HIV: post-exposure prophylaxis: practice question

A PSM 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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PSM · HIV: post-exposure prophylaxis

Sample item

A 25-year-old nurse sustains a deep needle-stick injury from a patient known to be HIV positive and presents 10 hours later. Her baseline HIV test is negative. Which post-exposure prophylaxis is appropriate under the national programme?

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

The answer and the reasoning

C. Tenofovir, lamivudine and dolutegravir for 28 days

Post-exposure prophylaxis should start as soon as possible, ideally within 2 hours and no later than 72 hours after a significant exposure. A three-drug regimen containing tenofovir, lamivudine and dolutegravir is given for 28 days, with baseline and follow-up testing. Single-drug or shortened courses are inadequate.

Option by option

  • A. A single dose of nevirapine

    Single-dose nevirapine is used to reduce mother-to-child transmission historically, not for occupational prophylaxis.

  • B. Zidovudine alone for 28 days

    Monotherapy is not adequate and is an obsolete approach.

  • C. Tenofovir, lamivudine and dolutegravir for 28 days (correct)

    A three-drug fixed-dose regimen for the full 28 days is the standard for a significant exposure.

  • D. Tenofovir, lamivudine and dolutegravir for 7 days

    Seven days is too short to ensure the prevention of establishment of infection.

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.

More PSM questions

Questions about this PSM question

What is the answer to this PSM question?

The best answer is C, Tenofovir, lamivudine and dolutegravir for 28 days. Post-exposure prophylaxis should start as soon as possible, ideally within 2 hours and no later than 72 hours after a significant exposure.

Why is "A single dose of nevirapine" not the answer?

Single-dose nevirapine is used to reduce mother-to-child transmission historically, not for occupational prophylaxis.

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

Monotherapy is not adequate and is an obsolete approach.

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

Seven days is too short to ensure the prevention of establishment of infection.

What concept does this question test?

It tests HIV: post-exposure prophylaxis in PSM. A three-drug regimen containing tenofovir, lamivudine and dolutegravir is given for 28 days, with baseline and follow-up testing. Single-drug or shortened courses are inadequate.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 HIV: post-exposure prophylaxis?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM 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.