Infection · UKMLA & AKT
Tetanus
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise tetanus — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Clostridium tetani - obligate anaerobe, Gram-positive, spore-forming rod; spores ubiquitous in soil, dust, animal faeces
- Spores germinate in anaerobic conditions (devitalised tissue, deep puncture wounds) → release tetanospasmin (zinc-dependent metalloprotease)
- Tetanospasmin travels retrogradely to spinal cord/brainstem → cleaves synaptobrevin (SNARE protein) in inhibitory interneurons → blocks glycine/GABA release → loss of inhibition of alpha motor neurons → uncontrolled muscle contraction
- Also acts on sympathetic nervous system → autonomic instability
- Toxin binding is irreversible - recovery depends on new nerve terminal sprouting (weeks to months)
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