ADM Safety & Infection Control 3 — Questions and Answers
Question 1: A clinician is exposed to blood from a patient of unknown HIV status via a needlestick. What is the recommended window period for HIV post-exposure prophylaxis (PEP) initiation?
- Within 1 hour
- Within 72 hours (Correct answer)
- Within 1 week
- Within 2 weeks
Correct answer: Within 72 hours
HIV PEP must be initiated within 72 hours of exposure to be effective, with earlier initiation being more beneficial.
Question 2: Which of the following is a harm reduction strategy that directly reduces the transmission of bloodborne infections among people who inject drugs (PWID)?
- Mandatory abstinence programs
- Syringe services programs (SSPs) (Correct answer)
- Supervised exercise programs
- Random drug testing
Correct answer: Syringe services programs (SSPs)
Syringe services programs reduce HIV and HCV transmission by providing sterile injection equipment and linking PWID to health services.
Question 3: Which organism is a common cause of infective endocarditis in patients who inject drugs, often affecting right-sided heart valves?
- Streptococcus viridans
- Staphylococcus aureus (Correct answer)
- Enterococcus faecalis
- Pseudomonas aeruginosa
Correct answer: Staphylococcus aureus
Staphylococcus aureus is the most common cause of endocarditis in people who inject drugs and frequently involves the tricuspid valve.
Question 4: A patient on buprenorphine maintenance therapy develops a fever and a fluctuant mass at an injection site. What is the most appropriate next step?
- Increase the buprenorphine dose
- Order blood cultures and refer for surgical evaluation (Correct answer)
- Prescribe oral antibiotics and observe for 1 week
- Discharge with wound care instructions
Correct answer: Order blood cultures and refer for surgical evaluation
A fluctuant mass with fever suggests abscess formation requiring blood cultures to rule out bacteremia and surgical evaluation for drainage.
Question 5: What is the recommended approach for disposing of used sharps in a clinic providing medication-assisted treatment?
- Place in any rigid container until full, then discard in regular trash
- Use an FDA-cleared sharps disposal container and follow local regulations (Correct answer)
- Recap and return to the pharmacy for disposal
- Dispose in a red bag with other biohazardous waste
Correct answer: Use an FDA-cleared sharps disposal container and follow local regulations
FDA-cleared sharps containers with proper disposal per local regulations are the standard for safe sharps management in clinical settings.
Question 6: Which hepatitis virus requires co-infection or superinfection with hepatitis B to cause disease?
- Hepatitis A
- Hepatitis C
- Hepatitis D (Correct answer)
- Hepatitis E
Correct answer: Hepatitis D
Hepatitis D (delta virus) is a defective RNA virus that requires HBV surface antigen for its own replication and transmission.
Question 7: In the context of addiction medicine, which of the following best describes 'universal precautions for opioid prescribing'?
- Treating all patients as potential opioid abusers and withholding medication
- Applying consistent risk assessment and monitoring practices to all patients regardless of perceived risk (Correct answer)
- Prescribing only short-acting opioids to all patients
- Requiring urine drug screens only for patients with prior substance use disorders
Correct answer: Applying consistent risk assessment and monitoring practices to all patients regardless of perceived risk
Universal precautions for opioid prescribing apply systematic risk assessment, informed consent, and monitoring to all patients to reduce risk and stigma.
ADM Safety & Infection Control 3
A clinician is exposed to blood from a patient of unknown HIV status via a needlestick.
What is the recommended window period for HIV post-exposure prophylaxis (PEP) initiation?