Sexual offences: HIV post-exposure prophylaxis: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Sexual offences: HIV post-exposure prophylaxis

Sample item

A 26-year-old woman presents 20 hours after an alleged penetrative rape by an unknown man. Which HIV post-exposure prophylaxis is recommended under the NACO guidelines?

ATenofovir, lamivudine and dolutegravir for 28 daysBZidovudine alone for 28 daysCTenofovir, lamivudine and dolutegravir for 7 daysDSingle-dose nevirapine

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Tenofovir, lamivudine and dolutegravir for 28 days

PEP should be started as soon as possible, ideally within 2 hours and not later than 72 hours after exposure. The NACO regimen is a three-drug combination of tenofovir, lamivudine and dolutegravir given for 28 days. She is within the window and should also be offered counselling and baseline testing.

Option by option

A. Tenofovir, lamivudine and dolutegravir for 28 days (correct)
A three-drug regimen for 28 days started within 72 hours is the recommended course.
B. Zidovudine alone for 28 days
A single drug is inadequate and a three-drug regimen is used.
C. Tenofovir, lamivudine and dolutegravir for 7 days
Seven days is too short to be effective, and 28 days are needed.
D. Single-dose nevirapine
Single-dose nevirapine is used for prevention of mother-to-child transmission, not for PEP.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is A, Tenofovir, lamivudine and dolutegravir for 28 days. PEP should be started as soon as possible, ideally within 2 hours and not later than 72 hours after exposure.

Why is "Zidovudine alone for 28 days" not the answer?

A single drug is inadequate and a three-drug regimen is used.

Why is "Tenofovir, lamivudine and dolutegravir for 7 days" not the answer?

Seven days is too short to be effective, and 28 days are needed.

Why is "Single-dose nevirapine" not the answer?

Single-dose nevirapine is used for prevention of mother-to-child transmission, not for PEP.

What concept does this question test?

It tests Sexual offences: HIV post-exposure prophylaxis in Forensic Medicine. The NACO regimen is a three-drug combination of tenofovir, lamivudine and dolutegravir given for 28 days. She is within the window and should also be offered counselling and baseline testing.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Sexual offences: HIV post-exposure prophylaxis?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.