CER CER - Certified Endoscope Reprocessor Chemical Disinfectants and Germicides Questions and Answers 5 — Questions and Answers
Question 1: A staff member accidentally splashes OPA solution into their eyes. Which immediate first-aid action is correct?
- Apply a neutralizing agent such as dilute sodium bicarbonate before rinsing
- Flush immediately with large amounts of water for at least 20 minutes (Correct answer)
- Patch the eye and seek medical attention without rinsing to prevent further irritation
- Rinse with normal saline for 5 minutes, then apply an antibiotic eye drop
Correct answer: Flush immediately with large amounts of water for at least 20 minutes
Immediate and prolonged water flushing (minimum 20 minutes) is the standard first-aid response for OPA or any chemical splash to the eyes.
Question 2: What is the primary reason that glutaraldehyde solution must be covered when not in use during the reprocessing process?
- To prevent evaporation of water that would increase the concentration above safe levels
- To limit vapor release and reduce staff exposure to irritating fumes (Correct answer)
- To prevent airborne microbial contamination from entering the solution
- To maintain the activation pH required for germicidal activity
Correct answer: To limit vapor release and reduce staff exposure to irritating fumes
Covering glutaraldehyde containers limits the release of irritating and potentially harmful vapors into the work environment, protecting staff from respiratory and mucous membrane irritation.
Question 3: An endoscope labeled by the manufacturer as compatible only with 2.4% alkaline glutaraldehyde is submitted for reprocessing. The facility only has OPA available. What should the technician do?
- Proceed with OPA since it has broader antimicrobial coverage than glutaraldehyde
- Consult the scope manufacturer's IFU before using any alternative chemical disinfectant (Correct answer)
- Use OPA at double the standard contact time to compensate for any incompatibility risk
- Reject the scope for reprocessing until glutaraldehyde is restocked
Correct answer: Consult the scope manufacturer's IFU before using any alternative chemical disinfectant
The endoscope manufacturer's Instructions for Use (IFU) must be followed for chemical compatibility; using an unapproved chemical can damage the scope and void warranties.
Question 4: Which of the following best describes the mode of action of OPA as a high-level disinfectant?
- Oxidation of microbial cell components, disrupting enzyme and cell wall function
- Alkylation of cellular proteins and nucleic acids, impairing microbial replication (Correct answer)
- Disruption of microbial cell membranes via surfactant action
- Generation of free radicals that irreversibly denature microbial DNA
Correct answer: Alkylation of cellular proteins and nucleic acids, impairing microbial replication
OPA is an aromatic dialdehyde that achieves germicidal activity primarily through alkylation, cross-linking the proteins and nucleic acids of microorganisms.
Question 5: A new glutaraldehyde product states a reuse life of 28 days after activation. Which best practice should guide the reprocessor?
- Use the solution for exactly 28 days regardless of MEC test results
- Test the solution's MEC daily and discard it when it falls below MEC or at 28 days, whichever comes first (Correct answer)
- Discard and replace the solution every 14 days to ensure a safety margin
- Extend the reuse life beyond 28 days if MEC tests continue to pass
Correct answer: Test the solution's MEC daily and discard it when it falls below MEC or at 28 days, whichever comes first
MEC testing must be performed before each use (or per policy), and the solution must be discarded when it either fails MEC testing or reaches the manufacturer's maximum reuse life, whichever occurs first.
Question 6: Which disinfectant is most associated with causing hypersensitivity reactions, including anaphylaxis, in patients who have undergone repeated endoscopic procedures?
- Peracetic acid
- Hydrogen peroxide
- Glutaraldehyde
- Ortho-phthalaldehyde (OPA) (Correct answer)
Correct answer: Ortho-phthalaldehyde (OPA)
OPA has been associated with anaphylaxis-like hypersensitivity reactions in patients receiving repeated cystoscopy, prompting FDA safety communications and warnings.
Question 7: When a disinfectant's label states it achieves 'sporicidal' activity, this means the product can achieve which level of microbial kill?
- High-level disinfection only
- Intermediate-level disinfection
- Sterilization (Correct answer)
- Low-level disinfection with extended contact time
Correct answer: Sterilization
A product that kills bacterial spores (the most resistant microbial form) under labeled conditions is classified as achieving sterilization, the highest level of microbial kill.
CER CER - Certified Endoscope Reprocessor Chemical Disinfectants and Germicides Questions and Answers 5
A staff member accidentally splashes OPA solution into their eyes.
Which immediate first-aid action is correct?