Infectious Disease and Sharp Injuries Quiz

Primary syphilis lesion is the portal of entry for bacteria.
Risk assessment is the first step in dental practice.
Symptoms of a certain condition include transitory rash on ears, face, and neck.
Symptoms of another condition include fever, fatigue, persistent cough for more than 3 weeks, and hemoptysis.
The causative agent for a specific condition (#4) needs to be identified.
The vaccine of choice for condition #4 needs to be identified (do not abbreviate).
Symptoms of a condition include primary chancre, mucosal lesions, mulberry molars, and Hutchinson's incisor.
The causative agent for condition #7 needs to be identified.
Treatment or antibiotic of choice for condition #8 needs to be identified.
Symptoms of a condition include painful, vesicular skin rash that scabs and causes scarring.
The causative agent for condition #10 needs to be identified.
The cranial nerve where virus #10 resides as a latent infection needs to be identified.
Symptoms of a condition include microcephaly, cataracts, deafness, cardiac problems (patent ductus arteriosus), inflammatory lesions of the brain, liver, and lungs.
Chicken pox reactivation causes a specific infection.
A tool for Tuberculosis screening is the tuberculin test or Pique test.

Sharp injury refers to any injury or puncture to the skin from a sharp instrument, including burs, syringe needles, and suture needles.
Sharp injuries usually result in minor skin damage but can transmit bloodborne viruses (BBVs).
Intact skin acts as a barrier to BBV transmission.
Infection does not occur through inhalation or the oral/fecal route.
Patients are the primary source of transmission of infectious diseases to dentists.
A case study showed that an HBe antigen positive dentist with acute Hepatitis B infected 6.9% of patients when he didn't wear gloves.
A study showed a rate of 1.7-3.5 injuries per year in the US and Scotland.
One third of dental workers are reluctant to report injuries.
Common causes of sharp injuries include forceful procedures, bending needles, passing instruments between dental staff members, sudden movement, poor visibility, resheathing needles, dismantling needles, and disposing of needles.

Healthcare workers need access to 24-hour management of sharp injuries.
Contact details for injury reporting should be readily available to staff.
Percutaneous sharps injuries require pressure to the puncture site then washing with soap and water. Do not scrub.
For splashes to the eyes, thoroughly wash with running water or eye wash solution (remove contact lenses first).
Exposure to oral mucous membranes requires vigorous rinsing with water and spitting out the solution.
Report incidents immediately, review the patient's medical history and ask about risk behaviours for BBV, arrange for blood samples to be taken from the donor (if needed) to be tested. Contact appropriate personnel (Occupational Health, Accident & Emergency, etc.) for assessment of injury, and counseling.
Administer post-exposure prophylaxis based on risk assessment.
Complete an incident report.

After a sharp injury, studies suggest the possible existence of a "window period".
PEP can inhibit viral replication after exposure to prevent HIV or HBV infection.
It can take up to 48-72 hours for HIV to be detectable in lymph nodes once it crosses the mucous membrane.
It can take up to 5 days for HIV to be detectable in blood following exposure.

Pre-exposure prophylaxis (PrEP) involves taking antiretroviral medications before potential exposure to HIV.
Post-exposure prophylaxis (PEP) involves taking antiretroviral medications after potential exposure to HIV.

Initiation of combination antiretroviral therapy (cART) effectively reduces HIV dissemination and replication.
PEP is offered to HIV-negative patients.
If the patient is HIV-positive and receiving effective cART, PEP is generally not needed; provided that a confirmed and sustained (<6 months) undetectable plasma HIV viral load is present.
PEP should be initiated as soon as possible, ideally within 1 to 2 days, but can be offered up to 72 hours after exposure.
Examples of PEP regimens include RALTEGRAVIR (TRUVADA) regimen for 28 days.
Follow-up appointments are scheduled every 12 weeks.
Recipients are monitored for symptoms of illness, such as flu-like symptoms and skin rashes.

Use instruments to retract the tongue and cheeks instead of fingers while using sharp instruments.
Do not bend local anesthetic needles.
Avoid recapping needles unless using safety needles with a retractable sheath or a needle guard.
Do not resheath needles with an unprotected hand.
Avoid passing sharps instruments from hand to hand during treatment.

Place sharps bins close to the point of use.
Wall mount or insert sharps bins into sturdy base plates.
Do not place sharps bins on unstable surfaces like the floor.
Keep the aperture (opening) of the sharps bin closed when not in use.
Never try to retrieve items from the sharps bin.
Place disposable sharps directly into puncture-proof yellow lidded waste receptacles.
Disposable syringes and needles should be discarded as a single unit into a bin.
Disposable safety scalpels should be used to avoid the need for blade release.
Do not leave burs in the handpiece to prevent skin and clothing contamination at the end of a treatment session.

The use of appropriate techniques for handling sharps to prevent injuries.
Use of surface barriers for handpieces, air/water connectors and hoses, and light handles/switches.

Specific steps are provided; in several formats (20-30 seconds for handrub, 40-60 seconds for handwash)

Different types of gloves (patient examination, surgeon's gloves) have specific indications and applications in patient care.
These notes give different types of gloves, and their use, and safety precautions to prevent injuries.

A step-by-step sequence for safely putting on personal protective equipment (PPE).
Notes about the type of PPE to use which will include a gown, mask/respirator, goggles/face shield, and gloves.