Antenatal care: tetanus-diphtheria immunisation: 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 · Antenatal care: tetanus-diphtheria immunisation

Sample item

A woman at 12 weeks of pregnancy received two doses of Td during her last pregnancy 2 years ago. What is the recommended Td schedule in this pregnancy?

AThree doses of Td at 0, 1 and 6 monthsBTwo doses of Td given 4 weeks apartCNo dose, because she was immunised in the last pregnancyDOne booster dose of Td

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

The answer and the reasoning

D. One booster dose of Td

Under the national schedule, a pregnant woman who received two Td doses in a pregnancy within the last 3 years needs just one booster dose in the current pregnancy. Two doses 4 weeks apart are for previously unimmunised women or those whose last dose was long ago. The aim is to prevent maternal and neonatal tetanus.

Option by option

A. Three doses of Td at 0, 1 and 6 months
A three-dose schedule is not part of the programme for pregnant women.
B. Two doses of Td given 4 weeks apart
Two doses are for women who are unimmunised or who have no recent dose.
C. No dose, because she was immunised in the last pregnancy
A booster is still given in each pregnancy, so no dose would leave protection lower.
D. One booster dose of Td (correct)
A single booster is the correct schedule when two doses were given in a pregnancy in the preceding 3 years.

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 PSM question

What is the answer to this PSM question?

The best answer is D, One booster dose of Td. Under the national schedule, a pregnant woman who received two Td doses in a pregnancy within the last 3 years needs just one booster dose in the current pregnancy.

Why is "Three doses of Td at 0, 1 and 6 months" not the answer?

A three-dose schedule is not part of the programme for pregnant women.

Why is "Two doses of Td given 4 weeks apart" not the answer?

Two doses are for women who are unimmunised or who have no recent dose.

Why is "No dose, because she was immunised in the last pregnancy" not the answer?

A booster is still given in each pregnancy, so no dose would leave protection lower.

What concept does this question test?

It tests Antenatal care: tetanus-diphtheria immunisation in PSM. Two doses 4 weeks apart are for previously unimmunised women or those whose last dose was long ago. The aim is to prevent maternal and neonatal tetanus.

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 Antenatal care: tetanus-diphtheria immunisation?

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.