MICROBIO quiz for final exam

Question

Hand hygiene promotion and flu clinics are examples of which kind of prevention undertaken by a public health nurse?

Answer 1

Primary prevention

Answer 2

Secondary prevention

Answer 3

Tertiary prevention

Answer 4

Community-based prevention

Answer 5

Primary prevention

Answer 6

Secondary prevention

Answer 7

Tertiary prevention

Answer 8

Restoration and rehabilitation, preventing complications from illnesses

Answer 9

Early detection and treatment of illnesses

Answer 10

Preventing infections from happening

Answer 11

Identifying different pathogens common in community settings

Answer 12

Protect the health of the community at large and give the Medical Officer of Health the power to act in public health emergencies

Answer 13

Detail which neighbourhoods of a municipality should be treated by which facility

Answer 14

Prevent the Medical Officer of Health from impeding efforts undertaken by frontline workers in emergencies related to infectious diseases

Answer 15

Deer mouse are the reservoir

Answer 16

Bats are the reservoir

Answer 17

It can be spread via person-to-person transmission

Answer 18

The average incubation period is 14-30 days (can be 3-60 days)

Answer 19

The key messages in public education include ventilating the area for 30 minutes before cleaning

Answer 20

Hantavirus

Answer 21

Shigellosis

Answer 22

Hantavirus

Answer 23

Shigellosis

Answer 24

Hantavirus

Answer 25

Staph aureus

Answer 26

You are most contagious 2 days before onset of symptoms until 5 days after

Answer 27

The incubation period is 2-5 days

Answer 28

The classic presentation of symptoms (parotiditis - unilateral or bilateral) are present in 2/3 of cases.

Answer 29

Meningitis, oophoritis, orchitis are complications that can occur with measles, not mumps

Answer 30

Shigellosis

Answer 31

smear positive sputum

Answer 32

short exposure time (very easily transmitted)

Answer 33

severity of cough

Answer 34

overcrowded housing and poor ventilation

Answer 35

delays in diagnosis

Answer 36

dry cough lasting more than 2-3 weeks

Answer 37

fever or chills

Answer 38

night sweats

Answer 39

hemoptysis

Answer 40

local symptoms (e.g. bone pain, swollen lymph nodes, dysuria)

Answer 41

It helps prevent the development of drug resistant strains of TB

Answer 42

It is a pain in the ass for the patient

Answer 43

It helps patients feel that nurses really care about them

Answer 44

It makes sure that there is emotional follow up

Answer 45

A TB skin test is a diagnostic test that involves an intradermal injection that is read within 48-72 hours of administration.

Answer 46

The size of a TB skin test induration plus the clinical picture helps determine whether a client needs a chest xray and sputum collection or not.

Answer 47

An induration following a TB skin test does not mean that someone has active TB disease. It only means they've been exposed at some point.

Answer 48

If a close contact of an active TB case has an initial TB skin test that is 0 mm, and a repeat test in 3 months is 20 mm, this is highly suggestive that the contact has developed active TB.

Answer 49

Epidemiology

Answer 50

Microbiology

Answer 51

Mycobacteriology

Answer 52

nosocomial

Answer 53

infectious

Answer 54

Nosocomial

Answer 55

an endemic disease

Answer 56

an epidemic

Answer 57

a pandemic

Answer 58

a nosocomial infection

Answer 59

incidence of HIV

Answer 60

prevalence of HIV

Answer 61

infectious nature of HIV

Answer 62

poor public health campaigns

Answer 63

contact transmission

Answer 64

vehicle transmission

Answer 65

vector transmission

Answer 66

traditional transmission

Answer 67

contact transmission

Answer 68

vehicle transmission

Answer 69

vector transmission

Answer 70

atypical transmission

Answer 71

contact transmission

Answer 72

vector transmission

Answer 73

vehicle transmission

Answer 74

bad healthcare

Answer 75

A non-living object on which microbes live that can harm human health

Answer 76

A device used to sterilize stationary objects in the OR

Answer 77

An instrument used on oncology floors that are a major source of HAIs

Answer 78

A type of infectious vector

Answer 79

patient in ICU or requiring extensive hands-on care

Answer 80

patient that has had invasive procedures or devices

Answer 81

patient with non-intact skin

Answer 82

debilitated patient with severe underlying disease

Answer 83

middle aged patients

Answer 84

patients who have recently had antibiotics

Answer 85

patients who are immunosuppressed

Answer 86

patients who have not been appropriately immunized

Answer 87

patients being cared for by inadequately trained staff

Answer 88

remove gloves; remove goggles or face shield; remove gown; remove mask or respirator

Answer 89

remove mask or respirator; remove goggles or face shield; remove gown, remove gloves

Answer 90

remove gloves; remove gown; remove goggles or face shield; remove mask or respirator

Answer 91

remove goggles or face shield; remove gloves; remove gown; remove mask

Answer 92

they are all common hospital acquired infections

Answer 93

none of them can be prevented

Answer 94

they are all very difficult to define

Answer 95

they are types of infections that occur in the community setting

Answer 96

using full-barrier precautions during central venous catheter insertion (e.g. surgical attire)

Answer 97

having the patient wear a mask during catheter insertion

Answer 98

using alcohol to prep skin

Answer 99

keeping in CVCs as long as possible

Answer 100

eosinophils

Answer 101

neutrophils

Answer 102

Neutrophils and monocytes

Answer 103

Neutrophils and eosinophils

Answer 104

Natural killer cells and lymphocytes

Answer 105

Neutrophils and monocytes (phagocytes) don't recognize specific bacteria - they only recognize anything that is "not self"

Answer 106

Eosinophils release histamine and are responsible for fighting helminths

Answer 107

Basophils contain histamine and are called mast cells when inside tissues

Answer 108

Macrophages are called monocytes when they are present in tissues

Answer 109

Lymphocytes and monocytes are granulocytes

Answer 110

Natural Killer cells are the first line of defence against viruses

Answer 111

Dendritic cells are responsible for forming immune tolerance against good bacteria in the gut

Answer 112

Eosinophils are called mast cells when in tissues

Answer 113

Some bacteria resist digestion, such as M. tuberculosis

Answer 114

Some bacteria produce toxins that cause phagocytes to self-digest, such as staphylococci and streptococci

Answer 115

Some bacteria are "slippery" (especially CAPSULES) and don't attach easily to the neutrophil or monocyte (aka macrophages in tissues)

Answer 116

Monocytes and neutrophils are phagocytic and can recognize specific bacteria

Answer 117

Redness, heat, and swelling occur mainly because basophils/mast cells release histamine, which causes capillaries to dilate and become more permeable

Answer 118

Redness, heat, and swelling occur mainly because macrophages/monocytes release histamine, which causes capillaries to dilate and become more permable

Answer 119

Damaged cells release cytokines, which triggers leukocytosis and chemotaxis (aka calls other cells to come help)

Answer 120

Patients with severe heart disease

Answer 121

Patients with fluid and electrolyte imbalances

Answer 122

Patients with a history of febrile convulsions (especially infants)

Answer 123

Patients in the ICU with a neurological injury

Answer 124

Patients who have an infection

Answer 125

They prompt surrounding cells to produce anti-viral proteins to block viral replication

Answer 126

They initiate phagocytosis

Answer 127

They release histamines

Answer 128

They initiate the complement cascade

Answer 129

Antibodies

Answer 130

artificial

Answer 131

artificial

Answer 132

Humoral immunity involves B lymphocytes forming antibodies

Answer 133

Cell-mediated immunity involves T lymphocytes killing cells directly

Answer 134

Cell-mediated immunity is active against agents inside cells

Answer 135

Humoral immunity is active against substances inside cells

Answer 136

B cells, along with macrophages and dendritic cells, can present antigens (thus becoming "antigen presenting cells")

Answer 137

Antigen presenting cells activate T helper cells, which secrete cytokines

Answer 138

The production of cytokines by T helper cells are necessary to begin the process of memory B cell production

Answer 139

Antigen presenting cells activate macrophages, which engulf viruses and kill them directly

Answer 140

IgG crosses the placenta and is the most abundant (80%) antibody in serum

Answer 141

IgA makes up about 10% of the antibodies in a serum sample and is found mostly in tears, saliva, colostrum, and mucous

Answer 142

IgM makes up about 5-10% of serum antibodies and indicates a RECENT infection because it is the first antibody in an encounter with a new antigen

Answer 143

IgE is about less than 0.005% of serum antibodies and is mostly related to allergy symptoms or helminth infection

Answer 144

IgD is elevated in some cancers

Answer 145

Due to the elevated IgM, we can say that this infection is very likely an OLD infection

Answer 146

We can let his fever run, unless he has contraindications, such as a pre-existing heart condiiton

Answer 147

We should be worried about him either having or developing ventilator associated pneumonia, as this is one of the most common and concerning hospital acquired infections

Answer 148

If he does not already have a ventilator associated pneumonia, we should be using a dilated alcohol solution to perform regular oral care

Answer 149

A worm infection

Answer 150

A new infection

Answer 151

A bacterial infection in her GI tract

Answer 152

An autoimmune disorder

Answer 153

Neutralization

Answer 154

Opsonization

Answer 155

Presentation

Answer 156

Opsonization

Answer 157

Neutralization

Answer 158

Packaging of antigens

Answer 159

Cell lysis

Answer 160

Cell integration

Answer 161

Opsonization

Answer 162

T cells are like "divas" - they don't produce antibodies so they interact only with antigens *presented* directly to them

Answer 163

T cells are like "divas" - they only produce antibodies for very few kinds of viruses

Answer 164

T cells are made in the thymus and mature in bone marrow

Answer 165

The three main kinds of T cells are helper, cytotoxic, and complement

Answer 166

Our immune systems mature by age 2-3 years

Answer 167

T cells are at their nadir (lowest) in winter

Answer 168

After running a marathon, you are at 6x the risk for an upper respiratory infection

Answer 169

One missed night of sleep drops NK cells by less than 1%

Answer 170

T cell immunity decreases during pregnancy

Answer 171

Reverse transcriptase makes errors 1 in every 10,000 copies, which is why resistant strains develop so easily and why we usually combine multiple medications

Answer 172

Ontario's priority populations, according to the AIDS Bureau, include heterosexual men, Western European immigrants, and Aboriginal men and women

Answer 173

Someone's viral load does not significantly impact their chances of transmitting HIV to a sexual partner

Answer 174

Male circumcision increases the risk of HIV transmission

Answer 175

C-section reduces risk by about 60%

Answer 176

Initiating HIV treatment for mother prior to birth

Answer 177

Treating other STIs before birth

Answer 178

Vaginal delivery reduces risk of transmission

Answer 179

"If your ELISA (antibody) test results are negative, this might mean that you are in the first stage of HIV infection and your body hasn't produced antibodies yet."

Answer 180

"If your ELISA (antibody) test results are negative, you are in the clear. However, you might want to consider whether you want to modify some of your risk factors by taking your PrEP regularly, for example."

Answer 181

"If you are in the first stage of HIV infection, called "acute HIV syndrome," your ELISA test will be positive but your RNA/molecular test will be negative, so we would recommend you get retested in six months."

Answer 182

"You should always use a condom."

Answer 183

Acute HIV syndrome

Answer 184

Latent stage

Answer 185

Advanced HIV infection (AIDS)

Answer 186

Initial stage

Answer 187

"If you are not taking your drugs regularly, you might develop a drug resistant strain of HIV, which could really limit your treatment options in the future."

Answer 188

"It's ok to have regular periods of not taking your ART drugs."

Answer 189

"Taking some medication breaks can actually help your body heal."

Answer 190

You are much more likely to become infected with Hep B than HIV following a needle stick injury

Answer 191

Your risk of contracting HIV from a workplace incident is greatly impacted by the type of body fluid you are exposed to (e.g very low risk from urine or saliva)

Answer 192

There are a number of documented cases of nurses contracting HIV after a skin splash

Answer 193

Your risk of contracting HIV is increased by increased gauge of needle, hollow bore needles versus suture needles, and the viral load of the patient

Answer 194

"You need to go to the emergency department downstairs right away so you can get post exposure prophylactic treatment."

Answer 195

"It's been more than three days since your possible exposure so you might be told that it's too late to take post exposure prophylaxis."

Answer 196

"You're an idiot."

Answer 197

"We should pray."

Answer 198

General symptoms include urethral discharge, dysuria (especially if drinking alcohol), and deep pelvic pain, possibly radiating to the back (might mean involvement of other structures)

Answer 199

A wide range of symptom severity, often asymptomatic

Answer 200

Gonorrhea infections may lead to other clinical manifestations, such as arthritis, dermatitis, and endocarditis

Answer 201

Taking cultures is not necessary - might as well go to NAAT directly because it has better sensitivity to diagnose both gonorrhea and chlamydia

Answer 202

Secondary syphilis can have numerous manifestations, including fever, malaise, rashes on palms and soles of feet, alopecia, hepatitis, and meningitis

Answer 203

Primary syphilis usually presents with a painful chancre on genitals

Answer 204

Latent syphilis will very likely be asymptomatic

Answer 205

Tertiary syphilis can present with cardiovascular, neurologic, or gummatous symptoms. The incubation period for tertiary syphilis can be between 1-46 years.

Answer 206

"You may develop malaise and fever within hours of this first dose, which is called a Jarisch-Herxheimer reaction and is due to the immune response to killed treponemes, not the penicillin itself."

Answer 207

"You may develop malaise and fever within hours of this first dose, which is a sign that you are having a serious allergic reaction to penicillin. Take yourself to an emergency department and tell them you've been given an IM dose of penicillin."

Answer 208

"What did you do that ended up with you having syphilis?"

Answer 209

"Did you know you can die of syphilis?"

Answer 210

Take a thorough sexual history, as this is often enough to diagnose clinically

Answer 211

Swab the blister for culture

Answer 212

Tell the patient that they should be practicing safer sex

Answer 213

Inform the patient that they will need to contact all their sexual partners and tell them they might have herpes

Answer 214

"Some types of HPV are oncogenic, meaning they can increase your risk of developing cancer. Would you be interested in getting tested to see if you carry an oncogenic strain?"

Answer 215

"Yes, you will likely develop cervical cancer, so we should increase the frequency of your Pap smears to every six months."

Answer 216

"No, HPV does not have any connection to increased risk of developing cancer."

Answer 217

"Google it."

Answer 218

Yellow Fever and Meningococcus vaccines are usually "required" vaccines

Answer 219

"Recommended" vaccines include MMR, chicken pox, DPT, Polio, and Tetanus

Answer 220

N Meningitidis vaccine should be given not only to the traveller but also their family members because the vaccine does NOT prevent the person from being a carrier

Answer 221

Children handle Hep A well but adults do not

Answer 222

"Unfortunately, since you're past 7 days, there would be no benefit to you receiving Hep B Immune Globulin."

Answer 223

"We should test your blood right away to see if you've been infected and we should get you some Hep B Immune Globulin asap."

Answer 224

"Did you get vaccinated before you left?"

Answer 225

"If you are infected, there are a few treatment options, including immunotherapy (e.g. interferon) and antiretrovirals (same medications that were used to treat HIV)."

Answer 226

A child who was touching and feeding animals at the family farm in Eastern Europe

Answer 227

A young woman who had a minor scratch from a potentially rabid dog - the scratch did not bleed

Answer 228

An elderly man who was licked by a potentially rabid dog on broken skin

Answer 229

A young child who had multiple transdermal bites and scratches from a dog in Bangkok

Answer 230

Falciparum

Answer 231

Falciparum

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MICROBIO quiz for final exam

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