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ADC Practice Question — Hand Hygiene

a dental practitioner is found to be HCV RNA positive,…

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.

Dr Priya Sharma is a dental practitioner who has recently been diagnosed with chronic hepatitis B infection. Her HBV DNA test shows a viral load of 150 IU/mL. She regularly performs surgical extractions and implant placements. A colleague advises her she should stop performing all dental procedures. Meanwhile, a new patient Mr Thompson discloses he is HIV-positive and requests a routine dental check-up. If a dental practitioner is found to be HCV RNA positive, what is the restriction on performing EPPs?

  • A. No restriction if the viral load is below 200 copies/mL
  • B. Must not perform EPPs while HCV RNA positive, but may return after successful treatment or spontaneous clearance
  • C. Must permanently cease all EPPs
  • D. May continue EPPs with enhanced PPE
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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: B

HCWs must not perform EPPs while they are HCV RNA positive, but may be permitted to return to EPPs after successful treatment, or following spontaneous clearance of HCV RNA. There are direct-acting antiviral hepatitis C medications with very high cure rates. (ICG p.15)

Source: ICG Section A: Practitioners with Infectious Disease
Remy's study tip — The differentiator is usually the Spaulding classification level or the step order in a protocol.

Exam preparation FAQ

How are Hand Hygiene questions structured in the ADC written exam?
ADC Hand Hygiene questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.
Should I memorise guidelines word-for-word for Hand Hygiene?
Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

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