18.2 - C.tetani

Question 1

tetanus neurotoxin aka?

Answer 1

tetanospasmin

Question 2

difference between tetanus and botulism toxin

Answer 2

site of action:
tetanus = CNS: blocks glycine/GABA release
Botulism = motor neurons release of ACh

Question 3

how many serotypes of tetanus toxin

Answer 3

one (botulism has ~7)

Question 4

what is mechanism of tetanus toxin? how different from botulism?

Answer 4

same MOA: (two chains) zinc endopeptidase degrades synaptobrevin (a SNARE protein) on glycine-containing vesicles

Difference is site of action only

Question 5

How many toxins does tetanus produce? and what class are they

Answer 5

2
neurotoxin
hemolysin (tetanolysin) = Beta hemolysis –> kills phagocytic cells and other tissue

Question 6

how is tetanus transmitted

Answer 6

wounds fromsoil containing spores

Question 7

what are 2 populations that are most susceptible to teatanus and why

Answer 7

older women: less adequately vaccinated

Diabetics: ???

Question 8

what type of wounds are more likely to produce a tetanus infx and why

Answer 8

minor wounds bc major wounds are better managed

Question 9

how does tetanus toxin travel? how is this different than botulism

Answer 9

via retrograde axonal transport

botulism travels in bloodstream

Question 10

what is trismus

Answer 10

lock-jaw

Question 11

difference in muscle effects between tetanus and botulism

Answer 11

tetanus = spastic/rigid paralysis; opisthotonic back and neck bending

botulism = flaccid

Question 12

how does tetanus and botulism kill

Answer 12

respiratory paralysis

Question 13

dx of tetanus

Answer 13

CP and history of puncture wound (may look insignificant)

Question 14

active tx of tetanus (2) infx and MOA

Answer 14

metronidazole or penicillin G - stop any further growth and toxin release

Question 15

passive immunization approach with tetanus (and MOA)

Answer 15

antitoxin (human tetanus immunoglobulin)

in order to neutralize free toxin in the tissue before transport.

Question 16

Which is given immediately in a tetanus infx

Answer 16

antitoxin (human tetanus immunoglobulin)

in order to neutralize free toxin in the tissue before transport.

Question 17

active immunization is achieved via what

Answer 17

tetanus toxoid

Question 18

When is the DTaP given (3) and what is the tetanus component composed of?

Answer 18

2, 4, 6 months

tetanus toxoid

Question 19

When is the DTaP booster given (2)?

Answer 19

15-18 months and 4-6 years

Question 20

when is the toxoid booster Tdap given in each of 3 populations

Answer 20

-11-16 years to used to boost for pertussis (and tetanus)
- any age that hasn’t had pertusis booster
pregnant women (to protect newborn)

Question 21

when is the Td booster given

Answer 21

every 10 years after age 16 I guess

Question 22

Why is the booster given?

Answer 22

can’t rely on memory cells - need to maintain circulating antibody

Question 23

minor and major wound respectively: how do you tx patients with 3 or more toxoid doses (childhood immunizations)

Answer 23

major wounds: toxoid if >5 years since last booster (you’re giving them their 10-yr booster early to increase the circulating Ab)

minor superficial wounds: toxoid only if >10 years since last booster (you’re giving them the booster they have missed)

Question 24

minor and major wound respectively: how do you tx patients with < 3 or unknown number of prior toxoid doses (unknown immune status)

Answer 24

minor superficial wounds: toxoid

major wounds: toxoid plus tetanus immune globulin (anti-toxin)