• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/115

Click to flip

115 Cards in this Set

  • Front
  • Back
What is the purpose of infection control in a dental office?
Wilkins- Ch 2 p.22

Purpose of INFECTION CONTROL-is to PROTECT
(1) Patients
(2) DHCP
(3) Other in dental office
Who is responsible for carrying out infection control practices in a dental office?
Wilkins- Ch 2 p.22

the ENTIRE dental team is responsible for ORGANIZING/MAINTAINING a system for

(1) sterilization
(2) disinfection
(3) care of instruments
(4) care of equipment
Who is the dental team responsible for not cross-contaminating?
Wilkins- Ch 2 p. 22

Dental must prevent DIRECT & INDIRECT CROSS-CONTAMINATION

(1) b/w dental personnel & pts
(2) one pt to another
What are "Standard Precautions"?
Wilkins- Ch 2, p.22

Standard Precautions-
(1) NEW term that recognizes
(2) BODILY FLUIDS + blood as infectious agents
What came before the Standard Precautions?
Wilkins - Ch 2, p.22

"Universal Precautions" came before Standard Precautions
What is "Universal Precautions"?
Wilkins- Ch 2, p.22

"Universal Precautions"
(1) OLD term
(2) only recognized BLOOD as infectious agent
(3) Treat everyone as if they had AIDS
According to the Standard Precautions definition-how can pathogens be spread?
Wilkins- Ch 2, p.22

Standard Precautions-contact with
(1) blood
(2) ALL BODY FLUIDS-secretions/excretions ***except sweat
(3) nonintact skin
(4) mucous membrane
What are other precautions that must be taken in a dental office?
Wilkins - Ch 2, p. 22

Other precautions
(1) Transmission-based (Ex: TB)
(2) Transmission via airborne droplets
(3) Skin contact transmission
Where do "microorganisms " of the oral cavity originate ?
Wilkins - Ch 2, p.24

Microorganism originate:

(1) few hours -1 day after birth
(2) with dev. of oral flora
Where does "salivary bacteria" come from?
Wilkins - Ch 2, p. 24

Salivary bacteria originates
(1) dorsum of tongue
(2) mucous membrane
(3) gingival/periodontal tissues
What is the "infection potential" in a dental office?
Wilkins -Ch 2, p.24

Infection Potential = High
Because....
(1) Pathogen organisms are TRANSIENT (travel)
(2) Pts may be CARRIERS of diseases
(3) Inappropriate work practices
(ex: careless hand washing)
(2)
What is "cross-contamination"?
Wilkins -Ch 2, p.24

"Cross-Contamination"

SPREADING of microorganism from one source to another
(1) DIRECTLY-person to person
(2) INDIRECTLY- inanimate object to person
What is the "infectious process"?
Wilkins -Ch 2, p.24-25

"Infectious Process"

is a chain of events req'd for the SPREAD of an infectious agent
What are the "essential features" for disease transmission?
Wilkins -Ch 2, p.25

Essential Features = 6 LINKS

(1) Infectious Agent
(2) Reservoir (home)
(3) Port of Exit = (Escape)
(4) Mode of Transmission
(5) Port of Entry =(Invasion)
(6) Susceptible Host = (Victim)
How is infection spread?
Wilkins -Ch 2, p.25

Infection is SPREAD by :

(1) at least ONE BREAK in the chain of 6 major links
(2) Oftentimes by not following STANDARD PRECAUTIONS and other reasons
What is an "infectious agent" ?
Wilkins- Ch 2, (p.25)

"infectious agent"

= the INVADING organism
What is a "reservoir" ?
Wilkins- Ch 2, (p. 25)

"reservoir"

= WHERE the invading organism LIVES

Examples
(1) inanimate object
(2) insect
(3) human cells or blood
What is "port of exit" ?
Wilkins- Ch 2, (p. 25)

"port of exit"

=HOW the invading organism ESCAPES from the "reservoir"
What is "mode of transmission"?
Wilkins- Ch 2, (p. 25)

"mode of transmission"

(1) DIRECT = person to person
Ex: contaminated hands
Ex: Droplet from sneezing to persons mouth

(2) INDIRECT = obj. to person
Ex: hypodermic needle
Ex: Sneezing into hands and touching a pt
What is "port entry" ?
Wilkins- Ch 2, (p. 25)

"port entry"

= HOW the invading organism ENTERS the new host

Examples
(1) respiratory tract
(2) mucous membranes
(3) break in skin
What is a "susceptible host"?
Wilkins- Ch 2, (p. 25)

"Susceptible Host"

= DOES NOT have IMMUNITY to the invading infectious agent
What are the "factors" that INFLUENCE the development of infection?
Wilkins- Ch 2, (p. 25-26)

"FACTORS" influencing dev. of infection:

(1) # of organisms
(2) DURATION of exposure
(3) VIRULENCE of organism (ability to survive)
(4) IMMUNE STATUS of host
(5) General phys.& nutritional status of host
If an infectious agent is present-will it lead to infection?
Wilkins- Ch 2, (p. 25)

Just b/c an infectious agent is PRESENT it MAY NOT necessarily lead to infection.

Certain factors MUST BE PRESENT
What are "factors" that ALTER normal defenses?
Wilkins- Ch 2, (p. 26)

FACTORS that ALTER normal defenses:

(1) ABNORMAL Phys. conditions
(2) SYSTEMIC Diseases
(3) DRUG Therapy
(4) PROSTHESIS & Transplants
How do "Abnormal Physical Conditions" ALTER normal defenses?
Wilkins- Ch 2, (p. 26)

"ABNORMAL Phys. Condition"
Ex: Defective Heart valve

ALTERS Normal Defenses by:
(1) susceptible to infective endocarditis from bacteria during a cleaning
How do "Systemic Diseases" ALTER a patient's normal defenses?
Wilkins- Ch 2, (p. 26)

SYSTEMIC DISEASES examples
(1) diabetes mellitus
(2) alcoholism
(3) leukemia
(4) glomerulonephritus
(5) AIDS

ALTER Normal defenses by:
(1) causing IMMUNOSUPPRESSION;
(2) increasing risk of INFECTION
How does "Drug Therapy" ALTER a patient's normal defenses?
Wilkins- Ch 2, (p. 26)

DRUG THERAPY used to treat "systemic diseases"
Examples
(1) steroids
(2) chemotherapeutic agents

ALTER Normal defenses by:
(1) SUPPRESSING immune system
(2) higher risk of INFECTION

***May require antibiotic premed
How do "Prosthesis & Transplants" ALTER a patient's normal defenses ?
Wilkins- Ch 2, (p. 26)

PROSTHESIS & TRANSPLANTS
Examples
(1) joint replacement
(2) cardiac prosthesis
(3) VA shunt for hydrocephalus
(4) Organ transplant

ALTER Normal defenses by:
(1) SUPPRESSING immune system
(2) higher risk of INFECTION

***May require antibiotic premed
Where do "airborne infections" start?
Wilkins - Ch 2, (p.26)

AIRBORNE INFECTIONS- start from infectious agents traveling in
(1) dust particles
(2) aerosols
What are examples of Dust-Borne organisms and do they reach the patients?
Wilkins - Ch 2, (p.26)

DUST-BORNE Organisms
(1) Clostridium tetani
(2) Staphylococcus aureus
(3) enteric bacteria

TRAVEL through DUST that:
(1) lands on instruments
(2) hands of DHCP
(3) Surfaces in dental office
What are "aerosols" ? What are the two types?
Wilkins - Ch 2, (p.26)

AEROSOLS -

are AIRBORNE PARTICLES w/contaminants that are occur in (1) SOLID (2) LIQUID form (3) are invisible (4) suspended in air long time

Classified by size
(1) aerosols <50 (smaller)
(2) spatter > 50 (larger)
Why are "aerosols" potentially dangerous?
Wilkins - Ch 2, (p.26)

AEROSOLS are dangerous b/c:

(1) they're SO SMALL we can breathe them DEEP into lungs
(2) remain airborne LONGER

THEY CONTAIN:
(1) resp. disease producing organisms
(2) traces of mercury or amalgam
Why is "spatter" potentially dangerous?
Wilkins - Ch 2, (p.26)

SPATTER is dangerous b/c:

(1) Drop or Spatter on obj. & people
When are "aerosols and spatter" produced?
Wilkins - Ch 2, (p.26)

AEROSOLS & SPATTER are created:
(1) breathing
(2) speaking
(3) coughing
(4) sneezing
(5) intraoral procedures
What dental equipment produces aerosols?
Wilkins - Ch 2, (p.26)

AEROSOLS- produced by equipment:
(1) air/water syringe tips
(2) handpieces
(3) ultrasonic scalers
What are some of the "microorganisms" found in the aerosols from ultrasonic scalers?
Wilkins - Ch 2, (p.27)

MICROORGANISMS (Ultrasonic scalers)

(1) Staphylococcus aureus
(2) albus
(3) pyogene
(4) Streptococcus viridans
(5) Lactobacilli
(6) actinomyces
(7) pneumococci
(8) diptheroids
***also VIRUSES
How do you PREVENT the transmission of "airborne infections"?
Wilkins - Ch 2, (p.27)

PREVENTION (Airborne infections)

(1) ELIMINATION / LIMITATION
ex: brushing & flossing; mouthrinses

(2) INTERRUPTION of Transmission
ex: rubber dam, HVE, manual scaling, vacuuming

(3) PROTECTION of susceptible recipient
ex: Clean water, running water lines, PPE for DHCP; eyewear for pt
How long must water lines be run (a) at the start of the day and (b) between each patient?
Wilkins - Ch 2, (p.27)

WATER LINES must be run
(1) Start of day = 2 min.
(2) After each pt = 20-30 sec.
What are some of the "pathogens" that are transmissible by the oral cavity?
Wilkins - Ch 2, (p.27)

PATHOGENS (Trans. by Oral Cavity)
(1) Tuberculosis
(2) Viral Hepatitis
(3) AIDS
(4) Herpetic Infections
What is "etiology" and "etiologic agents" ?
Wilkins - Ch 2, (p.27)

ETIOLOGY - the study of the CAUSE of diseases/disorders

ETIOLOGIC AGENT - disease causing
If a certain "pathogen" is present in the mouth--will it automatically show signs & symptoms?
Wilkins - Ch 2, (p.27)

NO !!!!!!!!!!!!!!!!!!!!
Sometimes pathogens are dormant
What is the "infectious agent" in Tuberculosis?
Wilkins - Ch 2, (p.27)

INFECTIOUS AGENT (TB) = Mycobacterium tuberculosis
What is "Tuberculosis"?
Wilkins - Ch 2, (p.27)

TUBERCULOSIS is
(1) a serious disease
(2) common communicable disease
(3) AIDS-defining illness--b/c it's often found in HIV+ people
How is "Tuberculosis" Transmitted?
Wilkins - Ch 2, (p.30)

TRANSMISSION of TB:
(1) Inhalation of DROPLETS
(2) Sputum
(3) Saliva
Are "Standard Precautions" enough to protect the DHCP from TB?
Wilkins - Ch 2, (p.30)

STANDARD PRECAUTIONS are NOT ENOUGH to protect the DHCP

REASON--Droplet Nuclei:
(1) are SMALL enough to pass though >95% of surgical masks
(2) remain suspended in air for HOURS
What are "factors" that AFFECT the transmission of TB?
Wilkins - Ch 2, (p.30)

FACTORS affecting transmission (TB)
(1) AMOUNT of droplets produced by TB infected person
(2) AMOUNT & DURATION of exposure
(3) SUSCEPTIBILITY of recipient
When is the "communicable period" of TB and when is it MOST "communicable"?
Wilkins - Ch 2, (p.30)

COMMUNICABLE PERIOD (TB)
(1) As long as viable BACILLI are discharged in sputum

MOST Communicable
(1) Just BEFORE the disease is diagnosed !!!!
What are other ways that TB can be "transmitted" besides inhalation and what other parts of the body can it affect besides the lungs?
Wilkins - Ch 2, (p.30)

TUBERCLE BACILLI can enter by:
(1) Ingestion
(2) direct inoculation

OTHER AFFECTED AREAS
(1) lymph nodes
(2) meninges
(3) kidneys
(4) bone
(5) skin
(6) oral cavity
What are "predisposing factors" for TB?
Wilkins - Ch 2, (p.30)

PREDISPOSING FACTORS (TB)
(1) Suppressed immune system
(2) Systemic conditions
What is the "incubation period" for TB?
Wilkins - Ch 2, (p.30)

INCUBATION PERIOD (TB)
(1) as long as 10 weeks
What are "early symptoms"of TB?
Wilkins - Ch 2, (p.30)

EARLY SYMPTOMS (TB)
(1) low-grade fever
(2) loss of appetite
(3) weight loss
(4) fatigue
(5) SLIGHT COUGH
(6) SPUTUM
What are "late symptoms" of TB? And how is TB tested for?
Wilkins - Ch 2, (p.30)

LATE SYMPTOMS (TB)
(1) spikes in temp. (ex: night sweats)
(2) weakness
(3) PERSISTENT COUGH

DIAGNOSED by:
(1) chest X-ray
(2) TB testing
How is TB "reactivated" ?
Wilkins - Ch 2, (p.30)

REACTIVATION (TB)

(1) Remains INACTIVE, then reoccurs
(2) INCOMPLETE treatment of primary infection
(3) Suppressed immune system
(4) LATENT TB infection--shows up years later
What is "multidrug-resistant TB" ? And how does TB become drug resistant?
Wilkins - Ch 2, (p.31)

MULTIDRUG RESISTANT TB-resists:
(1) isoniazid
(2) rifampin
(3) requires use of SECOND LINE drugs for treatment

BECOMES RESISTANT to DRUGS:
(1) Pt not taking meds as prescribed
(2) Meds NOT properly prescribed
How can "multidrug resistant TB" be PREVENTED?
Wilkins - Ch 2, (p.31)

PREVENTION OF MULTIDRUG RESISTANT TB
(1) EARLY diagnosis
(2) DOT- directly observed therapy
(3) LOCATE & treat persons w/ latent TB
What are some of the medications TB infected persons take?
Wilkins - Ch 2, (p.31)

TB-MEDICATIONS:
(1) Isoniazid
(2) pyrazinamide
(3) rifampin
(4) ethambutol
What is XDR Tuberculosis? What is this condition often associated with?
Wilkins - Ch 2, (p.31)

XDR Tuberculosis = "Extensively Drug-Resistant TB"

Discovered to be ESPECIALLY SEVERE in HIV+ patients
What does the CDC recommend for "clinically managing" TB?
Wilkins - Ch 2, (p.31)

CLINICALLY MANAGING (TB)
(1) Periodic ASSESSMENT
(2) Reviewing MEDICAL HISTORY
(3) REFERRING suspected pt w/TB for med.eval
(4) DEFERRING elective treatment who may have TB
(5) URGENT DENTAL CARE done in hospitals
(6) DHCP---getting med. eval.
(7) SEPARATING TB pts /suspected TB pts.
What if your pt has had a history of TB?
Wilkins - Ch 2, (p.31)

HISTORY OF TB:
(1) Consult w/physician for current status and clearance
If your pt was being treated for TB--how soon can you treat them?
Wilkins - Ch 2, (p.31)

PT UNDERGOING TB TREATMENT
(1) After several weeks on meds
(2) With physician clearance
What if your pt has a positive TB skin test?
Wilkins - Ch 2, (p.31)

POSITIVE TB SKIN TEST PT
(1) consult physician to determine ABSENCE OF DISEASE
(2) Pt may be placed on Isoniazid for 6 -12 month to prevent clinical disease
What if you recognize signs and symptoms of TB in your pt?
Wilkins - Ch 2, (p.31)

DO NOT TREAT PT!!!!

Refer to physician
(1) dry, unexplained cough
(2) chest pain
(3) fatigue fever
(4) dyspnea
(5) weight loss
What is "lymphodenopathy" ?
Wilkins - Ch 2, (p.32)

LYMPHODENOPATHY-

enlargement of regional lymph nodes
Tuberculosis is primarily a lesion of the lungs--but how else can it show up in an EO/IO exam?
Wilkins - Ch 2, (p.32)

TB EXPRESSIONS IN EO/IO EXAMS
(1) enlarged lymph nodes
(2) oral lesions (ulcers) on soft, hard palate, tongue
Aside from medication, what other treatment helps reduce TB?
Wilkins - Ch 2, (p.32)

TB INFECTED PTS RECEIVE
(1) Chemotherapy--to reduce contagiousness
What is "hepatitis" ? How many are there? List them.
Wilkins - Ch 2, (p.32)

HEPATITIS -
means inflammation of the liver

TYPES ********NO "F"
(1) Hepatitis A
(2) Hepatitis B
(3) Hepatitis C
(4) Hepatitis D
(5) Hepatitis E
(6) Hepatitis G
Contents of Titus Chapter 3
1. living the gospel before / toward all people (3:1-2)
2. the gospel transforms... "we ourselves were once foolish..." (3:3-8)
3. Avoiding foolish controversies, genealogies etc and people who continue in them when warned (3:9-11)
4. Personal instructions and Final Greetings (3:12-15)
How is "hepatitis A" TRANSMITTED? Give examples
Wilkins - Ch 2, (p.32)

TRANSMISSION OF HEPATITIS A:
(1) fecal-oral route
ex: unwashed hands

(2) waterborne and food-borne
ex: contaminated water/food

(3) Blood
ex: blood transfusion---but rare***
What is the "incubation period" for HEPATITIS A?
Wilkins - Ch 2, (p.32)

INCUBATION PERIOD (HEP. A):

(1) 15-50 days
What is the "communicable period" for HEPATITIS A?
Wilkins - Ch 2, (p.32)

COMMUNICABLE PERIOD (HEP.A):

(1) 2-3 weeks BEFORE the onset of jaundice
What are "signs and symptoms" of HEPATITIS A?
Wilkins - Ch 2, (p.32)

SIGNS & SYMPTOMS (HEP. A)
(1) jaundice


preicteric = BEFORE jaundice appears

icteric = while jaundice is present
How does one ACQUIRE IMMUNITY to HEPATITIS A? Is there a vaccine?
Wilkins - Ch 2, (p.32)

IMMUNITY
(1) immunity occurs after 2nd exposure
(2) Vaccine is available
How is the spread of HEPATITIS A prevented?
Wilkins - Ch 2, (p.32-34)

HEPATITIS A PREVENTION:
(1) sanitation
(2) personal hygiene-hand washing
(3) cooking food above 185 degrees
Who is at "risk" for contracting HEPATITIS A?
Wilkins - Ch 2, (p.34)

AT RISK FOR HEPATITIS A

(1) Travelers
(2) Men who have sex with men (anal sex)
(3) Drug users (injecting & non)
(4) People w/clotting disorders (blood)
(5) People w/chronic LIVER disease
(6) Children where Hep A is prevalent
What is Hepatitis B?
Wilkins - Ch 2, (p.34)

HEPATITIS B VIRUS (HBV)
aka "Serum hepatitis"

(1) Most SERIOUS occupational hazard for HCP
(2) occurs in any age
How does HEPATITIS B differ from hepatitis A?
Wilkins - Ch 2, (p.34)

HEPATITIS B DIFFERS FROM HEP A
(1) mode of transmission
(2) period of incubation
(3) onset
(4) existence of chronic carrier state
How is HEPATITIS B transmitted? Give some examples
Wilkins - Ch 2, (p.34)

TRANSMISSION OF HEP. B
by percutaneous + permucosal exposure

(1) Blood
ex: drug users sharing needles; accidental needle stick; blood transfusion
(2) Saliva + other bodily fluids
(3) Sexual contact
(4) Perinatal Transmission
ex: during pregnancy/after birth
Who is at "risk" for contracting HEPATITIS B?
Wilkins - Ch 2, (p.35)

(1) HCP
(2) Drug users
(3) Those who don't practice safe sex
(4) Pts w/chronic liver diseases
(5) Male prisoners
(6) Travelers/ Military abroad
(7) Infants of HIV+ mothers
What is the "incubation period" for HEPATITIS B?
Wilkins - Ch 2, (p.35)

INCUBATION PERIOD (HEP B.)
(1) 2-6months

***longer than HepA
What is the "communicable period" for HEPATITIS B?
Wilkins - Ch 2, (p.35)

COMMUNICABLE PERIOD (hEP B)
(1) before, during and after clinical signs

CARRIER STATE = indefinite
A "chronic carrier" of HBV is defined as?
Wilkins - Ch 2, (p.35)

CHRONIC CARRIER OF HEP B

= HBsAg marker in the blood serum for more than 6 months
How is "immunity" to Hep B defined? Is there a vaccine?
Wilkins - Ch 2, (p.35)

IMMUNITY OF HEP B

= presence of anti-HBs in serum

REASONING: b/c person has been previously exposed and is now
immune to reinfection)

VACCINE = available
How do you PREVENT the contraction of HEPATITIS B?
Wilkins - Ch 2, (p.36)

PREVENTION OF HEP B
(1) ELIMINATE trans. during Infancy/Childhood
(2) ENFORCE Blood Bank Control Measures
(3) ENFORCE sterilization
(4) USE of disposable Syringes/Needles
(5) Get vaccinations
What is the vaccination regimen for HEPATITIS B? And how long does it last?
Wilkins - Ch 2, (p.36)

PRE- & POST-EXPOSURE HEP B
(1) at onset
(2) 1 month
(3) 6 months

GIVEN: deltoid muscle of adults
LASTS: up to 15 years after successful immunization
When are Post-Prophylaxis for HEPATITIS B indicated?
Wilkins - Ch 2, (p.36)

POST-PROPHYLAXIS HEP B
(1) newborn of HBsAg positive mother
(2) significant exposure to HBsAg positive blood
What is the primary use of anti-HBs immune globulin (HBIG) ?
Wilkins - Ch 2, (p.37)

PRIMARY USE OF (HBIG)
(1) for postexposure prophylaxis
(2) it is HIGH-TITER vs IG that is "low-titer" , less effective
When is IG recommended as post prophylaxis?
Wilkins - Ch 2, (p.37)

IG reccomended for:
(1) Hep C
(2) Hep E
What is HEPATITIS C?
Wilkins - Ch 2, (p.37)

HEPATITIS C VIRUS (HCV)
aka "non-A, non-B"

(1) MOST CHRONIC BLOOD-BORNE infection in US
(2) freq. indication of for LIVER TRANSPLANT
(3) serologic tests have been dev. for blood donors
How is HEPATITIS C "transmitted" ?
Wilkins - Ch 2, (p.37)

TRANSMISSION OF HEP C
(1) percutaneous exposure
ex: contaminated needles, transfusion
(2) found in SALIVA
(3) SEXUAL transmission
(4) Perinatal exposure
What is the "disease process" of HEPATITIS C?
Wilkins - Ch 2, (p.37)

DISEASE PROCESS
(1) May not have clinical signs at onset
(2) 50-80% become chronic carriers
(3) 70% dev. serious liver disease
(4) may progress first 20 yrs w/o symptoms
Who is at "risk" for HEPATITIS C?
Wilkins - Ch 2, (p.37)

PEOPLE AT RISK (HEPATITIS C)
(1) 40 yrs or older
(2) MALES
(3) Mod.-heavy ALCOHOL intake
(4) HIV+ and those with HBV
What are the "risk factors" assoc. with HEPATITIS C?
Wilkins - Ch 2, (p.37)

RISK FACTORS FOR HEPATITIS C
(1) Blood transfusion (before 1991)
(2) injection drug use
(3) cocaine users
(4)tattooing, ear/body piercing
(5) perinatal transmission
(6) sexual transmission
(7) Hemodialysis
(8) Organ transplantation
How do you control and PREVENT transmission of HEPATITIS C?
Wilkins - Ch 2, (p.37)

PREVENTION OF HEPATITIS C
(1) follow measures rec. for Hep B
(2) behavior modification
(3) standard infection control procedures
Is there a vaccine for HEPATITIS C?
Wilkins - Ch 2, (p.37)

NO VACCINE FOR HEP C
What is HEPATITIS D?
Wilkins - Ch 2, (p.37)

DELTA HEPATITIS VIRUS or (HDV)
aka "Delta agent"

(1) can only cause infection in the PRESENCE OF HBV
How is HEPATITIS D "transmitted" ?
Wilkins - Ch 2, (p.37)

TRANSMISSION OF HEPATITIS D
(1) Co-infection with HBV
(2) Blood
ex: hemophiliacs , IV drug users
(3) Sexual contacts

***similar transmission as Hep B
(4) Perinatal
What is the "disease process" for HEPATITIS D?
Wilkins - Ch 2, (p.38)

DISEASE PROCESS-HEP D
(1) mortality rate is GREATER than Hep B
(2) onset= abrupt
(3) signs & symptoms resemble Hep B
(4) Coinfection/Superinfection w/ HBV
How do you PREVENT the "transmission" of HEPATITIS D?
Wilkins - Ch 2, (p.38)

PREVENTION -HEPATITIS D
(1) use measure to prevent Hep B
(2) Hep B vaccines
What is HEPATITIS E? Which other Hepatitis virus is it similar too?
Wilkins - Ch 2, (p.38)

HEPATITIS E VIRUS (HEV)
aka "enterically trans. non-A, non-B"

SIMILAR TO: ***Hepatitis A
How is HEPATITIS E "transmitted" ?
Wilkins - Ch 2, (p.38)

TRANSMISSION - HEPATITIS E:
(1) fecal-oral route
(2) contaminated water
What are "herpes virus" diseases?
Wilkins - Ch 2, (p.38)

HERPES VIRUS
(1) are HIGHLY infectious
(2) many exist---8 infect humans
How many "herpetic viruses" affect humans and what are they?
Wilkins - Ch 2, (p.38)

THERE ARE 8 HERPES VIRUSES
(1)HHV1=Herpes Simplex Virus Type 1
(2)HHV2=Herpes Simplex Virus Type 2
(3)HHV3=Varicella-Zoster Virus
(4)HHV4=Epstein-Barr Virus
(5)HHV5=Human Cytomegalovirus
(6)HHV6=Herpes Lymphotrophic virus
(7)HHV7=Human Herpes Virus 7
(8)HHV8=Kaposi's Sarcoma related virus
What are "general characteristics" of HERPES VIRUS?
Wilkins - Ch 2, (p.38)

CHARACTERISTICS-HERPES VIRUS
(1) latent-
ex: HSV1 latent in trigeminal ganglion
(2) malignant
ex: HSV2-cervical cancer/HSV1-oral
(3) recurrent- in immunosuppressed
(4) opportunistic org. in AIDS
How does HERPES related to periodontal infections?
Wilkins - Ch 2, (p.38)

HERPES & PERIO INFECTIONS
(1) herpes occurs in perio. pockets
(2) herpes suppresses immune system-perio pathogens fluorish
What is Herpes Simplex Virus Type 1? List infections it causes
Wilkins - Ch 2, (p.39)

Herpes Simplex Virus Type 1 (HSV1) (aka "oral herpes)

CAUSES THESE INFECTIONS:
(1) Herpetic gingivostomatitis
(2) Herpes labialis
(3) Herpetic Whitlow
(4) Herpetic conjunctivitis (ocular)
What is "prodome"
Wilkins - Ch 2, (p.40)

PRODROME
refers to burning, stinging sensation w/slight swelling that shows up as a FOREWARNING --before a local [herpes] lesion appears
What are "clinical characteristics" of HERPES LABIALIS?
Wilkins - Ch 2, (p.40)

CHARACTERISTIC- ORAL HERPES
(1) lesion ruptures
(2) crusting follows
(3) healing takes up to 10 days
(4) infectious w/ viral shedding
What is a HERPETIC WHITLOW?

How is it "transmitted" and "prevented"?
Wilkins - Ch 2, (p.40)

HERPETIC WHITLOW (HSV-1 or HSV-2)
(1) infection of the FINGERS
(2) virus enters around fingernails,or other cracks in skin

TRANSMITTED BY:
(1) contact w/lesion -pt's lip/saliva
(2) autoinfection-lip/nail biting

PREVENTED BY:
(1) wearing GLOVES!!!!!!!!!
What is OCULAR HERPES?

How is it "transmitted" and "prevented"?
Wilkins - Ch 2, (p.40)

OCULAR HERPES (HSV-1 or HSV-2)
lesions in the eyes

TRANSMITTED BY
(1) splashing of saliva/fluid to eye

PREVENTION:
(1) standard precautions
(2) use of PPE
(3) eyewear for pt
What is "Herpes Simplex Virus Type 2"?
Wilkins -Ch 2, (p.40)

Herpes Simplex Virus Type 2 (HSV2)
aka "genital herpes" although lesions can occur orally

LATENCY of VIRUS can NEVER be eradicated
What do you "clinically manage" a pt who has HSV2?
Wilkins -Ch 2, (p.40)

CLINICAL MANAGEMENT OF HSV2
(1) Postpone tx for active lesions!!!
(2) For future-pt is advised to call ahead to resched. when lesion is dev.
(3) Pt is prescribed Acyclovir (antiviral drug)
What is "VARICELLA-ZOSTER VIRUS"?

What infections does it cause?
Wilkins -Ch 2, (p.41)

HHV3- VARICELLA-ZOSTER VIRUS (VZV)

INFECTIONS:
(1) Chicken pox - (varicella)
Ex: often occurs in childhood; rash over entire body, scabs

(2) Shingles - (herpes zoster)
Ex: intraoral lesions may occur
What is EPSTEIN -BARR VIRUS?

How is it "transmitted" and what infections does it cause?
Wilkins -Ch 2, (p.41)

HHV4=EPSTEIN -BARR VIRUS (EBV)

TRANSMISSION: Saliva

INFECTIONS IT CAUSES:
(1) Infectious Mononucleosis
Ex:afflicts adolescents/young adults

(2) Hairy Leukoplakia
Ex: White linear lesions along border of tongue; assoc w/AIDS

(3) Endodontic Periapical Pathosis
Ex; Apical pain

(4) Periodontal disease severity
What is CYTOMEGALOVIRUS ?

How is it "transmitted and what infections does it cause?
Wilkins -Ch 2, (p.41)

HHV5=CYTOMEGALOVIRUS (HCMV)
most severe in infants infected in utero

TRANS. urine, saliva, genital secretions

INFECTIONS IT CAUSES:
(1) Periapical pathosis
(2) Periodontal disease w/EBV, HSV
****serious complication for AIDS pt
What is HERPES LYMPHOTROPHIC VIRUS?

What infections does it cause?
Wilkins -Ch 2, (p.42)

HHV6=HERPES LYMPHOTROPHIC VIRUS (HLV)

INFECTIONS IT CAUSES
(1) immune system suppression
Ex: depletes CD4 lymphocytes
(2) in HIV-periodontitis w/EBV