Bacteriology: tetanus prophylaxis in a dirty wound: practice question

A Microbiology 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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Microbiology · Bacteriology: tetanus prophylaxis in a dirty wound

Sample item

A 45-year-old farmer has a deep, soil-contaminated puncture wound from a rusty tool. He cannot recall ever being immunised against tetanus. Which tetanus prevention is most appropriate along with wound cleaning?

AOral penicillin alone for seven daysBTetanus toxoid alone, with no immunoglobulinCTetanus immunoglobulin alone, with no toxoidDToxoid plus immunoglobulin at separate sites

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

The answer and the reasoning

D. Toxoid plus immunoglobulin at separate sites

For a tetanus-prone wound in a person with unknown or incomplete immunisation, passive protection with human tetanus immunoglobulin is combined with the first dose of toxoid, given at separate sites. The primary series must then be completed.

Option by option

A. Oral penicillin alone for seven days
Antibiotics do not neutralise toxin already produced and cannot replace immunisation.
B. Tetanus toxoid alone, with no immunoglobulin
Toxoid alone gives no protection in the days before antibody develops in an unimmunised person.
C. Tetanus immunoglobulin alone, with no toxoid
Immunoglobulin alone gives only short passive cover and starts no active immunity.
D. Toxoid plus immunoglobulin at separate sites (correct)
Correct. Passive plus active immunisation at different sites protects now and builds lasting immunity.

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.

Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is D, Toxoid plus immunoglobulin at separate sites. For a tetanus-prone wound in a person with unknown or incomplete immunisation, passive protection with human tetanus immunoglobulin is combined with the first dose of toxoid, given at separate sites.

Why is "Oral penicillin alone for seven days" not the answer?

Antibiotics do not neutralise toxin already produced and cannot replace immunisation.

Why is "Tetanus toxoid alone, with no immunoglobulin" not the answer?

Toxoid alone gives no protection in the days before antibody develops in an unimmunised person.

Why is "Tetanus immunoglobulin alone, with no toxoid" not the answer?

Immunoglobulin alone gives only short passive cover and starts no active immunity.

What concept does this question test?

It tests Bacteriology: tetanus prophylaxis in a dirty wound in Microbiology. The primary series must then be completed.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Bacteriology: tetanus prophylaxis in a dirty wound?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology 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.