Tetanus

Question 1

Very low concentrationsof this highly potent toxin can result in tetanus (minimal lethal humandose)

Answer 1

2.5 ng/kg

Question 2

is an anaerobic, gram-positive, spore-forming rod whose spores are highly resilient and can survive readily in the environment throughout the world

Answer 2

C. tetani

Question 3

Percentage of cases of tetanus in which no puncture entry wound is found.

Answer 3

20–30%

Question 4

are the most common infection sitesin adults

Answer 4

Superficial abrasions to the limbs

Question 5

True or false:

Persons >60 years of age are at greater risk of tetanus because antibodylevels decrease over time

Answer 5

True

Question 6

Only those bacteria producing tetanus toxins can cause tetanus.

Answer 6

tetanospasmin

Question 7

The most common initial symptoms are (4)

Answer 7

trismus (lockjaw)
musclepain and stiffness
back pain
difficulty swallowing

Question 8

Without ventilatory support, is the most common cause of death in tetanus.

Answer 8

respiratory failure

Question 9

True or false:

Spasms strong enough toproduce tendon avulsions and crush fractures and this outcome is common

Answer 9

FALSE

have been reported, but IS RARE!

Question 10

anti-tetanus immunoglobulin G also may be measured in a sample taken before the administration of antitoxin or immunoglobulin; levels>___iU/mL (measured by standard ELISA) are deemed protective and do not support the diagnosis of tetanus

Answer 10

0.1 IU/ml

Question 11

is preferred for antibiotic therapy for tetanus

Answer 11

Metronidazole (400 mg rectally or500 mg IV every 6 h for 7 days)

Question 12

What alternative drug is used in tetanus infection that however theoretically may exacerbate spasms and in one studywas associated with increased mortality

Answer 12

is penicillin (100,000–200,000 IU/kg per day)

Question 13

What Antitoxin is the preparation of choice, as it is-less likely to be associated with anaphylactoid reactions.

Answer 13

human tetanus immune globulin or TIG single IM dose (3000–5000 IU) is given, with a portion injected around the wound.

Question 14

What second option antitoxin is available widely and is used inlow-income countries; after hypersensitivity testing, 10,000–20,000 U is administered IM as a single dose or as divided doses.

Answer 14

Equine-derived antitoxin

Question 15

What TIG doses of administered intrathecally.

Answer 15

50–1500 IU

Question 16

is the usual method of securing the airway in severe tetanus

Answer 16

tracheostomy

Question 17

Recovery from tetanus may take

Answer 17

4–6 weeks

Question 18

The WHO guidelines for tetanus vaccination consist of a primary course of

Answer 18

three doses in infancy, boosters at 4–7 and 12–15 years of age, and one booster in adulthood.