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Insomnia — USMLE Step 3 MCQ

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HardPsychiatry (outpatient management)InsomniaUSMLE Step 3

A patient at 10 weeks of pregnancy has newly diagnosed LTBI and no recent infectious contact, HIV, or immunosuppression. Which timing is most appropriate?

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Correct answer: C — Defer LTBI treatment until 2–3 months after delivery

The best answer is “Defer LTBI treatment until 2–3 months after delivery”. The absence of a recent infectious contact or immunocompromise makes deferral reasonable; CDC specifies reassessment and treatment at 2–3 months postpartum rather than immediate first-trimester therapy. Most pregnant patients with LTBI and no high-risk feature such as HIV or recent infectious contact may defer treatment until 2–3 months postpartum. The alternatives use a different threshold, timing, population, or intervention and therefore do not match the clinical facts presented.

Reference: CDC: Tuberculosis Clinical Care and Treatment During Pregnancy: https://www.cdc.gov/tb/hcp/clinical-care/pregnancy.html