Tetanus – Board-Style Questions

What this deck covers

tetanus in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. A stiff jaw after a nail
2. How the toxin works
3. Awake in every spasm
4. What proves it
5. Stopped sucking on day six
6. A weak face after an ear
7. Who will do worse
8. Sweating in week two
9. Back pain in recovery
10. The first injection
11. Choosing the antibiotic
12. Settling the spasms
13. A spasm that shuts the throat
14. Calming the storm
15. A garden fork in the foot
16. Protected after recovery?
17. How long it lasts
18. Preventing it in newborns

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Bacterial meningitis causing marked neck stiffness, Blocked release of glycine and GABA from inhibitory neurons, He has a temperature of 38.2 C between the attacks, By nerve conduction studies showing slowed motor velocity, Neonatal tetanus acquired through the umbilical stump, Localised, confined to the muscles of one limb, An injury on the foot rather than on the hand, Thyroid storm unmasked by the stress of prolonged illness, A vertebral compression fracture caused by the spasms, High-dose intravenous dexamethasone given for three days, Vancomycin, since resistance to other agents is now usual, Oral baclofen started at a low morning dose, Intubate now, with early tracheostomy for the long course, A bolus of intravenous labetalol, then an infusion.

Clinical pearls from this deck

• Trismus plus reflex spasms, fully alert: tetanus.
• Tetanus toxin silences inhibitory neurons in the cord.
• Spasms with full awareness point away from seizures.
• Tetanus is clinical: never wait for a test to treat.
• Good feeding, then no suck and spasms: neonatal tetanus.
• Trismus plus facial palsy after otitis: cephalic form.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Infectious Disease case decks · pediatric reference values.