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Immunology & Infection Control

Oct 03, 20245 min read

Immunoglobulins

  1. IgG: the most abundant immunoglobulin; able to cross the placenta. It is found in chronic infection.
  2. IgA: found in secretions and is found in breastmilk, which can confer immunity once consumed.
  3. IgM: the largest immunoglobulin, found to rise during acute infections.
  4. IgE: allerges; responsible for pruritus/urticaria, and helminths.
  5. IgD: no role

Asepsis

  1. Medical Asepsis: the use of barriers (PPE), hand hygiene, and environmental cleaning to minimize microorganisms.
  2. Surgical Asepsis: cleaning of the sterile field to isolate the operative area from the unsterile environment to avert contamination of open wounds.

Food & Water-borne Illness

Food and water-borne infections, (mn. Take Care Po, HA!)

  • Typhoid
  • Cholera
  • Polio
  • Hepatitis A and E
  • Amoebiasis

Lines of Defense

First Line of Defense

“Natural immunity” provided by:

  1. Intact skin and mucous membranes
  2. Enzymes in tears and body secretions
  3. Normal flora of the body

Second Line of Defense

Also natural immunity, the defensive immune cells of the body:

  1. Neutrophils, Eosinophils, Basophils
  2. Macrophages
  3. Natural Killer (NK) Cells: killers of virus and bacterial-infection cells.

Third Line of Defense

Acquired immunity; B-cells and T-cells. They mature in the bone marrow and thymus; these are the primary lymphoid organs. Secondary lymphoid organs include the appendix, spleen, and tonsils. They produce immunoglobulins and antibodies.

  1. B cells remain in the bone marrow to reach maturity. They differentiate to become antibody-producing plasma cells, produces antibodies and immunoglobulins, and are antigen producing cells.
  2. T cells migrate into the thymus to mature. They are composed of CD4 (Helper) T-cells and CD8 (Cytotoxic) T-cells.
    • CD4: . These are the cells destroyed in AIDS, and is monitored for patients with AIDS.
    • CD8

Immunity can be passive or active, and also natural or artificial.

Antibodies

Antibodies react with antigens. Antigens stimulate the production of antibodies.

Infection Control

Disinfection and sterilization both destroy microbes in non-living items. Distinctively, sterilization includes the destruction of gram-positive bacilli. Disinfection does not eliminate spores. For the destruction of microorganisms on living tissue, the action is termed as Antisepsis.

Chain of Infection

The chain of infection starts with a (1) microorganism, in a (2) reservoir, that exits through the (3) portal of exit, travels via the (4) mode of transmission, then enters the (5) portal of entry into a (6) host, the most important aspect of this chain.

  • The easiest aspect to break in this chain is the mode of transmission.

Aerosol-Generating Procedures (AGP)

These procedures require the use of N95 masks, which protect against aerosols. (mn. BASIC)

  1. Bronchoscopy
  2. Airway Suctioning
  3. Sputum Induction
  4. Intubation and Extubation
  5. PR, Ventilation (Manual, non-invasive bipap., CPAP)

Medical Wastes

Waste produced during the course of care and are contaminated or visibly soiled:

  • Blood or other potentially infectious materials
  • Urine, feces, suctioned fluids
  • Irrigating solutions, excretions, and secretions

A color-coding scheme is used for medical waste management:

  1. Red Container: sharps
  2. Green Container: non-infectious wet waste
  3. Black Container: non-infectious dry waste
  4. Yellow Container: infectious waste
  5. Orange Containers: radioactive waste

Hospital Infection Control Committee

  1. Chief of Hospital
  2. Infection Control Doctor
  3. Infection Control Nurse

Infection Control Basics

This includes sterilization, environmental care, healthcare waste management, and healthcare worker protection, etc.

  1. Hand Hygiene
  2. Isolation Procedure: the separation of agents to prevent contamination.
  3. Decontamination: the removal of moist body substances from items before cleaning and disassembly.
  4. Disinfection: the use of chemical agents. Spores are not destroyed.

Which of the following in the chain of infection is the easiest to break? a.) Portal of Entry b.) Portal of Exit c.) Mode of Transmission d.) Incubation

Which of the following describe IgA? a.) The most abundant immunoglobulin b.) Crosses placenta c.) Present in saliva and breastmilk d.) The first immunoglobulin that rises during acute infection

Which immunoglobulin is the largest? a.) IgM

Which immunoglobulin is for acute infection? a.) IgM

Which immunoglobulin is for chronic infection? a.) IgG

The nurse understands that, in the operating room, the absence of pathogenic organisms is called? a.) Disinfection b.) Sterilization c.) Antisepsis d.) Asepsis

A bacterial appears violet and rod-like under a microscope. Which is an accurate description? a.) A gram-positive bacilli. b.) A gram-positive cocci. c.) A gram-negative bacilli. d.) A gram-negative cocci.

Which of the following admitted patients is not placed in a negative pressure airflow private room? a.) A 45-y.o. with pulmonary tuberculosis b.) A 23-y.o. with varicella zoster c.) A 7-y.o. child with rubeola d.) A 5-y.o. child with diphtheria

Which of the following does not affect susceptibility to infection? a.) Stress b.) Chronic disease c.) Increasing Age d.) Poor nutrition e.) Increased normal flora in the body.

Which of the following is used for amoebiasis? a.) Blood and body fluid b.) Reverse isolation c.) Enteric isolation d.) Contact isolation

The body’s third line of defense include: a.) B cells b.) T cells c.) NK or natural killer cells d.) A and B only e.) All of the above

A breastfeeding mothers

Mr. X was diagnosed with acute hepatitis A. He has undergone work up and results are obtained on the next follow up. Which of the following shows acute Hepatitis A? a.) Reactive AntiHAV IgM b.) Reactive AntiGAB IgG c.) Reactive HbsAg d.) B and C only

Which of the folloiowng conditions will show rise in IgE? a.) A 70-y.o. patient with Ascariasis b.) A 53-y.o. patient with COVID-19 c.) A 36-y.o. patient Tuberculosis d.) A 32-y.o. patient with Typhoid Fever

Which of the following may be used for aerosol-generating procedures

Nurse J has finished suctioning the secretions of a patient on a mechanical ventilator with COVID-19. The first step for removal of protective barriers after leaving the isolation room of the patient is? a.) Removal of eyewear or goggles b.) Removal of gown c.) Removal of gloves d.) Hand washing

This is not included in general waste: a.) Diapers b.) Suctioned fluids c.) Paper towels used for drying hands d.) Dressing wrappers

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