4.11 H) Infectious Disorders Body Fluid Exposure

Front 1

(Dunn)
In regards to body fluid exposure, which of the following is correct?
A. The wearing of latex gloves decreases inoculum size by about 30%
B. The greatest risk of death is from HIV.
C. Percutaneous exposure to Hepatitis B is greatest if the source is

e antigen positive
D. There is a 25% risk of HBV if the source is e antigen negative.

Back 1

C. 40% transmission risk if source eAg +

A = 50%
B = Hepatitis B
D = 5% risk HBV if Source is eAg negative

Front 2

(Dunn)

In regards to exposure to HIV, the infectivity risk is higher when viral shedding is higher.

In what 2 situations does this occur?

Back 2

Situations for High viral shedding :

1. Acute seroconversion illness
2. Later stage / Terminal stages of AIDS

Front 3

(Dunn)
In regards to Body fluid exposure and the tests that are performed on the source blood, which is not an initial test?

A. Hep C
B. HIV
C. Anti-HBsAg
D. HBsAg

Back 3

C. Initial Source Tests are :

1. HIV

2. HCV

3. HbSAg

Front 4

(Dunn)
In regards to body fluid exposure, which of the following is not tested on the exposed patient?

A. HBeAg
B. HBsAg
C. Anti-HBsAb ( HepB Antibody )
D. HIV

Back 4

A.

Front 5

(Dunn)
In regards to body fluid exposure, which is

incorrect?
A. Hospitals (should) have a protocol for Staff/ Patient exposure.
B. Tetanus status must be addressed and treated.
C. The area should be immediately washed with betadine.
D. A Risk assessment must be performed for all Staff / patients.

Back 5

C. Soap and water is the recommendation

- or an alcohol-based antiseptic.

Front 6

(Dunn)

With body fluid exposures, what 4 General pieces of advice should be given to the exposed person to be aware of over the following 12 weeks?

Back 6

1. Practice safe sex
2. Avoid pregnancy
3. Do not donate blood
4. Report any febrile illness to the GP/ ED.

Front 7

(Dunn)

On what factors is the Risk Assessment

Stratification Protocol (RASP) applied

Back 7

1. HIV status of source
2. Inoculum type
3. Method of transmission
4. Estimated volume of inoculum.

Front 8

(Dunn)
Which of the following is incorrect regarding the RASP?
A. The risk is calculated : Z = A x B x C with the risk being 1 / Z
B. High risk sources are IVDU or unknown needle with a high local

prevalence of HIV.
C. dried old blood scores less than body fluids at risk such as semen.
D. A = source population, B = inoculum type, and C = method of

transmission.

Back 8

C. Scores more

[ "more" = higher score = lower risk{ ie. 1/score} ]

A = Source population

B = Inoculum Type

C = Method of transmission

Front 9

(Dunn)
In regards to the risk assessment for HIV

transmission, which of the following is

incorrect?
A. The all-cause risk of dying in the next 12 months for any person is 1/3000.
B. The risk of HIV with a needlestick from an HIV positive person is

negligible : 1/ 150,000.
C. in Australia, only 10% of injecting drug users are HIV infected.
D. The highest risk for HIV transmission is receptive anal intercourse from a HIV + person.

Back 9

C. In Australia, only 1-2 % of injecting drug users are HIV infected

Front 10

(Dunn)
In regards to Post Exposure prophylaxis (PEP), which of the following is incorrect?
A. It decreases the risk of seroconversion by 80%
B. The treatment regime is poorly tolerated - only 35% -due to adverse

effects.
C. A RASP score of 1/1000- 1/10,000 is a definite indication for PEP.
D. High risk exposures are given 4 weeks of 4 medications.

Back 10

C. RASP score < 1 / 1000 = definite indication

1/1000 - 1/10,000 = recommended BUT

OPTIONAL

Front 11

(Dunn)
In regards to PEP, which of the following is

incorrect?
A. PEP is not a primary prevention measure for HIV
B. It should be commenced ASAP ( within 1 hour)
C. It is recommended for high risk source + percutaneous inoculation of exposed.
D. Zidovudine + lamivudine is given for 4 weeks for high risk exposures.

Back 11

D. High risk HIV exposure:

4 medications for 4 weeks

Zidovudine + [ NRTI ]
Lamivudine + [ NRTI ]
Lopinavir + [ PI ]
Ritonavir [ PI ]

Front 12

(Dunn / Cameron)
In regards to the management of body fluid

exposures, which is incorrect?
A. Antiretroviral prophylaxis is not recommended for community

needlestick exposures- unless epidemiological circumstances indicate a high likelihood of HIV in the source.
B. Exposed persons not previously vaccinated against HBV should be

given a course of hepatitis vaccination.
C. The offending syringe for a needlestick, if brought in to the ED- should not be tested.
D. Bloodborne virus infection from needlestick exposures in the

community are extremely rare.

Back 12

B. Exposed persons not previously vaccinated against HBV should be given hepatitis

immunoglobulin AND commence hepatitis vaccination.