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NEW QUESTION # 142
In a retrospective case-control study, the initial case group is composed of persons
Answer: B
Explanation:
In a retrospective case-control study, cases and controls are selected based on disease status. The case group is composed of individuals who have the disease (cases), while the control group consists of individuals without the disease. This design allows researchers to look back in time to assess exposure to potential risk factors.
Step-by-Step Justification:
* Selection of Cases and Controls:
* Cases: Individuals who already have the disease.
* Controls: Individuals without the disease but similar in other aspects.
* Direction of Study:
* A retrospective study moves backward from the disease outcome to investigate potential causes or risk factors.
* Data Collection:
* Uses past medical records, interviews, and laboratory results to determine past exposures.
* Common Use:
* Useful for studying rare diseases since cases have already occurred, making it cost-effective compared to cohort studies.
Why Other Options Are Incorrect:
* B. without the disease: (Incorrect) This describes the control group, not the case group.
* C. with the risk factor under investigation: (Incorrect) Risk factors are identified after selecting cases and controls.
* D. without the risk factor under investigation: (Incorrect) The study investigates whether cases had prior exposure, not whether they lacked a risk factor.
CBIC Infection Control References:
* APIC Text, Chapter on Epidemiologic Study Design.
NEW QUESTION # 143
A patient has an oral temperature of 101° F (38.33 C). Erythema and tenderness arc noted at the central line site. Blood samples are submitted for culture and intravenous vancomycin is ordered. This is an example of which of the following forms of antibiotic treatment?
Answer: D
Explanation:
Empiric antibiotic therapy is the immediate initiation of antibiotics based on clinical judgment before laboratory confirmation of an infection. In this case, the presence of fever, erythema, and tenderness at the central line site suggests a possible bloodstream infection, prompting empiric treatment with vancomycin.
Step-by-Step Justification:
* Initiation Before Lab Confirmation:
* Empiric therapy starts treatment based on symptoms while awaiting culture results.
* Prevents Complications:
* Delayed treatment in central line-associated bloodstream infections (CLABSI) can lead to sepsis.
* Common in High-Risk Situations:
* Empiric treatment is used in cases where waiting for lab results could worsen the patient's condition.
Why Other Options Are Incorrect:
* B. Prophylactic:
* Prophylactic antibiotics are given to prevent infection, not to treat an existing one.
* C. Experimental:
* Experimental treatment refers to clinical trials or unproven therapies, which does not apply here.
* D. Broad spectrum:
* Broad-spectrum antibiotics cover multiple bacteria, but empiric therapy may be narrow- spectrum based on suspected pathogens.
CBIC Infection Control References:
* APIC Text, Chapter on Antimicrobial Stewardship and Empiric Therapy.
NEW QUESTION # 144
A healthcare worker experiences a percutaneous exposure to a patient with untreated HIV. The next step is to:
Answer: D
Explanation:
* HIV post-exposure prophylaxis (PEP) should be initiated within 2 hours to be most effective.
* Waiting for results (B) delays critical treatment.
* PEP should always be offered after high-risk exposure, not only if symptoms develop (C).
* Retesting after 6 months (D) is recommended but should not delay PEP initiation.
CBIC Infection Control References:
* APIC Text, "Bloodborne Pathogens and PEP," Chapter 11.
NEW QUESTION # 145
Which of the following microorganisms does NOT cause gastroenteritis in humans?
Answer: B
Explanation:
Gastroenteritis, characterized by inflammation of the stomach and intestines, typically presents with symptoms such as diarrhea, vomiting, and abdominal pain. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the identification of infectious agents in the "Identification of Infectious Disease Processes" domain, aligning with the Centers for Disease Control and Prevention (CDC) guidelines on foodborne and enteric diseases. The question requires identifying the microorganism among the options that does not cause gastroenteritis, necessitating an evaluation of each pathogen's clinical associations.
Option B, "Rhinovirus," is the correct answer as it does not cause gastroenteritis. Rhinoviruses are the primary cause of the common cold, affecting the upper respiratory tract and leading to symptoms like runny nose, sore throat, and cough. The CDC and WHO classify rhinoviruses as picornaviruses that replicate in the nasopharynx, with no significant evidence linking them to gastrointestinal illness in humans. Their transmission is primarily through respiratory droplets, not the fecal-oral route associated with gastroenteritis.
Option A, "Norovirus," is a well-known cause of gastroenteritis, often responsible for outbreaks of acute vomiting and diarrhea, particularly in closed settings like cruise ships or nursing homes. The CDC identifies norovirus as the leading cause of foodborne illness in the U.S., transmitted via the fecal-oral route. Option C,
"Rotavirus," is a major cause of severe diarrheal disease in infants and young children worldwide, also transmitted fecal-orally, with the CDC noting its significance before widespread vaccination reduced its impact. Option D, "Coxsackievirus," a member of the enterovirus genus, can cause gastroenteritis, particularly in children, alongside other syndromes like hand-foot-mouth disease. The CDC and clinical literature (e.g., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases) document its gastrointestinal involvement, though it is less common than norovirus or rotavirus.
The CBIC Practice Analysis (2022) and CDC guidelines on enteric pathogens underscore the importance of distinguishing between respiratory and gastrointestinal pathogens for effective infection control. Rhinovirus's exclusive association with respiratory illness makes Option B the microorganism that does not cause gastroenteritis.
References:
* CBIC Practice Analysis, 2022.
* CDC Norovirus Fact Sheet, 2021.
* CDC Rotavirus Vaccination Information, 2020.
* Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 9th Edition, 2019.
NEW QUESTION # 146
Which of the following is the BEST strategy for reducing bloodstream infections associated with central venous catheters?
Answer: C
Explanation:
* Chlorhexidine-impregnated dressings reduce central line-associated bloodstream infections (CLABSI) by preventing bacterial colonization.
* Routine catheter replacement (A) increases insertion risks without reducing infections.
* Daily blood cultures (C) are unnecessary and lead to false positives.
* Povidone-iodine (D) is less effective than chlorhexidine for skin antisepsis.
CBIC Infection Control References:
* APIC Text, "CLABSI Prevention Measures," Chapter 10.
NEW QUESTION # 147
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