Infection · UKMLA & AKT
Tetanus
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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