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INPA Level 4 Prep / 4006 Final Prep

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INPA Level 4 Prep / 4006 Final Prep

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@PROFDOCDIGITALLIBRARIES



INPA Level 4 Prep / 4006 Final Prep

1. What is colonization?: No S&S of illness
2. What is infection?: Organism gets past host defences, becomes pathogen,
causes disease
3. What is an epidemic?: Periodic occurrence of a disease affecting large # of
people.
4. What is the S in C&S?: Sensitivity
5. What is TB?: Tuberculosis - airborne, kills more adults, low income countries
6. What is the TB infectious agent?: Mycobacterium tuberculosis - acid fast
aerobic rod, slow growth incubation 2-12 weeks, sensitive to heat & UV. Can lay
dormant for years.
7. What are TB risk factors?: Exposure, immunosuppressed, substance abuse,
poor living conditions, limited access to health care, Hx of inadequate Tx.
8. What are TB symptoms?: Insidious, low grade fever, cough 3+ weeks /
nonproductive / mucopurulent / blood tinged, night sweats, weight loss, chest pain,
fatigue.

9. What is a normal Mantoux Tuberculin skin test?: Either no firm bump at
test site; or bump LESS THAN 5mm (0.2in).
This is a negative result.

10. What is an abnormal Mantoux Tuberculin skin test?: High risk - firm bump
5mm (0.2in)

Moderate risk - firm bump 10mm (0.4in)

Low risk - firm bump 15mm (0.6in)

These are positive results.
11. What are the Tx options for TB?: On meds for 6-12 months (compliance an
issue)

INH (Isoniazid)
Rifampin
Pyrazinamide (Vit B6)


,@PROFDOCDIGITALLIBRARIES




Streptomycin
Ethambutol

After 2-3 weeks AND 3 neg. sputum smears pt considered non-infectious but must
continue meds for remaining time.
12. What are protective measures for TB?: - N95
- Neg. pressure room, isolation
- Gowns/gloves if coughing (standard precautions)
13. What is MRSA?: Methicillin Resistant Staph Aureus

- Methicillin (same as Cloxacillin)

- 25% have nasal colonization of staph, some is MRSA

- Acquired by hospital stays or community

- Skin infections, pneumonia, and bloodstream infections (if MRSA gets past body
defenses)
14. What are MRSA risk factors?: - Elderly, sick, immunosuppressed
- Open wounds
- Tubes
- Receiving broad-spectrum Abx.
- ICU or burnt unit
- Injection drug users
- Crowded living conditions
15. How is MRSA transmitted?: Direct physical contact OR indirect by touching
contaminated objects (survives objects: days to months, hands: 3 hours)
16. What is the Tx for MRSA?: For infected pt - Vancomycin, Chlorhexidine soap,
Mupiricin ointment

For colonized pt - can be decontaminated "decolonized protocol"
17. What are protective measures for MRSA?: - Private room/cohorts - Gowns/
Gloves
- Mask if MRSA is in sputum



, @PROFDOCDIGITALLIBRARIES




- Dedicated equipment
- Hand hygiene
- Chlorhexidine
18. What is VRE?: Vancomycin Resistant Enterococci

- E.bacteria live in bowel- Resistant
to most Abx.
- Can live on skin, infected wound,
blood, and urine- Surfaces: weeks
19. Risk factors of VRE?: - Prev. treatment with Vancomycin
- Hospitalization
- Elderly, immunosuppressed
- Invasive procedures (surgery, foleys, central lines, open wounds)
20. Tx for VRE?: If colonized - no Tx. available

If infected - combo of Abx.
21. How is VRE transmitted?: Direct / indirect contact
22. What are protective measures for VRE?: - Private room
- May cohort with VRE but not with MRSA or a combination of MRSA & VRE-
Dedicated equipment
- Gown/gloves
- Hand hygiene
- Restrict from common areas
23. What is C.Diff?: Clostridium Difficile

- Spore forming bacteria, produces toxins, cause intestinal inflammation (can be
part of normal flora) - Surfaces: 9 months
- Passed by fecal oral route
24. What are the symptoms of C.Diff?: - Foul smelling watery diarrhea -
Fever
- Abdo pain
- High WBC
25. C.Diff Stoll Specimens?: - Sample must be watery - Toxin
degrades in 2 hrs at room temp - No tests for pt's with Tx.

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