Communicable diseases: rabies prophylaxis in pregnancy: 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 · Communicable diseases: rabies prophylaxis in pregnancy

Sample item

A woman at 28 weeks of pregnancy is bitten on the arm by a stray dog that cannot be traced and has bleeding wounds. She asks if rabies vaccine can be avoided because of pregnancy. What is the correct advice?

AGive full post-exposure prophylaxis, as pregnancy is no contraindicationBGive only wound care and observe the dogCGive immunoglobulin alone and no vaccineDDefer vaccine until after delivery

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

The answer and the reasoning

A. Give full post-exposure prophylaxis, as pregnancy is no contraindication

Rabies is almost uniformly fatal once symptoms begin, so there is no contraindication to cell-culture vaccine or immunoglobulin in pregnancy. Wound washing, rabies vaccine and, for category III exposure, immunoglobulin infiltrated around the wounds are all given. The dog cannot be observed here.

Option by option

A. Give full post-exposure prophylaxis, as pregnancy is no contraindication (correct)
Correct. Post-exposure prophylaxis is life-saving and safe, so pregnancy is not a reason to withhold it.
B. Give only wound care and observe the dog
Observation is not possible when the dog is untraceable, and a bleeding bite needs full prophylaxis.
C. Give immunoglobulin alone and no vaccine
Immunoglobulin gives passive cover only, and the vaccine is still required for active immunity.
D. Defer vaccine until after delivery
Deferring vaccination risks fatal disease and is not advised.

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 A, Give full post-exposure prophylaxis, as pregnancy is no contraindication. Rabies is almost uniformly fatal once symptoms begin, so there is no contraindication to cell-culture vaccine or immunoglobulin in pregnancy.

Why is "Give only wound care and observe the dog" not the answer?

Observation is not possible when the dog is untraceable, and a bleeding bite needs full prophylaxis.

Why is "Give immunoglobulin alone and no vaccine" not the answer?

Immunoglobulin gives passive cover only, and the vaccine is still required for active immunity.

Why is "Defer vaccine until after delivery" not the answer?

Deferring vaccination risks fatal disease and is not advised.

What concept does this question test?

It tests Communicable diseases: rabies prophylaxis in pregnancy in PSM. Wound washing, rabies vaccine and, for category III exposure, immunoglobulin infiltrated around the wounds are all given. The dog cannot be observed here.

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 Communicable diseases: rabies prophylaxis in pregnancy?

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.