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Immunology and Serology (Laboratory) > Laboratory Safety and Chain of Infection (P) > Flashcards

Laboratory Safety and Chain of Infection (P) Flashcards

1
Q

What are biological hazards?

A

A biological substance that poses a threat to the health of humans by exposure to harmful microorganisms or infectious agents

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2
Q

What are the different sources of biological hazards in healthcare facilities?

A

1) Patients
2) Medical devices and equipment
3) Specimen
4) Water sources and irrigations
5) Vents and air conditioning
6) Fomites

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3
Q

What is chain of infection?

A

A process by which infection is spread in a community at a given period

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4
Q

What are the components that are required for continuing the chain of infection?

A
  • Source
  • Method of transmission
  • Susceptible host
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5
Q

Explain the process of chain of infection

A

Transmission occurs when the agent leaves its reservoir or host through a portal of exit, is conveyed by some mode of transmission, and enters through an appropriate portal of entry to infect a susceptible host

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6
Q

What are the components of chain of infection?

A

1) Infectious agent
2) Reservoir
3) Portal of exit
4) Mode of transmission
5) Portal of entry
6) Susceptible host

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7
Q

What are infectious agents?

A

Potentially harmful microbes

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8
Q

What are the examples of infectious agents?

A
  • Bacteria (pathogens)
  • Viruses
  • Fungi
  • Protozoa
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9
Q

What is reservoir?

A

Habitat in which the infectious agent normally lives, grows, and multiplies

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10
Q

Is reservoir the source of infectious agent being transmitted?

A

It may and it may not be the source of the infectious agent that is being transmitted

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11
Q

Provide an example of reservoir

A

Clostridium botulinum (botulism)

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12
Q

What are the different types of reservoir?

A

1) Human reservoir
2) Animal reservoir
3) Environmental reservoir

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13
Q

What is human reservoir?

A

May or may not show the effects of illness

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14
Q

What are the different types of human reservoir?

A

1) Carrier
2) Asymptomatic or passive
3) Incubatory carriers
4) Convalescent carriers
5) Chronic carriers

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15
Q

What is a carrier?

A

A person with inapparent infection who is capable of transmitting pathogen to others

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16
Q

What are asymptomatic or passive carriers?

A

Also called as healthy carriers

Those who never experienced symptoms despite being infected

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17
Q

What are incubatory carriers?

A

Those who can transmit the agent during the incubation period before clinical illness begins

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18
Q

What are convalescent carriers?

A

Those who have recovered from their illness but remain capable of transmitting to others

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19
Q

What are chronic carriers?

A

Those who continue to harbor a pathogen such as Hepatitis B virus or Salmonella Typhi for months or even years after their initial infection

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20
Q

Is animal to animal transmission of diseases possible?

A

Yes

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21
Q

In the case of animal reservoirs, human serves as what?

A

Incidental hosts / accidental hosts

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22
Q

What is zoonosis?

A

An infectious disease that is transmissible under natural conditions from vertebrate animals to humans

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23
Q

What are the examples of zoonotic diseases?

A

1) Brucellosis
2) Anthrax
3) Plague
4) Trichinellosis / trichinosis
5) Tularemia
6) Rabies

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24
Q

Who or what are the reservoir of brucellosis?

A

Cows and pigs

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25
Q

Who or what are the reservoir of anthrax?

A

Sheep

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26
Q

Who or what are the reservoir of plague?

A

Rodents

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27
Q

Who or what are the reservoir of trichinellosis or trichinosis?

A

Swine

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28
Q

Who or what are the reservoir of tularemia?

A

Rabbits

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29
Q

Who or what are the reservoir of rabies?

A

Bats, racoons, dogs, and other mammals

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30
Q

What are the examples of environmental reservoirs?

A

1) Plants
2) Soil
3) Water

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31
Q

What are the fungal agent that can live and multiply in the soil?

A

Fungal agents that cause histoplasmosis

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32
Q

What infectious agents are present in water?

A

Legionella pneumophila (causative agent of Legionnaires disease)

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33
Q

What is portal of exit?

A

1) The path by which a pathogen leaves its host

2) Usually corresponds to the site where the pathogen is localized

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34
Q

What are the examples of portal of exit?

A

1) Respiratory tract
2) Urine
3) Feces
4) Skin lesions
5) Crossing of placenta (transmission via the placenta)
6) Cuts or needles
7) Blood-sucking arthropods

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35
Q

What are the infectious agents that can be transmitted via the respiratory tract?

A

1) Influenza viruses

2) Mycobacterium tuberculosis

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36
Q

What are the infectious agents that can be transmitted via urine or feces?

A

Schistosomes

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37
Q

What are the infectious agents that can be transmitted via feces?

A

Vibrio cholerae

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38
Q

What are the infectious agents that can be transmitted via skin lesions?

A

Sarcoptes scabiei

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39
Q

What are the infectious agents that can be transmitted via the placenta (crossing of placenta)?

A

1) Rubella
2) Syphilis
3) Toxoplasmosis

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40
Q

What are the infectious agents that can be transmitted via cuts or needles in the skin?

A

Hepatits B

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41
Q

What are the infectious agents that can be transmitted via blood-sucking arthropods?

A

Malaria

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42
Q

What is mode of transmission?

A

The method on how an infectious agent is transmitted

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43
Q

What are the different classifications of modes of transmission?

A

1) Direct (direct contact)

2) Indirect (indirect contact)

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44
Q

What is direct contact as mode of transmission?

A

1) Occurs through skin-to-skin contact such as kissing and sexual intercourse
2) Contact with soil or vegetation harboring infectious organisms

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45
Q

What are the infections or diseases that can be transmitted via direct contact (person to person)?

A

1) Infectious mononucleosis (kissing disease)

2) Gonorrhea

46
Q

What is the infectious agent or pathogen that can be transmitted via direct contact with contaminated soil?

A

Hookworm

47
Q

What are the different classifications of direct contact (mode of transmission)?

A

1) Direct contact

2) Droplet spread

48
Q

What is droplet spread (mode of transmission)?

A

Refers to spray with relatively large, short-range aerosols produced by sneezing, coughing, or even talking

49
Q

Why is droplet spread classified as direct contact?

A

Because transmission is by direct spray over a few feet, before the droplets fall to the ground

50
Q

What are the examples of infectious agents that can be transmitted via droplets?

A

1) Pertussis
2) Meningococcal infection
3) SARS and SARS-COV2 infections

51
Q

What is indirect transmission (mode of transmission)?

A

The transfer of an infectious agent from a reservoir to a host by suspended air particles, inanimate objects (vehicles), or animate intermediaries (vectors)

52
Q

What is airborne transmission?

A

Occurs when infectious agents are carried by dust or droplet nuclei (5 microns) suspended in air and may be blown over great distances

53
Q

What are the infectious agents that can be transmitted via airborne transmission?

A

1) Measles
2) Tuberculosis
3) Influenza
4) Colds
5) Chickenpox

54
Q

What are vehicles (mode of transmission)?

A

May indirectly transmit an infectious agent

55
Q

What are the example of vehicles (mode of transmission)?

A

1) Food
2) Water
3) Biologic products (blood)
4) Fomites (inanimate objects)

56
Q

What are vectors (mode of transmission)?

A

Organisms that may carry an infectious agent through purely mechanical means or may support growth or changes in the agent

57
Q

What are the examples of vectors (mode of transmission)?

A

1) Mosquitoes
2) Flies
3) Ticks

58
Q

What are the two types of transmission via vectors?

A

1) Mechanical transmission

2) Biologic transmission

59
Q

What is mechanical transmission (mode of transmission)?

A

Example of this are flies which carries Shigella on their appendages and fleas carrying Yersinia pestis in their gut

60
Q

What is biologic transmission (mode of transmission)?

A

The principle of this is that the causative agent of malaria or guinea worm disease undergoes maturation in an intermediate host before it can be transmitted to humans

61
Q

What is portal of entry?

A

1) Refers to the manner in which a pathogen enters a susceptible host
2) Must provide access to tissues in which the pathogen can multiply or a toxin can act

62
Q

Often, infectious agents use the same portal of entry to enter a new host that they used to exit the source host. What are the examples of these infectious agents and what are their portal of entries?

A

1) Influenza, tuberculosis, COVID 19 -> respiratory tract
2) Gastroenteritis, intestinal infections -> fecal-oral route
3) Hookworm -> skin
4) Syphilis -> mucous membranes
5) Hepatitis B and human immunodeficiency virus (HIV) -> blood

63
Q

What is a susceptible host?

A

1) The final link in chain of infection

2) The host that is being infected by infectious agents or pathogens

64
Q

What are the factors that contributes to the susceptibility of a host which affects the ability of a host to resist such infection or to limit the pathogenicity of an infectious agent?

A

1) Genetic or constitutional factors
2) Specific immunity
3) Nonspecific factors

65
Q

How can the genetic makeup of an individual affect with regards to his / her susceptibility?

A

An individual’s genetic makeup may either increase or decrease susceptibility

66
Q

Who are often considered as more susceptible hosts?

A

1) Immunocompromised patients
2) Newborn and infants
3) Elderly

67
Q

What are the different types of safety hazard in the lab?

A

1) Biologic
2) Sharps
3) Chemical
4) Radioactive
5) Electrical
6) Fire / Explosive
7) Physical

68
Q

What are the sources for biologic hazards?

A

Infectious agents

69
Q

What are the sources for sharps hazards?

A

1) Needles
2) Lancets
3) Broken glass

70
Q

What are the sources for chemical hazards?

A

1) Preservatives

2) Reagents

71
Q

What are the sources for radioactive hazards?

A

1) Equipment

2) Radioisotopes

72
Q

What are the sources for electrical hazards?

A

1) Ungrounded or wet equipment

2) Frayed cords

73
Q

What are the sources for fire or explosive hazards?

A

1) Open flames

2) Organic chemicals

74
Q

What are the sources for physical hazards?

A

1) Wet floors
2) Heavy boxes
3) Patients

75
Q

What are the possible injuries that may be obtained via biologic hazards?

A

1) Bacterial infections
2) Fungal infections
3) Viral infections
4) Parasitic infections

76
Q

What are the possible injuries that may be obtained via sharps hazards?

A

1) Cuts
2) Punctures
3) Blood-borne pathogen exposure

77
Q

What are the possible injuries that may be obtained via chemical hazards?

A

Exposure to toxic, carcinogenic, or caustic / corrosive agents

78
Q

What are the possible injuries that may be obtained via radioactive hazards?

A

Radiation exposure

79
Q

What are the possible injuries that may be obtained via electrical hazards?

A

Burns or shock

80
Q

What are the possible injuries that may be obtained via fire or explosive hazards?

A

Burns or dismemberment

81
Q

What are the possible injuries that may be obtained via physical hazards?

A

1) Falls
2) Sprains
3) Strains

82
Q

What are the standard precautions that can be done inside the lab?

A

1) Handwashing
2) Wearing of gloves
3) PPE -> mask, eye protection (goggles), and face shield
4) Gown
5) Patient care equipment
6) Environmental control
7) Linen
8) Occupational Health and Blood Borne Pathogens
- > sharps container
- > proper disposal of sharps
9) Patient placement
- > isolation

83
Q

What are the standards for Occupational Exposure to Blood Borne Pathogens Standard?

A

1) Requiring all employees to practice UP / standard precautions
2) Providing lab coats, gowns, face, and respiratory protection, and gloves to employees and laundry facilities for non-disposable protective clothing
3) Providing sharps disposal containers and prohibiting recapping of needles
4) Prohibiting eating, drinking, smoking, and applying cosmetics, lip balm, and contact lens in the work area
5) Labelling all biohazardous material and containers
6) Providing free immunization for HBV
7) Establishing a daily disinfection protocol for work surfaces; an appropriate disinfectant for blood-borne pathogens is sodium hypochlorite (household bleach diluted 1:10)
8) Providing medical follow-up for employees who have been accidentally exposed to blood-borne pathogens
9) Documenting regular training in safety standards for employees

84
Q

What are the proper ways or applications when it comes to chemical handling?

A

1) Acid should always be added to water to avoid the possibility of sudden splashing caused by the rapid generation of heat in some chemical reactions.
2) Wearing goggles and preparing reagents under a fume hood are recommended safety precautions
3) Chemicals should be used from containers that are of an easily manageable size.
4) Pipetting by mouth is unacceptable in the laboratory

85
Q

What is the meaning of MSDS?

A

Material Safety Data Sheet

86
Q

What are the components of MSDS?

A

1) Physical and chemical characteristics
2) Fire and explosion potential
3) Reactivity potential
4) Health hazards and emergency first aid procedures
5) Methods for safe handling and disposal

87
Q

What is radioactivity (radioactive hazards)?

A

Encountered in the clinical lab when procedures using radioisotopes are performed

88
Q

Is radioactivity present in labs?

A

Yes, but its amount is very small and presents little danger

89
Q

Are the effects of radiation cumulative?

A

Yes, and these effects are related to the amount of exposure

90
Q

The amount of radiation exposure is related to what?

A

1) Combination of time
2) Distance
3) Shielding

91
Q

What device is required for personnel working in a radioactive environment?

A

Measuring devices

92
Q

What is the purpose of measuring devices in a radioactive environment?

A

To determine the radiation that the personnel are accumulating

93
Q

Provide an example of application that may pose electrical hazard

A

The danger of water or fluid coming in contact with equipment (greater chances in labs)

94
Q

Is it okay to operate equipment with wet hands?

A

No

95
Q

Who is responsible for monitoring electrical equipment?

A

Designated hospital personnel

96
Q

What should a lab personnel do to prevent occurrence of electrical hazards?

A

Observe for any dangerous conditions (such as frayed cords and overloaded circuits, and report them to appropriate persons)

97
Q

What should be done if an equipment become wet?

A

It should be unplugged and allowed to dry completely before reusing

98
Q

What should be done to an equipment before cleaning?

A

It should be unplugged

99
Q

What should be done to all electrical equipment?

A

Must be grounded with three pronged

100
Q

What should be done when an accident involves electrical shock occurs?

A

1) The electrical source must be removed immediately

2) This must be done without touching the person or the equipment involved

101
Q

How to operate a fire extinguisher?

A

PASS

1) Pull the pin
2) Aim at the base of the fire
3) Squeeze handles
4) Sweep nozzle side to side

102
Q

What are the general safety practices that will reduce the risk of inadvertent contamination with blood or body fluids?

A

1) Staff must wear laboratory coats and be additionally protected from contamination by infectious agents.
2) Food and drinks should not be consumed in work areas or stored in the same area as specimens. Containers, refrigerators, or freezers used for specimens should be marked as containing a biohazard.
3) Specimens needing centrifugation are capped and placed into a centrifuge with a sealed dome.
4) A gauze square is used when opening rubber-stoppered test tubes to minimize aerosol production (introduction of substances into the air).
5) Autodilutors or safety bulbs are used for pipetting.
- > Pipetting of any clinical material by mouth is strictly forbidden

103
Q

What are the different protective techniques for infection control (in tems of selection and use of gloves)?

A

Selection and Use of Gloves

  • Gloves for medical use are sterile surgical or nonsterile examination gloves made of vinyl or latex.
  • Latex gloves provides more tactile sensitivity ;however, either type is usually satisfactory for phlebotomy and as a protective barrier during technical procedures.
  • Latex-free gloves should be available for personnel with sensitivity to usual glove material.
  • Rubber household gloves may be used for cleaning procedures
104
Q

What are the guidelines related to the selection and general use of gloves?

A

1) Use sterile gloves for procedures involving contact with normally sterile areas of the body or during procedures in which sterility has been established and must be maintained.
2) Use nonsterile examination gloves for procedures that do not require the use of sterile gloves. Gloves must be worn when receiving phlebotomy training.
- > The National Institute of Occupational Safety and Health Administration (OSHA) mandates the use of gloves for phlebotomy.
3) Gloves should be changed between each patient contact.
4) Wear gloves when processing blood specimens, reagents, or blood products, including reagent red blood cells.
5) Gloves should be changed frequently and immediately if they become visibly contaminated with blood or certain body fluids or if physical damage occurs.
6) Do not wash or disinfect latex or vinyl gloves for reuse.
- > Rubber gloves may be decontaminated and reused, but disinfectants may cause deterioration. Rubber gloves should be discarded if they have punctures, tears, or evidence of deterioration or if they peel, crack, or become discolored.
7) Using items potentially contaminated with human blood or certain body fluids (e.g., specimen containers, lab instruments, countertops
8) Gloves should be properly removed or covered with an uncontaminated glove or paper towel before answering the telephone, handling laboratory equipment, or touching doorknobs

105
Q

What is the proper handwashing technique or process?

A

1) Palm to palm
2) Between fingers
3) Back of hands
4) Base of thumbs
5) Back of fingers
6) Fingernails
7) Wrists
8) Rinse and wipe dry

106
Q

What is the proper way of donning PPE?

A

1) Sanitize or wash hands
2) Wear the protective gown
3) Wear the mask. Ensuring that no air leakage at the upper part and lower chin.
4) Wear the eye goggle or face shield.
5) Wear the shoe cover if needed.
6) Wear the gloves.

107
Q

What is the proper way of doffing PPE?

A

1) Remove gloves. Using one hand, grasp the palm of the other hand and peel off the first glove.
2) Perform hand hygiene.
3) Remove gown.
4) Perform hand hygiene.
5) Exit the patient’s room and close the door.
6) Remove goggles/face shield.
7) Perform hand hygiene.
8) Remove mask/respirator

108
Q

How to properly decontaminate working areas?

A
  • All work surfaces should be cleaned and sanitized at the beginning and end of the shift with a 1:10 dilution of household bleach
  • Instruments such as scissors or centrifuge carriages should be sanitized daily with a diluted solution of bleach
109
Q

What is the purpose of diluted household bleach?

A

Inactivates HBV in 10 minutes and HIV in 2 minutes

110
Q

Where should disposable materials contaminated with blood be disposed?

A

In containers marked as “Biohazard” and should be properly discarded

111
Q

Where should infectious wastes be disposed?

A

These must be disposed into proper biohazard containers with the following features:

1) Conspicuously marked “Biohazard” with the universal biohazard symbol
2) Universal color—orange, orange and black, or red
3) Rigid, leakproof, and puncture resistant.
4) Used for blood and other potentially infectious body fluids, as well as disposable materials contaminated with blood or fluid

Immunology and Serology (Laboratory) (5 decks)

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