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Apex Review > Miscellaneous topics 5 > Flashcards

Miscellaneous topics 5 Flashcards

1
Q

______- is the most important method of infection prevention

A

Hand-washing

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2
Q

The most common source of bloodstream infection in hospitalize patients is

A

the central venous catheter

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3
Q

The preferred method of skin prep before central line placement is

A

chlorohexidine

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4
Q

Alcohol based products are ________________ and must be allowed to dry for __________

A

flammable; two minutes

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5
Q

What three surgical care improvement project (SCIP) measures are we responsible for

A
  1. a prophylactic abx is administered within 60 minutes of surgical incision (vancomycin is 120 minutes)
  2. cardiac surgery patients must achieve glycemic control (<200 mg/dL)
  3. colorectal patients are normothermic upon arrival to PACU (>36 C)
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6
Q

What is required in contact precautions?

A

gown and gloves

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7
Q

What is required for droplet precautions?

A

gown, gloves, and surgical mask

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8
Q

What is required for airborne precautions?

A

gowns, gloves, N95 respirator, negative pressure room

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9
Q

Creutfeldt-Jakob disease can lead to

A

encephalopathy and dementia

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10
Q

Etiologies of prion disease include

A

consumption of contaminated animal protein
contaminated implants (corneal or dural tissue)
cadaveric pituitary hormone supplementation

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11
Q

Which procedure places health care workers at the HIGHEST risk of developing a positive skin TB test?
a. bronchoscopy
b. VATs
c. cataract removal
d. Open reduction internal fixation of a femur

A

a. bronchoscopy

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12
Q

Tuberculosis targets the

A

anterior apical segments of the lung but it can also infect the brain, kidney, joints, spine, and GI tract

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13
Q

Patients with TB experience

A

a productive cough, hemoptysis, weight loss, fever, night sweats, anorexia, and general malaise

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14
Q

The most common test for TB is

A

a tuberculin skin test

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15
Q

A positive tuberculin skin test necessitates a

A

CXR

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16
Q

Treatment of TB includes

A

isoniazid, rifampin, pyridoxine

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17
Q

Side effects of TB treatment drugs include

A

thrombocytopenia & kidney failure

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18
Q

Providers should observe ______ precautions when caring for a patient with TB

A

airborne

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19
Q

Procedures that produce the highest TB exposure risk for health care personnel are

A
  1. bronchoscopy (highest risk)
  2. endotracheal intubation (second highest risk)
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20
Q

Elective procedures for the patient with TB should be delayed until the patient is

A

on antituberculous chemotherapy
has 3 negative acid-fast bacillus tests and demonstrates symptom improvement

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21
Q

If doing a procedure on a positive TB patient, observe the following:

A

wear N95 mask
HEPA filter placed between the y-piece and the patient’s airway
bacterial filter placed on the expiratory limb of the circle circuit
dedicated anesthesia machine and ventilator whenever possible
pre-and postop care in a negative pressure isolation room

22
Q

What is the first-line treatment for tuberculosis?

A

isoniazid

23
Q

What defines a positive Mantoux test?

A

induration >10 mm at side of injection

24
Q

Anaphylaxis causes degranulation of: (select 2):
a. neutrophils
b. monocytes
c. basophils
d. mast cells

A

c. basophils
d. mast cells

25
Q

White blood cells can be divided into

A

granulocytes and agranulocytes

26
Q

Granulocytes include

A

neutrophils
basophils
eosinophils

27
Q

Neutrophils (role)

A

immune defense

28
Q

The role of basophils is

A

essential component of allergic reactions

29
Q

The role of eosinophils is

A

immune defense against parasites

30
Q

Agranulocytes include

A

monocytes
lymphocytes- B lymphocytes, T lymphocytes, natural killer cells

31
Q

The role of monocytes is

A

immune defense

32
Q

The role of B lymphocytes is

A

humoral immunity

33
Q

The role of T lymphocytes is

A

cellular immunity

34
Q

The role of natural killer cells is to

A

limit spread of tumor and microbial cells

35
Q

_______________ prevents degranulation of basophils and mast cells

A

Epinephrine

36
Q

B lymphocytes are different than t lymphocytes in that they

A

produce antibodies

37
Q

The function of natural killer cells is reduced by

A

opioids (concern of cancer recurrence)

38
Q

What are the four types of hypersensitivity reactions?

A

type 1: immediate hypersensitivity
type 2: antibody-mediated
type 3: immune complex mediated
Type 4: delayed

39
Q

What is an example of a type 1 hypersensitivity reaction?

A

anaphylaxis
extrinsic asthma

40
Q

What is an example of a type 2 hypersensitivity reaction?

A

ABO-incompatibility
heparin-induced thrombocytopenia

41
Q

What is an example of a type 3 hypersensitivity reaction?

A

snake venom reaction

42
Q

What is an example of a type 4 hypersensitivity reaction?

A

contact dermatitis

43
Q

Common culprits for perioperative allergic reactions include

A

NMBD- succinylcholine, rocuronium
latex
antibiotics- beta-lactams are the most common

44
Q

Treatment of intraoperative anaphylaxis includes

A
  1. discontinue the offending agent
  2. administer epinephrine
  3. liberal IV hydration
  4. Administer H1 & H2 receptor antagonists
  5. Hydrocortisone 250 mg IV
  6. albuterol for bronchospasm
45
Q

What can be given for refractory hypotension in the setting of anaphylaxis?

A

vasopressin

46
Q

What are the three ways in which epinephrine treats anaphylaxis?

A

prevents degranulation
provides CV support
dilates the airways

47
Q

Anaphylaxis requires prior

A

sensitization or cross-reactivity

48
Q

An anaphylactoid reaction requires

A

no prior exposure

49
Q

Anaphylaxis and anaphylactoid reactions lead to the degranulation of

A

mast cells & basophils

50
Q

What are the CV presentation of anaphylaxis?

A

hypotension
tachycardia
arrhythmia
cardiac arrest

Apex Review (224 decks)

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