skip to main content

Decision-making capacity — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeDecision-making capacityUSMLE Step 3

A patient stops injectable cabotegravir PrEP but expects ongoing sexual exposure. What is the best plan?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Start oral PrEP within 8 weeks and perform dual HIV testing quarterly for 12 months

The best answer is “Start oral PrEP within 8 weeks and perform dual HIV testing quarterly for 12 months”. The prolonged pharmacokinetic tail can become nonprotective and select resistance, so prevention and dual-test follow-up must continue. After discontinuing injectable cabotegravir while HIV exposure continues, CDC advises starting oral PrEP within 8 weeks after the last injection and performing HIV antigen-antibody plus RNA testing every 3 months for 12 months because of the long pharmacokinetic tail. The alternatives use a different threshold, timing, population, or intervention and therefore do not match the clinical facts presented.

Reference: CDC HIV Nexus: Clinical Guidance for PrEP: https://www.cdc.gov/hivnexus/hcp/prep/index.html