Surgical Instruments Sterilization — MCQs
Which is false regarding Spaulding's criteria?
All are methods of sterilization except.
Which item cannot be effectively sterilized using a hot air oven?
Biological indicator for determining efficacy of autoclaving is
All of the sterilization methods are properly matched except?
The minimum time required for the sterilization of surgical instruments by moist heat at 134°C is:
What is the preferred method for sterilizing disposable syringes?
Which of the following agents is both a disinfectant and an antiseptic?
Heat-labile instruments for use in surgical procedures can be best sterilized by what method?
A new born boy is having lumbosacral meningomyelocele and awaiting the surgical repair. The sac is best protected with sterile gauze piece soaked with
Surgical Instruments Sterilization Indian Medical PG Practice Questions and MCQs
Question 1: Which is false regarding Spaulding's criteria?
- A. Non critical items require only decontamination
- B. Cardiac catheters are examples of critical items
- C. Semi critical items need low level disinfection (Correct Answer)
- D. Semi critical items are those which come in contact with mucous membrane or non intact skin
Explanation: ***Semi critical items need low level disinfection*** - This statement is **FALSE** and is the **correct answer** to this question. - **Semi-critical items** require **high-level disinfection**, NOT low-level disinfection. - Semi-critical items come into contact with mucous membranes or non-intact skin and require removal of all vegetative bacteria, fungi, mycobacteria, and most viruses. - Examples include endoscopes, laryngoscope blades, and respiratory therapy equipment. *Non critical items require only decontamination* - This statement is **TRUE** (or at least acceptable in context). - Non-critical items contact intact skin and require **cleaning** and **low-level disinfection** (which falls under the umbrella term "decontamination"). - Examples include blood pressure cuffs, stethoscopes, and bedpans. *Cardiac catheters are examples of critical items* - This statement is **TRUE**. - **Cardiac catheters** enter the **vascular system** (sterile tissue), making them **critical items**. - Critical items require **sterilization** to prevent severe systemic infection. *Semi critical items are those which come in contact with mucous membrane or non intact skin* - This statement is **TRUE** and correctly defines **semi-critical items** according to Spaulding's classification. - This is the standard definition used in medical device processing protocols.
Question 2: All are methods of sterilization except.
- A. Filtration
- B. Heat
- C. Gases
- D. Sunlight (Correct Answer)
Explanation: ***Sunlight*** - While sunlight has some **disinfectant** properties due to its **UV radiation**, it is not considered a reliable method of **sterilization** because it cannot kill all forms of microbial life, including bacterial spores. - Sterilization requires the **complete elimination of all viable microorganisms**, which sunlight cannot consistently achieve. *Gases* - Certain gases, such as **ethylene oxide** and **hydrogen peroxide vapor**, are effective **sterilizing agents** used for heat-sensitive materials and medical devices. - These gases penetrate packaging and kill microorganisms by **alkylating proteins** and **nucleic acids**. *Filtration* - **Filtration** is a method of **sterilization** for liquids and gases that cannot withstand heat, by physically removing microorganisms. - Filters with very small pore sizes (e.g., **0.22 micrometers**) can retain bacteria and fungi, even though they do not kill them. *Heat* - **Heat** is one of the most common and effective methods of sterilization, used in various forms like **dry heat** (e.g., sterilization ovens) and **moist heat** (e.g., autoclaving). - **Autoclaving** with **saturated steam under pressure** is particularly effective as it rapidly coagulates and denatures microbial proteins.
Question 3: Which item cannot be effectively sterilized using a hot air oven?
- A. Liquid paraffin
- B. Instruments
- C. Culture media (Correct Answer)
- D. Needles
Explanation: ***Culture media*** - Heat sterilization in a hot air oven would cause **dehydration** and **degradation of nutrients** in most culture media, rendering them unusable for microbial growth. - Many components of culture media, such as **sugars** and **proteins**, are heat-sensitive and will break down at the high temperatures required for sterilization in a hot air oven. *Liquid paraffin* - **Oils** and **greases** can be effectively sterilized by a hot air oven because they are unable to be sterilized by steam due to its inability to penetrate oil-based substances. - The dry heat effectively kills microorganisms by causing **oxidative damage** to cellular components without causing unwanted chemical reactions. *Instruments* - **Surgical instruments** made of metal are ideal for sterilization in a hot air oven as dry heat can penetrate their surfaces and kill microorganisms without causing corrosion common with moist heat. - This method is effective for instruments that can withstand high temperatures and are sensitive to moisture. *Needles* - **Metal needles** can be safely sterilized in a hot air oven, as it effectively destroys all microbial life including spores, and prevents **rusting** or **dulling** often caused by steam sterilization. - The dry heat ensures that instruments remain sharp and undamaged after sterilization.
Question 4: Biological indicator for determining efficacy of autoclaving is
- A. Bacillus stearothermophilus (Correct Answer)
- B. Pseudomonas aeruginosa
- C. Clostridium perfringens
- D. Salmonella typhi
Explanation: ***Bacillus stearothermophilus*** - *Bacillus stearothermophilus* (now *Geobacillus stearothermophilus*) is a **thermoduric spore-forming bacterium** used as a biological indicator for **autoclave efficacy**. - Its spores are highly **resistant to heat**, making them ideal for challenging the sterilization process. *Pseudomonas aeruginosa* - *Pseudomonas aeruginosa* is a **Gram-negative bacterium** known for causing hospital-acquired infections, but it is **not used as a biological indicator** for autoclaving. - It is **less resistant to heat** and sterilization methods compared to bacterial spores. *Clostridium perfringens* - *Clostridium perfringens* is a **spore-forming anaerobic bacterium** associated with gas gangrene and food poisoning. - While it forms spores, its **heat resistance profile is different** from that of *Bacillus stearothermophilus*, and it is not the standard biological indicator for autoclaving. *Salmonella typhi* - *Salmonella typhi* is a **Gram-negative bacterium** that causes typhoid fever. - It is a **pathogen but not a spore-former**, and therefore, it is easily killed by autoclaving and not suitable as a biological indicator for monitoring sterilization effectiveness.
Question 5: All of the sterilization methods are properly matched except?
- A. Culture media - Autoclaving
- B. Glassware & syringes - Hot air oven
- C. Catgut suture - Radiation
- D. Bronchoscope - Autoclaving (Correct Answer)
Explanation: ***Bronchoscope - Autoclaving*** - **Autoclaving** uses high temperature and steam, which can damage the delicate heat-sensitive components and lenses of a bronchoscope. - **Bronchoscopes** are typically sterilized using **low-temperature sterilization methods** such as **ethylene oxide**, hydrogen peroxide plasma, or glutaraldehyde. *Catgut suture - Radiation* - **Radiation** (e.g., gamma irradiation) is a suitable and common method for sterilizing **heat-sensitive materials** like catgut sutures, ensuring sterility without compromising material integrity. - This method effectively destroys microorganisms by damaging their DNA. *Culture media - Autoclaving* - **Autoclaving** is the standard and most effective method for sterilizing **culture media**, which requires complete elimination of all microbial forms including spores. - The high heat and pressure achieved in an autoclave denature proteins and destroy microbial structures. *Glassware & syringes - Hot air oven* - A **hot air oven** is appropriate for sterilizing **heat-stable items** like glassware and metal syringes, as it provides dry heat that penetrates well and kills microorganisms by oxidation. - This method is particularly useful for items that can be damaged by moisture or steam.
Question 6: The minimum time required for the sterilization of surgical instruments by moist heat at 134°C is:
- A. 15 minutes
- B. 30 minutes
- C. 60 minutes
- D. 3 minutes (Correct Answer)
Explanation: ***Correct: 3 minutes*** - At a temperature of **134°C**, the high pressure of **moist heat** (prevacuum sterilization) effectively denatures proteins and destroys all microorganisms, including spores, requiring only **3-4 minutes** of exposure time. - This short duration ensures rapid turnaround time for surgical instruments while achieving complete **sterilization**, making it ideal for urgent or flash sterilization cycles. - This is a standard protocol widely used in hospital autoclaves for wrapped instruments. *Incorrect: 15 minutes* - While 15 minutes is a common sterilization time, it is typically used at a lower temperature of **121°C** (gravity displacement sterilization) for moist heat sterilization. - At 134°C, a 15-minute exposure would be unnecessarily long, consuming more energy and time without additional sterilization benefit. *Incorrect: 30 minutes* - A 30-minute sterilization cycle is excessive for moist heat at **134°C**, indicating a misunderstanding of standard sterilization parameters. - This duration is more typical for sterilization at **121°C** with gravity displacement, or for large/dense loads requiring extended heat penetration time. *Incorrect: 60 minutes* - A 60-minute cycle is far too long for routine sterilization of surgical instruments at **134°C** with moist heat. - Such extended times are generally reserved for **dry heat sterilization** (160-180°C for 60-120 minutes) or very specific difficult-to-sterilize items with complex lumens.
Question 7: What is the preferred method for sterilizing disposable syringes?
- A. Gas sterilization (Ethylene oxide) (Correct Answer)
- B. Steam sterilization (Autoclave)
- C. Chemical sterilization (Cidex)
- D. Dry heat sterilization (Hot air oven)
Explanation: ***Steam sterilization (Autoclave)*** - While generally effective, **disposable syringes** are typically **pre-sterilized** by the manufacturer using methods like radiation or ethylene oxide and are not meant for resterilization. - Reusing and resterilizing disposable syringes, even with an autoclave, is **not recommended** due to potential material degradation and safety concerns. *Chemical sterilization (Cidex)* - **Cidex (glutaraldehyde)** is a high-level disinfectant primarily used for **heat-sensitive instruments** that cannot withstand high temperatures, such as endoscopes. - It involves **immersion** and is not suitable for the rapid, high-volume sterilization of plastic disposable syringes due to potential residue and material incompatibility. *Dry heat sterilization (Hot air oven)* - Requires **prolonged exposure** to high temperatures and is suitable for **glassware** and **oil-based substances**. - **Plastic disposable syringes** would melt or degrade at the required temperatures (160-170°C) for effective dry heat sterilization. *Gas sterilization (Ethylene oxide)* - **Ethylene oxide (EtO)** is the **preferred industrial method** for sterilizing heat-sensitive and moisture-sensitive medical devices, including **disposable plastic syringes**, by manufacturers. - It penetrates packaging effectively and sterilizes without damaging plastic, but requires specialized equipment and extensive aeration due to its **toxic and flammable nature**, making it impractical for point-of-use sterilization.
Question 8: Which of the following agents is both a disinfectant and an antiseptic?
- A. Hydrogen peroxide (Correct Answer)
- B. Sodium hypochlorite
- C. Glutaraldehyde
- D. Methylated spirit
Explanation: ***Hydrogen peroxide*** - It is used as a **disinfectant** for surfaces and medical equipment, effectively killing bacteria, viruses, fungi, and spores. - It is also applied as an **antiseptic** for wound cleaning and oral rinses due to its ability to release oxygen, which is toxic to anaerobic bacteria. - H₂O₂ represents the **classic example** of a dual-purpose agent with **balanced use** in both roles. *Sodium hypochlorite* - Primarily used as a **disinfectant** for surfaces and water purification due to its strong oxidizing properties. - While it has antimicrobial properties, it is generally considered too **irritating and corrosive** for direct application to living tissues as an antiseptic. *Glutaraldehyde* - This is a **high-level disinfectant** and sterilant, often used for heat-sensitive medical instruments like endoscopes. - Its high toxicity and irritant nature make it unsuitable for use as an **antiseptic** on living tissues. *Methylated spirit* - Methylated spirit (denatured ethanol) is **predominantly used as an antiseptic** for skin preparation before injections or minor procedures. - While alcohols do have disinfectant properties for surfaces, methylated spirit's **primary clinical role** is skin antisepsis rather than environmental disinfection. - Unlike hydrogen peroxide, it lacks the **balanced dual-purpose application** that makes H₂O₂ the classic textbook example.
Question 9: Heat-labile instruments for use in surgical procedures can be best sterilized by what method?
- A. Absolute alcohol
- B. Ultraviolet rays
- C. Chlorine releasing compounds
- D. Ethylene oxide gas (Correct Answer)
Explanation: ***Ethylene oxide gas*** - **Ethylene oxide** is a highly effective **sterilizing agent** that can penetrate packaging and is suitable for **heat-sensitive materials** due to its low-temperature application. - It works by **alkylating microbial proteins and nucleic acids**, leading to the death of all microorganisms, including **spores**. *Absolute alcohol* - While **alcohol** is an effective **disinfectant**, it is not a reliable sterilant as it does not consistently kill **bacterial spores**. - Its efficacy as a disinfectant is also limited by its **rapid evaporation** and inability to penetrate organic matter effectively. *Ultraviolet rays* - **UV radiation** is a surface disinfectant and is not suitable for sterilizing surgical instruments as it has **poor penetration** capabilities and cannot sterilize shadowed or covered areas. - It primarily works by damaging the **DNA of microorganisms**, making it effective for air and surface disinfection but not for complex instruments. *Chlorine-releasing compounds* - **Chlorine compounds** are potent disinfectants, but they are often **corrosive to metals** and can damage delicate surgical instruments upon prolonged exposure. - While effective at killing many microorganisms, they are also **not reliably sporicidal** at concentrations safe for instrument sterilization and may leave residues.
Question 10: A new born boy is having lumbosacral meningomyelocele and awaiting the surgical repair. The sac is best protected with sterile gauze piece soaked with
- A. Mercurochrome
- B. Methylene blue
- C. Normal saline (Correct Answer)
- D. Tincture benzoin
Explanation: ***Normal saline*** - **Normal saline** creates a moist environment, which prevents the delicate neural tissue within the **meningomyelocele sac** from drying out and sustaining further damage. - Using a sterile gauze soaked in normal saline also reduces the risk of infection by providing a clean barrier until surgical repair can be performed. - This is the **standard of care** for preoperative management of meningomyelocele. *Mercurochrome* - **Mercurochrome** contains mercury, which is highly toxic and can be absorbed through the delicate membranes of the meningomyelocele sac, causing systemic toxicity. - It is an antiseptic and not ideal for maintaining the delicate neural tissue's viability due to its potential for **chemical irritation** and damage. *Methylene blue* - **Methylene blue** is primarily used as a dye or for specific medical treatments, but it is not suitable for dressing a meningomyelocele due to its potential for irritation and lack of benefit in protecting neural tissue. - It does not provide the necessary hydration and protection for the exposed neural elements and may cause a **chemical burn** or local tissue damage. *Tincture benzoin* - **Tincture benzoin** is an adhesive protectant often used to improve adhesion of bandages or to protect skin, but it is **irritating** and not sterile. - It is definitely not indicated for direct application over exposed neural tissue as it can cause significant **chemical irritation** and inflammation.
Want unlimited practice?
Get full access to all questions, explanations, and performance tracking.
Start For Free