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Pediatrics · Paediatric infections: infantile botulism
Sample itemA 5-month-old has constipation, a weak cry, poor sucking, ptosis, dilated sluggish pupils and descending symmetric weakness over several days. What is the mechanism of the toxin responsible?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Cleaves SNARE proteins and blocks acetylcholine release at the nerve terminal
Infantile botulism results from ingestion of Clostridium botulinum spores, which germinate in the infant gut and release toxin. The toxin cleaves SNARE proteins and prevents presynaptic acetylcholine release, giving a descending flaccid paralysis with constipation. Honey is a recognised source, and human botulism immune globulin is used for treatment.
Option by option
A. Blocks postsynaptic nicotinic receptors
Postsynaptic receptor blockade describes curare and similar agents.
B. Cleaves SNARE proteins and blocks acetylcholine release at the nerve terminal (correct)
Correct. Botulinum toxin blocks acetylcholine release presynaptically.
C. Inhibits acetylcholinesterase in the synapse
Cholinesterase inhibition would produce excess cholinergic stimulation, not paralysis.
D. Blocks glycine and GABA release in the spinal cord
Blocking inhibitory neurotransmitter release is the action of tetanus toxin, which causes spastic rigidity.
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.
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