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Wrong-site surgery prevention — USMLE Step 3 MCQ

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HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeWrong-site surgery preventionUSMLE Step 3

A 28-year-old pregnant household contact of a patient with invasive meningococcal disease presents 12 hours after notification. Which chemoprophylaxis is preferred?

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

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Correct answer: D — Ceftriaxone 250 mg IM once

The best answer is “Ceftriaxone 250 mg IM once”. Ceftriaxone avoids pregnancy concerns with rifampin and ciprofloxacin and is effective as a single adult IM dose. Pregnant close contacts should receive ceftriaxone; for age 15 years or older the chemoprophylaxis dose is 250 mg IM once, ideally within 24 hours of identifying the index case. The alternatives use a different threshold, timing, population, or intervention and therefore do not match the clinical facts presented.

Reference: CDC: Meningococcal Disease Surveillance Manual: https://www.cdc.gov/surv-manual/php/table-of-contents/chapter-8-meningococcal-disease.html