skip to main content

Elevated PSA — USMLE Step 3 MCQ

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

HardPreventive Medicine, Epidemiology, BiostatisticsElevated PSAUSMLE Step 3

A college student is hospitalized with meningococcal meningitis. His roommate slept in the same room and directly assisted him during vomiting 12 hours before antibiotics were started. The roommate received MenACWY vaccine 2 years ago, is asymptomatic, and is not pregnant. Which management is most appropriate?

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

Reveal the answer and explanation

Correct answer: B — Administer meningococcal chemoprophylaxis even though prior vaccination is documented

The best answer is “Administer meningococcal chemoprophylaxis even though prior vaccination is documented”. Direct exposure to oral secretions and prolonged household-style contact qualify this roommate as a close contact. Chemoprophylaxis should be given as soon as possible regardless of vaccination status because vaccines do not cover every strain and do not provide immediate sterilizing immunity. Culture-directed delay, vaccine alone, observation, and a full therapeutic meningitis regimen are inappropriate.

Reference: CDC Clinical Guidance for Meningococcal Disease: https://www.cdc.gov/meningococcal/hcp/clinical-guidance/index.html