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CBIC Section 1
Identification of Infectious Disease Processes
| Question | Answer |
|---|---|
| Virulence | The ability to grow and multiply |
| Infectivity | The ability to enter tissue |
| Pathogenicity | The ability to cause disease |
| Duration of exposure | The length of time the person is exposed to organism |
| Size of inoculum | The number of organisms needed to cause disease. |
| Patient w/ the same airborne disease may share a room if there is no clinical contraindication. T or F | True |
| Cohorting of patients infected or colonized with a common organism by room or personnel assignments can reduce the risk of transmission of infectious agents to other noninfectious patients. | True |
| Increased HAI rates have been associated with the use of nonpermanent staff | True |
| The IP wants to calculate the surgeon-specific rate of infections associated with spinal fusion surgeries in the facility. Which one of the following data elements will he need? | Number of spinal fusion surgeries performed by each surgeon within the designated time frame Number of spinal fusion infections for each surgeon within the designated time frame. |
| Colonization | Occurs when microorganism inhabit a specific body site (such as the skin) but don't cause S/S. |
| What is the difference between signs and symptoms? | Signs: Quantitative data (temp, BP etc) Symptoms: Subjective(how a pt is feeling) |
| Infection | Clinical signs of illness or inflammation (i.e. localized pain/tenderness, redness, warmth, swelling, pus, fever) due to tissue damage caused by the microorganism's invasion |
| IgM | Early Immune recognition & response first reacting immunoglobulin |
| IgD | Functions in later immune responses |
| IgG | Late-occurring immunoglobulin in an immune response & is the longest lived. |
| IgE | Principle allergy-inducing immunoglobulin |
| IgA | Effective in preventing virus infections of the respiratory tract and intestinal mucosa |
| The most immediate postoperative surgical site infections, beginning in less than 24 hours from incision are caused by: a) Staphylococcus aureus b) Streptococcus pneumoniae c) Streptococcus pyogenes d) Escherichia coli | c) Streptococcus pyogenes |
| What bacterial factor/structure facilitates bacteria implanting on plastic devices? a) Cell wall b) Exotoxins c) Endotoxins d) Glycocalyx | d) Glycocalyx-also on skin |
| Which immune marker represents past exposure to disease? a) IgM b) IgE c) IgA d) IgG | IgG antibodies are the antibodies that provide long- term resistance to infections after immunizations. |
| 10 M is admitted w/ a 3-day hx of temp, abd pain, D/V. Just returned from a week camping expedition in the mountains that included trips to the seashore. A STC is reported w/ many lactose-negative colonies. What is the most probable causing organism? | Yersinia enterocolitica |
| The IP is reviewing the chart of a patient with a sputum culture positive for pathogens. Which of the following findings indicates that the specimen had been properly collected from a patient with a possible bacterial pneumonia? | Numerous neutrophils and few if any epithelial cells |
| A 14 M from rural Maryland was seen in the emergency room with fever, fatigue, chills, headache and a large annular lesion on his left thigh which the patient described as burning and itching. What is the most probable vector of this child’s illness? | Tick |
| What is the time frame it takes for the Erythema migrans to appear after being bitten by a tick? A. 1-7 Days B. 3-14 Days C. 3-30 Days D. 7-30 Days | C. 3-30 Days |
| True or False: The tick must be attached for 36 to 48 hours or more before the Lyme disease bacterium can be transmitted | True |
| A pt who is extremely immunocompromised. While reviewing the labs for this pt, you discover a sputum examination for AFB, which is smear +. The Dr is aware but states isolation is not necessary. What is a reason that the pt does not need isolation? | His regular sputum culture is growing Nocardia spp. |
| A 38-F being tx for CA has a WBC of 2.3. This is an improvement during the past 2 wks. Her Dr has been aggressive in tx every potential infection. Pt is on an ABX for a BSI from S. epidermidis. Now has a fever of 100.4. What action should be taken? | More blood cultures because she may be developing fungal septicemia |
| Which of the following virulent factors associated with the Enterobacteriaceae are associated with septic shock and DIC? A. Flagellar H antigens B. Capsule K antigens C. Pathogenic islands D. LPS-polysaccharides and Lipid A endotoxin | LPS-polysaccharides and Lipid A endotoxin |
| Some bacteria can transform into endospores | Bacillus anthracis • Clostridium tetani • Clostridium difficile • Clostridium perfringens • Clostridium botulinum |
| In a Gram stain procedure, Gram-positive bacteria stain purple because: | They have a thick peptidoglycan cell wall that retains the primary stain during the alcohol decolorization |
| You have isolated a bacterium from your skin. Chemical analysis shows that it contains proteins, peptidoglycan, lipids, DNA, and teichoic acid. What sort of bacteria is this? | Gram-positive |
| A microbe that can grow in the absence of oxygen but is also able to utilize oxygen for growth is a/an: A. Aerobe B. Obligate anaerobe C. Facultative anaerobe D. Microaerophilic anaerobe | C. Facultative anaerobe |
| Fastidious organisms require _____ media, and __________ media is used to inhibit normal commensals. 1. Differential 2. Enriched 3. Selective 4. Nutrient broth 5. Synthetic sheep blood agar A. 1,3 B. 2,3 C. 5,1 D. 3,4 | |
| Fastidious organisms require Enrichment media. Which media is used to inhibit normal commensals? A. Differential B. Enrichment C. Selective D. Synthetic sheep blood agar | |
| An example of a selective media that inhibits Gram-positive bacteria is: A. Sabouraud agar B. Chocolate agar C. Trypticase Soy agar D. MacConkey’s agar | |
| The Director of the Operating Room (OR) requests that the OR surfaces be routinely environmentally cultured. The IPs best response should be: | Routine culturing should not be considered unless an epidemiologic investigation is being conducted |
| Important considerations regarding BC specimens include: 1. Collect prior to the initiation of antimicrobial therapy 2. Collect from a central venous catheter whenever possible 3. Ensure that the volume of the specimen collected is sufficient 4. Cultu | |
| You receive a call from a man who thinks he was exposed to HIV. His baseline HIV test (ELISA) was negative. At what time period after exposure would we be most likely to detect HIV antibodies? A. 1 to 3 months B. 3 weeks C. 6 months D. 12 months | |
| A Dr orders a culture, O & P specimen on a 10 M admitted w/ diarrhea. A liquid stool specimen is collected from the patient at 9pm. The specimen is refrigerated until 9am the next day when the Dr calls and requests that the lab look for amoebic tropho | Perform a trichrome stain on the original specimen B. Request a fresh specimen C. Perform a concentration on the original stool specimen D. Perform a saline wet mount on the original specimen |
| Pts w/ cell-mediated immunity dysfunction are susceptible to infections attributed to pathogenic intracellular bacteria. is. I.e of these organisms include: 1. Salmonella typhi 2. Bacteroides fragilis 3. Listeria monocytogenes 4. Staphylococcus aureus | A. 3,4 B. 1,2 C. 1,3 D. 2,3 |
| An example of an obligate intracellular parasitic bacterium would be an organism responsible for: 1. Hepatitis 2. Q fever 3. Malaria 4. Chlamydia A. 2,3 B. 2,4 C. 3,4 D. 1,2 | |
| Which of the following specimens can remain at room temperature after collection if transport to the lab will be delayed? A. Sputum B. Urine C. Stool D. Cerebral spinal fluid | |
| Which factor is commonly associated with Clostridium difficile infections (CDIs)? | Prophylactic antibiotics or antibiotic to treat a primary bacterial infection |
| What is/are the highest risk antimicrobial(s) associated with causing CDI? Third-generation cephalosporins B. Fluoroquinolones C. Clindamycin and Vancomycin D. Metronidazole | Third-generation cephalosporins Third-generation cephalosporins have supplanted clindamycin as the highest risk antimicrobials associated with CDI |
| What class of antibiotics do cephalosporins belong to? A. Fluoroquinolones B. Beta-lactam drugs C. Macrolides D. Aminoglycosides | Fluoroquinolones |
| What is considered the “gold standard” for CDI diagnostic testing? A. Stool culture B. Cell Cytotoxic Assay C. Enzyme Immunoassay for Toxins A and B D. PCR | A. Stool culture |
| 50 percent of infants through about 1 year of age harbor the organism and its toxin without any gastrointestinal tract symptoms. T/F | True |
| 60 percent of hospitalized patients of all ages asymptomatically carry toxigenic and nontoxigenic strains of C. difficile in their stool | False |
| Which of the following treatments has been shown to significantly improve the prevention of recurrence of Clostridium difficile infection? A. Fecal transplants B. Subtotal colectomy C. Colon cleansing D. Antimicrobial therapy | |
| A pt was recently diagnosed with C. Diff of the colon. You are called to institute Contact Precautions & do all of the following EXCEPT: | D. The patient is moved to a negative pressure room to avoid airborne fomite exposure |
| The optimal time to collect a sputum specimen for an acid- fast bacilli (AFB) testing to rule out TB would be: A. First thing in the morning B. After respiratory treatment C. Prior to the patient going to bed D. Prior to a respiratory treatment | |
| When a patient with AIDS is admitted with possible pneumonia, the physician, who is a general practitioner, orders airborne isolation. What is the correct response? | A. A TST skin test should be placed to determine if patient may have TB B. A sputum specimen should be collected for AFB daily x 3, if TB is suspected D. PCP is not transmitted person-to-person and does not require isolation |
| Which of the following statements is false regarding influenza viruses? | B.Influenza A strains have been the predominant cause of worldwide epidemics (pandemics) C.Influenza A and B strains have been named according to the city, or state and year of their initial isolation |
| A pt w/ rust-colored sputum, malaise, weight loss & fatigue is admitted from a LTC. The Dr orders sputum for AFB smear & culture, fungal & bacterial cultures. A chest xray shows RUL infiltrates. The pt has a -PPD, & 1 sputum specimen is smear -. | |
| The validity of a culture report is dependent on the quality of the specimen sent. To determine if an expectorated specimen was sputum and not saliva, the Gram stain should show: | A.>10 epithelial cells per low-power field & abundant P. aeruginosa in pure culture B.> 10 epithelial cells per low-power field & mod to abundant polys C. Many WBCs and organisms on low-power field D. Fewer than 10 epithelial cells per low-power field |
| TRUE or FALSE: Enterobacteriaceae are Gram-positive organisms | False |
| Enterobacteriaceae are naturalinhabitants of A. Lung B. Urinary Tract C. Gastrointestinal tract D. Skin | C. Gastrointestinal tract |
| What is the single most important means to effectively reduce the transmission and horizontal spread of Enterobacteriaceae and other microorganisms in allhealthcare settings? | Hand Hygiene |
| Enterobacteriaceae are associated most often with which of the following HAI: 1. Pneumonias 2. Surgical site infections 3. Bacteremia 4. Urinary Tract Infections A. 1, 2 and 3 B. 1, 3, and 4 C. 3 and 4 D. 1,2,3 and 4 | |
| APACHE SCORE | Acute Physiology and Chronic Health Evaluation II Score |
| The most common organism associated with pneumonia in school aged children | Mycoplasma pneumoniae |
| Bacterial Meningitis 1) Opening Pressure 2) Glucose 3) Predominate inflammatory 4) WBC counts 5) Total protein 6) Staining | 1) Elevated 2) normal to decreased 3) Neutrophils 4) >1000 5) Elevated 6) gram +/- cocci or gram -rods |
| Viral Meningitis 1) Opening Pressure 2) Glucose 3) Predominate inflammatory 4) WBC counts 5) Total protein 6) Staining | 1) Normal 2) Normal 3) Lymphocyte 4) < 100 per m3 5) normal to elevated 6) Gram - |
| Fungi Meningitis 1) Opening Pressure 2) Glucose 3) Predominate inflammatory 4) WBC counts 5) Total protein 6) Staining | 1) Variable 2) low 3) Lymphocyte 4) variable 5) Elevated 6) India ink + |
| TB Meningitis 1) Opening Pressure 2) Glucose 3) Predominate inflammatory 4) WBC counts 5) Total protein 6) Staining | 1) Variable 2) low 3) Lymphocyte 4) variable 5) Elevated 6) AFB + |
| An example of pneumonia generally acquired from an environmental source is: | Legionella |
| When reviewing a gram stain you see gram negative bacilli which organism will this mostly likely represent? 1) E. Coli 2) S. aureus 3) Enterococcus faecium 4) Clostridim perfringens | 1) E. Coli |
| Wound swabs for culture should be obtained from which of the following: 1) skin surface adjacent to the wound 2) purulent material from the dressing 3) wound surface before cleaning 4) drainage after cleaning wound surface | 4) Drainage after cleaning wound surface |
| Environment that increases risk of TB | Overcrowded prisons |
| Administrative control | Screening of HCW at risk |
| Environmental control | Keeping infected pts isolated |
| Agent for TB | Mycobacterium tuberculosis |
| Engineering Control | Portable HEPA unit |
| At high risk for TB | Immunocompromised pts |
| Pathogenicity | Ability to cause disease |
| Invasive | Ability to enter & grow in host |
| Infectious Dose | Number of organisms needed for infection to occur |
| REservoir | The habitat where an infectious disease lives, multiplies & grows. |
| Influenza Virus | A causative agent of illness/disease |
| Droplet; direct/indirect contact | mode of transmission |
| Infected person | Reservior |
| Respiratory tract | portal of entry and/or exit |
| non-vaccinated people & those in high risk gropus | susceptible hosts |
| Wound Swabs for culture should be obtained how? | Drainage after cleaning wound surface |
| Normal Flora | Microbes that are normally present in a particular environment & are found in most people, most of the time. |
| Pathogen | an organism that is causing disease |
| Colonization | when a microbe is present but no disease |
| Contaminant | Microorganism is present due to poor handling or poor specimen acquisition. |
| Specificity | Test characteristic which is the true negative rate |
| Gram stain results are either | Positive or negative |
| Cocci or Bacilli are | Types of bacterial shapes |
| Colonization | Presence of organism doesn't necessarily indicate disease |
| Most common nucleic acid amplification test | PCR |
| Cerebral spinal fluid w/ a predominance of neutrophils, elevated protein, & decreased glucose is usually indicative of meningitis caused by which class of organism? | Bacterial |
| Many people carry this in their nares | MRSA |
| Heads the list of most common pathogens causing CLABSI | Coagulase negative Staph |
| Slime AKA | Bio film |
| MRSA strains that develop resistance to this are Super Bugs | Vancomycin |
| Rapidly becomes colonized by microorganisms embedded in bio film | IV catheters |
| GPC found in enteric tract but are the 3rd most common causes of BSI's | Enterococcus species |
| Can be the cause of antibiotic resistance in E. coli & Klebsiella | ESBL |
| Grows in shampoo in your shower & contaminants medication vials | Serratia |
| Normal flora in GI tract | E. Coli, Proteus, Enterobacter |
| Normal flora in the GI tract but most common cause of UTI’s | E. Coli |
| Acinetobacter | Organism which is resistant to many drugs |
| Scary cause of severe meningitis | Neisseria meningitides |
| genus containing species TB, kansaii & gordonae | Mycobacterium |
| does not jump nor fly | Head louse or bed bugs |
| Infectious particle w/ no DNA or RNA present | Prion |
| Mold associated w/ construction | Aspergillus |
| virus which remains dormant in nerve cells | Varicella |
| One way to detect scabies | skin scraping |
| When reviewing the gram stain of a person w/ a wound infection, the IP sees gram + organisms in clusters. Which organism would this most likely represent? | Staphylococcus |
| What precautions do we use with every patient | Standard Precautions |
| Which precautions require a special negative air pressure room? | Airborne Precautions |
| Disease transmitted by airborne particles should use what preactions? | Airborne |
| Disease transmitted by droplets should use what precations? | Droplet |
| Uncontained body fluids should use what precautions? | Contact |
| All pt's/residents should use what preacutions? | Standard |
| A gram + coccus resistant to methicillin | MRSA |
| Also known as CRE | Carbapenem resistant enterobactericae |
| Prudent use of antibiotics | Antibiotic Stewardship |
| Normally lives in the intestinal tract but is resistant to Vancomycin | VRE |
| Negative pressure room | Airborne infection isolation Room (ALL room) |
| Used to prevent inhalation of airborne disease | N95/PAPR |
| Tuberculin skin tests | TST |
| Infected with TB w/o any symptoms | Latent TB |
| By 2020 the % of HCWs expected to receive influenza vaccine | 90% |
| Precautions that are required to prevent transmission of influenza | Droplet precautions |
| Adults may be contagious for X days prior to flu symptoms | One day |
| Respiratory etiquette includes: | Cover your cough |
| How chickenpox is transmitted | Airborne & Contact |
| How Shingles is contracted | From reactivation of Herpes Zoster |
| Disseminated Shingles requires Contact & this precaution | Airborne |
| Localized shingles requires this precaution | Standard |
Created by:
JRWeidenaar
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