skip to main content

Type 2 diabetes near goal — USMLE Step 3 MCQ

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

HardInternal Medicine (chronic management)Type 2 diabetes near goalUSMLE Step 3

A patient takes ertugliflozin each morning and is scheduled for elective total knee arthroplasty on Friday morning. The surgeon asks for the latest acceptable day on which the patient may take a dose while still completing the recommended four full medication-free calendar days before surgery. Which instruction is correct?

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

Reveal the answer and explanation

Correct answer: D — Take the final dose Sunday and withhold it Monday through Thursday

The best answer is “Take the final dose Sunday and withhold it Monday through Thursday”. Ertugliflozin should be discontinued at least four days before scheduled surgery. A final Sunday dose followed by no doses Monday, Tuesday, Wednesday or Thursday provides four complete medication-free calendar days before Friday surgery and is therefore the latest acceptable final dose. A Saturday final dose is safe but is not the latest acceptable day asked for.

Reference: FDA Prescribing Information: STEGLATRO (ertugliflozin), revised December 2024: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/209803s008lbledt.pdf