skip to main content

Cervical intraepithelial neoplasia — USMLE Step 2 CK MCQ

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

HardObstetrics & GynecologyCervical intraepithelial neoplasiaUSMLE Step 2 CK

A previously unvaccinated 44-year-old kidney-transplant recipient taking tacrolimus and mycophenolate is bitten by a rabid raccoon. The wound is immediately washed and human rabies immune globulin is infiltrated. Which vaccine follow-up is required?

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

Reveal the answer and explanation

Correct answer: A — Vaccine on days 0, 3, 7, 14, and 28, followed by antibody testing

An immunocompromised, previously unvaccinated person requires the standard wound care and HRIG plus a five-dose rabies vaccine regimen on days 0, 3, 7, 14, and 28. Because immunosuppression can blunt vaccine response, rabies virus-neutralizing antibody should be measured after the series and further management coordinated with public health authorities if the response is inadequate. The four-dose schedule without serology is for immunocompetent people. Two doses on days 0 and 3 apply to previously vaccinated people, who also should not receive HRIG. HRIG provides immediate passive protection at the exposure site but cannot replace active immunization.

Reference: CDC: Rabies Post-Exposure Prophylaxis Guidance: https://www.cdc.gov/rabies/hcp/clinical-care/post-exposure-prophylaxis.html