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74 Cards in this Set

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Acute diahrrea illness caused by infection of the intestine by Vibrio Cholare?
cholera
How is cholera transmitted?
person drinking water or eating contamnited food..feces on infected person
Metods of control of cholera
active immuination oral vacines provide high levels protecion for motnths
Isolation with enteric precautions of severly-ill patients, handwashing/fly control concurrent disinfection of feces and vomitus of linens and articles used by patients
Infection disease of animals humans caused by bacterium name Yeresihra pestis?
Plague/Bubonic
How is Plague/bubonic plague transmitted?
People usually get plague form being bitten by a rodent flea is carrying the plague bacterium or by handling an infected animal
What is the treatment for plague?
modern antibiotiscs
Clinical forms of Bubonic
Lymphadentits develops in lymph nodes receiving drainage from the site of the flew bite, where there may be intial lesion
Fever is usually presetn
Methods of control for palgue?
basic objective to reduce likelhood of people being bitten by fleas, having contact with infective tissues or exudates.
Specific methods include for plague?
Educaiton
Rat-proofing buildings and ships
storage and disposal of food and gargage
patient isloation and concurrent disinfecitno
Clothing repellants
Viral disease transmitted btw humans by a mosiquito?
Yellow fever..rare caused of illnes in travlers
Methods of control of yellow fever?
Immunzation (including contacts) every 10yrs
Case report univerasally requried by the WHO, MER
Isolation
Blood and body fluid preautions
Clothing, bednets, repellents
Methods of control for Smallpox?
based imms. with vaccinia virus
What instruction outlines quaratine regulations of the Armed forces?
SECNAVINST 6210.2A Joint service instruction with ARmy and Air force
Bumednote 6210 has replaced BUMEDINST 6250.13, Procurement of Derattling/Deratting exemption Cert. They are now referred to as what?
Shipd Sanitiation Control Certificates.
Current Shipborad Sanitation Control Certificate is requried for?
MRE
Entering foreing ports
How long is the certificate good for?
6months, but may be extended once for one month by the original issure
Time span the CO must notify higher authoriets of quarantine conditions aboard thier vessels prior to arrival in US ports, CO will give how long of a notice prior to entern the port?
12-72 hrs
What is the refernece number for the TB control programs?
BUMEDINST 6224. 8A
What is the reference number for Medical Event report?
BUMEDINST 6220.12B
What is the purpose of TB control program?
Provides policy and guidance for controlling TB among department of the Navy military personnel and military sealift Command civilian mariners
What is the approved material for Tuberculin skin test?
premixed tween-80 stabilized intermediate strength 5tu
Disposable 1ml tb syrings
Graudated in 0.1ml intervals and fitted with 25 gauge 5/8 inch needle
Disease produced by infection with Mycobaterium Tuberculosis?
TB
Patient is symptomatic, and/or exhibits laboratory/radiographic evidence or infection?
Active disease
Patient is asymptomatic, but exhibts a positive PPD?
Tuberculosis Infection
What is the Mantoux method?
Tuberculin skin test using a syringe and needle to inject PPD of tuberculing
Area around the site of tuberculin injection that is raised and firm?
Induration
What is a Tuberculin reactor?
person with positibve TST when read 48-72 hours after adminstration
Person with negatibe TST when read 48-72 hours after administration ?
Non-reactor
What is the BCG vaccine?
BAcillus Calmette Guerin vaccines made from live-attenuated Mycobaterium and are used in some countries to prevent infection ot Mycobaterium tuberculosis
What is the prenvertive therapy for TB?
INH in oral daily dose of 5mg/kg (300mg max) for 9 months to accomlish 270 daily doses within 12 months
A documented TB skin tes must be done how long prior to serparation of AD?
6months
Where is the PPD skin test administarted in a patient?
Asepticaly perpare skin;
make an intradermal injection of .1ml of intermediate strength 5tu on the Volar aspect of the left forearm
How should a PPD test be documented?
after 48-72 hours, measure induartion in mm at its widest transerves diameter
Measure/record any induration
Where do you record the PPD skin test?
NAVMED 6230/4 or NAVMED 6230/5 with
date, TB type, dose, route, site results date read, reader name, and signature
What are some indications for preventiave therapy for INH?
TB reactore with induration 15mm is candidate
<15mm is candidate for therapy only if one of the criteria or BUMEDINST 6224.8a applies
BCG vaccine will give you what type of reading for PPD Test?
false postive PPD reading of less thatn <`0mm induration and wane iwthin 8 yers
When is the MER report due to NEPMU upon suspicion/confirmation of new TB diagnosis?
24 hours
Patients CO is information addressee
submit a second MER when active TB is either ruled in or out
Summeary annual report is from when to when?
1 Jan to Dec 31
How long is the report kept?
reatined for at least 3 years
When should the annual Summary Record be submitted by?
by 28 FEb of the following year to NEPMU
When should a patient recieve a chest x-ray?
new reactor to rule out active disease
Any time active disease is suspected
New and previous reactors who are contacts of potentially infectious case of active disease
When is CXR not indicated?
old reactore as part of annual evalution if asymptomatic
TB- non-reactors
What is the only method to administering Purified Protein Derivative?
Mantoux
What is the affect of INH on the liver?
could incease the liver enzymes (SGOT/SGPT) blood levels
When would you considering withholding INH therpay?
if patient's transaminase levels exceed 3-5 times the upper limit of normal
An outbreak or suspected outbreak situations is reported by what type of message?
Priority
What is the perferred method of submission of MER?
NDRSi Naval Disease REporting System, internet
The MER for routine report must be submitted to whom and by when?
NEPMU and by the end of the month
What is the main goals (purposes) of Medical Event Report?
a. timely and adequate public health response
b. Estimation (statistical means) of distrubution, trends and risks
c. Development and assessment of policy an resource allocation for the control of medical events
The MER is assigned the report control symbol?
MED 6220-3
What are the responsibilities of the Navy and Marine Corps Public Health Center?
1. perform global surveillance and montioring of resportable medical events
2. Tabulates and analyzes MERs to examine Navy and Marine Corps trends and demographic data
Maintain NDRSi
4. Send data to defense medical survillance system or higher authorit
What is sent whe a medical evetn may attract high level navy interest or affect operational readiness?
OPREP Navy blue message OPNAV -3
OPNAVINST 3100.6 series
What instruction governs the immunization and chemoprohylaxis program?
BUMEDINST 6230.15 SERIES
WHAT supersed the BUMEDINST 6230.15 series?
NAVMEDCOMINST 6230.3
Where are the imms documented?
navmed 6230-4 adult HREC imms
PHS 731 international cert of vacc
Who determines types of health care personnel and their levels of certifaction in CPR and life support?
Type commander
All imms may be given at sea or ashore at the discretion of teh MDR with the concurrence of the CO, except?
yellow fever
When can yellow fever be given?
onIDC ships only be conducted in port during normal working hours after prior notification and concurrence of local RSG/Group MO unless MO is present
What imms if hypersensitive to eggs you do not administer?
influzea
yellow fever
Mealses /mumps (anaphylactic reaction only)
What is the storage temp for Anthrax?
36-46F
Do not freeze
Once open, use until expired
Storage for Yellow fever?
btw 32-41 F (0-5C)
multidose vial or reconsituted vacine must be discaded after 1 hour of reconstition
Storage for Adenovirus Vaccine Tablest?
Store 35.6-46.4 (2-8C)
Storage for MMR?
btw 35.6-46.4 (2-8 celsius)
Can withstand temp below 32F or 0C
Store in dark place
dis
Who all require PPD testing?
All personnel entering AD
all individuals beginning employment as CIVMAR for MSC
How often is PPD tested?
annual screeing during PHA
All AD and REserve
CIVMARS
Individuals deemed to be at risk of TB
What are the elements of Tb control program?
TB screeing
Prevention of Active disease
Mangament of ACtive disease
TB contact investiongation
What is the Prevention of ACtive disease?
Medical evaluation
Chemoprophylaxis
Medical departments providing inpatient/outpatient services must submit a MER for the following incidences?
Reportable condition is suspected or confirmed
Notified of a communicable disease outbreak or injury
Ships or aircraft quarantined in international travel
Suspected or confirmed outbreak or nosocimal infections occur from a single source of morbidity or mortality
Condition is unusual in presentation, clinical course, or outbreak potential
Record results on forms?
NAVMED 6230/4 or NAVMED 6230/5
What is the procedure for NON-compliate or extended doses?
Treatment has been interrupted for more than two months, pt must examined to exclude active TB dz
-do not restart the 9mtn daily INH regimen if least 270 doeses of INH can be admin in 12 months
What is the other alternative to dosing a pt instead the daily dose of 300mg?
INH can be given twice weekly 15mg/kg body weight up to 900mg
Using the direct observation therpay more managable
What is the recommended dosing of ANthrax?
5 shots 18months
.5 ml IM
0,4,6months, 12mnths, 18 mnths, yearly booser
Dosing of JEV?
Admin to pesonnel going into endemic area
3 shots of 1.0ml on 0,7, 30
Must complete 10days prior of enter endemic area
Dosage of Plague?
only required personnel deploying to endemic area
3 doses 1.0ml .2 ml 1mtnh later and .2ml btw 3-6months after the second dose
IM