training approach should the IP recommend for improving HH

A

implemenation of a mentoring program based on peer to peer instruction and coaching

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143
Q

QI measure for IP

A

analysis of program eval scores for classes

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144
Q

professional competency

A

communication, values, reasoning, teamwork, knowledge, skill

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145
Q

research methods features

A

time period of the study, clear criteria for defining cases and controls, methods of quality assurance

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146
Q

item analysis

A

process for examining students test scores to assess the quality of the individ test questions and the test itself
useful for improving qualiity of the test and increasing the instructors skill in test construction

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147
Q

water temp for laundry

A

160F for 25 min minimum

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148
Q

programs that need to include employee ed

A

risk assessment, program plan, annual budget and allocation of resource

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149
Q

legionella prevention

A

hot water for 124+, cold at 68

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150
Q

agency approving antiseptics

A

FDA

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151
Q

Hydrogen peroxide vapor

A

cannot be used during occupation

HVAC needds to be turned off to keep vapor effective

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152
Q

most likely to improve IP

A

thoroughly cleaning and disinfecting all surfaces in a room that have potentially come into contact w hands

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153
Q

ultrasonics

A

fine cleaning of instruments

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154
Q

AAMI ST79 mechanical cleaner verification

A

weekly (if not daily) at install, major reparis, when changing cleaning chem

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155
Q

Saline cleaning

A

cannot be used on items to be sterilized

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156
Q

3rd party reprocessor survey

A

observe cleaning and econ, inspeciton and testing, sterilizaiton load prep

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157
Q

Preveiosly infected and now immune hep B

A

Anti-HBc (core indicates actual infection) and Anti-HBs

158
Q

available immunoglobulin preps

A

hep a, measles, polio, rubella, hep b, rabies, varicella

159
Q

how long can bed bugs survive without feeding

A

1 yr

160
Q

best classroom setup for teacher and class interaction

A

horseshoe w writing surfaces

161
Q

biggest concern w unk jewelry in emergency

A

not being familiar w the opening mech to remove it

162
Q

bioterrorism resp event precautions

A

only airborne

163
Q

blood bank most likely surveyor

A

fda

164
Q

bridge btw thoery and actual practice

A

case study- builds lerner skills

165
Q

c diff can last on surfaces for

A

5 months

166
Q

CHG for PICC

A

30s dry time and low incidence allergies

167
Q

cryptosporidium disinfectant

A

6% hydrogen peroxide (for all protozoa)- resistant to chlorine

168
Q

decon SPD air exchange rate

A

10/hr, vent outside

169
Q

dirty endoscope carrying case

A

discard after use

170
Q

endoscopy cleaning process

A

HLD, rinse w sterile water, flish channels w 70-90% alcohol, dry using forced air

171
Q

flu vaccine highest priority

A

hcp working w high risk patients (ie lung transplant)

172
Q

frequency histograms and polygons most useful with

A

interval scale and ratio scale

173
Q

HBsAg dialysis

A

separate patients by room or area, dedicate machine and equip, exclude from reprocessing programs

174
Q

hep c sexual transmission risk

A

low, 1.3-27% in long term partners

175
Q

high sensitivity

A

most ppl who actually have dz have a positive result and few have negative

176
Q

high touch surface cleaning freq in patient room

A

3x/day (2 for low touch)

177
Q

highest needlestick tranmission risk

A

hollow-bore needles that can be filled with blood, UV stylet stick

178
Q

HIV vs HBV

A

hiv transmission after percutaneous exposure has been 0.3% vs 22-31% for HBV

179
Q

hydrogen peroxide vapor efficacy against spores

A

ineffective

180
Q

incidence density

A

total # new cases over period of time each was observed

181
Q

legionella sources

A

drinking water distribution (water faucets, ice machines, water devices, water source exposure)

182
Q

measles confirmation

A

positive IgM, 4x increase in IgG or hemagglutination inhibition or neutralizing ab, positive pcr

183
Q

measles virus proper handling

A

transport on ice and place in cx or freeze at -70 until placed in cx, room temp or less cold lowers infectiviity and can cause false negative

184
Q

most common intrapartum infection

A

GBS (strep agalactiae)
common in genitals
neurologic sequelae and death possible

185
Q

most common UTI org

A

e coli

186
Q

negative control amplified DNA

A

inaccurate, should not produce any amplification signal

187
Q

OR floor turn over clean

A

3-4 ft perimeter around the table unless larger area IDed

188
Q

prevention strategies to reduce ssis

A

admin abx prophylaxis, ID and treat remote infections before operation, reducing skin bioburden (or active surv culturing)

189
Q

pesudomembranous colitis diagnosis

A

c diff toxin assay and/or colonoscopy

190
Q

quality of care measure example

A

hep b imunity rates

evals compliance w desired care

191
Q

rocky mountain spottend fever ab test

A

weil-feliz agglutination

differentiates rickettsial ab

192
Q

RR

A

incidence of 1/incidence of 2

193
Q

scarlet fever

A

1-7D incubation
GAS
diffuse red rash on Dday 2 that fades

194
Q

self managed team

A

small, autonomous groups who determine, plan, and manage daily activities with little or no supervision
cost saving and increases productivity

195
Q

special cause variance

A

lies more than 3 standard deviations outside the mean

196
Q

spinal fluid assay, eeg, and mri test for

A

CJD (typical eeg, positive assay, high signal abnormalities)

197
Q

ssi lowest risk

A

elective proc, non-dirty or contaminated wound, anaesthesiology score less than 3, shorter proc time

198
Q

varicella exposure

A

VZIG and exclude from work days 10-28

199
Q

viral load in hiv patient

A

increases in antiretroviral phase ,decreases in asymptomatic infection, increases as patient progresses to AIDS

200
Q

when to restrict employee from patient contact

A

small, painful vesicular lesion on fingertip (indicates herpes)

201
Q

norwegian scabies

A 
crusted scabies, highly contagious
pruritic lesions on hands, webs of fingers, wrists, extensor surfaces, and outer feet, armbits, butt, and waist
contact until 24 hrs post treatment
infestagion of mite sarcoptes scabies
incubation 4-6 weeks
reinfestation 1-3 days
environmental fomites as well
202
Q

sarcoptes scabies

A

not a vector of infectious agents

humans are natural reservior

203
Q

guidelines for transporting specimen

A

w/in 2 hours of collection

204
Q

TB testing

A

positive indicates exposure
QFT-G: blood assay, 80% cx confirmed
TST: intradermal, for remote exposures and children <5
Test at time of exposure and 12 wks post
Chest xray for those prior positive and symptomatic
IGRA blood test for those w BCG vaccine

205
Q

mantoux induration positive

A

> 5 for immunocompromised, recent contact, fibrotic change on cxr
10 mm- recent arrival from high prevalent country, injection drug user, resident/employee of high risk congregate settings, myco lab personnel, high risk, medically underserved minority, children <4
15 no risk factors

206
Q

hep a igm detectability

A

5-10 days post exposure

207
Q

hep a food service worker restriction

A

until 7d post jaundice

208
Q

hep a shedding period

A

2-4 wks before and 1-3 weeks post jaundice

209
Q

hep a symptoms by age

A

70% asymptomatic in children <6

Jaundice in 70%+ adults

210
Q

hep a incubation

A

avg 4 weeks

211
Q

hep a prodromal phase

A

nonsp symptoms prior to jaundice, 1-2 wks

212
Q

hep a precautions

A

contact only for incontinent or diapered patietns

213
Q

hep a prophylaxis

A

household or sex contacts or outbreaks

214
Q

pertussis

A

bordatella pertussis, gram neg aerobic pleomorphic bacillus

cyclic outbreaks

215
Q

pertussis incubation period

A

10-14 days

7-10 days for immunocopromised (range of 6-21

216
Q

pertussis paroxysmal stage

A

whooping cough 1-6 wks (up to 10)

217
Q

pertussis communicable stage

A

1.5 weeks prior to cough and 3 weeks after

218
Q

pertussis precautions

A

droplet

219
Q

pertussis employee work exemption

A

furlough symptomatic employees through the first 5D of therapy

220
Q

initial element in virulence

A

ability to survive in external enviro during transit btw hosts

221
Q

second element in virulence

A

mech for transmission to new host

222
Q

ssi mgmt

A

open and drain incision
debride
implement antimicro mgmt as needed
manage open wound

223
Q

western blot for HIV

A

HIV ab in serum

224
Q

bacterial meningitis

A 
elevated opening pressure
cloudy csf
predominant neutrophils
1000+ WBC/mm
low-normal glucose
elevated protein concentration
225
Q

fungal meningitis

A

variable opening pressure, low glucose, predominant lymphocyts, variable WBC
elevated protein
positive india ink gram stain

226
Q

viral meningitis

A

normal opening pressure, normal glucose
predominant lymphocytes
<100 WBC/mm
normal-elevated protein

227
Q

CDI

A

gram + anaerobic bacillus
15-25% recurrence
10D vanc treatment

228
Q

flu shedding period

A

1-2D post infection

lasts less than 5 days usually

229
Q

flu incubation

A

1-4 days

230
Q

flu staff furlough

A

5D post diagnosis or duration of illness

231
Q

CDI risk factors

A

prophylactic abx, protein pump inhibitor, GI surgery, LOS, serious underlying illness, immunocompromised, advanced age

232
Q

MDRO colonization/infection risk factors

A

antimicro therapy in last 90 d, current hospitalization of 5+days, immunosuppressed, high freq resistance in community or unit, HA PNEU

233
Q

cap quality measures

A

o2 assessment win 24 hours
pneumococcal vaccine screen for patients over 65
abx timing (win 6 hours)
abx selection
blood cx in ED prior to admin of abx, abx election, smoking cessation, flu vaccine

234
Q

aspiration prevention measures

A

oropharyngeal cleaning and decon w aseptic agent
orotracheal intubation unless contraindicated rather than nasotracheal
head of bed elevated at 30-45 degrees
stress ulcer prophylaxis
use of noninvasive vent when possible

235
Q

immunocompromised status

A

HIV w CD4 <200, leukemia/lymphoma, neutropenia, splenectomy, early post transplant, cytotoxic chemo, high dose steroid therapy

236
Q

malnutrition effect of body’s immune system

A 
altered intestinal bacteria
tissue integrity impairment
mucosal secretions decreased
respiratory tract celia decreased
stomach acid secretion decreased
237
Q

lyme disease endemic areas

A

New England, mid-Atlantic, upper Midwest, ,N Cali

238
Q

lyme disease

A

borrelia burgdorferi
spirochete
black legged ticks

239
Q

lyme symptoms

A

fever, HA, fatigue, erythema migrans

can spread to joints, heart, nervous system

240
Q

lyme incubation

A

7-14d post bite

241
Q

lyme peak exposure

A

june-august

242
Q

Lyme IgG and IgM

A

IgM 2-4 post erythema, IgG 6 wks post dz

243
Q

ESBL

A

beta lactamases in common gram neg bacteria (e coli and klebsiella)
resistant to all beta lactams (cephalosporin and monobactams) except carbapenem and cephamycins

244
Q

mechanical barriers to infection

A

intact skin, mucous membranes, cilia

245
Q

chem barriers to infection

A

fatty acids in sweat, saliva, nasal secretions, and tears

246
Q

pathogenic intracellular bacteria

A

listeria monocytogenes, salmonella, mycobacterium, nocardia, legionella, rodococcus equi, pseudomonas pseudomallei

247
Q

cell mediated immunity dysfx susceptibility

A

pathogenic intracellular bacteria

248
Q

biofilm

A

substance preventing water soluble elements from reaching pathogens, polymeric conglomeration of extracellular DNA, protein, and polysaccharides

249
Q

h pylori

A

gram neg, responsible for chronic antral gastritis

250
Q

gram stain

A

determines peptidoglycans

gram positive=thick andpurple (iodine not removed in alcohol wash)

251
Q

bacterial spores

A

formed by gram pos usually

252
Q

staph aureus

A

most rapid onset of symptoms of food poisoning (1-6 hrs)

1-2D ill

253
Q

neutrophil

A

depletion provides best indication of susceptibility to most bacterial infections
most abundant WBC
formed by stem cells in the bone marrow
short lived, highly motile

254
Q

neutropenia

A

depletion

255
Q

salmonella

A

crampying, abd pain, diarrhea within 12 hr-3 days

4-7 days ill

256
Q

HIV time to measurable ab

A

1-3 month

257
Q

HIV exposure

A

PEP immediately

258
Q

90D SSI surv

A

craniotomy, CABG, BRST, CARD< FUS< FX< HER< HPRO, KPRO

259
Q

30D SSI surv

A

c sec, lami, appy, billi, colo, hyst, ovry

260
Q

process measure

A

focuses on process or the steps in a process that lead to a sp outcome
eval compliance w desired care or support practices to monitor variaction
ie. appropriate abx dosage

261
Q

conditions to be met to benchmark data to other facilities

A

standardized definitions are used consistently
adequate training of personnel to collect store manage and analyze data
data are calculated using same methodology as nationally validated system

262
Q

chi square test

A

eval effect of a var on outcome, calc OR or RR, if each cell of the table is greater than 5
(observed freq-expected)^2/expected

263
Q

fishers exact test

A

data are small in numbers
used for analysis of contingency tables
valid for all sample sizes

264
Q

statistical process control charts

A

monitor process of care
facilitate the determination of variation, monitor outcomes
helpful in determining special cause or common cause variations

265
Q

sensitivity

A

tp/(tp+FN)

266
Q

dup

A

dup

267
Q

mesokurtic

A

bell shaped, 0

268
Q

leptokurtic

A

peaked curve, +

269
Q

platykurtic

A

flat curve, -

270
Q

power increases when

A

sample size increases, sig level increases, true value of ther parapmeter being tested is further from the value in the null

271
Q

confounding var

A

extraneous var that systematically varies w indep and influences dep var

272
Q

causality criteria

A 
strength of ass- higher incidence among exposed
consistency- obs in numerous studies
specificity- 1 factor and 1 dz
temporality- exposure before dz
biological gradient
plausibility
coherence- known info about bio spectrum of dz and ass factor
analogy
causality- similar ass shown causal
273
Q

frequency polygon

A

useful for showing 2 sets of data on a sinlge graph
uses connecting lines and data points
graph of freq distribution w values of the var on the x axxis and # obs on the y
data points plotted at the midpoints of the intervals and connected w a straight line

274
Q

human herpesvirus

A 
kaposis sarcoma- systemic tumor w cutanious lesions
found on skin and spread elsewhere
significant mortality and morbidity
transmitted via saliva
contact precautions
275
Q

coccidioidomycosis

A

10-50% ppl in endemic areas exposed
inhalation of airborne spores of coccidiodes immitus or pasadassi
native to arid and desert areas in N. America, C. America, and S. America
Found at lower elevations that receive less than 20 in of rain yearly in warm, sandy soil
lieves 4-12 in below surface

276
Q

population attributable risk percent

A

proportion of a dz that could be prevented by eliminating the exposure in the entire study pop
RR-1/RR

277
Q

Relative risk

A

(a/(a+b))/(c/(c+d))

278
Q

dup

A

dup

279
Q

domestic poultry flu strains

A

H5N1

280
Q

swine flu strains

A

H1N1, H3N2, H1N2

281
Q

PPV

A

tp/(tp+fp)

282
Q

NPV

A

tn/(tn+FN)

283
Q

very low prevalence of dz effect on PPV and NPV

A

PPV lowered

NPV increased

284
Q

norovirus

A

sever dz more common in older adults, young children and immunocompromised
increases in winter months
lasts 5D
Shed 3wks
incubate 12-48 hours
abdominal cramping w/wo nausea, vomitting, diarrhea

285
Q

attributable risk

A

difference in rate of a condition btw exposed and unexposed

incidence in exposed (# exposed w dz/total exposed)-incidence in unexposed)

286
Q

postmortem care of deseased TB patient

A

approved mask necessary for resp protection

287
Q

fungal infection high risk patients

A

burn, premature NICU baby, bone marrow transplant

288
Q

smallpox

A

N95
vaccine not harmful to pregnant
7-17D incubation
fever, headache, papules, pustular vesicles
isolate until scaps separate
highest fatality rate of all bioterrorism agents

289
Q

HVAC outbreak cx considerations

A

ID purpose of cx and appropriate methods before hand
anticipate decisions and planned actions to results of culturing before undertaking process
determine whether there are existing standards to interpret results

290
Q

abx timeout

A

win 24-*48 hrs of cx results being available

291
Q

vent bundle

A 
head 30-45 degrees
peptic ulcer dz prophylaxis
DVT prophylaxis
oral care w aseptic agent
sedation vacations to assess ability to breath on own
circuits changed only when soiled/malfx
periodically training condensate in tuing
respiratory filter only for tb
292
Q

neisseria meningitis precautions

A

droplet until 24 hours post therapy

293
Q

neisseria PEP

A

intensive exposure without precautions (mouth to mouth, intubation, endotracheal tube mgmt, close examination of oropharynx)

294
Q

neisseria morphology

A

gram - diplococci

295
Q

publishing fed agencies in the us pertaining to infection and medical or regulated waste

A

EPA, FDA, US DOT

296
Q

factors that must bre present for contaminated waste to be capable of causing infection

A

dose and host susceptibility
portal of entry
presence and virulence of a pathogen

297
Q

airborne iso room req

A

negative airflow, exaust outside, daily monitoring of air pressure w visual indications

298
Q

effective strat to curb abx resistance

A

formulary restriction, auto stop orders, abx cycling

299
Q

active surv cx plan

A

provide addtl personnel to obtain cx
addtl personnel to process cx
provide a mech for communicating results to providers
measure outcome to eval the effectiveness of the asc program and contact precautions

300
Q

flu oubtreak in acute care setting measures

A

perform rapid flu test for patients and personnel w recent onset of symptoms
restrict staff mvmt from areas of facility having outbreaks
restrict or limit elective med and surg admits

301
Q

communication to patients before flu vaccine

A

annual formulation to protect against most likely flu strains
inactivated flu contains noninfectious viral components and cannot cause flu
fever, malaise, myalgia, and other systemic symptoms can occur after vaccine

302
Q

CVC indication

A

chemo, dialysis, TPN, long term abx

303
Q

CVC infection factors

A 
site
catheter material
sterile precautions
skin prep/heavy colonization
stopcocks
hub contamination
inexperienced operator
giudewire exchange through old catheter
CHG
304
Q

CDC CVC rec

A

min # ports and lumens
use totally implantable for long term use
use subclavian access for nontunnelled
HD should use jugular or femoral route
cuffed catheter for long term dialysis
cap, mask, sterile gown, gloves
chg
antimicro/antiseptic impregnated catheters for long term use when other strat have failed
catheter shouldnt be removed for fever alone
no routine replacement
guidewire replacement shouldnt be used for replacement of infected catheter

305
Q

CJD

A

85-95% sporadic
PrP gene turns to sheets
mean onset 50-70 yo
7-9 months onset to death

306
Q

how can IPs use the epi triangle during outbreak investigation

A

examine host factors (changes in immunity or procs win pop served)

307
Q

risk factors for young girls to dvp UTI

A

bubble bath w prolonged soaking, excessive urine holding, delayed bladder emptying

308
Q

maternal milk withholding

A

breast abcess, HIV, west nile

309
Q

hep c natl rec

A

screening and testing blood donors
viral inactivation of plasma derived products
risk reduction counseling and screening of persons at risk of HCV infection
adherence to st precautions and safe work practices

310
Q

HCW immunizaiton program

A

hep a, hep b, flu, measles, mumps, rubella, tetanus, pertussis, varicella

311
Q

vaccine storage

A

central area of the unit, away from walls, vents, coils
not on top shelf
enough room to store years largest inventory wo crowding
calibrated thermometer
unit must be dedicated to vaccines
35-46 F- otherwise potency reduced

312
Q

hep b postexposure unvaccinated or known nonresponder and positive source or unk

A

HBIG and series

313
Q

hep b postexposure unvaccinated and negative or unk source

A

vaccine series

314
Q

hep b post exposure unk ab and positive source or unk

A

test exposed and follow recc

315
Q

varicella

A 
rash 15d post exposure
rash in 3-4D
airborne, lesions contact
PNEU 30% more fatal in women
fetal death result of sever maternal infection
316
Q

varicella work exclusion

A

day 10-21

317
Q

varicella immunity proof

A

2 doses of varicella
lab evidence immunity
lab confirmation of dz

318
Q

mmr immunization proof

A

1+ vaccine post 1st bday
lab evidence of immunity
history of dz based on healthcare diagnosis
birth before 1957 (unless wo evidence of immunity)

319
Q

anthrax working restrictions

A

inhalation anthrax not transmissible among humans

no restrictions

320
Q

dup

A

dup

321
Q

fda

A

dvp, implements, monitors, enforces standards for safety, effeectiveness, and labelling of all drugs and biologics

322
Q

JC IP standars

A

min risk for dvmt of an HAI through an orf wide IP program
ID risk for the acquisition and transmission of infectious agents on an ongoing basis
effective mgmt of the IP program
collab of reps from relevant components and fx win the org
allocation of adequate resources to the IP program

323
Q

dup

A

dup

324
Q

human factor limits

A

limited memory capacity (5-7 pieces for short term)
neg effects of stress and cog tunnel vision
neg influence of fatigue and sensory overload
overdep on multitasking skills in complex work enviro

325
Q

model for improvement

A

setting aims, est measures, selecting changes that will make an improvement
testing the selected changes in a plan, do study, act cycle
small scale testing followed by refinement and more testing until changes are ready on a larger scale

326
Q

FMEA tool

A

proactive, preventive approach to ID potential failures and opporutnities for error

327
Q

mode way of operating

A

manner in which something can happen (failure)

way failure occurs and its impact on the process

328
Q

increased infeciton risk

A

low nurse staffing levels

use of nonpermanent staff

329
Q

IP busines splan

A

formal statement of a set of business goals, resasons they are attainable and plan to reach them
decision making tools and cost and revenue est are central
IP needs to demonstrate whether the expanded program will be worth the investment

330
Q

strategic planning

A

process for defining stragety or direction and making decsions on allocating resources
setting goals, determining actions to acheive them, mobilize resources to execute actions
planned obj that a dept or org strives to achieve
ie implment an electronic surv system in the next 3 years

331
Q

fx mgmt

A

most common type
person w mgmt authroity over an org unit within a bus, company, or org
ongoing responsibilites and arent usually directly affiliated w project teams, other than ensuring goals and obj align w org strat and vision

332
Q

quality improvement

A

systematic and continuous actions leading to measurable improvemtn in healthcare services and health status of targeting patient groups
data is cornerstone
describe how well current systems are working and what happens when changes are applied and document success
doesnt include dept sp goals

333
Q

action planning

A

determine what tactic the org will use to accomplish goals, who is responsible, timeline, resources and eval criteria

334
Q

item analysis

A

process of examining student test scores in order to assess the quality of the individ test questions and test itself
useful for improving quality of hte test and increasing instructor in test construction and IDin areas needing improvement or emphaiss

335
Q

enabling factors to capture capaicty to change

A

necessary skills and capability
necessary resources
managed by training and coaching for skill dvmt or by helping ppl obtain access
ppl must be motivated to change

336
Q

disinfectant consideration

A

ease of use, efficacy, acceptabiligy, safety, cost

337
Q

hot water washing for laundry

A

160F for min of 25 minutes

338
Q

OR airflow

A

noninductional unidirectional infusion of air w supply over table and exhaust near floor at periphery
laminar isnt appropriate as airflow rate is high and may induce hypothermia

339
Q

AIIR

A

maintained under neg air pressure
min of 12 air exchanges per hour
visible means of monitoring air flow (for new construction)
anterooms not req but must be room for hand washing and storage/disposal of PPE
if dedicated neg air room, should exhaust directly outside

340
Q

legionella

A

occurs throug hinhalation of aerosols

optimum growth temp 77-108F

341
Q

antispetics

A

antimicro agents safe for use on skin

342
Q

detergents

A

tend to be more enviro friendly, less toxic, and less likely to cause resp reactions than disinfectants

343
Q

disinfectants

A

must be used on horizontal surfaces and high touch

accepable for cleaning floor provided occupant was not on iso

344
Q

just in tiem teaching

A 
increase learning during class time, enhance motivation, encourage practice, enable instructor to fine tune classroom activities to meet needs
motivate students to examine knowledge and get ready to modify, add, and apply it
345
Q

professional competency

A

communication, values, reasoning, teamwork, knowledge, skill

346
Q

behaviorism

A

combines elements of philosophy, methodology, and theory
focuses on change in external behavior achieved through large amount of repetition of desired actions, reward of good habits, and discourages bad habits

347
Q

OSHA

A

safeguards workers against helaht hazards caused by bloodborne pathogens
exposure ocntrol plans, universal precautions, engineering and work flow practice controls, PPE< housekeeping, lab, hep B, post exposure follow up, hazard communication, recordkeeping

348
Q

lit eval

A

is question important, appropriate, and clearly stated
study pop appropriate and adequately described
choise of design applicbale
selection and exclusion criteria described
outcoems equally and evaluated and blinded
proportion lost to follow up
stat tests
sample size
confouding factors taken into account
data to provide answer
conclusions reasonable and justified
other explanations account for observed results

349
Q

internal validity

A 
how well an experiment is done, whehter it avoids systematic errors
strong evidence for causality
proc described
results report data
discussion assesses bias
350
Q

healthcare learning

A

req training activities that address literacy, cultural diversity, cross training, and tech advances
informed by learning theories and the ed needs of the pop
creative and flexible

351
Q

strategic plans

A

determine the direction an org will go in the future and what the org must do in order to reach the goal, mission, or vision
analysis of the org
forming conclusions about what an org must do as a result of issues facing the org

352
Q

GLOVE ONLY ON DOMINATN HAND WHILE SUCTIONING AIRWAY OF A PATIENT MECHANICALLY VENTILATED. IP SUSPECTS…

A

NURSE HAS INADEQUATE CONCERN OF PERSONAL RISK

353
Q

LAB DOES NOT TEST FOR LEGIONELLA. LEGIONELLA HAS NOT BEEN DIAGNOSED. IP SHOULD…

A

DISCUSS CONCERNS ABOUT MISSING CASES OF LEGIONELLA WITH THE ICC

354
Q

IP NOTICES SEVERAL NEWBORNS READMITTED WITH STAPH. FIRST THING

A

GATHER DATA ON NEONATAL READMITS TO ID POST DISCHARGE INFECTIONS

355
Q

IP ASKED TO DVP A PERFOMRANCE MASURE DESIGNED TO HAVE A SIG IMPACT ON HEALTH OPO MISSION OF PROVIDING HIGHEST STANDARD OF CARE. WHAT IS THE BEST SELECTION

A

REDUCE CAUTIS IN LONGTERM CARE FACILITY

356
Q

CAP INDICATOR

A

HIGH WBC

357
Q

IP annual safety module on disease transmission and iso. What focuses psychomotor skills

A

mock isolation with mannequin in contact and have staff don and doff

358
Q

monther collection and storage of milk

A

milk should be kept by mother to avoid mistakes

359
Q

care of hcildren with HIV inservice

A

determine if there are existing program materials that would meet ed needs

360
Q

computer based training advantage

A

user interaction

361
Q

specimen that should be protected fromair exposure

A

lung abcess aspirate

362
Q

urinary catheter standardization first step

A

after cost analysis conducted

363
Q

cystic fibrosis patient concerning organism

A

burkholderia cepacia

364
Q

hav infeciton rate review

A

current prevalence data in community served by facility

365
Q

new ic program rec

A

purchase of data management software for survellance

366
Q

hep b vaccine series started 2 years ago with 2 doses received. What now

A

give 3rd dose and check ab after 1 month

367
Q

effective bioterrorism response

A

facilitate response plan based on obvious signs and unusual occurences

368
Q

B19 DNA

A

fifth disease

369
Q

fifth disease

A

parvovirus, distinctive face rash, airborne and contact

370
Q

most important characteristic for establishing a definsible manual for legal or accredidaation purposes

A

tailor published recs to fit needs of the facility and reflect actual practice

371
Q

workplace initiativs directly linked to profesional and reg stadards as well as a facilities policies and procs are base don

A

competency based ed

372
Q

most feasible presentation with 48 hour notice

A

prepare hand outss and prepare overhead transparencies

373
Q

bar soap risk

A

no documented risk, racks that allow water drainage must be provided

374
Q

single use open suction catheter vs multi use closed system catheter

A

no reco for the preferential use of either

375
Q

IG offering for hep a patient

A

household contacts

376
Q

best tool for identifying potential process failure

A

flow chart

377
Q

multi drug resistant diphtheroid most likely source

A

SKIN

378
Q

ICP OUTBREAK MANUSCRIPT PREPARATION

A

WRITE REPORT USING RESEARCH PROCESS

379
Q

MOST IMPORTANT IC MEASURE FOR ELDERLY LONG TERM CARE RESIDENTS

A

PRESERVING AND ENHANCING HOST DEFENSES

380
Q

WATER QUALITY GUIDELINES

A

INSTALLMENT OF NONSPLASH FLOOR DRAINS W HORIZONTAL FLOW FLUSH BOWL IN DEDICATED SYSTOSCOPY ROOMS, SINCE NO MAJOR SURGERIES ARE DONE HERE

381
Q

SEWER BACK UP INTO CLEAN AREA OF CENTRAL SERVICE ACTION

A

DETERMINE HIGHEST LEVEL OF CONTAMINATION IN THIS AREAS, REMOVE SUPPLIES AT AND BELOW LEVEL AND REPROCESS

382
Q

OCC EXPOSURE REQUIRING FOLLOW UP SCREENING FOR A PRENANT HCW

A

active tb

383
Q

C DIFF INCREASE CONTRIBUTING SOURCE

A

CONVERSION FROM EAR TO RECTAL THERMOMETERS

384
Q

RYAN WHITE COMPREHENSIVE AIDS RESOURCE EMERGENCY ACT REQ NOTIFICATION OF AN EMERGENCY RESPONSE EMPLOYEE WHEN EXPOSED TO..

A

INFECITOUS, POTENTIALLY FATAL DISEAES

385
Q

RESERVOIR MOST DIFFICULT TO CONTROL AND CONTAIN

A

ENDOGENOUS FLORA

386
Q

JOB CLASSIFICATION WITH MINIMAL EXPOSURE RISK TO A BLOODBORNE PATHOGEN

A

REC THERAPY

387
Q

MOST LIKELY PATHOGEN FOR A FEVER, COUGH, AND PULMONARY INFILTRATE FUNGUS AFTER VACATIONING IN S. CALI

A

COCCIDIOIDES IMMITUS

388
Q

HEP G AND HEP B SIMILARITIES

A

SEXUALLY TRANSMITTED

389
Q

UNDERLYING CONDITION FOR PATIENT WITH LOW GRADE FEVER, PREVIOUSLY ADMITTED BI-MONTHLY, DIAGNOSED WITH CANDIDA

A

hiv

390
Q

INCREASED INFECTION RISK AT FREE STANDING ENDOSCOPY CENTER

A

USING SEPARATE CONTAINER AND FRESHLY PREPARED SOLUTIONS TO PERFORM HLD OF REUSABLE BIOPSY FORCEPTS

391
Q

BEST METHOD TO ENHANCE ADHERENCE TO REGS AND STANDARDS

A

LINK COMPLIANCE W PERFORMANCE EVAL

392
Q

STATEMENT EXAMPLE: TO PROTECT THE PATIENTS THROUGH DVMT, IMPLEMENTATION, AND EVAL OF EVIDENCE BASED IP AND C PROGRAM

A

objective

CIC (2 decks)

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