Addiction Medicine Certification Infection Control & Prevention 2 — Questions and Answers
Question 1: A patient with opioid use disorder presents with fever and a new heart murmur after IV drug use. Which organism is most commonly responsible for right-sided infective endocarditis in people who inject drugs?
- Streptococcus viridans
- Staphylococcus aureus (Correct answer)
- Enterococcus faecalis
- Pseudomonas aeruginosa
Correct answer: Staphylococcus aureus
Staphylococcus aureus, including MRSA, is the most common cause of right-sided (tricuspid valve) infective endocarditis in people who inject drugs.
Question 2: Which hepatitis virus is transmitted exclusively via the fecal-oral route and does NOT cause chronic infection?
- Hepatitis B
- Hepatitis C
- Hepatitis A (Correct answer)
- Hepatitis D
Correct answer: Hepatitis A
Hepatitis A is transmitted fecal-orally, causes only acute infection, and does not lead to chronic liver disease.
Question 3: A clinician is counseling a patient who injects drugs about syringe service programs (SSPs). Which of the following is a proven benefit of SSPs?
- They increase overall drug use in the community
- They reduce HIV and hepatitis C transmission without increasing drug use (Correct answer)
- They replace the need for medication-assisted treatment
- They are prohibited under federal law
Correct answer: They reduce HIV and hepatitis C transmission without increasing drug use
Evidence consistently shows SSPs reduce HIV and HCV transmission among people who inject drugs without increasing drug use rates in the community.
Question 4: Which of the following best describes the window period for HIV infection?
- The time between exposure and development of AIDS
- The time between HIV infection and when tests can reliably detect the virus or antibodies (Correct answer)
- The period during which antiretroviral therapy is most effective
- The duration of the acute retroviral syndrome
Correct answer: The time between HIV infection and when tests can reliably detect the virus or antibodies
The window period is the interval between HIV infection and when diagnostic tests (antigen/antibody or RNA tests) become reliably positive.
Question 5: A patient receiving buprenorphine for OUD discloses sharing injection equipment. Which vaccination is MOST urgently indicated if not previously administered?
- Pneumococcal vaccine
- Hepatitis A and B vaccines (Correct answer)
- Meningococcal vaccine
- HPV vaccine
Correct answer: Hepatitis A and B vaccines
Hepatitis A and B vaccines are strongly recommended for people who inject drugs due to high risk of blood-borne and fecal-oral transmission in this population.
Question 6: Which of the following describes the mechanism by which HIV preferentially infects CD4+ T cells?
- HIV binds to the CD8 receptor on cytotoxic T cells
- HIV uses its gp120 envelope protein to bind CD4 receptors and CCR5/CXCR4 co-receptors (Correct answer)
- HIV integrates into B cell DNA via surface immunoglobulin binding
- HIV binds macrophage toll-like receptors to enter cells
Correct answer: HIV uses its gp120 envelope protein to bind CD4 receptors and CCR5/CXCR4 co-receptors
HIV gp120 binds the CD4 receptor, then engages CCR5 or CXCR4 co-receptors, facilitating viral entry into CD4+ T cells and macrophages.
Question 7: A person who injects drugs develops a painful, fluctuant abscess at an injection site. What is the first-line management for a simple cutaneous abscess?
- Oral antibiotics alone
- IV antibiotics and hospitalization
- Incision and drainage (Correct answer)
- Warm compresses and observation only
Correct answer: Incision and drainage
Incision and drainage is the primary treatment for cutaneous abscesses; antibiotics may be added for surrounding cellulitis or systemic signs.
Addiction Medicine Certification Infection Control & Prevention 2
A patient with opioid use disorder presents with fever and a new heart murmur after IV drug use.
Which organism is most commonly responsible for right-sided infective endocarditis in people who inject drugs?