PREVMED 2 Flashcards

1
Q

What is Reverse Osmosis

A

the reverse of natural osmosis achieved by external application of sufficient reverse pressure to cause the solvent to flow in its UNNATURAL DIRECTION

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2
Q

Define coaming

A

a raised frame to keep water out

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3
Q

What is distillation

A

**The total process the distilling plant forms, including evaporation and condensation

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4
Q

What is total coliform?

A

A group of closely related, mostly harmless BACTERIA that live in soil and water as well as the guts of animals

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5
Q

What is NAVSEASYSCOM responsibility?

A

**Responsible for potable water systems, including treatment FACILITIES and processes to assure that safe drinking water is from an approved source:

Design
Construction
Maintenance

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6
Q

What is NAVFACENGCOM responsible for

A

**promulgating instructions for SHIP-TO-SHORE.

Also providing water from an approved source when ship is berthed at naval facility

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7
Q

What is BUMED responsibility

A

**Promulgate instructions, notices or other publications to reflect AFLOAT water requirements

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8
Q

Who is responsible for promulgating the water sanitation bill?

A

**Commanding Officer

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9
Q

Who is responsible for the supply and treatment of potable water sources?

A

**Engineering department

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10
Q

how many gallons per day are specified by NAVSEASYSCOM for daily operations

A

**50 gallons per man per day

No less than 2 gallons per day per man while in water conservation hours

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11
Q

When ship-to-shore or ship-to-ship connections are about to be made, WHO must be present?

A

Medical

Authorized personnel

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12
Q

What is the requirement to receive water from an UNAPPROVED source?

A

**Allowed to be received onboardif the water hasbeentreated at a minimum of 2.0 ppm prior to receipt

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13
Q

What are the shore-to-ship approved sources that fall under

US military sources including establishment under cognizance of?

A

**British Royal Navy
Canadian Forces
Royal Australian Navy

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14
Q

What are the three types of Distillation plants

A

steam distilling: Uses steam
Heat distilling: uses heat
Vapor Compression Type: USES ELECTRICAL ENERGY

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15
Q

How many types of reverse osmosis are there and what are they?

A

2

**single: additional disinfection required such as bromine or chlorination

Triple: additional disinfection NOT required

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16
Q

a single pass RO plant requires what?

A

additional disinfection with chlorine or bromination is required

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17
Q

is additional disinfection required for a triple pass RO plant?

A

no, the water quality is often better than distilled water

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18
Q

Potable water tanks should NEVER be filled with what kind of water?

A

Ballast water, unless necessary for survival of the ship

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19
Q

What is the approving authority for Potable water tank coating

A

**NSF/ANSI

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20
Q

What are the requirements for sounding tubes?

A
  • Disinfect prior to use: 100 ppm FAC for 2 minutes

- LABELED: “Potable Water Use Only”

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21
Q

Potable water filling lines must be what color and how far off the deck?

A
  • **Dark Blue

- 18 inches from the deck

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22
Q

How far off the deck will potable water hose lockers be when located on the weather deck?

A

18 inches

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23
Q

What is printed, step by step instructions for disinfection of hoses and risers post CONSPICUOUSLY INSIDE THE LOCKER

A

**Water sanitation bill

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24
Q

How are hoses labeled?

A

POTABLE WATER ONLY

1 inch high letters every 10 feet

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25
What is the halogen residual range?
0.2 - 2.0 ppm
26
if potable water is coming from sources of doubtful quality, what will the halogen residual requirements?
**2.0 ppm
27
How often is the emergency potable water tank tested
Monthly
28
Each positive sample will have how many repeat samples and from where
3 repeat one at original one upstream no more than 5 service connections (01-15-2-L) one down stream no more than 5 service connections (01-20-2-L)
29
Which diethyl-p-phenylene diamine (DPD) test, test for FAC or TBR
**DPD #1
30
Which diethyl-p-phenylene diamine tests for total chlorine residual?
**DPD #4
31
What is the accuracy of the color comparator?
(+) or (-) 10 percent
32
What is the accuracy of the Portable Spectrophotometer?
(+) or (-) 2 percent
33
For the color comparator test how soon after additional test tab is placed will you read the results?
60 seconds
34
How often do you test halogen?
daily while underway weekly otherwise
35
how often is bacteriological testing completed?
Weekly Whenever abnormal halogen demand is present after repairs to potable water systems
36
What temperature is BACTI samples incubated at?
Incubate samples for 24 hours at 35 degrees C
37
Where will you record BACTI results?
Potable water log and/or TMIP including positive and negative controls
38
Cross connections with non-potable systems occur when what type of Leaks in common bulkheads occur?
``` Potable water tanks Fuel tanks Ballast tanks Bilges Wastewater tanks ```
39
What is the least desirable method of water disinfection?
**Manual Chlorine Disinfection (batch method) because it may result in over chlorination
40
What is the desirable disinfectant choice
**Calcium hypochlorite (HTH)
41
What is the clear, slightly yellow liquid called in regards to HTH?
Supernatant
42
What is the chlorine dosage rule of thumb?
One once HTH per 5,000 gallons of water equals 1.0ppm FAC
43
What are the two types of brominators?
In-line (proportioning) | Recirculation
44
How long do you hold solution for in METHOD ONE of disinfecting water systems?
**24 hours Drain Refill Test BACTI
45
In METHOD TWO of disinfection of water sources how long will the disinfected surfaces remain in contact with chlorine solution
30 minutes Refill Test BACTI
46
In METHOD THREE how long will you hold the solution for?
6 hours THEN add potable water to chlorine solution to fill tank and hold THIS water for 24 hours Drain refill Perform Test
47
When attempting to control taste and odor which method requires approval from NAVSEASYSCOM?
**Steam method
48
When storing HTH how long can the ready use stock stay in storage?
no more than 7 days
49
How many bottles of HTH can be stored in an individual locker or bin?
**no more than; 48 SIX OZ bottles
50
How will all fire resistant lockers, bins and enclosures containing HTH be labeled?
"Hazardous Material, Calcium Hypochlorite" RED LETTERS WITH A WHITE BACKGROUND
51
How long will the MDR maintain the record of potable water surveillance?
**2 years
52
How will you document the results of a bacteriological test result?
Presence or absence Include +/- controls Purpose of test
53
For a colilert bacteriological test, what is the color that indicates the sample is positive for total coliform?
Yellow Florescent yellow is positive for fecal coliform
54
For a Colisure bacteriological test, What color indicates the sample is positive for total coliforms?
Magenta Florescent light blue is positive for E. coli Yellow=negative
55
What are some sources of contamination?
leaks in common bulkheads between potable water tanks and fuel tanks, ballast tanks, bilges and wastewater tanks
56
CHT operates in three modes, what are they?
restricted waters at sea in port
57
What type of CHT is installed on the majority of navy ships?
**Type II-B Marine sanitation device
58
Each tank has two sewage pumps which are connected in parallels to discharge sewage and grey water to what receiving facility?
Ship Waste Off-loading Barge (SWOB) or it will go overboard
59
What chemical causes the greatest danger to ships and personnel?
**H2S | Hydrogen Sulfide
60
who must be notified in the event of a CHT spill or leak
Engineering officer XO SMDR
61
what toxic gas is associated with a rotten egg smell?
Hydrogen Sulfide
62
What immunizations are required for personnel working with wastewater?
Polio (IPV) | Tetanus (Td)
63
What type of PPE is required by CHT workers?
``` Coveralls RUBBER BOOTS RUBBER GLOVES Face shield SCBA (when necessary) ```
64
When cleaning cht contaminated clothing what will you use?
Hot water and soap
65
If a CHT spill occurs in medical, the galley, or berthing spaces what EPA approved disinfectants will be used?
**Germicides: Phenolic type Iodine Type
66
How is CHT color coded?
**Gold (on valve handles and operating levers)
67
Untreated sewage in US waters is prohibited within what range?
Within 3 nautical miles of shore
68
In port, sewage and grey water is collected in holding tanks and discharged into a sanitary sewer through what?
**sewage risers
69
What test can engineering personnel use to pinpoint small leaks from pumps or pressurized systems?
Paper towel test
70
Why must untreated sewage, when held in larger than 2000 gallon tanks be aerated?
Because it can become explosive if not aerated
71
Can you enter a CHT pump room if H2S odor is detected?
Only if wearing supplied airline respirator with full face mask
72
Who provides on-site advice, when requested in the event of major sewage leaks or spills?
Medical department representative
73
What temperature does potable hot water have to be?
120 degrees
74
What is the purpose of BACTI testing?
**Ensure Water fit for human consumption | Assess adequately disinfected
75
For a crew of 400-800 people, how many samples are needed?
8 samples
76
How much water will you put in a bacti testing tube?
100mL
77
How long will you allow the water to run before obtaining your sample?
2 to 3 minutes
78
Who provides onsite advise in regards to CHT?
Medical department representative
79
Who inspects the type II B marine sanitation device?
Medical department representative
80
CHT pump rooms must have negative pressure as well as how many EEBD
**2 EEBD | And a warning plaque
81
If you’re in restricted waters, what is the disposition of CHT?(you cannot transfer it overboard)
**Remain in the holding tank
82
How are sounding tubes disinfected
100 ppm FAC for 2 minutes
83
what is the easiest and safest water source?
Public water source
84
What are some influences of water choice?
Quality Quantity Accessibility
85
What is the least contaminated water source?
ground
86
What is the water source that provides the most quantity?
Surface water
87
What is the most common WATER TREATMENT METHOD?
ROWPU Reverse osmosis water purification unit
88
What can the ROWPU produce water from?
fresh water brackish water sea water
89
How many gallons per hour does the lightweight purifier produce?
125 gallons per hour
90
What is the most common method of disinfecting field water?
Chlorination sufficient chlorine is added to the water to achieve the desired free available chlorine after 30 minute contact time
91
When disinfecting natural surface water or well water under the direct influence of surface water for drinking, and no other treatment is available what is the treatment?
**5 ppm FAC after 30 minute contact time Emergency use only!!!**
92
What is the primary means for the receipt and storage of bulk drinking water and for issue to combat forces under tactical conditions?
Potable water storage and distribution systems (PWS/DS)
93
How long will you KEEP ALL INTERIOR SURFACES WET for? (Field water sanitation)
60 minutes
94
If either water or the required chemical are short in supply how will you disinfect after preparing 5 gallon of water with 100ppm?
USE A LONG HANDLED BRUSH, STICK, OR ROD with a cloth secured to the end, swab the interior of the tank every 10 minutes or as often as necessary to keep the walls clean for an HOUR
95
what type of disinfectant is most common and in granular form?
**Calcium Hypochlorite (HTH)
96
How many gallons is the semitrailer mounted fabric tank carry?
3000-5000
97
Define surge
**Personnel embarked aboard ship for SHORT DURATION during SPECIAL OPERATIONS or exercises, and mobilization
98
Define transients
refers to personnel embarked for short duration who DO NOT CONTRIBUTE TO THE HOST SHIP operational capability
99
What is the maximum temperature of berthing, messing, and medical?
80 degrees F
100
Berthing, messing, normal working spaces and medical shall be heated to what temperature?
**minimum 65 degree F dry bulb temperature
101
What is the ventilation exchange rate?
Exchange rate of 15 changes per hour designed to minimize humidity and odors
102
What type of pillows are prohibited?
**polyurethane
103
What type of mattress foam inserts are required on ship
Low smoke foam rubber
104
Each lavatory shall have what?
one mirror one shelf two electrical outlets
105
is hot bunking authorized?
no
106
What personnel will make routine sanitary inspections of toilets, lavatories, and berthing spaces?
``` xo mdr ood jood chief master at arms divo Division chief ```
107
What action is performed to shower curtains to prevent mildew, odor, and soap accumulations
sanitize
108
Berthing spaces, common rooms and head facilities should be cleaned how often?
**Daily
109
When will a barber shop worker wash their hands?
between patrons after touching likely contaminated items before leaving the shop
110
What therapeutic practices are prohibited?
- **treating pimples | - removing ingrown hair
111
how is hair removed from the deck?
**by a DUSTLESS method
112
What is the max psi for vacuum equipped clippers
**15 psi
113
how often is bedding changed to prevent odor?
frequently
114
How often does the barber shop get inspected by a medical department representative?
quarterly
115
what must be provided to supply laundry workers with drinking water?
Sanitary angle jet type water fountains
116
How far from shore must you be to use seawater with plumbing fixtures?
50 fathom curve (25 miles from shore)
117
hygienically safe laundry WITHOUT BLEACH should be what temperature
**120-140 degrees F
118
What is a necessary step when chlorine bleach is not included in the formulation?
heated air dryers
119
When handling contaminated laundry what will you NOT do?
contaminated linen MUST NOT be sorted | soiled is sorted
120
what training must be provided tp personnel prior to using laundry/dry cleaning equipment?
Safety First aid PPE
121
How will you contain contaminated laundry
received in impervious, double sealed bags outer bag is red and labeled with biohazard symbol and word biohazard. inner bag must be hot water soluble
122
what is the purpose of quarantine regulations?
the movement of DoD equipment and personnel (ships, aircraft, and other modes or method of transport) entering or departing US or foreign country/ ports may introduce undesirable non-native species and disseminate communicable diseases
123
what are the quarantinable diseases
``` cholera diphtheria infectious TB plague small pox yellow fever viral hemorrhagic fevers SARS Influenzas caused by novel or reemergent viruses or have potential to cause a pandemic ```
124
Cholera is the acute diarrheal illness caused by infection of the intestine with what bacterium
Vibrio Cholerae
125
Where can the cholera bacterium also live?
brackish rivers and coastal waters
126
what are the methods of control for cholera?
CONCURRENT DISINFECTION OF FECES AND VOMITUS OF LINENS AND ARTICLES USED BY PATIENTS immz case reporting isolation
127
what type of plague is extensively involving the lungs and the sputum is loaded with causative agent
pneumonic
128
how do people usually contract the plague
bite from a rodent flea that is carrying the plague bacterium Yersinia pestis
129
how is yellow fever transmitted
between humans by a mosquito (AEDES EGYPTI)
130
What is variola virus
small pox
131
where are small pox stocks held under security at?
**CDC Atlanta GA | Biotech- Koltsoco, Russia
132
what do you immunize with, in regards to small pox
vaccinia virus
133
what is OPNAVINST 6210.2
Quarantine regulations of the navy -provides guidance on navy responsibilities, liaisons, foreign quarantine and public health service requirements
134
what is BUMEDINST 6210.4
Ship sanitation certificate program
135
how does small pox present within 2 to 4 days
skin eruption
136
can a foreign official come on board with CO approval?
yes, but only to verify certs
137
within 12 to 72 hours, if is there is a quarantine disease on board who will the CO send a radio message to?
senior naval officer in command of port to be entered
138
In the last 15 days prior to US arrival what conditions are reported
Patient has temp 100F or greater accompanied by rash, grandular swelling or jaundice or which has presented for more than 48 hours Pt has diarrhea in a 24 hour period of three or more loose stools death due to illness other than battle casualties
139
What are the elements of the TB control program?
``` tb screening preventative therapy tb case identification tb patient management contact investigation ```
140
What are the tests used when a person has been identified as being exposed to mycobacterium tuberculosis
Tuberculin skin test - Mantoux Method | Interferon Gamma Release Assays (IGRA)
141
What is the effect therapy to prevent the development of tb in a newly infected
(1) the antibiotic regimen of choice is: Isoniazid (INH) and Rifapentine (RPT) in an oral weekly dose of 15mg/kg (900mg max) of INH
142
who requires periodic SCREENING
All active duty and reserve personnel - Annual screening during PHA - Document on NAVMED 6224/8
143
What is the monthly INH evaluation documented on?
NAVMED 6224/9
144
What is direct observed therapy?
Those who have difficulty with treatment adherence? **MUST BE USED ON PATIENTS ON INH REGIMENS GIVEN TWICE WEEKLY**
145
When would you consider withholding INH?
patients transaminase level exceed 3x the upper limit of normal if associated with symptoms or 5x upper limit of normal if asymptomatic
146
what is an active TB case?
an illness in which TB bacteria are multiplying and attacking a part of the body. Usually the lungs
147
what is latent TB?
a condition where TB bacteria is alive but inactive in the body
148
how long after administration of the TST does the results have to be read by a competent medical authority
48 to 72 hours
149
how would you record the result of a TST
Record any size in duration in mm absence of induration reported as 0mm or zero mm
150
what is TB treatment dosage based off?
weight
151
what is the primary objective of medical event reports?
Enables navy public health experts to be proactive in offering their assistance to local level medical staff
152
Who is the primary consultant with medical event reporting?
Cognizant Navy Environmental and Preventative medicine unit (NEPMU)
153
A diagnosis, case or medical event becomes reportable once it has been classified as:
Based off of clinical assessment, lab and epidemiology reports will determine if it is, Suspected Probable Confirmed
154
What is a disease and injury report?
Disease and injury surveillance involves monitoring the incident of specific pre diagnostic syndromes and injuries occurring in a unit
155
MER is generally unclassified material however should be marked, what?
For official use only
156
to have a MER updated to a higher classification who do you contact?
security officer or Commanding officer
157
what are the two types of MER?
urgent: within 24 hours routine: no later than 7 calendar days
158
What is 6220.12?
medical surveillance and medical event reporting TECHNICAL MANUAL
159
INFECTIOUS TB is what priority of medical event report?
urgent
160
Whats the official system that is used to capture, store, and communicate information related to RME’s?
DRSi Disease Reporting System Internet
161
How often will you get the typhoid vaccine if exposed to the typhoon organism continually or repeatedly
2 years
162
What temperature do you store yellow fever at?
Store between 36F to 46F (2 to 8C)
163
What must be properly stored and readily available at all vaccine locations?
Epinephrine
164
Where will vaccine information sheets be prepared
US department of health and human services Centers for disease control and prevention
165
What instruction states yellow fever cannot be given underway on an IDC ship
COMNAVSURFORINST 6000.1
166
What is required in barbershops?
Hot and cold running water
167
What must be worn when attending to patrons?
(2) A clean smock or other freshly laundered over garment must be worn while attending patrons.
168
Employees must be medically screened and determined to be free of what?
free of communicable disease prior to their initial assignment.