Term
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Definition
| Tuberculosis Control Program |
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Term
|
Definition
| Initial Tuberculosis Exposure Risk Assessment |
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Term
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Definition
| Interim Tuberculosis Exposure Risk Assessment |
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Term
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Definition
| Monthly Evaluations for Patients Receiving Treatments for Latent Tuberculosis Infection (LTBI) |
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Term
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Definition
| Latent Tuberculosis Infection |
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Term
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Definition
| Adult Immunization Record |
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Term
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Definition
| Child Immunization Record |
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Term
| What is the scientific term for TB? |
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Definition
| Mycobacterium tuberculosis |
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Term
| What is the purpose of TB testing? |
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Definition
| To identify persons with LTBI so that they may be treated before the disease becomes active and before transmission to others. |
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Term
| When should the TB test be administered? |
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Definition
1. During the Periodic Health Assessment (PHA)
2. Operational Suitability screening
3. Within 6 months of separation from Naval Service |
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Term
True or False?
QFT-G is used with the TST |
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Definition
FALSE
Either the TST or the QFT-G is used, but not together. |
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Term
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Definition
| Tuberculin, Purified Protein Derivative |
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Term
| What is the approved tuberculin skin test material for the routine Montoux test is the? |
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Definition
Tween-80-stabilized intermediate strength PPD available as
NSN-6505-00-105-0102 |
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Term
| Where should tuberculosis testing be recorded? (Adult & Child) |
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Definition
| NAVMED 6230/4 Adult Immunization Record or NAVMED 6230/5 Child Immunization Record |
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Term
| Name 4 authorized Navy electronic medical information systems |
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Definition
1. Armed Forces Health Longitudinal Technology Application (AHLTA)
2. Medical Readiness Reporting System (MRRS)
3. Shipboard Non-Tactical ADP Program (SNAP)
4. Automated Medical System (SAMS) |
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Term
| PPD test reaction must be read within how many hours? |
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Definition
| Within 48 to 72 hours after administration |
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Term
| What should you record if the patient comes back late for reading or does not return at all? |
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Definition
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Term
| What should you record if there is no induration (reaction)? |
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Definition
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Term
| What is the US FDA approved BAMT to provide diagnostic aid for M. tuberculosis? |
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Definition
| QuantiFERON -TB Gold (QFT-G) |
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Term
| What does BAMT stand for? |
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Definition
| Blood Assay for Microbacterium Tuberculosis |
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Term
|
Definition
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Term
| What is the best situation to use the two-step procedure (TST/PPD)? |
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Definition
| Most useful in reducing the likelihood of interpreting a boosted response as evidence of a new infection such as in older health care workers entering and MTF screening program. |
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Term
| What should all persons with a positive QFT-G be evaluated for before LTBI is diagnosed? |
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Definition
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Term
| Can a service member deploy while undergoing evaluation for a positive TST? |
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Definition
| No. Service member must not deploy until all evaluations are complete and results have been reported. |
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Term
| An increase in reaction size of 10 mm or more (TST/PPD), within a 3 year period, is considered what? |
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Definition
| Skin test conversion/positive test indicative of recent infection with TB. |
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Term
High Risk:
Reaction ≥5 mm of induration is considered positive in what three types of patients (TB)? |
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Definition
1. Recent close contacts of active TB patients
2. Persons with fibrotic or other changes on chest radiograph consistent with prior TB
3. Patients suspected of having active TB. |
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Term
Medium Risk:
Reaction ≥10 mm of induration is considered positive in what three types of patients? |
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Definition
1. Recent immigrations (within last 5 yrs) from high TB prevalence countries
2. Mycobacterium laboratory personnel
3. Persons with clinical conditions that place them at increased risk |
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Term
Low Risk:
Reaction ≥15 mm of induration is considered positive in what three type of patient? |
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Definition
| Persons with no risk factors for TB |
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Term
| At least one of what four types of medical practitioners must evaluate a newly identified patient w/ a positive BAMT or TST? |
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Definition
1. Medical Officer
2. Nurse practitioner
3. Physicians Assistant
4. Independent Duty Corpsman |
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Term
| What document should be completed in the evaluation of a newly identified patient with positive BAMT or TST? |
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Definition
| NAVMED 6224/7 Initial Tuberculosis Exposure Risk Assessment (TST). |
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Term
| Which ICD-9 code in AHLTA should be used for documenting the NAVMED 6224/7 Initial Tuberculosis Exposure Risk Assessment? |
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Definition
V74.1
"Screening Exam for Pulmonary Tuberculosis" |
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Term
| What should the chest x-ray be examined for when evaluating due to a postive BAMT or TST? |
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Definition
| Fibrotic changes consistent with old TB infection and for any signs of active TB. |
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Term
| What immediate action should be taken concerning a patient suspected of having active TB disease? |
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Definition
| Immediately mask & isolate the patient and refer to the appropriate provider and/or facility for evaluation, diagnosis, and treatment. |
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Term
| Does LTBI refer to an an infection with active TB disease? |
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Definition
No
LTBI refers to a LATENT TB Infection |
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Term
| What is the preferred treatment for an patient who meets the criteria for LTBI? |
|
Definition
Isoniazid (INH) treatment
INH 5 mg/kg (300 mg max) daily for 9 months to accomplish 270 daily doses within 12 months is preferred. |
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Term
| What is the alternate treatment for a patient meeting the criteria for positive LTBI? |
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Definition
| INH 15 mg/kg (900 mg max) twice weekly for 9 months only in combination with direct observation therapy (DOT). |
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Term
| What tests should be completed on patients with increased risk for liver disease or INH-induced hepatoxicity before starting INH treatment? |
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Definition
| serum AST (SGOT), ALT (SGPT), and bilirubin |
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Term
| When should the care provider consider witholding INH treatment? |
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Definition
| If a patients transaminase levels exceed 3 - 5 times the upper limits of normal. |
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Term
True or False?
INH is the only treatment for LTBI? |
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Definition
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Term
How oftent should patients have follow-up visits during therapy for LTBI?
What form should be used during these follo-up visits? |
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Definition
Monthly
NAVMED 6224/9 Monthly Evluation of Patients Receiving Therapy for Latent Tuberculosis Infection (LTBI) |
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Term
| Which ICD-9 code should be used in AHLTA for the NAVMED 6224/9 Monthly Evlauation of Patients Receiving Therapy for Latent Tuberculosis Infection (LTBI)? |
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Definition
V68.1
"issue of repeat prescriptions". |
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Term
|
Definition
| Directly Observed Therapy |
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Term
| DOT is expecially indicated for patients undergoing treatment for LTBI who. . . ? |
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Definition
1. Very high risk for developing active TB and who are high risk for non-adherence with treatment.
2. Patients diagnosed with active disease. |
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Term
| If a person gives an undocumented history of a positive BAMT or TST w/out documentation of adequate course of treatment for LTBI or active TB what should you do? |
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Definition
|
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Term
| Should you perform a new BAMT or TST on a patient with a creditable history of a past positive BAMT or TST? |
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Definition
| No. Document whether the patient received an adequate course of treatment for LTBI or active TB. If there has been no adquate course of treatment proceed with chest x-ray, evatuation, and appropriate treatment. |
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Term
You should document that you educated the patient on the implications of his/her BAMT or TST results, benefits and risks of LTBI treatment, and potential signs of adverse drug effects.
On what form should you document that this patient education took place? |
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Definition
| SF 600 Medical Record Chronological Record of Medical Treatment. |
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Term
| If the patient has a 2 month or more interruption or gap in LTBI treatment, what needs to be done? |
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Definition
A provider must evaluate for active TB and consider use of DOT.
- a 9-month daily INH regimen should not be re-started if the remainder of the 270 total doses can still be administered within a 12 month period. - |
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Term
All naval service beneficieries who transfer from the treating health care facility or leave military service before completing a course of treatment for LTBI must be counseled on the need for continued treatment.
This couseling must be documented on what form? |
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Definition
| NAVMED 6224/9 Monthly Evaluation for Patients Receiving Treatment for Latent Tuberculosis Infection (LTBI). |
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Term
| What actions besides documentation of counseling on the importance of continued treatment should the treating medical department take when a patient leaves before completing LTBI treatment? |
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Definition
1. Contact the gaining medical departments about all transferring members currently receiving treatment for LTBI
2. Ensure the member has enough medication to continue LTBI treatment enrout to gaining medical department where treatment is to continue.
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Term
| Are members leaving active service eligible for continued treatment for LTBI post seperation? |
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Definition
| Yes. Members are eligible for follo-up care at Veterans Administration (VA) facilities by calling the local VA prior to seperation or discharge. |
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Term
|
Definition
| Sexual Assault Prevention and Response |
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Term
| What does the term "sexual assault" refer to in SECNAVINST 1752.4A? |
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Definition
| Rape, Indecent Assault, Forcible Sodomy, Assault with Intent to Rape, and Assault with Intent to Commit Sodomy. |
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Term
True or False?
The victim of a crime has the right to be provided information about the conviction, sentencing, imprisonment, and release of the offender |
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Definition
True.
as per SECNAVINST 1752.4A Encl (1)
Crime bill of Rights #7 |
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Term
| Where can you find the instructions on completing an official report of a sexual assault for the DON Integrated Database (ID) on crime? |
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Definition
| NAVPERS 1752/1: pages 9-13. |
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Term
|
Definition
| Management of Infectious Waste |
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Term
| Where is exposure to infectious waste more likely to occur? |
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Definition
| Occupational settings that generate, transport, store, treat, or dispose of potentially infectious materials. |
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Term
| What is the definition of Infectious waste? |
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Definition
| Liquid or solid waste containing pathogens in sufficient numbers and sufficient virulence to cause infectious disease in susceptible hosts exposed to the waste. |
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Term
| Examples on non-infectious waste |
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Definition
| Used hygiene products, diapers, facial tissues, sanitary napkins (unless from postpartum suites or gynecological surgery wards), unless waste is from isolation rooms. |
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Term
| Examples of infectious waste. |
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Definition
| Sharps: Hypodermic needles, syringes, scalpel blades, suture needles, Pasteur pipettes, specimen slides, sover slips, glass petri plates, and broken glass contaminated with potentially infectious material. |
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Term
| Is microbiological waste considered "infectious waste"? |
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Definition
| Yes. Wastes from cultures and stocks containing microbes that, due to their species, type, and virulence, or concentration are know to cause disease in humans. |
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Term
| More examples of infectious waste? |
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Definition
| Liquid or semi-liquid body fluids, vaginal secretions, cerebrospinal fluid, amniotic fluids, live vaccine, saliva in dental procedures, and any body fluid visibly contaminated with blood. |
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Term
| Segregate infectious waste and non-infectious waste at. . . . ? |
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Definition
|
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Term
| What should an infectious waste container be labeled with and/or what color should the container be? |
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Definition
| The universal BIOHAZARD symbol should be present and/or a RED container. |
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Term
| True or False? It is perfectly acceptable to transport BIOHAZARD containers in Chutes and Dumbwaiters? |
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Definition
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Term
| How should anatomical pathology waste be packaged and treated? |
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Definition
| Double-wall corrugated boxes or equivalent rigid containers that are double lined with plastic bags for transport and incineration in an infectious waste incinerator. |
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Term
| What ethical constraints would prevent the normal transport and disposal of anatomical waste (human remains)? |
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Definition
| Cremation or burial by a licensed mortician. Logistical constraints may require freezing before disposal. |
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Term
| Can blood, suctioned fluids, or other potentially infectious liquid waste be decanted into a clinical sink? |
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Definition
| Yes, (but NOT a hand washing sink), unless it is prohibited by State or local regulations. |
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Term
| Do more strict state and/or local regulations override less strict regulations in the BUMEDINST 6280.1A? |
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Definition
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Term
| To assist in the liquid infectious waste disposal, what can be added to blood and/or other potentially hazardous fluids? |
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Definition
| Commercially available absorbent materials which form a semi-rigid gel when added to liquids. Formed gels still must be treated as infectious waste. |
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Term
| How should you package and transport bulk blood that cannot be decanted into a clinical sink or solidified to a gel? |
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Definition
| Placed into rigid containers that are double-lined with plastic bags for transport and incineration. Containers must be labeled and color coded. |
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Term
| How long shall non-refrigerated infectious waste be stored? |
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Definition
| 7 Days (preferably less) accept in States with stricter regulations. |
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Term
| What should be taken into consideration when contracting companies for infectious waste disposal? |
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Definition
|
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Term
| Where should infectious waste be stored? |
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Definition
| In a designated area located at or near the treatment or transport site. |
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Term
| Construction of storage areas must consider what? |
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Definition
| Prevention of rodent intrusion and other pests. |
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Term
| What should be visible on the outside of the infectious waste storage area? |
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Definition
| BIOHAZARD shall be clearly visible as well as the symbol. |
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Term
| What must occur before infectious waste can be compacted or grinded? |
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Definition
| It must be sterilized and rendered noninfectious. |
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Term
| What pieces of information shall be included in your practical system of monitoring the disposal of infectious waste? |
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Definition
| Date - Time - type of waste - amount (weight, volume, or number of containers) - disposition. |
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Term
| What should you retrieve from your off-site disposal company? |
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Definition
| Written documentation of proper treatment and disposal. |
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Term
| When should all personnel with occupational exposure to infectious waste receive training and how often? |
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Definition
| Training shall be receive at initial assignment and annually thereafter. Said training is required to be documented. |
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Term
| What should areas exposed to an infectious waste liquid spill be decontaminated with? |
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Definition
| An Environmental Protection Agency approved disinfectant or a solution of household bleach diluted 1:10 with clear water. |
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Term
| What are the 4 major types of infectious waste? |
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Definition
| 1. Microbiological 2. Pathological 3. Bulk Blood & other Potentially Infectious Liquid 4. Sharps in sharps containers |
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Term
| Name the 3 methods of treatment for microbiological waste? |
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Definition
| Steam sterilization; chemical disinfection; incineration. |
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Term
| Name the 2 methods of treatment for pathological waste? |
|
Definition
|
|
Term
| Name the 1 method of treatment for Bulk blood and other potentially infectious liquids. |
|
Definition
|
|
Term
| Name the 2 methods of treatment for sharps in sharps containers |
|
Definition
| Steam sterilization & incineration |
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Term
| Which types of waste are disposed of in a sanitary landfill? |
|
Definition
| Microbiological, Pathological, Bulk blood & other potentially infectious liquids, and sharps in sharps containers. |
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Term
| What types of waste are disposed of via burial? |
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Definition
|
|
Term
| What type of waste is disposed of in a sanitary sewer? |
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Definition
| Bulk blood and other potentially infectious liquids. |
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Term
| What requirements are there for steam sterilization for effectiveness? |
|
Definition
| 121 degrees Celsius (250 degrees F), for at least 90 minutes at 15 lbs per square inch of gauge pressure. |
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Term
| What disinfection is most appropriate for liquid waste? |
|
Definition
|
|
Term
| Ash remaining after incineration may go directly to a sanitary landfill unless what? |
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Definition
| State or local regulations require testing for characteristics of hazardous waste. |
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Term
| Disposal of placentas by grinding with subsequent discharge to a sanitary sewer is acceptable unless? |
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Definition
| Prohibited by State or local laws or regulations. |
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Term
|
Definition
| Management of Infectious Waste |
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Term
|
Definition
| Health Services Augmentation Program (HSAP) |
|
|
Term
HSAP (BUMEDINST 6440.5C)
Ch. 1 |
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Definition
| HSAP Assignment Guidlines |
|
|
Term
HSAP (BUMEDINST 6440.5C)
Ch. 2 |
|
Definition
| Administration of Deployable Personnel |
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|
Term
HSAP (BUMEDINST 6440.5C)
Ch. 3 |
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Definition
|
|
Term
HSAP (BUMEDINST 6440.5C)
Ch. 4 |
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Definition
|
|
Term
HSAP (BUMEDINST 6440.5C)
Ch. 5 |
|
Definition
|
|
Term
HSAP (BUMEDINST 6440.5C)
Ch. 6 |
|
Definition
| Medical Fleet Response Plan (MFRP) |
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|
Term
HSAP (BUMEDINST 6440.5C)
Ch. 7 |
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Definition
| Expeditionary Medicine Platform Augmentation, Readiness, and Training System (EMPARTS) |
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|
Term
HSAP (BUMEDINST 6440.5C)
Ch. 8 |
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Definition
|
|
Term
What are the Dental Item Classifications?
|
|
Definition
Critical
Semicritical
noncritical |
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Term
| What are critical, semicritical, and noncritical dental item classifications based on? |
|
Definition
| The pathways through which cross contamination may occur and the location and technique of instrument in use. |
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Term
|
Definition
Instruments and materials that penetrate the skin, mucous membranes, or bone.
Must be sterile before use |
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Term
| What are semicritical items? |
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Definition
Instruments, equipment, or sterile materials that frequently contact mucous membranes but cannot be sterilized due to their design or inability to withstand heat.
These items require at least high level disinfection. |
|
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Term
| What are noncritical items? |
|
Definition
Instruments, equipment, or materials that do not normally penetrate or contact the mucous membranes but which are exposed to splatter, spray, or splashing of blood, or are touched by contaminated hands.
Require intermediate disenfection. |
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