DSSSB 14 August 2024
Child Health Nursing (Pediatrics)
Easy
All of the following are the common manifestations of neonatal tetanus, EXCEPT:
Appeared in: DSSSB 14 August 2024
Explanation
- Neonatal tetanus is caused by a neurotoxin from Clostridium tetani that leads to severe, uncontrolled muscle contractions and rigidity, a state known as hypertonia.
- Hypotonia is the medical term for decreased or low muscle tone, often described as 'floppiness'.
- This condition is the clinical opposite of the spastic paralysis and extreme muscle stiffness that are the hallmarks of tetanus.
- Therefore, hypotonia is not a manifestation of neonatal tetanus.
Why Other Options Were Wrong
- Option A: Trismus, or lockjaw, is a classic and often the first sign of tetanus. It is caused by the spasm of the masseter muscles.
- Option B: Dysphagia, or difficulty swallowing, is a common manifestation resulting from spasms of the pharyngeal muscles.
- Option D: Opisthotonus is a hallmark sign of severe, generalized tetanus. It is a dramatic arching of the back caused by powerful spasms of the extensor muscles of the neck and spine.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of neonatal tetanus as background academic context rather than a clinical decision trigger.
- Early recognition of tetanus signs, such as difficulty feeding and increasing stiffness, is critical for initiating life-saving treatment in a neonatal intensive care unit (NICU).
- Neonatal tetanus is almost entirely preventable through two key public health measures: maternal immunization with the tetanus toxoid vaccine and ensuring clean, aseptic cord care practices after delivery.
- What if? If a neonate presented with hypotonia (floppiness), poor feeding, and a weak cry, the differential diagnosis would shift away from tetanus towards conditions like neonatal sepsis, birth asphyxia, congenital myopathies, or metabolic disorders.
How to Approach the Question
- First, identify the core concept being tested, which is the clinical presentation of neonatal tetanus.
- Note the keyword 'EXCEPT'. This means you are looking for the option that is NOT a sign of the disease.
- Recall the basic pathophysiology of tetanus: the toxin causes unopposed nerve firing, leading to muscle hyperactivity, rigidity, and spasms (hypertonia).
- Evaluate each option against this core principle.
- Trismus (lockjaw), dysphagia (swallowing difficulty), and opisthotonus (back arching) are all classic examples of muscle spasms and rigidity.
- Hypotonia means decreased muscle tone, which is the direct opposite of the effects of the tetanus toxin. Therefore, it is the correct answer.
Concept Tested & Keywords
- Concept Tested: Clinical manifestations of neonatal tetanus
- Stem keywords: neonatal tetanus, common manifestations
- Lead-in keywords: EXCEPT
- Negative lead-in flag: The question asks for the exception among the given options.
Question ID
Q42JCB4W4g6iQNPZeg1X3t
Reference Book
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1826-1828
E6 Medicine Davidson Principles Practice 24e p. 1146-1148
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 269-271
Practise the full DSSSB 14 August 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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