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Needlestick injury

Clinical Discipline(s)/Organ System(s)
Emergency Medicine, Infectious Diseases
Progress Test Topic(s)
Infectious disease
A final year NZ European medical student sustains a needlestick injury whilst scrubbed up with his consultant general surgeon. The patient is New Zealand born and undergoing an elective procedure. The student is concerned that he may have been exposed to an infectious disease.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Immunological response to microorganisms
   - Passive and active immunity
   - Routes of transmitting an infectious disease
   - Transmission and pathophysiology of hepatitis B and C virus, and human immunodeficiency virus (HIV)
   - How vaccinations induce an immune response
   - Pharmacology of anti-retroviral and anti-viral drugs
   - Tetanus exposure and microbiology and disease
Clinical and Communication Skills 
   - History from a patient with a needlestick injury
   - Perform a general examination; recognise generalised lymphadenopathy
   - Explain the possible outcomes following a needlestick injury
   - Management of a needlestick injury, including surveillance
   - Role of Occupational Health Department
   - Interpret hepatitis B and C and HIV serology, full blood count, liver function tests
   - Management of acute hepatitis
   - Identifying tetanus prone injuries and immunisation, both passive and active, to prevent tetanus.
Personal and Professional Skills 
   - Role of the Accident Compensation Corporation
   - Health worker vaccinations
   - Self-care: preventing needlestick injuries
   - Managing an anxious patient and exploring beliefs about injury/illness
   - Explaining the risks and benefits of prophylaxis following a needlestick
Population Health 
   - New Zealand vaccination programme
   - Epidemiology of hepatitis B and C, HIV
Conditions to be considered relating to this scenario
hepatitis B
Less common but 'important not to miss'
hepatitis C, HIV, fulminant liver failure