Professional Documents
Culture Documents
CHN Handies
CHN Handies
NERVOUS SYSTEM
Tetanus Meningitis Encephalitis Poliomyelitis Rabies
meningococcal meningitis
epidemic cerebrospinal infantile paralysis, hydrophobia,
Lock jaw brain fever
meningitis, cerebrospinal heine-medin disease lyssa, la rage
fever
Clostridium Tetani Neisseria meningitides a. Mosquito-borne encephalitis polioviruses (Legio-debilitans) Rhabdovirus
Hemophilus influenzae Causative agent: Arbovirus picornavirus family
Diploccocus pneumonia (arthropod-borne virus) • Brunhilde (I)
(pneumoccocus) Flavivirus family: West Nile • Lansing (II)
Meningoccocus virus, St. Louis Encephalitis • Leon (III)
Togavirus family: Japanese
3 days to 30 days 2 to 10 days B, Australian X, Equine 7 to 14 days 10 days to 10 year for man
Encephalitis 3 to 8 weeks for rabid animals
Bunyavirus: La Crosse
not directly transmitted from meningococcal – until bacteria are viruses Infectious during the first few dogs and cats can transmit the
person to person not present in nose and throat Mode of transmission: bite of an days and after onset of virus from 3 to 10 days before
discharge hemophilus – even infective mosquito symptoms when the virus is the onset of symptoms and
without nasal discharge Incubation period: varies present in the throat and feces throughout the course of the
according to the viral disease disease
direct inoculation or indirect direct contact including b. Viral encephalitis - direct contact including Transmitted through the bite of
contamination through break in respiratory droplets and Causative agent: virus respiratory droplets and rabid animal or through infected
the skin, tooth decay and discharges from throat and nose depends on the type of discharges from throat and saliva in a break in the skin.
umbilical cord cutting (tetanus of infected persons disease present before nose of infected persons
neonatorum) (nasopharyngeal secretions complication (nasopharyngeal secretions)
Mode of transmission – and ingestion of fecally
direct contact through contaminated milk, food and
droplet material
Incubation period – depends
on the pre-disease state, but
usually 5 to 15 days
c. Amoebic meningoencephalitis
Causative agent
Naeglena fowleri
Acanthamoeba
Mode of transmission: water
infected by N. fowleri which
enters nasal passages and
Acanthamoeba through skin
penetration.
Incubation period: 3 – 7
days
negative immunity negative immunity can lead to permanent immunity Brunhilde causes permanent offers active immunity
immunity and Lansing/Leon
causes temporary immunity
Trismus Signs of meningeal irritation Signs of meningeal irritation Stage 1 – Invasive or Abortive Rabid Animal
Risus sardonicus Opisthotonus Brudzinski sign. Increase ICP Stage Stage 2 – Pre-paralytic • Dumb form.
Rigidity of the abdomen and Kernig’s sign Decorticate (toward center) and Stage • Furious form.
extremities Opisthotonus decerebrate (extension) Hoyne sign) Man
Nuchal rigidity Child : high-pitched cry, bulging of Poker’s sign • Invasive stage
II. RESPIRATORY SYSTEM
Diptheria Pertussis Tuberculosis Influenza
Pseudoembrane Whooping cough Koch, phthsis, PTB Flu
Corynebacterium diptheriae Bordotella Pertussis Mycobacterium tuberculosis Influenza virus A (most severe)
Klebs Loeffler bacillus Hemophilus influenza Mycobacterium africanum Influenza virus B (less extensive)
Bordet-Gengou bacillus Mycobaterium bovis Influenza virus C
2 to 5 days 7 to 10 days but not exceeding 21 days. less than one month. It may persist for 1 to 5 days (average of 2 days)
lifetime as a latent infection.
Variable until virulent bacilli has disappeared from In early catarrhal stage, paroxysmal cough As long as the tubercle bacilli is being Probably limited to 3 days from
secretions and lesions, usually 2 weeks and seldom confirms provisional clinical diagnosis 7 discharged through the sputum clinical onset.
more than 4 weeks. 2 to 4 weeks (untreated days after exposure to 3 weeks after onset
individuals) and 1 to 2 weeks (treated individuals) of typical paroxysms.
Spread by droplet infection or contact with direct spread through respiratory and Airborne droplet through droplet infection, by direct
nasopharyngeal secretions and with utensils or salivary contacts. Crowding and close Direct invasion through mucus contact to infected fomites, and by
personal belongings of an infected individual association with patients facilitate spread membrane or breaks in the skin airborne spread inside a crowded and
Bovine tuberculosis enclosed areas.
provides temporary immunity contracting the disease offers long-lasting contracting the disease doesn’t provides unknown duration of
immunity provide total immunity immunity but due to ability of the
virus to mutate, new strains provides
improbable immunity
• Antigenic shift
• Antigenic drift
Psedumembrane • Invasive stage (catarrhal stage) According to extent • Headache, fever and muscle pain
• Nasal type • Spasmodic stage – 4 to 12 weeks • Minimal • Dry cough worsens over a few
• Pharyngeal type (uncommon yet very Whooping cough • Moderately advanced days and acute symptoms go
dangerous) • Convalescence stage • Far advanced away within a week
• Laryngeal type (most serious type) According to manifestations • Continuous lingering hacking
• Wound type • Active cough, fatigue and generalized
• Mucous membrane type • Inactive weakness
According to DOH • Chilly sensation, backaches and
• Category I limb pain
• Category II
• Category III
• Category IV
Nose and throat culture Clinical manifestations – assessment Direct Sputum Smear Microscopy – Nasopharyngeal secretion analysis
Shick’s test Nasopharyngeal swab (Bordet-Gengou test) Chest X-ray
Maloney’s test Increase WBC and lymphocyte count Mantoux test
Purified protein derivative
WHO – 10- 14 mm (+)
DOH – 8 to 10 mm (+)
1. Administer medications, as ordered. 1. Administer medications, as ordered. 1. Medications: HRZES 1. Administer medications, as
a. Equine diphtheria anti-toxin a. Penicillin • Fixed dose combination (FDC) ordered.
b. Penicillin / erythromycin 2. Avoid abdominal hernia by using • Single drug formulation (SDF) a. Amantidine (Symmetrel) /
c. Mild analgesia – control pain abdominal binders Rimantidine (Flumadine) –
2. Maintain patency of airway. 3. Symptomatic / supportive care 2. Chemoprophylaxis: Isoniazid and Zanamivir (Reenza) and
a. RES-P-RA-2-R-Y Vitamin B6 for 6 months to 1 year. Oseltamivir (Tamiflu)
b. Tracheostomy set at bed side 2. Symptomatic / supportive care
3. Throat irrigation and clearing 3. RES-P-RA-2-R (General
4. Symptomatic / supportive care management)
4. Symptomatic / supportive care
• DPT immunization – 3 doses, given @ 6 weeks, IM @ thigh with one month interval BCG immunization – given at or Respiratory secretion isolation.
• Avoid contact with nasopharyngeal secretions. No kissing. anytime after birth, 1 dose ID, .05 ml
Secretions should be disposed and if possible, burn it. at right deltoid region
Cover nose and mouth when sneezing
and coughing
Respiratory isolation
III. GASTROINTESTINAL
Dysentery
Typhoid Fever Cholera (Violent)
(enteric fever) Bacillary Amebic
cholera, el tor, washerwoman’s
(shigellosis, blood flux aamebiasis
disease
Salmonella typhosa Shflesneri, Vibrio cholera (classical) Entamoeba histolytica
Shboy-dii, Vibrio el tor (both with serotypes ogawa
Sn-connei, and inaba)
Sh-dysenteriae,
variable; average 2 weeks, usually 1 to 3 1 days, usually less than 4 years old few hours to 5 days, average of 3 days usually 2 to 4 weeks
weeks
as long as typhoid bacilli are present in During acute infection and until 7 to 14 days after onset, occasionally 2-3 during the period of cyst passing which
the excreta microorganism is absent from feces months may occur for years
Ingestion of contaminated water and food Ingestion of contaminated water, milk and Ingestion of contaminated water, milk and Ingestion of contaminated water and food
due to infected urine and feces (feco-oral food due to infected urine and feces (feco- food due to infected urine and feces (feco- containing the cyst form (feco-oral route).
route). Flies serves as the vector oral route). Flies also serve as a vector oral route). Flies also serve as a vector It can also be contracted through sexual
carrier carrier. El tor can exists in water for an means
extended period of time
gives no permanent immunity gives no permanent immunity frank clinical attack may offer temporary Negative immunity. Reinfection is possible
immunity, which may give protection for
several years
Prodromal stage • Chills and fever • Invasive stage • Abdominal pain
Fastidial • Nausea and vomiting • Collapse stage • Vomiting
• Rose spot in the abdomen • Tenesmus – painful straining Profuse watery stool (rice • Chills
Ladder-like fever • Stool with pus and blood watery stool) • Bloody or mucopurulent diarrhea
Spleenomegaly Signs and symtomps of • Can lead to brain amebiasis, liver
Typhoid psychosis dehydration – Washerwoman’s amebiasis and lung amebiasis
Carphologia sign
Subsultus tendinum • Reaction stage
Defervescence
Lysis/convalescence
Blood culture Rectal swab Rectal swab Stool exam – trophozoites or cysts present
Fecalysis and Urinalysis Stool exam Stool exam in fresh stool
Increase WBC Serologic test Vomitus exam Sigmoidoscopy
1. Administer medications, as ordered. 1. Administer medications, as 1. Administer medications, as ordered - 1. Administer medications, as ordered –
a. Chloramphenicol, Ampicillin ordered. Tetracycline Metronidazole (Flagyl)
2. Administer IVF to treat dehydration and a. Sulfamethoxazole 2. D-I-A-R-E-O (general management for 2. D-I-A-R-E-O (general management for
diarrhea b. Trimetoprim diarrhea) diarrhea)
3. D-I-A-R-E-O (general management for c. Severe cases: Ampicillin, 3. Symptomatic / supportive care 3. Symptomatic / supportive care
diarrhea) Tetracycline, Cotrimoxazole 4. Continue breastfeeding for infants. 4. Prevent severe dehydration leading to
4. Symptomatic / supportive care 2. D-I-A-R-E-O (general management 5. Prevent severe dehydration leading to shock
5. Prevent possible complications (e.g. for diarrhea) shock
perforation, hemorrhage, peritonitis) 3. Symptomatic / supportive care
4. Prevent possible complications
(e.g. severe dehydration
• B-A-H-A-W (general management for food handling)
• CDT immunization (IM deltoid area) provides 6 months immunity
• Exclude infected individuals in preparing and handling food.
• Environmental sanitation
• Four R’s of Proper Food handling
• Avoid sexual practices that may permit feco-oral contamination
IV. INTEGUMENTARY
Measles German Measles Chicken Pox Herpes Zoster Leprosy
rubeola, , little red disease, hard rubella, roseola, varicella shingles, zona hansen’s disease, hansenosis,
measles, seven-day measles, rothein, three-day measles leprae, leoniliasis
nine-day measles
Morbili virus of the Paramyxovirus Rubella virus or Togavirus Varicella zoster virus (VZV) reactivated Varicella-Zoster Mycobacterium leprae
family virus (VZV)
10-12 days 14-21 days 2 to 3 weeks 7-14 days 5 ½ months to 8 years
4 days before and 5 days One week before and 4 days Not more than one day One day before and 5-6 3 months, if one week of
after after appearance of rashes before and more than 6 days after appearance of treatment, client is non-infectious
days after appearance of lesions
the first crop
transmitted through droplet transmitted through droplet Direct contact or droplet airborne – inhalation of droplet/spray
infection and direct contact with infection and direct contact with spread, indirect through from coughing and sneezing of
nasopharyngeal secretions of nasopharyngeal secretions of fomites soiled by discharges untreated leprosy patient; prolonged
infected persons infected persons, indirectly through of infected individual. skin to skin contact
fomites
contracting the disease provides contracting the disease provides lifetime immunity temporary immunity
natural active immunity (lifetime) natural active immunity (lifetime)
but can be latent
Pre-eruptive stage Pre-eruptive stage Pre-eruptive stage Neuralgic, burning • Lepromatous type
High fever Low grade fever Low grade fever pain experienced along • Tuberculoid type
Conjunctivitis (Stimson’s Forscheimer’s spot – Headache the cluster of skin • Indeterminate type
sign) fine red spot on the soft Body malaise vesicles, along courses of • Borderline type
Koplik’s palate EruEruptive stage peripheral sensory nerves
Eruptive stage Eruptive stage Macular- (usually unilateral and According to presence of lesions:
Deep red maculo-papular Pink-red papular-vesiculo- found in the trunk, thorax Single-lesion paucibacillary
eruptions (begins at the maculopapular rashes, pustular rashes and face) Paucibacillary
hairline, behind the ears, relatively smaller than (appearing first in Fever and malaise Multibacillary
back of the neck) – measles’ rash (appears on the trunk or any According to WHO and MDT
cephalocaudal in face first then going to the covered part of the
Paucibacillary – tuberculoid and
appearance (3rd day) trunk and extremities body – unifocular)
indeterminate
Rash turns from red to (cephalocaudal) Multibacillary – lepromatous and
brown (in 2 to 3 days) borderline
Post-eruptive stage - Post-eruptive stage
desquamation Rashes start to crust and
Post-eruptive stage - According to DOH
• disappear
flaking Early signs:
Change in skin color – either
reddish or whitish
Loss of sensation on the skin
lesion
Anhydrosis
Thickened and painful nerves
Muscle weakness or paralysis of
extremities
Nasal obstruction or bleeding
Conjunctivitis
Ulcers that doesn’t heal
Late signs
Madarosis
Lagophthalmos
Clawing of fingers and toes
Contractures
Sinking of the nose bridge
Gynecomastia
Chronic ulcers
Slit skin smear
Physical assessment
Lepromin reaction test
1. C-A-T-I (general management 1. C-A-T-I (general 1. Administer medications as 1. Administer drugs as 1. Administer medications as
for pruritus) management for pruritus) ordered. ordered. ordered.
2. Symptomatic / supportive care 2. Symptomatic / a. Penicillin a. Analgesics Multidrug therapy – Rifampicin,
3. Prevent complications (e.g. supportive care b. Alkalinizing agents b. Corticosteroids Dapsone, Clofazimine
otitis media, 3. Prevent complications c. Acyclovir – Immunosin c. Antiviral 2. Symptomatic / supportive care
bronchopneumonia, bronchitis (e.g. otitis media, d. 1 % Hydrocortisone (Acyclovir) 3. Provide emotional and
bronchopneumonia, lotion 2. C-A-T-I (general psychological support
bronchitis 2. C-A-T-I (general management management for pruritus)
for pruritus) 3. Symptomatic / supportive
3. Symptomatic / supportive care
care a. Promote bed rest
4. Prevent complications (e.g. b. Isolate client
pneumonia, impetigo,
encephalitis)
Anti-measles vaccine – given to Respiratory secretion isolation Respiratory secretion isolation BCG immunization
child after nine months, (0.5 cc, Avoid German measles during Avoid skin contact if still untreated.
SQ, deltoid muscle) pregnancy (first trimester
Respiratory secretion isolation
V. VECTOR-BORNE DISEASES
Dengue Malaria Filariasis Leptospirosis Schistosomiasis
Dengue virus types 1, 2, 3 & 4 and P. falciparum Wuchureria bancrofti, Leptospira interrogans Schistosoma mansoni (endemic
Chikungunya • Most common in the Brugia malayi and Brugia Leptospira icterohemorrhagiae (most in the Philippines)
Philippines, around 70% of timori virulent) causing Weil’s disease. S. haematobium
cases 51: japonicum
• Causes severe/complicated
malaria and death if not
treated promptly and
appropriately
• Resistance to antimalarial
drugs in the country is
widespread but low grade
• 12 days
P. vivax
• Comprised around 30% of
cases
• Very rarely causes severe
disease
• Sensitive to antimalarial
drugs; resistance suspected
in some countries (New
Guinea, Indonesia)
• Relapse is common if not
treated adequately with
anti-relapse drug
• 13 to 17 days
P. malariae
• Very rare; less than 1% of
cases in the country
• Infection is usually not
severe but may last up to 50
years if not treated
• Drug resistance has not yet
been documented
• 13 to 16 days
P. ovale
• Not found in the Philippines;
present in some Africa
countries
• Relapse may occur if not
treated adequately with
anti-relapse drug;
• Drug resistance has not yet
been
• 28 to 30 days
uncertain, probably 6 days to 1 starts from the entry of the ranges from 7 to 19 days, with starts from the entry of the
week infective larvae to the average of 10 days infective larvae to the
development of clinical development of clinical
manifestations, usually it manifestations, usually it ranges
ranges from 8 to 16 months from 8 to 16 months
unknown, presumed to be on the 1st Unknown, presumed to be on the 1st
week of illness – when virus is still week of illness – when virus is still
present in the blood present in the blood As long as microorganism is present in water
Aedes Agypti (biological Anopheles flavistoris – breeds on Aedes poecilus, usually Through contact of the skin, Fresh water contaminated by
transmitter) slow-flowing, partly shaded water found in abaca stalks especially open wounds with water, Schistosoma eggs when infected
Aedes albopictus (biological and bites at night. moist soil or vegetation people urinate or defecate in the
transmitter) contaminated with urine of infected water.
Culex fatigans. Aedes Aegypti Anopheles litoralis - vector in host. Vector includes wild rat Oncomelania quadrasi, a tiny
coastal areas snail serves as an intermediate
Low flying mosquito that bites at Anopheles maculatus host
the lower extremities before sunrise Anopheles mangyanus
and sunset and usually breeds on a Anopheles balabacensis
clear, stagnant water.
o immunity is contracted because no immunity is contracted No known immunity Immunity is contracted, but possible no immunity is contracted
there are four different strains of infection reoccurrence is observed if
dengue other serovars caused the infection.
Grade 1 – Febrile stage (first 4 Cold stage Asymptomatic stage Leptospiremic phase • Liver damage
days) • Presence of chills mostly 10 to • No clinical signs and • Fever, headache • Malnutrition
• Herman’s sign 15 minutes symptoms • Nausea and vomiting • Weakness
• Petechiae may be present Hot stage Acute stage • Cough, chest pain • Accumulation of fluid in the
Grade 2 – Hemorrhagic stage (4th to • Fever, headache • Lymphadenitis • Myalgia abdominal cavity (ascites)
7th days) • Diarrhea, nausea and vomiting • Lymphangitis • Conjuctivitis, jaundice • Inflammation of the skin and
• Melena • Nose bleeding • Male genitalia – • Hematemesis, hematuria, itching
• Hematochezia • Last for 4 to 6 hours funiculitis, epidydimits, hepatomegaly
• Epistaxis Diaphoretic stage or orhitis (redness, Immune phase
Grade 3 – Circulatory failure / Toxic • Sweating painful, tender scrotum)
stage • Generalized body malaise Chronic stage
Grade 4 – Hypovolemic shock • Decreased pulse rate, • Hydrocoele
temperature and respiratory • Lymphedema
rate • Elephantiasis
Others
• Anemia
• Hepatomegaly
• Splenomegaly
Torniquet test / Rumple Lead’s test Malarial Smear Physical examination and Agglutination test Fecal and urinal examination
Hematocrit level Quantitative Buffy Coat history taking CSF analysis
Platelet count Nocturnal Blood Culture and Sensitivity
examination (NBE)
Immunochromatographic
Test (ICT)
1. Administer medications as 1. Administer medications as 1. Administer 1. Administer medications, as 1. Administer Praziquantel
needed. needed Diethylcarbamazine ordered (Biltricide). Alternative drugs
Vitamin K – to promote a. Blood Schizonticides - Citrate (DEC) or Penicillin and other B include
blood clotting. -quines (Choloroquines, 2. Assist in surgical lactam antibiotics Oxamniquine for S.
Antipyretics – for fever. No Primaquines, Quinidine therapy Tetracycline mansoni
aspirin. Sulfate) a. Lymphovenous (Doxycycline) Metrifonate for
2. Control bleeding b. Antipyretics for fever anastomosis - Erythromycin in patients haematobium.
3. Avoid shock 2. Symptomatic / supportive care b. Chyluria to allergic to penicillin. 2. Symptomatic / supportive
4. Symptomatic / supportive 3. Symptomatic / 2. Symptomatic / supportive care care
care supportive care a. Measure abdominal
girth
• 4 o’clock habit by DOH • 4 o’clock habit by DOH • 4 o’clock habit by DOH • Environmental sanitation • Proper waste disposal
C – hemically treated mosquito C – hemically treated mosquito C – hemically treated • Eradication of rats • Use of molluscicides
nets nets mosquito nets • Use of rubber boots • Apply 70% alcohol after
L – arvivorous fishes L – arvivorous fishes L – arvivorous fishes exposure to water
E – nvironmental sanitation E – nvironmental sanitation E – nvironmental • Use of rubber boots
A – nti-mosquito soaps A – nti-mosquito soaps sanitation • Water can be treated with
N – ymph tree / eucalyptus tree N – ymph tree / eucalyptus tree A – nti-mosquito soaps iodine or chlorine, standing
N – ymph tree / 48-72 hours before use
• Isolation of the infected person • Isolation of the infected person eucalyptus tree
• Improve irrigation and
(sleeping under the mosquito (sleeping under the mosquito cultural practices
net) net) • On stream-clearing
• Case finding and reporting • Mass screening – MBS – Mass
Blood Smear collection
• House spraying (fumigation)
• 0n stream-seeding
• On stream-clearing
VIII. BIOTERRORISM
Small Pox Anthrax SARS (Severe Acquired Respiratory Syndrome)
Variola virus Bacillus Anthracis Human Corona Virus
60 days (inhalation)
12 days 7 to 10 days
1-6 days (cutaneous)
Droplet Inhalation, ingestion and skin lesion Airborne
Inhalation: Fever
Fever Cough, headache, fever, vomiting, chills, dyspnea, syncope Cough
Malaise Cutaneous: Rapid respiration and distress
Headach Maculopapular rash, eschar Dyspnea
Backache Intestinal: Atelectasis
Maculo-papular rashes on face, mouth and Nausea and vomiting, abdominal pain, hematochezia, ascites,
pharynx massive diarrhea
3. Presence of classical sings and symptoms that are highly specific to a certain disease is known as:
a. Tell tall signs
b. Pathognomonic sign
c. Distinctive sign
d. Fastigium sign
4. When will you consider that an infection is acquired in the hospital and called as nosocomial?
a. When infection occurred upon admission
b. When infection is acquired before discharge
c. When infection is validated by the laboratory of the hospital
d. When the patient is within 14 days of hospital stay
7. Which of the following causative agent are able to live in a non-nutritive environment and is easily
transmitted in the hospital?
a. S. aureus
b. P. aeruginosa
c. E. Coli
d. H. influenza
8. The infection brought by normal biota of the body with low degree of virulence but may take
advantage when the body is immunocompromised:
a. Opportunistic infection
b. Nosocomial infection
c. True infection
d. Parasitic infection
9. When a disease can be easily transmitted from one person to another, such infection is:
a. Communicable
b. Infectious
c. Contagious
d. Virulent
10. What is the difference between gonorrhea and influenza when taking into consideration being
infectious and contagious?
a. Gonorrhea is infectious and influenza is contagious
b. Influenza is infectious and gonorrhea is contagious
c. Both are contagious and infectious
d. Gonorrhea and influenza is not contagious but only infectious
12. An organism that is capable of invading and multiplying in the body of the host:
a. Causative agent
b. Reservoir
c. Bacteria
d. Carrier
14. Shigella species only requires 10 microorganisms to cause infection while Salmonella must have
1,000 bacteria to initiate disease. This property of microorganism is known as:
a. Viability
b. Toxigenecity
c. Virulence
d. Invasiveness
15. (Refer to number 16) Also, this directly proportional relationship of number and infection refers to
what property of the causative agent?
a. Dose
b. Antigenicity
c. Specificity
d. Mode of action
16. A person whose medical history and symptoms suggest that he may now have or be developing
some communicable disease is known as:
a. Patient
b. Carrier
c. Contact
d. Suspect
17. A special type of toxin found on the cell wall of the gram negative bacteria that causes sepsis
especially when they lyse themselves (suicide bomber):
a. Exotoxin
b. Enterotoxin
c. Endotoxin
d. Epitoxin
18. The type of exotoxin that is released in the GI tract that stimulates the vomiting center of the body
and exhibits its harmful effect by the inflammation of the intestinal tract:
a. Exotoxin
b. Enterotoxin
c. Endotoxin
d. Epitoxin
19. A non cellular microorganism that contains a nucleus of DNA and/or RNA with a surrounding protein
coat and are self-limiting. Also known as the ultimate parasite:
a. Virus
b. Protozoa
c. Amoeba
d. Bacteria
20. Beds in the hospital are arranged in such a way that droplet transmission of microorganism can be
prevented. This is done by:
a. Letting a single bed occupy a single room
b. Arranging the bed not facing the door or window
c. Positioning the bed 1 meter away from each other
d. Placing blinders in each patient, if possible.
21. When an infective microorganism escaping from the reservoir is suspended in the air and is carried
through air current in the form of droplet nuclei, the mode of transmission is:
a. Airborne
b. Droplet
c. Pressurized
d. Fomites
23. Which of the following precautions doesn’t require any private room?
a. Reverse isolation
b. Strict isolation
c. Droplet precaution
d. Universal precaution
24. A vector that transmits a microorganism by harboring it to its system and serves as its reservoir:
a. Mechanical vector
b. Biological vector
c. Accidental host
d. Intermediate vector
25. Which of the following will most likely acquire an infectious disease?
a. A 30 year old male who is alcoholic
b. A pregnant mother
c. A healthy sexual worker
d. A patient who is discharged from the hospital
26. The pattern of infection where the pathognomonic signs of a specific disease is present is:
a. Incubation period
b. Prodromal period
c. Invasion/ fastigium period
d. Convalescent period
27. Cholera, tetanus, and typhoid fever occurs intermittently or on and off in different parts of the
country. This is pattern of disease occurrence is known as:
a. Endemic
b. Epidemic
c. Sporadic
d. Pandemic
28. A newly emerged strain of E. Coli that killed hundreds of hamburger eaters in the United States:
a. Sin Nombre Coli
b. E. coli O157:H7
c. Colicollus coli
d. Legionairre’s coli
29. Level of prevention focused on the early sick and aimed to detect diseases at its early state:
a. Primary
b. Secondary
c. Tertiary
d. Quarternary
31. Health education is prevents communicable diseases through IEC. Which of the following refers to
the part of IEC that involves behavioral change?
a. Information
b. Education
c. Communication
d. Integration
32. An information learned and caused a change in behavior of the client will only be effective if:
a. Able to apply everyday
b. If shared with other members of the family or even the society
c. If kept and considered as own
d. Written and well documented
33. Which of the following vaccine is introduced intradermally at right deltoid region?
a. BCG
b. DPT
c. Measles
d. Hep B
34. Which of the following vaccine is very sensitive from heat and should be stored at (-15 C to -25C) at
the freezer?
a. Measles
b. DPT
c. BCG
d. Hep B
35. Hep B is given for three doses and the schedule is:
a. At birth, 6 weeks after the 1st dose and 8 weeks after the 2nd dose
b. At six months with interval of 4 weeks in each doses
c. At birth with 4 weeks interval
d. Given together with DPT and OPV
36. What will the nurse do if a child developed convulsion within 24 hours after giving DPT?
a. Give TSB and paracetamol, as ordered.
b. Do not give the second dose of DPT.
c. Give the child DTaP instead.
d. The child must begin with DT only on the second dose because the child reacted negatively
and developed pertussis with the first dose.
38. Environmental sanitation refers to the study of all factors in man’s physical environment which may
exercise or may not exercise deleterious effect on his health and well-being. Which of the following
is not included?
a. Safe and Water Supply
b. Proper Excreta and Waste Disposal
c. Food Sanitation
d. Sexual worker’s occupation sanitation program
39. The four R’s of food sanitation includes all of the following, except:
a. Right Source
b. Right Price
c. Right Storage
d. Right Cooking
42. Food establishments in the community shall be appraised as to their sanitary conditions. Which of
the following is important for the cook or cook helper to have?
a. Inspection
b. Approval of all food sources
c. Updated health services
d. Compliance to health certificate
43. A patient is removed from the other persons because he is susceptible in acquiring a certain
disease. This kind of isolation is called as:
a. Strict isolation
b. Contact isolation
c. Source isolation
d. Reverse isolation
45. The restriction of activities of well person that has been exposed to a case of communicable
disease to prevent disease transmission during the incubation period but without limitation to
movements:
a. Complete quarantine
b. Source isolation
c. Surveillance
d. Separation
46. A patient with typhoid fever and have several bouts of diarrheal stool prompts a nurse to use what
kind of precaution:
a. Contact
b. Reverse Isolation
c. Drainage precaution
d. Enteric precaution
49. A patient with suspected tuberculosis has been admitted to the hospital. Which of the following is
not appropriate?
a. Droplet precautions
b. Source isolation
c. Standard precautions
d. Use of a type of N95 respirator by the health care provider
51. It is the killing of microorganisms by chemical and physical means. It can be done through dry heat,
moist heat and radiation:
a. Disinfection
b. Sterilization
c. Sanitation
d. Disinfestation
52. You are caring a client in isolation. After nursing care is done what will you remove first after
handling the patient?
a. Mask
b. Gown
c. Gloves
d. Bonnet
53. The process of weakening microorganism through consecutive steps of freezing and dessication.
This process is used for making vaccine:
a. Use of formaldehyde
b. Lyophilization
c. Attenuation
d. Moist heat application
54. The process of rendering surface that has been heavily exposed to infectious pathogen safe to
handle is known as:
a. Disinfection
b. Decontamination
c. Sterilization
d. Anti-septic
55. When a nurse uses alcohol on the client’s skin before an injection, she uses what kind of chemical-
removing-microorganism?
a. Antiseptic
b. Disinfectant
c. Decontaminant
d. Antimicrobial
56. The removal of stains and any contaminants from a kitchen utensils done at home is also known as:
a. Sanitization
b. Sanitation
c. Decontamination
d. Disinfection
57. The client with tuberculosis is expelling large amount of sputum. The nurse, every time the client
coughs, removes the soiled linen and discards the tissues and burns it. This technique is what kind
of disinfection?
a. Terminal
b. Concurrent
c. Longitudinal
d. Post-expulsion
58. The process of filling animal forms through use of gaseous agent.
a. Indoor Residual Spraying (IRS)
b. Disinfestation
c. Sanitation
d. Gaseous Desentisization
59. Medical hand washing can be done for ___ and with elbows ___ :
a. 10 – 15 seconds: down
b. 10 – 15 seconds: up
c. 3 - 5 minutes: down
d. 3 – 5 minutes: up
67. Which of the following management neutralized the toxins present in the body with tetanus?
a. Anti-tetanus toxin
b. Tetanus immunoglobulin
c. Penicillin
d. Equine anti toxin
68. DPT immunization provides how many years of protection?
a. 2 years
b. 5 years
c. 7 years
d. 10 years
71. Wounds with patients with suspected tetanus infection is best cleaned by:
a. Soap and water
b. 3% hydrogen peroxide
c. Iodophor
d. Cydex
74. Which of the following causative agents of meningitis which is common among children?
a. Hemophilus influenza
b. Streptococcus pneumonia
c. Meningococcus
d. E. coli
75. The drug of choice for this meningitis causative agent is Penicillin:
a. Hemophilus influenza
b. Streptococcus pneumonia
c. Meningococcus
d. Clostridium tetani
76. Meningoccocemia is a result of the systemic profileration of the microorganism in the body
characterized by except:
a. Petechial rash
b. Hypotension
c. DIC
d. Convulsion
77. Meningitis is the characterized by flexion of the hip and knee while in supine position, when neck is
flexed. This is known as:
a. Kernig’s sign
b. Brudzinski’s sign
c. Opisthotonus
d. Nuchal rigidity
78. Chemoprophylaxis for meningitis includes which of the following pharmacological intervention for 2
days and 2 dose and is contraindicated for pregnant mothers and taking contraceptives:
a. Rifampicin
b. Penicillin
c. Ceftriaxone
d. Penicilin
80. The following management decreases tendency of increased intra-cranial pressure, except:
a. Avoid valsalva maneuver
b. Administer anti-diuretics
c. Lessen environmental stimuli
d. Elevate head part
82. West nile virus, St. Louis Encephalitis are mosquito-related encephalitis and is caused by:
a. Flavivuris
b. Togavirus
c. Bunyavirus
d. Paramyxovirus
83. It is a kind of encephalitis that resulted from complication of communicable disease of viral origin
due to ascending infection:
a. Secondary encephalitis
b. Amoebic encephalitis
c. Toxic encephalitis
d. Mosquito-borne encephalitis
85. The only mosquito borne encephalitis that have vaccine made from inactivated brain of mouse,
given for three doses of I cc:
a. Australian X Encephalitis
b. Equine Encephalitis
c. Japanese B encephalitis
d. St. Louise encephalitis
86. Mad cow disease is a kind of encephalitis and medically called as:
a. Kuru
b. Creudzfeldt Jakob Disease
c. Scrapie
d. Bovine spongiform encephalitis
87. Amoebic encephalitis is brought by a microorganism from waters containing organic waste and
enters body through nasal passages, olfactory nerve reaching the CNS. What is this amoeba?
a. N. fowleri
b. Acanthamoeba
c. Plasmodium ovale
d. T. brucei
88. Increase ICP among infants is manifested primarily by all of the following, in exception of:
a. High-pitched cry
b. Bulging of fontanels
c. Decrease pulse rate
d. Projectile vomiting
89. The following are the diagnostic procedures for encephalitis, except:
a. EEG
b. Blood culture
c. Nose and throat swab
d. Lumbar puncture
90. Which of the following intervention can be a preventive measure against encephalitis?
a. Avoid nasopharyngeal secretions from infected individuals with toxic encephalitis
b. CLEAN program of DOH
c. Influenza virus vaccine
d. Proper food handling
93. In 1955, Jonas Salk introduced this vaccine to prevent poliomyelitis caused by Sabin’s vaccine?
a. OPV
b. IPV
c. OPT
d. OPM
97. How many days will it take to have an irreversible paralysis among client with Poliomyelitis?
a. 30 days
b. 60 days
c. 90 days
d. 100 days
98. Which kind of paralysis that affects the cranial nerves and respiratory muscles?
a. Spinal
b. Bulbar
c. Bulbo-spinal
d. Laundry’s paralysis
99. Diagnostic procedure for poliomyelitis includes all of the following, except:
a. Muscle Grading Scale
b. Electroencephalogram
c. Lumbar puncture
d. Stool exam