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Nausea and vomiting in pregnancy — GPhC CRA MCQ

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HardGastro-intestinal TherapeuticsNausea and vomiting in pregnancyGPhC CRA

A patient with paroxysmal nocturnal haemoglobinuria requires ravulizumab tomorrow. They received a quadrivalent meningococcal vaccine and a meningococcal B vaccine today; delaying complement inhibition is judged clinically unsafe. What additional protection is required?

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

Reveal the answer and explanation

Correct answer: D — Begin antibacterial prophylaxis through day 14 after vaccination

Explanation lettering: D = shown as A · E = shown as B · A = shown as D · B = shown as E

A is correct: when ravulizumab must begin less than 2 weeks after meningococcal vaccination, antibacterial prophylaxis is required until 2 weeks after vaccination. B ignores the interval needed for an immune response. C is inconsistent with the documented clinical need for urgent complement inhibition. D is not a recommended substitute for the bridging prophylaxis. E addresses the wrong organism and mechanism; patients also require education that vaccination and prophylaxis do not eliminate meningococcal risk.

Reference: Ultomiris ravulizumab SmPC. https://www.medicines.org.uk/emc/product/11945/smpc