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21 Cards in this Set
- Front
- Back
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What causes tetanus?
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Clostridum tetani (gram positive rod, anaerobic)
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What are the 5 common clostridia?
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Clostridium tetanus
Clostridum botulinum Clostridium perfringins (gas gangrene) Clostridium difficil Clostridium perfringes (food poisoning) |
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How prevent tetanus?
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A toxoid based immunization (toxoid is a protein that mimicks a toxin)
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Where find tetanus?
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Dirt, manure, animal hair, plaster
More comon rural Spores into tissues #1 - neonatal into baby's umbilical stump |
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What is the #1 cause of tetanus?
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Baby umbilical stump
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How many tetanus deaths per year?
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1 million
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What is the incubation period for tetanus?
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3-10 days
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How does tetanus toxin work?
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Blocks inhibitatory nerve signal, resulting in muscle spasm
Sx peak 1 week after onset, continue for 3 weeks |
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What is trismus?
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Masseter rigidity
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What are the neuro presentations of tetanus?
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Spasm
Generalized increased muscle tone and reflexes Masseter rigidity (trismus) Local paresthesias Local spasms (risus sardonicus -- creasWhated forehead, tight lips) Swallowing dysfurnction Respiratory dysfunction Sympathetic overactivity (sweating, salivation, tachy, bp swings) |
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What instigates tetanus spasms
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Minor stimuli - visual, auditory
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What are signs of neonatal tetanus?
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Usually after 1st week of birth
Poor sucking Convulsions at onset Hyperflexion posturing, adduction arms, clenched fists, hyperextension of legs |
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What is the mortality of neonatal tetanus?
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70%
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What are some findings of "local tetanus"
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Rigidity/spasm localized to innoculation site
Cephalic tetanus -- cranial nerves only affected |
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What are non-neuro signs of tetanus?
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Omphalitis (cellulitis around umbilicus in newborn)
CNS meningitis Aspiration pneumonia Mouth/gi ulcers due to hypoxia of tissues Cranial nerve palsies Vertebral fx due to extreme spasm |
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How dx tetanus?
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Clinical sx/hx
Bacteria isolation unreliable |
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DDX of tetanus?
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Hypocalcemia (spasms in limbs)
Poisoning (CO, phenothiazines) Narcotic withdrawal Rabies (progresses faster, rigidity uncommon) |
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DDx of trismus?
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Tetanus
Mumps Mandibular fx Dental abscess TMJ pain from serum sickness |
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How to tell if trismus from tetanus?
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In tetanus, increasing pressure on mouth induces spasm...
Other conditions, you can gently force mouth open |
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Treatment of tetanus?
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Nursing
Antitoxin (Tetanus Immune Globulin) Equine Tetanus Antitoxin IVImmunoglobulin (IVIG) (only works on circulating toxin, not bound toxin) Antibiotics (PCN or tetracycline) Muscle relaxants/sedatives |
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Prevent tetunus how?
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Give tetanus toxoid vaccine
Immunize pregnant moms before 7 mos (so can make antibodies) |
