Blood Borne Pathogens

Front 1

contamination

Back 1

presence of microorganisms without multiplication

Front 2

colonization

Back 2

presence of microorganisms with multiplication but NO invasion of tissues

Front 3

infection

Back 3

microorganisms present, multiplying, and invading tissue

Front 4

risk of infection

Back 4

dose of bacterial contamination * virulence / resistance of host

Front 5

characteristics of viruses

Back 5

1. smallest microorganisms
2. require living tissue for growth and reproduction
3. not killed by antibiotics

Front 6

characteristics of fungi (yeasts)

Back 6

1. reproduce by spores
2. present in air, soli, water
3. not killed by antibiotics
4. cause infection in the immunosuppressed

Front 7

protozoa

Back 7

- single celled
- parasitic

Front 8

contributing factors for infection

Back 8

- age
- immune response
- underlying conditions and illnesses
- interventions and treatments

Front 9

transmission of infection

Back 9

1. airborne
2. droplet - mucous membranes
3. contact
4. vehicle - in food or water
5. vector

Front 10

preventing spread of infection

Back 10

1. hand hygiene
2. medical asepsis
3. standard precautions
4. isolation
5. barrier practices

Front 11

Airborne Precautions

Back 11

- neg. pressure isolation room
- respiratory protection
- limit transport of patient from room to room

Front 12

Airborne Diseases

Back 12

- TB: active, untreated pulmonary or layngeal
- measles
- varicella-zoster

Front 13

Droplet Precautions

Back 13

- single room
-wear mask w/in 3 feet of patinet
-use mask on patient during transport

Front 14

Droplet Diseases

Back 14

- meningococcal meningitis
- influenza, pertussis, diptheria
- rubella, mumps

Front 15

Contact Precautions

Back 15

- single room or cohort
- gown and gloves for contact with patient or support equipment
- dedicated equipment

Front 16

contact diseases

Back 16

- antimicrobial-resistant organisms
- lice
- scabies
- C. difficile
- varicella-zoster
-impetigo
- RSV

Front 17

Neutropenic precautions

Back 17

- single room
- handwashing
- limit traffic into the room
- no fresh fruits or vegetables

Front 18

Neutropenic person

Back 18

- person at-risk for acquiring infection
- absolute granulocyte count < 1000

Front 19

Healthcare - Associated Infection

Back 19

- aka Nosocomial infection
- not present or incubating on admission

Front 20

stats for healthcare-associated infection

Back 20

- 5% of all hospital admissions
- ~2 million patients per year
- $4.5 billion associated
costs
- 1/3 may be preventable

Front 21

Urinary Tract Infections

Back 21

- 10^5 or greater organisms on culture
- > 10 WBCs per high power field on urinalysis

Front 22

UTI associated with indwelling urinary catheters

Back 22

- chronic indwelling urinary catheters - colonization of urine
- residents in LTC facilities frequently colonized and asymptomatic
- leading nosocomial infection in acute and long term care

Front 23

Pneumonia

Back 23

- 2nd most common nosocomial infection in the US (15%)

Front 24

Pneumoina - Long term care

Back 24

- Bacterial pneumonia usually secondary to aspiration
- may also occur following viral URI and influenza

Front 25

organisms that cause pneumonia

Back 25

- streptococcus pneumoniae
- klebsiella pneumoniae
- staphylococcus aureus

Front 26

types of skin and soft tissue infection

Back 26

- surgical wound infections
- chronic wound: pressure ulcers, stasis ulcers
- soft tissue infections
- topcial skin infections

Front 27

Incisional Surgical Site Infection

Back 27

-within 30 days of surgery and involves skin, subq tissue, or muscle above fascia and any of the following:
- purulent drainage, postive culture from fluid from would, surgeon opens wound, doctor diagnosis of infection

Front 28

Intrinsic factors for wound infection

Back 28

- age - extremes
- nutritional status - serum albumin <3.5g/dl
- diabetes - glucose > 200mg/dl in immediate post-op period
- smoking - nicotine delays healing
- obestiy >20% ideal body weight

Front 29

barriers to wound healing

Back 29

Host factors:
- age
- underlying disease
- malnutrition
Altered immune response:
- disease / conditions
- drugs / tratemtns
- bypass natural defenses

Front 30

Non-surgical skin and soft tissue infections (ex)

Back 30

- chronic wounds --> pressure ulcers and static ulcers
- cellulitis
- fungal skin infection

Front 31

C. difficile diarrhea

Back 31

- profuse, watery
- associated with prior antibiotic use
- higher incidence in patients receiving tube feeding
- environmental contamination
- cross-infection potential

Front 32

Def - Mulit-drug-resistant organism

Back 32

- organism that has developed mechanism to protect it from being killed by the use of anitmicrobial agents

Front 33

significance of multi-drug-resistant organisms

Back 33

- increased potential for sepsis and death in patients with MDRO
- increased length of hospitilization
- increase cost
- patiens with MDRO are reservoirs for trnasmission of MDRO to others

Front 34

MRSA

Back 34

Methicillin-resistant Staphylococcus aureus
- also resistant to Nafcillin, oxacillin
- not just hospital bug

Front 35

Treatment for MRSA (methicillin-resistant staph aureus)

Back 35

Vancomycin

Front 36

control measures for MRSA

Back 36

- single room or cohort if colonized or infected
-contact precautions
- if outbreak suspcted, take additional precautions

Front 37

GISA or VISA

Back 37

- glycopeptide intermediate resitance staph aureus or vanomycin intermediate resistance staph aureus

Front 38

problem with GISA or VISA

Back 38

No treatment

Front 39

control measures for GISA

Back 39

- rapid identification of staph with th ereduced sensitivity to glycopeptide agents
- isolation
- 1:1 care for patient or cohort
- baseline cultures of HCW, roommates, and others with direct contact with pateint

Front 40

more control measures for GISA

Back 40

- avoid patient transfer between facilities
- notify local and state DOH and CDC

Front 41

VRE

Back 41

Vancomycin-resistant enerococci
- E. faecium predominantly

Front 42

VRE characteristics

Back 42

- survives on environmental surfaces
- transient carriage on HCW hands
- NO rectal colonization of healthy HCWs
- VRE coloniation frequent, but infx uncommon
- concern that will shart resistance factor with S aureus

Front 43

VRE and C. difficile

Back 43

- electronic thermometes and transmission of C. difficile
- tx. of C. difficile my predispose to dev. of VRE
- patients at risk for C. difficile may be reservoirs for VRE

Front 44

control measures for VRE

Back 44

- prudent vancomycin use
- education
- rapid identification of VRE
- isolation
-dedicated noncritical items
- env. cleaning and disinfection

Front 45

control for VRE in LTC

Back 45

- consider room with person not at high riske for VRE disease

Front 46

VRE patients in LTC - when to allow them to ambulate and participate in activities?

Back 46

1. moist body substances are contained
2. resident washes hands prior to leaving the room

Front 47

types ofPediculosis

Back 47

1. head - most common
2. body
3. pubic

Front 48

Nits

Back 48

eggs of lice
- do not wash or blow away
-most often found at nape of neck, behind ears, crown

Front 49

treatment of head lice

Back 49

1. insecticidal shampoo (not use Lindane)
2. fine tooth comb - removes nits
3. nit check for 10 days

Front 50

Scabies - what caused by

Back 50

caused by the mite - Sarcoptes scabiei --> burrows under skin
- spread skin to skin contact

Front 51

symptoms of scabies

Back 51

- severe itching - esp at night
- rash - back "tracks"
- symptoms not releived by moisturizing or other interventions

Front 52

usual loctaions of scabies

Back 52

wrist, finger webs, elbows, skin fold, pelvic girdle, butt, behind knees, sides of feet

Front 53

Tx of scabies

Back 53

- contact precautions
- insecticide lotion - apply in shower
- change linens and clothes

Front 54

Infection with varicella-zoster virus

Back 54

- chickenpox
- attaches to nerve endings and becomes dormant

Front 55

local zoster vx. disseminated zoster

Back 55

local - nerve endings in one dermatome, unilateral distribution, standard precautions
disseminated - full body involved, airborne and contact precautions

Front 56

Herpes Zoster

Back 56

reactivation of varicella-zoster virus when immune response compromised.
- shingles

Front 57

#2 leading cause of death due to infectious disease in the world

Back 57

Tuberculosis

Front 58

etiologic agent and transmission of TB

Back 58

- Mycobacterium tuberculosis
- droplet expelled and inhaled

Front 59

T/F: YOu can be infected with TB without disease

Back 59

true

Front 60

TB infection with NO disease

Back 60

- cannot spread
- + skin test
- neg x-ray
- no symptoms

Front 61

sites of active TB

Back 61

- lungs
- larynx
- lymph nodes
- brain
- kidneys
- bone

Front 62

why has there been a recent return in TB?

Back 62

- decreased funding and attention
- lack of compliance with infx control measures
- poor ventialation and air in older facilities
- HIV epidemic
- Inc immigaration from high-prevalence countries
- inc inmates and homeless

Front 63

impact on reappearnce of TB

Back 63

- increased morbidity and mortality
- resistant strains
- $$
- new quidelines for prevention and control

Front 64

populations with high prevalence of TB infection

Back 64

- residents LTC facilites
- HIV +
- Inmates
- ppl who inject drugs
- ppl with occupational exposure

Front 65

S&S of TB

Back 65

- long duration
- fatigue
- malaise
- weight loss
- fever
- night sweats
- cough / blood (pulmonary)

Front 66

Mantoux Tuberculin Skin Test

Back 66

- for TB
- inject PPD into skin
- Examined 48-72 hours
- measured for induration NOT redness

Front 67

other diagnostic tests for TB

Back 67

- x-ray
- AFB smear
-AFB culture

Front 68

infx control for TB

Back 68

- airborne isolation
- precaution for cough-inducing procedures
- effective anti-TB tx

Front 69

which Hepatitis viruses are caused by viruses?

Back 69

Hep A, B, C, D, E

Front 70

Hep A mode of trnsmission, incubation period

Back 70

-fecal-oral
-15-50 days - avg 28 days

Front 71

Hep A - diagnosis, outcome,

Back 71

- anti-HAVIgM
- outcome: mild, self-limiting

Front 72

which strands of hepatitis can use a vaccine

Back 72

Hep A
Hep B
Hep D

Front 73

Which strands of Hepatitis have prevention with hygiene?

Back 73

Hep A
Hep E

Front 74

Hepatitis transmitted by blood and body fluids

Back 74

Hep B
Hep C
Hep D

Front 75

Hepatitis transmitted by fecal-oral route

Back 75

Hep A
Hep E

Front 76

Diagnosis of Hep B

Back 76

HBsAg

Front 77

Diagnosis of Hep C

Back 77

anti-CHV
HCV-PCR and elevated LTFs

Front 78

super infection with HBV

Back 78

Hep D

Front 79

20% mortalilty in pregnant women

Back 79

Hep E

Front 80

stages of HIV

Back 80

- acute retroviral syndrome
- asymptomatic
- early symptomatic
- late symptomatic
- advanced

Front 81

epidemiology of HIV in the US

Back 81

- 800,000 - 900,000 with HIV in US
- 40,000 new cases per year
- 70% infx in men

Front 82

transmission of HIV

Back 82

- sexual contact
- blood to blood
- perinatally

Front 83

body fluids for HIV transmission

Back 83

- blood - highest amt virus
- semen - high amt virus
- vaginal secretion - lower
- breast milk - low

Front 84

components of OSHA bloodborne pathogen rule

Back 84

- written exposure control plan
- enginerring controls
- safe work practices
- hep B vaccine
- education and post-exposure follow-up

Front 85

percutaneous exposure

Back 85

any new break in the skin caused by contaminated needle or other sharp object

Front 86

mucous membrane exposure

Back 86

any splash of blood or body fluds to the eyes, eras, nose, mouth, etc.

Front 87

non-intact skin

Back 87

any contact of blood or body fluid with an existing break in the skin

Front 88

bloodborne pathogens

Back 88

- Hep B
- Hep C
- Hep D
- HIV

Front 89

risk of HIV infx after exposure

Back 89

0.2-0.3%

Front 90

why the risk of HIV varies with an exposure

Back 90

- amount of blood involved
- amount of virus in blood
- if postexposure treatment taken

Front 91

risk of infection with hep B after exposure to HBV infected blood?

Back 91

- 6-12% risk
- varies with amount blood, amount virus, and whether HCW had antibody to HBV

Front 92

factors that contribute to development of infection

Back 92

- immune response
- underlying conditions / illness
- occupational exposure
- unsafe work practices
- missing or poor engineering controls

Front 93

infection control for healthcare worker

Back 93

- hand hygiene
- safe practices
- be kind to immune system
- up to date immunizations

Front 94

post-exposure follow up for blood and body fluid exposure

Back 94

- wash / flush with water or saline
- report to supervisor
- medical evaluation and follow-up

Front 95

post-exposure follow up for communicable disease

Back 95

- report to supervisor
- review your immune status
- medical evaluation if susceptible