Mehl. UW Tetanus and botulism 04-02 (2) Flashcards
Mehl. Botulism. causes what?
flaccid paralysis.
Mehl. Botulism. Mo?
Botulin toxin of Clostridium botulinum
Mehl. Botulism. mos mechanism?
Inhibits release of presynaptic acetylcholine, which is normally stimulatory at muscles.
Mehl. Botulism. CP?
Can present as floppy baby syndrome;
can also cause cranial nerve palsies.
Mehl. Botulism. how acquired?
Acquired as spores in honey in infants under 1;
acquired as pre-formed toxin from canned goods in anyone older.
Mehl. Tetanus. mos?
Clostridium tetani
Mehl. Tetanus. mechanism of mo?
inhibits release of presynaptic neurotransmitters GABA and glycine, which are normally inhibitory
Mehl. Tetanus. CP?
Can present as opisthotonos (arched back) and trismus (lock-jaw).
Mehl. Tetanus.
Presents in two patients on USMLE: 1) neonate born at home whose umbilical cord was cut with a kitchen knife + tied with twine;
Mehl. Tetanus.
Presents in two patients on USMLE: 2) random dude who cut himself in back yard.
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Mehl. Tetanus. When is given DtaP?
2, 4, 6, months, then again at 15-18 months, then again at 4-6 years
Mehl. Tetanus. when give boosters?
School-age kids require Tdap booster at 11-12 years, followed by Td booster every 10 years thereafter.
UW. neonatal tetanus. table. CP?
difficult feeding, trismus
Spasm and hipertonicy: clenced hands, dorsiflexed feet, opisthotonus
UW. neonatal tetanus. table. Tx?
Supportive
Antibiotics + tetanus immunoglobulin
UW. neonatal tetanus. table. Prevention?
Vaccination
Hygienic delivery and cord care
UW. neonatal botulism, CP?
weakness, constipation, poor feeding
UW. neonatal botulism, mos where is found?
honey and soil
UW. C tetani produces tetanospasmin, that prevents inhibitory neurotransmiter release at the junction of the upper and lower motor neurons.
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UW. neonates are incr. risk to expose to C. tetani in case of unhygienic delivery or cord care practice.
in case they would mention delivery at home
UW. neonatal tetanus. why poor feeding?
due to trismus (lockjaw)
UW. neonatal tetanus. Supportive Tx?
nutrition, respiratory support
UW. neonatal tetanus. Tx abs?
eg metronidazole
UW. neonatal tetanus. Tx with injection?
passive immunization with tetanus immune globulin.
UW. Routine vaccination of pregnant women against tetanus has virtually eliminated neonatal tetanus in the developed world, but sporadic cases continue to occur in unvaccinated communities.
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