7 Immunisation and infection control

Question 1

What are our non-specific immune defences?

Answer 1

Unbroken skin.
Mucous membranes of gut + lung.
Acid and enzymes in gut.
Non specific metabolism.

Question 2

How long do maternal antibodies transferred in the womb protect the baby for?

Answer 2

A year.

Question 3

What is the definition of an antigen?

Answer 3

Anything that can be bound by an antibody.

Question 4

Which antibodies are part of the first + second immune response?

Answer 4

1st: IgM.
2nd: IgG.

Question 5

Which vaccines act through live immunity?

Answer 5

Live, inactivated components, and inactivated toxins.

Question 6

What constitutes passive immunity?

Answer 6

Vertical transmission and breastfeeding.
Injection of pooled immunoglobulin.
HNIG - pooled plasma.
Specific - tetanus, botulism, hep B, rabies, VZV

Question 7

Name 4 live vaccines:

Answer 7

MMR.
BCG.
Yellow fever.
VZV.

Question 8

Name 3 inactivated vaccines:

Answer 8

Pertussis.
Typhoid.
HPV.

Question 9

Name 2 vaccines made from components of organisms:

Answer 9

Influenza.

Pneumococcal.

Question 10

Name 2 vaccines made from inactivated toxins:

Answer 10

Diphtheria.

Tetanus.

Question 11

Advantages and disadvantages of live vaccines:

Answer 11

Single does, strong.

Unstable, revert to virulence, not in immunosepressed, contamination, interference by viruses.

Question 12

Advantages and disadvantages of inactivated vaccines:

Answer 12

Stable, clear constituents, can’t cause infection.

Several doses needed, local reactions, needs adjutant, shorter lasting.

Question 13

What are the five key steps in breaking the chain of infection?

Answer 13

Eliminate pathogenic organism.
Remove source/reservoir.
Minimise transmission.
Eliminate exit and entry.
Reduce susceptibility.

Question 14

What 4 steps are taken to eliminate pathogenic organisms?

Answer 14

Environmental cleaning: H2O2.
Equipment decontamination: sterilise + disinfect
Antisepsis: skin prep, MRSA decon
Antibiotic prophylaxis

Question 15

What two steps are taken to remove the source/resevoir of infections?

Answer 15

Hand hygiene.

Environmental cleaning and decontamination.

Question 16

Which 5 steps are taken to minimise transmission of infections organisms?

Answer 16

Hand hygiene.
PPE.
Equipment decontamination.
Source isolation
Disposable equipment use.

Question 17

Which 5 steps are taken to eliminate entry of organisms?

Answer 17

Antisepsis.
Asepsis.
Air handling (+ve kPa, laminar flow).
Sharps management.
Patient management (invasive devices).

Question 18

What 2 steps are taken to reduce susceptibility to infection?

Answer 18

Antibiotic stewardship.

Immunisation.

Question 19

Define sterilisation. 4 methods.

Answer 19

Complete killing or removal of all types of micro-organisms.

Heat, chemical, filtration, ionising radiation.

Question 20

How is sterilisation by heat performed?

Answer 20

Moist: autoclave - steam, high kPa.
Dry: oven.

Question 21

Define disinfection.

Answer 21

Removal or destruction of sufficient numbers of potential harmful micro-organisms to make an item safe to use.

Question 22

Define antisepsis.

Answer 22

Disinfection when applied to living tissue or damaged skin.

Question 23

Chemical disinfection is largely limited to:

Answer 23

Environmental decontamination (spills, surfaces).
Antisepsis.
Heat-sensitive items.

Question 24

What infection control method is used for surgical instrument reprocessing?

Answer 24

Sterilisation by moist heat.

Question 25

What infection control method is used for flexible endoscopes?

Answer 25

High level disinfection by chemical methods.

Question 26

What infection control method is used for syringe needles?

Answer 26

Sterilisation: gamma irradiation pre use and disposal afterwards.

Question 27

What infection control method is used for central venous catheter site?

Answer 27

Antisepsis: 2% chlohexidine in 70% isopropyl alcohol.

Question 28

What infection control method is used for a surgeons hands?

Answer 28

Washing with surgical scrub.