Trismus, risus sardonicus and opisthotonos are the features of?

NORCET 3 - 2022 (Shift-1)

Medical & Surgical Nursing

Easy

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

Tetanus is the correct diagnosis as the question lists its three classic clinical features: trismus, risus sardonicus, and opisthotonos.
These symptoms are caused by tetanospasmin, a neurotoxin produced by the bacterium Clostridium tetani.
The toxin blocks inhibitory neurotransmitters in the central nervous system, leading to unopposed muscle contraction and spasm.
Trismus (lockjaw) is the spasm of jaw muscles, risus sardonicus is a sardonic smile from facial muscle spasms, and opisthotonos is the severe arching of the back.

Option A: Diphtheria's hallmark sign is a pseudomembrane in the throat and a 'bull neck' appearance, not the neuromuscular spasms of tetanus.
Option B: Plague, specifically bubonic plague, is characterized by fever and painful, swollen lymph nodes called buboes, typically in the groin, armpit, or neck.
Option C: Q-fever is a zoonotic infection that typically causes a flu-like illness with high fever, severe headache, and sometimes pneumonia or hepatitis. It does not cause spastic paralysis.

Visual 1: Image 1: Illustration of Risus Sardonicus - A drawing showing the characteristic facial expression of a patient with tetanus, highlighting the raised eyebrows and grinning appearance.
Visual 2: Image 2: Illustration of Opisthotonos - A diagram showing a patient with severe arching of the back, with only the head and heels touching the surface, to demonstrate the powerful muscle spasms.
Visual 3: Diagram 3: Pathophysiology of Tetanus - A flowchart showing how C. tetani spores enter a wound, produce tetanospasmin, which then blocks inhibitory neurotransmitters (GABA/glycine) at the synapse, leading to spastic paralysis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of Tetanus as background academic context rather than a clinical decision trigger.
Tetanus is a medical emergency requiring immediate hospitalization, often in an ICU setting, for airway management and control of spasms.
Prevention through vaccination with the tetanus toxoid is highly effective and a critical part of routine immunization schedules and post-exposure prophylaxis for wounds.
Nursing care for a patient with tetanus is intensive, focusing on minimizing external stimuli (noise, light, touch) to prevent triggering spasms, maintaining a patent airway, and administering muscle relaxants and sedatives.

How to Approach the Question

First, identify the key terms in the question: 'Trismus,' 'risus sardonicus,' and 'opisthotonos.'
Recognize that these three terms represent a classic, well-known clinical triad.
This is a factual recall question. Access your knowledge of infectious diseases and their pathognomonic signs.
Evaluate the options. Diphtheria, Plague, and Q-fever have distinct presentations that do not match this triad.
Link the triad of symptoms directly to Tetanus, which is famous for causing these specific types of muscle spasms.

Concept Tested & Keywords

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