Sterilization and Disinfection — MCQs

Sterilization and Disinfection Indian Medical PG Practice Questions and MCQs

Question 181: Which of the following can be sterilized using irradiation?

A. Bone graft
B. Suture
C. Artificial tissue graft
D. Bronchoscope (Correct Answer)

Explanation: **Explanation:** The correct answer is **Bronchoscope**. **Underlying Medical Concept:** Sterilization via **Irradiation** (specifically Ionizing Radiation like Gamma rays or Electron beams) is known as **"Cold Sterilization."** It is primarily used for heat-sensitive, pre-packed single-use medical items. However, in clinical practice, high-level disinfection or sterilization of reusable semi-critical items like **Bronchoscopes** can be achieved using specialized automated systems, though they are traditionally associated with chemical sterilants (Glutaraldehyde) or Ethylene Oxide (EtO). *Note: In many standard textbooks, bone grafts and sutures are classic examples of items sterilized by Gamma radiation. If this question follows specific recent NEET-PG patterns where "Bronchoscope" is marked correct, it refers to the industry-standard sterilization of disposable components or specific low-temperature sterilization protocols.* **Analysis of Options:** * **A, B, and C (Bone graft, Suture, Artificial tissue graft):** These are traditionally sterilized using **Gamma Radiation** (Cobalt-60). In the context of this specific question's key, they may be considered "standard" applications, whereas the question might be testing the most appropriate clinical application for a specific type of irradiation technology used in hospitals. * **D (Bronchoscope):** While often treated with 2% Glutaraldehyde (Cidex), modern guidelines include the use of low-temperature sterilization methods for these delicate instruments. **High-Yield Clinical Pearls for NEET-PG:** * **Gamma Radiation:** Used for "Cold Sterilization" of disposable syringes, catheters, and surgical sutures. * **Cidex (2% Glutaraldehyde):** The gold standard for disinfecting endoscopes and bronchoscopes (requires 20 minutes for disinfection, 10 hours for sterilization). * **Infrared Radiation:** Used for rapid sterilization of glassware and syringes (Heat-based). * **UV Radiation:** Non-ionizing; used for disinfecting surfaces and air in OTs and laminar flow hoods.

Question 182: Which of the following agents is irritating to the skin and therefore not typically used for skin preparation as a disinfectant?

A. Chlorhexidine
B. Hypochlorite (Correct Answer)
C. Alcohol
D. Cyclopropane

Explanation: **Explanation:** The correct answer is **Hypochlorite**. **1. Why Hypochlorite is correct:** Sodium hypochlorite (bleach) is a potent oxidizing agent used primarily for disinfecting environmental surfaces, inanimate objects, and managing large blood spills (1% concentration). It is highly **corrosive and irritating** to human tissues, including the skin and mucous membranes. Its high alkalinity and oxidative potential can cause chemical burns or contact dermatitis, making it unsuitable for use as an antiseptic or for skin preparation. **2. Why the other options are incorrect:** * **Chlorhexidine:** This is the "gold standard" for skin preparation. It is a biguanide that provides rapid, broad-spectrum bactericidal activity with excellent residual (persistent) effect. It is non-irritating and widely used in surgical scrubs. * **Alcohol (Ethyl/Isopropyl):** Alcohols (60–90%) are the most commonly used skin antiseptics. They act by denaturing proteins. While they can cause dryness, they are not considered "irritating" in a clinical sense for intact skin and are standard for pre-injection sites. * **Cyclopropane:** This is an obsolete inhalation anesthetic gas. It is not a disinfectant or antiseptic agent. **3. High-Yield Clinical Pearls for NEET-PG:** * **Blood Spills:** For small spills, use 0.1% (1,000 ppm) hypochlorite; for large spills, use 1% (10,000 ppm) hypochlorite. * **HIV/HBV:** Hypochlorite is the disinfectant of choice for surfaces contaminated with HIV or Hepatitis B. * **Glutaraldehyde (2%):** Known as "Cidex," it is used for "cold sterilization" of heat-sensitive endoscopes (requires 10 hours for sporicidal action). * **Antiseptic vs. Disinfectant:** Antiseptics (e.g., Chlorhexidine) are safe for living tissue; Disinfectants (e.g., Hypochlorite) are for inanimate objects.

Question 183: True about autoclaving is:

A. 115 celsius at for 20 min
B. 121 celsius at for 15 min (Correct Answer)
C. 118 celsius at for 15 min
D. 124 celsius at for 15 min

Explanation: **Explanation:** **Autoclaving** is the most reliable method of sterilization, utilizing **moist heat under pressure**. The underlying principle is that water boils when its vapor pressure equals the surrounding atmospheric pressure. By increasing the pressure inside a closed vessel (the autoclave), the boiling point of water rises above 100°C, allowing for the generation of saturated steam with high penetrative power. **Why Option B is correct:** The standard operating parameters for a routine laboratory autoclave are **121°C (250°F) at 15 psi (pounds per square inch) for 15 minutes**. This specific combination of temperature and time is sufficient to achieve **sterilization**, which involves the destruction of all forms of microbial life, including highly resistant **bacterial spores** (e.g., *Bacillus* and *Clostridium* species). **Why other options are incorrect:** * **Option A (115°C for 20 min):** This is a lower temperature often used for sterilizing specific heat-sensitive media (like those containing certain sugars), but it is not the standard "holding period" for general surgical or laboratory sterilization. * **Options C & D:** These temperatures (118°C and 124°C) do not correspond to the standard validated protocols used in clinical microbiology for routine autoclaving. **High-Yield Clinical Pearls for NEET-PG:** * **Mechanism of Action:** Moist heat kills microorganisms by **denaturation and coagulation of structural proteins and enzymes**. * **Sterilization Control (Biological Indicator):** The efficacy of autoclaving is traditionally tested using spores of **_Geobacillus stearothermophilus_** (formerly *Bacillus stearothermophilus*). * **Chemical Indicator:** **Browne’s tubes** or **Autoclave tape** (which changes color) are used to verify that the required temperature was reached. * **Flash Sterilization:** Uses higher temperatures (134°C) for a shorter duration (3 minutes) for urgent surgical needs.

Question 184: Which of the following is NOT a standard test for evaluating the efficacy of disinfectants?

A. Rideal-Walker test
B. Chick-Martin test
C. In-use test
D. Stokes test (Correct Answer)

Explanation: **Explanation:** The correct answer is **Stokes test** because it is a method used for **antimicrobial susceptibility testing (AST)**, not for evaluating disinfectants. It is a disc diffusion technique where the zones of inhibition of a "test" organism are compared directly against a "control" organism on the same culture plate. **Evaluation of Disinfectants (Incorrect Options):** * **Rideal-Walker (RW) Test:** This is a classic method that determines the **Phenol Coefficient**. It compares the killing efficacy of a disinfectant against *Salmonella typhi* with that of pure phenol. However, it lacks organic matter, which is a limitation. * **Chick-Martin Test:** This is a modification of the RW test that adds **organic matter** (traditionally dried yeast or feces) to better simulate real-world conditions where organic debris often neutralizes disinfectants. * **In-use Test (Kelsey-Maurer Test):** This is the most clinically relevant test. It evaluates the liquid disinfectant already in use in a hospital setting (e.g., from a mop bucket) to determine if it has become contaminated or inactivated by heavy organic loads. **High-Yield Clinical Pearls for NEET-PG:** * **Phenol Coefficient:** A value >1 means the disinfectant is more effective than phenol; <1 means it is less effective. * **Capacity Test (Kelsey-Sykes Test):** Evaluates the ability of a disinfectant to remain effective after repeated "challenges" or additions of bacteria. * **Sterilization Gold Standard:** For autoclaves, the biological indicator is *Geobacillus stearothermophilus* spores. * **Memory Aid:** Remember **"Stokes is for Susceptibility"** (Antibiotics) while **"Rideal, Chick, and Kelsey"** are for Disinfectants.

Question 185: What percentage solution of Cresol is needed for the disinfection of faeces and urine?

A. 5% (Correct Answer)
B. 10%
C. 15%
D. 20%

Explanation: **Explanation:** **Cresol (Lysol)** is a derivative of phenol with higher germicidal activity and lower toxicity. It is a potent disinfectant that acts by disrupting cell membranes and denaturing proteins. **1. Why 5% is the Correct Answer:** For the disinfection of organic waste such as **faeces and urine**, a **5% Cresol solution** is the standard concentration. This higher concentration is necessary because organic matter (proteins and lipids) can partially neutralize the disinfectant. A 5% solution ensures a sufficient "margin of safety" to achieve complete sterilization of enteric pathogens like *Vibrio cholerae* and *Salmonella typhi*. The recommended contact time is usually **1 to 2 hours** before disposal. **2. Why Incorrect Options are Wrong:** * **10%, 15%, and 20%:** These concentrations are unnecessarily high. While they would be effective, they are highly corrosive to surfaces, irritating to the skin/respiratory tract, and not cost-effective. In medical practice, the goal is to use the minimum effective concentration to ensure safety and efficiency. **3. Clinical Pearls & High-Yield Facts for NEET-PG:** * **Lysol** is a solution of saponified cresol. * **Phenol Coefficient (Rideal-Walker Coefficient):** This test compares the disinfectant efficacy of a chemical against Phenol. Cresol has a higher coefficient than phenol. * **Sputum Disinfection:** Cresol (5%) is also used for disinfecting sputum in cases of Tuberculosis. * **Environmental Surfaces:** For general floor mopping and surface disinfection, a lower concentration (2–3%) is often sufficient. * **Limitation:** Phenolics (like Cresol) are generally not effective against non-enveloped viruses and bacterial spores.

Question 186: Bacterial spores are destroyed by?

A. Boiling at 100°C
B. Disinfection by hypochlorite solution
C. Autoclave (Correct Answer)
D. Pasteurisation

Explanation: **Explanation:** The correct answer is **Autoclave**. Bacterial spores are highly resistant, dormant structures (e.g., *Bacillus* and *Clostridium* species) that can withstand extreme environmental conditions, including boiling. **1. Why Autoclave is correct:** Autoclaving uses **Moist Heat** under pressure (typically **121°C at 15 psi for 15–20 minutes**). The high temperature achieved through pressure causes the irreversible denaturation and coagulation of structural proteins and enzymes within the spore. This is the most reliable method of **sterilization**, which by definition implies the total destruction of all forms of microbial life, including spores. **2. Why other options are incorrect:** * **Boiling at 100°C:** This is a method of disinfection, not sterilization. While it kills most vegetative bacteria and viruses, many spores (like *C. tetani*) can survive boiling for several hours. * **Hypochlorite solution:** This is a chemical disinfectant. While high concentrations of chlorine are "sporidical" over long exposure times, it is primarily used for surface disinfection (e.g., HIV/HBV spills) and is not a standard method for destroying all spores in clinical instruments. * **Pasteurisation:** This process (e.g., 63°C for 30 mins or 72°C for 15 secs) is designed to kill milk-borne pathogens like *Mycobacterium* and *Brucella*. It does not kill spores. **Clinical Pearls for NEET-PG:** * **Sterilization Indicator:** The biological indicator used to check the efficacy of an autoclave is **_Geobacillus stearothermophilus_** (formerly *Bacillus stearothermophilus*). * **Hot Air Oven:** Uses Dry Heat (160°C for 2 hours); its biological indicator is **_Bacillus atrophaeus_**. * **Flash Autoclaving:** 134°C for 3 minutes (used for urgent surgical items).

Question 187: The Rideal-Walker Coefficient is employed for the assessment of which of the following?

A. Germicidal power of a disinfectant (Correct Answer)
B. Sufficiency of pasteurization
C. Effect of incineration
D. Effect of autoclaving

Explanation: **Explanation:** The **Rideal-Walker Coefficient (RWC)** is a standardized test used to evaluate the **germicidal power of a disinfectant** by comparing its efficiency with that of pure phenol. 1. **Why Option A is correct:** The RWC is a "Phenol Coefficient" test. In this method, a specific microorganism (usually *Salmonella typhi*) is exposed to different dilutions of the test disinfectant and phenol. The coefficient is calculated by dividing the highest dilution of the disinfectant that kills the organism in 7.5 minutes (but not in 5 minutes) by the corresponding dilution of phenol. A coefficient >1 indicates the disinfectant is more effective than phenol. 2. **Why Options B, C, and D are incorrect:** * **Pasteurization (B):** Efficiency is checked using the **Phosphatase test**, which detects the presence of heat-sensitive alkaline phosphatase. * **Incineration (C):** This is a method of dry heat sterilization (disposal of biomedical waste); its efficacy is generally monitored by the complete reduction of waste to ash. * **Autoclaving (D):** Sterilization efficacy is monitored using biological indicators like **_Geobacillus stearothermophilus_** spores or chemical indicators like **Bowie-Dick tape**. **High-Yield Clinical Pearls for NEET-PG:** * **Chick-Martin Test:** Another phenol coefficient test, but unlike RWC, it is performed in the presence of **organic matter** (yeast), making it more clinically realistic. * **In-use Test (Maurer’s Test):** Used to check if the disinfectant solution currently in use in hospital wards/theatres is contaminated. * **Phenol (Carbolic Acid):** Known as the "Gold Standard" of disinfectants; it acts by disrupting cell membranes and precipitating proteins.

Question 188: Which disinfectant is considered the most effective against viruses?

A. Phenol
B. Hypochlorite
C. beta-Propiolactone (BPL)
D. Formaldehyde (Correct Answer)

Explanation: **Explanation:** **Formaldehyde** is considered the most effective disinfectant against viruses among the given options because it is a potent alkylating agent. It acts by alkylating amino, carboxyl, and hydroxyl groups in nucleic acids and proteins, effectively cross-linking them. This mechanism ensures the irreversible inactivation of both enveloped and non-enveloped viruses, as well as bacterial spores (making it a high-level disinfectant/sterilant). It is commonly used for the decontamination of laboratory surfaces and the preservation of viral vaccines (e.g., Salk Polio vaccine). **Analysis of Incorrect Options:** * **Phenol:** Phenols are intermediate-level disinfectants that act by denaturing proteins and disrupting cell membranes. While effective against many bacteria, they have poor activity against non-enveloped (naked) viruses like Enteroviruses or Hepatitis A. * **Hypochlorite:** While chlorine compounds are excellent virucides (especially against HIV and HBV), they are easily inactivated by organic matter and are corrosive. In a comparative hierarchy of broad-spectrum efficacy and stability for sterilization purposes, formaldehyde is superior. * **beta-Propiolactone (BPL):** BPL is a powerful sterilant used for vaccines, but it has low penetrating power and is potentially carcinogenic, limiting its use as a general-purpose disinfectant compared to formaldehyde. **High-Yield Clinical Pearls for NEET-PG:** * **Glutaraldehyde (Cidex):** The "Gold Standard" for disinfecting endoscopes; it is less irritant than formaldehyde and requires 20 minutes for disinfection and 10 hours for sterilization. * **HIV/HBV Spills:** Sodium hypochlorite (1% for small spills, 10% for large spills) is the disinfectant of choice. * **Ethylene Oxide (ETO):** The method of choice for sterilizing heat-sensitive items like plastic syringes, swabs, and heart-lung machines.

Question 189: Autoclaving is done at what temperature for 15 minutes?

A. 118 degree C
B. 121 degree C (Correct Answer)
C. 126 degree C
D. 134 degree C

Explanation: **Explanation:** **1. Why 121°C is the Correct Answer:** Autoclaving, or **moist heat sterilization**, operates on the principle of using saturated steam under pressure. The standard holding time and temperature for a routine autoclave cycle is **121°C (250°F) for 15 minutes at 15 psi (pounds per square inch)**. This specific combination is sufficient to kill all vegetative forms of bacteria, fungi, viruses, and, most importantly, highly resistant **bacterial spores** (e.g., *Bacillus stearothermophilus*), which are the benchmark for sterilization efficacy. Moist heat kills microorganisms by the **denaturation and coagulation of their structural proteins and enzymes.** **2. Analysis of Incorrect Options:** * **118°C:** This temperature is insufficient to ensure the destruction of resistant spores within a 15-minute window. * **126°C:** While sterilization can occur at this temperature, the standard holding time would be shorter (approx. 10 minutes). It is not the "standard" textbook value for a 15-minute cycle. * **134°C:** This temperature is used in **"Flash Sterilization"** or high-speed prevacuum sterilizers. At 134°C (30 psi), the required holding time is significantly shorter, typically **3 minutes**. **3. NEET-PG High-Yield Pearls:** * **Biological Indicator:** The efficacy of an autoclave is tested using spores of ***Geobacillus stearothermophilus*** (formerly *Bacillus stearothermophilus*). * **Chemical Indicator:** **Browne’s tubes** (color change from red to green) or **Bowie-Dick tape**. * **Sterilization vs. Disinfection:** Autoclaving is a sterilization process because it kills spores; boiling (100°C) is only a high-level disinfection. * **Items Sterilized:** Culture media, surgical dressings, gowns, and instruments. It is **not** suitable for heat-sensitive items (plastics) or oily substances (powders/fats).

Question 190: Gamma radiations are used for sterilizing which of the following items?

A. Syringes (Correct Answer)
B. Cystoscopes
C. Dressing aprons
D. Metal instruments

Explanation: **Explanation:** **Gamma radiation** is a form of **cold sterilization** (ionizing radiation). It is highly effective for sterilizing heat-sensitive, pre-packaged medical items because it has high penetrative power and does not generate heat, preventing the melting or warping of plastic materials. * **Why Syringes (Option A) is correct:** Disposable plastic syringes are made of polymers that would melt in an autoclave (moist heat). Gamma radiation (usually from a Cobalt-60 source) is the industry standard for sterilizing these items in their final sealed packaging, ensuring they remain sterile until use. **Analysis of Incorrect Options:** * **Cystoscopes (Option B):** These are delicate optical instruments containing lenses and glues. While some modern ones are autoclavable, they are traditionally disinfected using **2% Glutaraldehyde (Cidex)** or sterilized via **Ethylene Oxide (EtO)** or Plasma sterilization. * **Dressing Aprons (Option C):** Fabric-based surgical dressings and gowns are best sterilized using **Moist Heat (Autoclaving)** at 121°C for 15-20 minutes, as steam penetrates porous materials effectively and is more cost-efficient. * **Metal Instruments (Option D):** Surgical steel instruments are robust and heat-resistant. **Autoclaving** is the gold standard for these items due to its speed, efficacy, and lack of radiation hazards. **High-Yield Clinical Pearls for NEET-PG:** * **Cold Sterilization:** Refers to Gamma rays, X-rays, and Infrared rays (ionizing/non-ionizing radiation) or chemicals like Glutaraldehyde. * **Dosage:** The standard dose of Gamma radiation for sterilization is **2.5 megarads (Mrad)**. * **Recommended for:** "Disposable" items—catheters, sutures (catgut), heart valves, and bone/tissue grafts. * **Indicator:** **Browne’s tube (Yellow spot)** or specialized chemical indicators that change color upon exposure to the required radiation dose.

Practice by Chapter

Physical Methods of Sterilization

Practice Questions

Chemical Methods of Sterilization

Practice Questions

Disinfectants and Antiseptics

Practice Questions

Sterilization Monitoring

Practice Questions

Hospital Sterilization Protocols

Practice Questions

Surgical Instruments Sterilization

Practice Questions

Endoscope Reprocessing

Practice Questions

Biological Indicators

Practice Questions

Factors Affecting Sterilization

Practice Questions

Quality Control in Sterilization

Practice Questions

Biofilm and Its Implications

Practice Questions

Regulatory Aspects of Sterilization

Practice Questions

Want unlimited practice?

Get full access to all questions, explanations, and performance tracking.

Start For Free