ADC Practice Question — Source Patient Management

What is the risk of HIV seroconversion after a mucous membrane exposure to HIV-infected blood (as opposed to a sharps injury)?

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. What is the risk of HIV seroconversion after a mucous membrane exposure to HIV-infected blood (as opposed to a sharps injury)?

A. 0.3%
B. 0.09%
C. 3%
D. 0.003%

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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

After a sharps injury with HIV-infected blood: 0.3% risk of seroconversion. After a mucous membrane exposure to HIV-infected blood: 0.09%. The mucous membrane exposure risk is lower than the percutaneous (sharps) risk. Only a very small proportion of occupational exposures to HIV result in transmission. (ICG p.84)

Source: ICG Appendix: HIV Exposure Risk

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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What is the risk of HIV seroconversion after a mucous membrane exposure to HIV-infected blood (as opposed to a sharps injury)?

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