ADC Practice Question — Source Patient Management

How do the post-exposure protocols differ, and which infection is more likely to be transmitted?

Infection control in the ADC exam tests decision-making around exposure incidents, instrument classification, and decontamination protocols. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

Two dental workers sustain needlestick injuries from source patients: Worker A's source is hepatitis B positive, Worker B's source is hepatitis C positive. How do the post-exposure protocols differ, and which infection is more likely to be transmitted?

A. Both infections are managed identically after needlestick
B. Hepatitis B has a lower transmission risk than HIV
C. Hepatitis B: higher transmission risk (~30% from HBeAg-positive source vs 0.3% for HIV)
D. Hepatitis C is preventable by vaccination

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: C

Hepatitis B: higher transmission risk (~30% from HBeAg-positive source vs 0.3% for HIV). If the worker is vaccinated and has documented immunity (anti-HBs >10 mIU/ml), no treatment is needed — the vaccine provides protection. If not immune: hepatitis B immunoglobulin (HBIG) within 72 hours PLUS accelerated vaccination course. Hepatitis C: lower transmission risk (~1.8%) but NO vaccine and NO post-exposure prophylaxis exists. Management is surveillance: HCV RNA testing at 4-6 weeks, antibody testing at 12 and 24 weeks. If seroconversion occurs, early antiviral treatment (direct-acting antivirals) achieves >95% cure rate. The key difference: HBV is preventable by vaccination, HCV is not

Source: Odell 4th Ed, Case 31: A Sharps Injury

Remy's study tip — The differentiator is usually the Spaulding classification level or the step order in a protocol.

Exam preparation FAQ

Should I memorise guidelines word-for-word for Source Patient Management?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

How are Source Patient Management questions structured in the ADC written exam?

ADC Source Patient Management questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

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