Infectious Diseases Hospital Epidemiology and Infection Control: Review Questions George J. Alangaden, MD Dr. Alangaden is an associate professor of internal medicine, Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI. Choose the single best answer for each question.
	1. Which of the following agents used for routine decontamination of hands in health care settings is most bactericidal and least irritating to the skin? Alcohol-based handrub Antimicrobial soap and water Chlorhexidine handwash Plain soap and water Triclosan handwash Click here to compare your answer. 2. A 24-year-old man who is undergoing chemotherapy for Hodgkin’s lymphoma is hospitalized with a temperature of 101°F and a generalized vesicular rash. He has not received the varicella vaccine and is uncertain if he had chickenpox as a child. Which of the following is the most appropriate empiric infection control measure to institute? Airborne precautions Droplet precautions Contact precautions Airborne and contact precautions Airborne and droplet precautions Click here to compare your answer. 3. A medical resident is accidentally splattered with blood on his arms while performing cardiac resuscitation. The source patient, who is HIV-infected but is seronegative for hepatitis B and C, has been hospitalized with pneumocystis pneumonia. The resident immediately washes his arms with soap and water. On examination of his arms, there are no abrasions or skin lesions. Which of the following is the most appropriate medical management option for the resident? Initiate postexposure prophylaxis (PEP) immediately with 2 antiretroviral drugs Initiate PEP immediately with 3 antiretroviral drugs Monitor closely for any clinical features of acute retroviral syndrome No further work-up or treatment Perform baseline and follow-up serologic testing for HIV seroconversion Click here to compare your answer.		4. A 62-year-old man with diabetes mellitus and chronic obstructive pulmonary disease is admitted to the intensive care unit in septic shock and respiratory failure. He is orally intubated, placed on a mechanical ventilator, and is being nursed in a semirecumbent position. Which of the following can decrease this patient’s risk of ventilator-associated pneumonia? Changing the ventilator circuit tubing every 48 hours Chest physiotherapy Optimization of endotracheal tube cuff pressures Selective antimicrobial decontamination of the gastrointestinal tract Use of disposable suction catheters Click here to compare your answer. 5. Which of the following is a recommended strategy to prevent infections of nontunneled central venous catheters (CVCs)? Culture all catheter tips after removal to identify if infected Guidewire exchange of malfunctioning catheter if no signs of infection Immediate guidewire exchange of potentially infected catheters Replace catheters after a maximum 7 days of use Use antimicrobial impregnated catheters whenever possible Click here to compare your answer.
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