MICROBIO quiz for final exam

Primary prevention

Secondary prevention

Tertiary prevention

Community-based prevention

Primary prevention

Secondary prevention

Tertiary prevention

Detection

Restoration and rehabilitation, preventing complications from illnesses

Early detection and treatment of illnesses

Preventing infections from happening

Identifying different pathogens common in community settings

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

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

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

Rabies

Hantavirus

Mumps

TB

Shigellosis

Hantavirus

Measles

Mumps

Shigellosis

Hantavirus

Rabies

Staph aureus

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

The incubation period is 2-5 days

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

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

Measles

Mumps

Rubella

Shigellosis

It helps prevent the development of drug resistant strains of TB

It is a pain in the ass for the patient

It helps patients feel that nurses really care about them

It makes sure that there is emotional follow up

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

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.

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.

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.

endemic

pandemic

nosocomial

infectious

Endemic

Pandemic

Epidemic

Nosocomial

an endemic disease

an epidemic

a pandemic

a nosocomial infection

incidence of HIV

prevalence of HIV

infectious nature of HIV

poor public health campaigns

contact transmission

vehicle transmission

vector transmission

traditional transmission

contact transmission

vehicle transmission

vector transmission

atypical transmission

contact transmission

vector transmission

vehicle transmission

bad healthcare

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

A device used to sterilize stationary objects in the OR

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

A type of infectious vector

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

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

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

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

they are all common hospital acquired infections

none of them can be prevented

they are all very difficult to define

they are types of infections that occur in the community setting

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

having the patient wear a mask during catheter insertion

using alcohol to prep skin

keeping in CVCs as long as possible

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

Eosinophils release histamine and are responsible for fighting helminths

Basophils contain histamine and are called mast cells when inside tissues

Macrophages are called monocytes when they are present in tissues

Lymphocytes and monocytes are granulocytes

Natural Killer cells are the first line of defence against viruses

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

Eosinophils are called mast cells when in tissues

Some bacteria resist digestion, such as M. tuberculosis

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

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

Monocytes and neutrophils are phagocytic and can recognize specific bacteria

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

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

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

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

They initiate phagocytosis

They release histamines

They initiate the complement cascade

Humoral immunity involves B lymphocytes forming antibodies

Cell-mediated immunity involves T lymphocytes killing cells directly

Cell-mediated immunity is active against agents inside cells

Humoral immunity is active against substances inside cells

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

Antigen presenting cells activate T helper cells, which secrete cytokines

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

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

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

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

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

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

IgD is elevated in some cancers

A worm infection

A new infection

A bacterial infection in her GI tract

An autoimmune disorder

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

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

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

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

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

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

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

Male circumcision increases the risk of HIV transmission

"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."

"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."

"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."

"You should always use a condom."

Acute HIV syndrome

Latent stage

Advanced HIV infection (AIDS)

Initial stage

"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."

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

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

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

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)

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

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

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

"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."

"You're an idiot."

"We should pray."

gonorrhea

chlamydia

HIV

HPV

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

Primary syphilis usually presents with a painful chancre on genitals

Latent syphilis will very likely be asymptomatic

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

"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."

"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."

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

"Did you know you can die of syphilis?"

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

Swab the blister for culture

Tell the patient that they should be practicing safer sex

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

"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?"

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

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

"Google it."

Yellow Fever and Meningococcus vaccines are usually "required" vaccines

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

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

Children handle Hep A well but adults do not

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

"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."

"Did you get vaccinated before you left?"

"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)."

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

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

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

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