Communicable diseases: tetanus prophylaxis: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · Communicable diseases: tetanus prophylaxis

Sample item

A 35-year-old farmer has a deep wound from a rusted tool contaminated with soil. He cannot recall any previous tetanus immunisation. What is the best management in addition to wound cleaning and debridement?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Tetanus toxoid vaccine plus human tetanus immunoglobulin at separate sites

A tetanus-prone wound in a person with unknown or incomplete immunisation needs both active and passive immunisation. Human tetanus immunoglobulin (250 IU) gives immediate protection and the toxoid starts the active response, given at different sites with different syringes. Wound toilet is essential and an antibiotic may be added but cannot replace immunisation.

Option by option

  • A. Tetanus toxoid vaccine plus human tetanus immunoglobulin at separate sites (correct)

    Correct. Both active and passive immunisation are needed for a dirty wound with unknown status.

  • B. Antibiotics alone

    Antibiotics do not neutralise tetanus toxin or provide immunity.

  • C. Human tetanus immunoglobulin alone

    Immunoglobulin alone gives temporary protection and does not begin the primary series.

  • D. Tetanus toxoid vaccine alone

    Toxoid alone does not give immediate antibody and is insufficient for a high-risk wound.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More PSM questions

Questions about this PSM question

What is the answer to this PSM question?

The best answer is A, Tetanus toxoid vaccine plus human tetanus immunoglobulin at separate sites. A tetanus-prone wound in a person with unknown or incomplete immunisation needs both active and passive immunisation.

Why is "Antibiotics alone" not the answer?

Antibiotics do not neutralise tetanus toxin or provide immunity.

Why is "Human tetanus immunoglobulin alone" not the answer?

Immunoglobulin alone gives temporary protection and does not begin the primary series.

Why is "Tetanus toxoid vaccine alone" not the answer?

Toxoid alone does not give immediate antibody and is insufficient for a high-risk wound.

What concept does this question test?

It tests Communicable diseases: tetanus prophylaxis in PSM. Human tetanus immunoglobulin (250 IU) gives immediate protection and the toxoid starts the active response, given at different sites with different syringes. Wound toilet is essential and an antibiotic may be added but cannot replace immunisation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Communicable diseases: tetanus prophylaxis?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.