Tetanus

Tetanus

Q. 1

Which of the following are true about tetanus ‑

 A

Gram –ye spore forming aerobe 

 B

Because of tetanospasmin

 C

Muscle enzymes are normal

 D

Vegetative cell will die with tetracycline

Q. 1

Which of the following are true about tetanus ‑

 A

Gram –ye spore forming aerobe 

 B

Because of tetanospasmin

 C

Muscle enzymes are normal

 D

Vegetative cell will die with tetracycline

Ans. B

Explanation:

Ans. is ‘b’ i.e., Because of tetanospasmin 

  • Clostridium tetani is a gram (+)ve, spore forming, anaerobic bacillus.
  • Tetanospasmin (neurotoxin) is responsible for tetanus.
  • Tetanus is characterized by increased muscle tone (muscle spasm) and rigidity.

Diagnosis of tetanus

  • The diagnosis of tetanus is based entirely on clinical findings. The diagnosis is established on the basis of

history of an injury, (particularly one in which either soil or fecal material has been introduced) 6-12 days before the

onset of typical clinical findings.

  • Wound should be cultured in suspected cases. However, C. tetani can be isolated from wounds of patients

without tetanus and frequently cannot be recovered from wounds of those with tetanus.

  • Other laboratory findings may be –

i)        There may be leukocytosis

ii)      Muscle enzyme levels may be raised

iii)    Electromyogram may show continuous discharge of motor units and shortening or absence of the silent

interval normally seen after an action potential. 

Treatment of tetanus

  • Treatment of tetanus includes :‑

1)       Antimicrobial therapy :- Antibiotic therapy is administered to eradicate vegetative cells, i.e. to eliminate the

source of toxins. Penicillin and metronidazole are first line drugs. Clindamycin and erythromycin are alternatives for penicillin – allergic patients. (Tetracycline is not used).

2)       Antitoxin :- is given to neutralize circulating toxin. Human tetanus immune globuline (TIG) is the

preparation of choice.

3)       Control of muscle spasms :- Many agents, alone or in combination, have been used to treat the muscle spasms

of tetanus, which are painful and can threaten ventilation by causing laryngospasm or sustained contraction of ventilatory muscles. Benzodiazepines (Diazepam, larazepam, midazolam) are used most commonly. Alternatives are Barbiturates and chlorpromazine. Mechanical ventilation with a nondepolarizing neuromuscular blocking agent may be used for spasms unresponsive to medications. Other agents include propofol, dantrolene, intrathecal beclofen, succinylcholine and magnesium sulfate.

4)         Respiratory care :- Intubation or tracheostomy, with or without mechanical ventilation may be required.

5)       Autonomic dysfunction :- For sympathetic overactivity labetalol, esmolol or clonidine may be used.

Vaccine :- Patient recovering from tetanus should be actively immunized


Q. 2

Tetanus is caused by

 A

Cl. Tetani

 B

Cl. Welchii

 C

Cl. edematiens

 D

CI. Septicum

Q. 2

Tetanus is caused by

 A

Cl. Tetani

 B

Cl. Welchii

 C

Cl. edematiens

 D

CI. Septicum

Ans. A

Explanation:

Ans. is ‘a’ i.e., Cl. Tetani 


Q. 3

True regarding pre-exposure tetanus immunization are all except:     

September 2005

 A

If already immunized, a booster in the last trimester is advocated

 B

Vaccine is given intramuscularly

 C

Tetanus immunoglobulin is injected to the mother

 D

2 doses are recommended

Q. 3

True regarding pre-exposure tetanus immunization are all except:     

September 2005

 A

If already immunized, a booster in the last trimester is advocated

 B

Vaccine is given intramuscularly

 C

Tetanus immunoglobulin is injected to the mother

 D

2 doses are recommended

Ans. C

Explanation:

Ans. C: Tetanus Immunoglobulin is Injected to the Mother

Administration of attenuated virus vaccines are contraindicated during pregnancy, this includes vaccines against measles, mumps, poliomyelitis, rubella, yellow fever, and varicella.

MMR vaccination can be given during lactation and does not affect the baby.

The CDC recommends that non-pregnant women who receive the MMR vaccine or varicella vaccination should wait four weeks before getting pregnant.

In situations where inactivated virus or parts of a virus are administered, in general, there is no contraindication to immunization during pregnancy. Thus influenza vaccination is given to pregnant women at risk, as are vaccinations against hepatitis A and B.

HPV vaccine was introduced in 2006. It is not to be used during pregnancy.

BCG(Live attenuated bacterial) vaccine is used against tuberculosis and is contraindicated in pregnancy

Inactivated bacterial vaccine is used during pregnancy for women who have a specific risk of exposure and disease. Vaccination against pneumococcus or meningococcus infections, or typhoid fever show no confirmed side effects regarding the fetus.

Tetanus toxoids appear safe during pregnancy and are administered intramuscularly.

0.5 ml tetanus toxoid is given at 6 weeks interval for 2 such,the first one to be given between 16-24 weeks..

Immune globulins are used for post exposure prophylaxis. Such agents are considered in pregnant women exposed to hepatitis B, rabies, tetanus, varicella, and hepatitis A

Quiz In Between


Q. 4

 All of the following are true regarding tetanus except:

 A

It is transmitted from person to person

 B

Herd immunity is not of much value

 C

The main reservoir is soil and intestine of animals and humans

 D

Incubation period is 6-10 days

Q. 4

 All of the following are true regarding tetanus except:

 A

It is transmitted from person to person

 B

Herd immunity is not of much value

 C

The main reservoir is soil and intestine of animals and humans

 D

Incubation period is 6-10 days

Ans. A

Explanation:

Ans. a. It is transmitted


Q. 5

Main site of action of tetanus toxin:

 A

Presynaptic terminal of spinal cord

 B

Postsynaptic terminal of spinal cord

 C

Neuromuscular junction

 D

Muscle fibers

Q. 5

Main site of action of tetanus toxin:

 A

Presynaptic terminal of spinal cord

 B

Postsynaptic terminal of spinal cord

 C

Neuromuscular junction

 D

Muscle fibers

Ans. A

Explanation:

Ans. is. a’ i. e. Presynaptic terminal of spinal cord


Q. 6

Tetanus is caused by:

 A

Gram positive bacilli

 B

Gram negative bacilli

 C

Gram positive cocci

 D

Gram negative cocci

Q. 6

Tetanus is caused by:

 A

Gram positive bacilli

 B

Gram negative bacilli

 C

Gram positive cocci

 D

Gram negative cocci

Ans. A

Explanation:

Ans. is. ‘a’ i. e. Gram positive bacilli


Q. 7

Most common symptom of tetanus is:

 A

Tonic-clonic seizures

 B

Hemplegia

 C

Lock-jaw

 D

Opisthotonus

Q. 7

Most common symptom of tetanus is:

 A

Tonic-clonic seizures

 B

Hemplegia

 C

Lock-jaw

 D

Opisthotonus

Ans. C

Explanation:

Ans. is. ‘c’ i. e. Lock-jaw

Quiz In Between



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