Rare vaccinated diseases

Question 1

What causes tetanus and what does it do

Answer 1

Clostrodium tetani
Bacteria produces neurotoxin that blocks NMJ
Leads to spasm and autonomic dysfunction

Question 2

How is it transmitted

Answer 2

Soil contaminated wound

Question 3

How does it present

Answer 3

General malaise then rapid sepsis / neuro
Trismus - Locked jaw
Opisthotonos - spasm of muscle leading to backward arching in head, neck and spine
Laryngeal and resp muscle affected = death

Question 4

How do you Rx

Answer 4

Clean and decried wound
Tetanus Ig and anti-toxin if open wound
Ax to kill live (metronidazole) 
Benzo's if painful spasm
Intubation and ventilation often needed

Question 5

What causes diphtheria

Answer 5

Corynebacterium

Airborne

Question 6

What is key Sx

Answer 6

Tachy without fever
Dense looking mucous membrane
- Unilateral profuse nasal discharge and crusting if nose
- Tonsillar inflammation and LN if tonsil
- Husky voice, brassy cough and resp distress

Question 7

What are complications

Answer 7

Obstruction
2 myocarditis = almost always fatal
Peripheral neuropathy. / encephalitis = rare

Question 8

How do you Rx

Answer 8

Penicillin + anti-toxin to counteract toxin released

Question 9

What causes poliomyelitis

Answer 9

Polio (enterovirus)

Faecal oral route as multiples in intestine

Question 10

How does it present

Answer 10

Asymptomatic in 70%
Mild URTI / GI / diarrhoea
5% = serious CNS

Question 11

What CNS

Answer 11

Aseptic meningitis
Paralysis affecting anterior horn cell (LMN)
- Flaccid
- Hyporeflexia
- Muscle wasting legs > arm
Classic wasted deformed leg with foot drop

Question 12

How do you manage

Answer 12

Prevent with vaccine
Two types
Live oral - risk of polio but mucosal immunity where replicates
Injection = killed