Tetanus

Question 1

Forms spores terminally, producing a drumstick or tennis racket appearance microscopically

Answer 1

C. tetani

Question 2

2nd most poisonous substance known

Answer 2

Tetanospasmin

Question 3

1st most poisonous substance known

Answer 3

Botulinum toxin

Question 4

MC form of tetanus

Answer 4

Neonatal (or umbilical) tetanus

Question 5

MOA of tetanus toxin

Answer 5

Blocks normal inhibition of antagonistic muscles by inhibiting release of glycine and GABA

Question 6

Incubation period of tetanus infection

Answer 6

2-14 days

Question 7

In generalized tetanus, presenting symptom in about half of the cases is

Answer 7

Trismus

Question 8

Neonatal tetanus typically manifests within

Answer 8

3-12 days of birth

Question 9

T/F Opisthotonus is characteristically seen in neonatal tetanus

Answer 9

F

Question 10

T/F Tetanus toxin cannot be neutralized by TIG after it has begun its axonal ascent to the spinal cord

Answer 10

T

Question 11

Antibiotic of choice for tetanus

Answer 11

Penicillin G; Metronidazole equally effective

Question 12

Highest survival rates with generalized tetanus are achieved with ___ agents

Answer 12

NM blocking agents such as pancuronium and vecuronium

Question 13

Favorable prognosis of tetanus is associated with

Answer 13

1) Long incubation period 2) Absence of fever 3) Localized disease

Question 14

Unfavorable prognosis of tetanus is associated with

Answer 14

1) Onset of trismus <7 days after injury 2) Onset of generalized tetanic spasms <3 days after onset of trismus

Question 15

Active immunization for tetanus should begin in infancy with what vaccine and at what schedule

Answer 15

DTaP (diphtheria-tetanus toxoid-acellular pertussis) at 2, 4, and 6 months of age, booster at 4-6 years of age, and at 10-yr intervals therafter

Question 16

WHO recommendation for tetanus toxoid among pregnant women to eliminate neonatal tetanus

Answer 16

At least 2 doses

Question 17

Recommendation for TIG for non-minor wounds

Answer 17

All non-minor wounds require human TIG EXCEPT in a fully immunized patient

Question 18

Recommendation for tetanus toxoid booster to injured persons whose immunization status is unknown or incomplete

Answer 18

Administer to all

Question 19

Recommendation for tetanus toxoid booster to injured persons who have COMPLETED primary immunization series

Answer 19

1) Clean and minor wound but ≥10 years since last booster - give booster 2) Non-minor wound and ≥ 5 years since last booster - give booster