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ADC Practice Question — Source Patient Management

dental assistant is NOT immune to hepatitis B. What…

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 Mehta's dental assistant sustains a needlestick injury from a needle used on Mrs Garcia (58F), who is known to be hepatitis B positive (HBsAg positive, HBe-antigen positive). The assistant is unsure of her own HBV vaccination status. The practice must manage both the injured worker and the source patient appropriately. The dental assistant is NOT immune to hepatitis B. What prophylaxis must be given, and within what timeframe?

  • A. HBIG within 7 days plus vaccination course
  • B. HBIG within 48-72 hours AND start HBV vaccination within 7 days
  • C. HBV vaccination only — HBIG is not indicated
  • D. HBIG within 2 weeks plus oral antiviral medication
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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

If the staff member is NOT immune to hepatitis B: give single dose of HBIG within 48-72 hours, AND start a course of HBV immunisation within 7 days, repeated at 1-2 months, then again at 6 months. Check antibody levels 2-4 weeks after final dose. Without prophylaxis from an HBe-antigen positive source, transmission risk exceeds 30%. (ICG p.83)

Source: ICG Appendix: HBV Prophylaxis
Remy's study tip — The differentiator is usually the Spaulding classification level or the step order in a protocol.

Exam preparation FAQ

How should I prepare for Infection Control in the ADC exam?
Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.
How do I approach an unfamiliar Source Patient Management vignette?
Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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