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Adult immunisation — CCFP MCQ

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HardPreventive care and screeningAdult immunisationCCFP

A 44-year-old has fever, neck stiffness, confusion and a nonblanching rash. There are no focal neurologic findings or papilledema. Blood cultures have been drawn. What should be done next?

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

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Correct answer: D — Give dexamethasone and empiric IV antibiotics, then perform lumbar puncture when feasible

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

D is correct. Suspected bacterial meningitis with possible meningococcemia requires immediate dexamethasone and empiric IV treatment; investigations must not create delay. E makes imaging an absolute prerequisite. A puts culture yield before survival. B grossly under-treats a critical illness. C omits bacterial coverage on a false rash inference.

Reference: Emergency Care BC: Meningitis management: https://emergencycarebc.ca/clinical_resource/clinical-summary/meningitis-management/