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TSICP CBIC CIC Exam Prep (1)
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TSICP CBIC CIC Exam Prep (1)
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TSICP CBIC CIC Exam Prep□ Diagnostic test examples - ANS-▪ Laboratory specimen collection ▪ Imaging test ▪
Procedure or exam ▪ Physician diagnosis ▪ Initiation of treatment
14 day duration - ANS-no studies available to base on, but: discussed in great detail,
agrees with routine BSI treatment
Having concrete timeframe: potentially decreases subjectivity, and potentially increases
consistency
1985 Study of Efficacy of Nosocomial Infection Control (SENIC) - ANS-- One ICP
(infection control professional):250 beds
- An effective infection control physician
- Program reporting infection rates back to the surgeon and those clinically involved with
the infection
- An organized hospital-wide surveillance system
4 Methods: High-level disinfection - ANS-all microorganisms EXCEPT spores
4 Methods: Intermediate-level disinfection - ANS-destroys most virus and most fungi but
not spores
4 Methods: Low-level disinfection - ANS-destroys vegetative bacteria, some viruses and
fungi, but not spores or mycobacteria
4 Methods: Sterilization - ANS-all microorganisms and spores
Accrediting and Regulatory Agencies - ANS-Examples
-TJC, Det Norske Veritas (DNV), CMS, OSHA, State and local health authorities
Acid Fast Bacilli (AFB) - ANS--mycobacteria
-high lipid content in cell wall
-stain poorly with Gram stain
-stain using carbol fuschin
-resist decolorization with acid-alcohol
-all specimens get a direct stain
-sputum require decontamination and concentration procedure
-require different media and longer incubation periods for isolation and identification
,Adult learning - ANS-Response to current situations (adapting to new systems)
• Problem-centered
• Readiness to learn
• Prefer practical knowledge
• Retention with immediate application
• Attach greater value to personal experience
• Motivated by job needs (promotion)
Adverse Effects of Antibiotics on Normal Flora - ANS--Kill normal flora
-Select resistant mutants
Agent Specific Information - ANS--Most agents of bioterrorism are not transmitted
person to person (except smallpox and pneumonic plague)
-Use standard precautions with all agents plus specific additional precautions
airborne transmission - ANS--used to prevent transmission of infectious organisms that
remain suspended in air and travel great distances
-place patient in an airborne infection isolation room
-wear N95 or higher respirator when entering room
-limit transport of patients to essential medical procedures
-discontinue airborne precautions according to pathogen-specific recommendations
Anthrax - ANS--no person to person transmission
-standard precautions
-after invasive procedures or autopsy, instruments and area should be thoroughly
disinfected
-Exposure to powder or dust confirmed to be anthrax spores requires treatment with
antibiotics for 6 weeks or more
Antibiotic Resistance - ANS--ESBL: extended spectrum beta lactamase
-resistant to 3rd generation cephalosporins
-cefotaxime, ceftazidime, cefpodoxime, and monobactams (aztreonam))
-D Test: Inducible Clindamycin Resistance
Bacteria per square inch - ANS--Computer = 3,295
-Phone = 25,127
-Toilet = 49
,BACTERIAL IDENTIFICATION - ANS--Presumptive
--gram stain
--colony morphology and odor
--spot tests: catalase, indole
-Definitive
--Biochemical tests (manual, automated system)
--Molecular diagnostics
Bacterial Morphology - ANS-Bacteria have four major shapes:
-Cocci: spherical
-Bailli: rods. Short bacilli are called coccobacilli
-Spiral Forms: comma-shaped, S shaped, or spiral
-Pleomorphic: Lacking a distinct shape
Basic Virology - ANS--Viruses are very small (15-300 nm) intracellular parasites (human
hair is about 100 microns)
-Don't reproduce outside of a cell
-Viruses which infect bacteria are called bacteriophages
-The complete viral particle outside a host cell is call virion
Beneficial effects of normal flora - ANS--compete for space and nutrients with
pathogens
-produce antimicrobial substances
-produce nutrients: Vit. K, B6, B12
-Occupy receptors and prevent attachment of pathogens
Best Practices on the Jobsite - ANS--maintains all barriers
-keep areas dry and humidity low
-notify EHS or IC of possible mold contamination
-Keep work areas clean
-keep foods confined to designated areas
-Prevent standing water
-clean out trash bins daily to prevent attracting pests
Biofilm - ANS-Structured community of microorganisms • Encapsulated in a complex
matrix •
Adheres to a living or inert surface •
, Often characterized by: surface attachment ,structural heterogeneity, genetic diversity
,complex community interactions, extracellular matrix of polymeric substances- AKA
slime, sludge
Biofilm Stages - ANS-1.) Attachment
2.) Growth
3.) Detachment
Biological Monitors - ANS--daily
-steam: Geobacillus stearothermophilus
-Dry heat: geobacillus stearothermophilus
-ETO: bacillus atrophaeus
-Low temperature technologies (H202 gas): Geobacillus stearothermophilus
Bivariate Relationships - ANS--correlation
-regression
-confound variables
Blood Cultures - ANS--Quality of collection affects microbial recovery, contamination
rates, and the ability of physicians to interpret test results.
• Even with good collection technique, 1%-3% of blood cultures are found to be
contaminated (rates are higher in teaching hospitals and EDs)
• Meticulous attention to skin antisepsis is necessary to prevent contamination
-2-3 cultures from different venipuncture sites are recommended
• A single culture is inappropriate
• A single draw for multiple sets is inappropriate
• Volume of blood cultured is the most important variable in recovering a pathogen
• 20 cc should be drawn from each venipuncture site with 10cc added to each bottle
(aerobic and anaerobic)
Bloom's Taxonomy Cognitive Levels - ANS-Recall • Comprehension • Application •
Analysis • Synthesis • Evaluation
Botulism - ANS--no person to person transmission
-standard precautions
Bowie-Dick test - ANS-Specifically designed for use with a prevacuum steam sterilizer
to test for air entrapment
Is for a vacuum and done once a day, NOT a sterilization monitor
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