Healthcare

Question 1

HCAI meaning

Answer 1

Healthcare associated infections

Question 2

What did Ignaz Semmelweis instigate? (2 wards, obstetrics)

Answer 2

Handwashing with chlorinated lime and ward cleaning with calcium chloride

Question 3

HAP meaning

Answer 3

Healthcare aquired pneumoniae

Question 4

VAP meaning

Answer 4

Ventilator acquired pneumonia

Question 5

HAP and VAP criteria

Answer 5

those that developed pneumonia >48 hours after admission to the hospital or mechanical ventilation, respectively

Question 6

What are the main organisms causing pneumonia

Answer 6

Streptococcus pneumoniae
Mycoplasma
Haemophilus influenzae
Chlamydiophila
Viral

Question 7

Healthcare acquired pneumonia is caused by what main organisms

Answer 7

Pseudomonas aeruginosa
MRSA
Klebsiella pneumoniae
Haemophilus influenzae
Moraxella catarrhalis

Question 8

Ventillator acquired infections causing pneumoniae are caused by what main organisms

Answer 8

Pseudomonas aeruginosa
MRSA
Legionella
Klebsiella pneumoniae
Haemophilus influenzae
Moraxella catarrhalis

Question 9

Why do HAP and VAP occur

Answer 9

Aspiration
Suction
Tube feeding
Mechanical ventilation
Lungs are warm and moist
Age
Nuritrion

Question 10

How to prevent respiratory tract infections in healthcare

Answer 10

Prevent aspiration
Minimise or avoid repeated intubation
Avoid PPIs/H2 blockers
Upright position
Hand hygiene
PPE compliance

Question 11

A fifth of HCAIs are UTIs, true or false

Answer 11

True

Question 12

CAUTI meaning

Answer 12

Catheter-associated urinary tract infection

Question 13

CAUTI symptoms

Answer 13

new onset or worsening fever and rigors
altered mental status
malaise or lethargy with no other identified cause
flank pain
costovertebral angle tenderness
acute haematuria
pelvic discomfort

Question 14

CAUTI complications

Answer 14

Pyelonephritis
Urosepsis

Question 15

What bacterium usually causes UTIs

Answer 15

E. coli (uncomplicated)

Question 16

General organism classes that cause UTIs

Answer 16

Gram negative commensal organisms predominate
Some Gram positives – Enterococcus and Staphylococcus

Question 17

CAn fungi cause utis in minor cases

Answer 17

Yes

Question 18

haBSI meaning

Answer 18

Hospital aquired bloodstream infections

Question 19

BSI symptoms

Answer 19

Chills
Rapid heart rate
Low blood pressure
hyperventilation
Abodominal pain
Nausea and vomiting
diarrhoea

Question 20

Primary haBSI

Answer 20

Primary haBSI – directly related to an indwelling vascular catheter or have no identified source

Question 21

Secondary haBSI

Answer 21

Secondary haBSI – has arisen as a result of an infection at another site, eg UTI, RTI, skin/soft tissue infection

Question 22

Central-Line Associated Bloodstream infection (CLABSI

Answer 22

primary haBSI due to central indwelling catheters.

Question 23

Long term catheters give opportunity for what

Answer 23

Biofilms

Question 24

Do gram-ves or +ves mostly cause BSIs

Answer 24

Gram negative

Question 25

What organisms cause surgical site infections (SSIs)

Answer 25

Enterobacterales, e.coli most common

Question 26

How to prevent SSIs, preoperative

Answer 26

MRSA screening and decontamination Short-term antibiotic prophylaxis according to guidance Hair removal not needed unless it will interfere with surgery Appropriate theatre wear

Question 27

Preventing SSIs, intraoperative

Answer 27

Hand decontaminations Gloves Antiseptic skin preparation Maintain homeostasis (temp, fluids, glucose) Appropriate wound dressing

Question 28

Preventing SSIs postoperative

Answer 28

Aseptic dressing changes Wound cleaning Tissue viability nurse advice

Question 29

GI infection, main two

Answer 29

C. difficile, norovirus

Question 30

Is C.diff anerobic or aerobic

Answer 30

Anaerobic

Question 31

C. diff spores are extremely hardy or easy kill

Answer 31

Spores are extremely hardy and can survive heat, UV light, dessication, radiation and most cleaning agents

Question 32

C.diff, pseudomembranous colitis symptoms

Answer 32

Life threatening Inflammation of colon pseudomembranes “volcano lesions”