Trismus, risus sardonicus and opisthotonus are the features of?

Appeared in: UPRVUNL - 2021

Explanation

The question asks to identify the disease characterized by trismus, risus sardonicus, and opisthotonus.
This combination of symptoms forms the classic clinical triad for Tetanus.
Trismus (lockjaw) is the spasm of jaw muscles, Risus sardonicus is a sardonic smile from facial muscle spasms, and Opisthotonus is severe backward arching of the body from spinal muscle spasms.
These symptoms are caused by tetanospasmin, a neurotoxin from Clostridium tetani, which blocks inhibitory neurotransmitters, leading to unopposed muscle contraction.

Option A: Diphtheria's hallmark signs are a pseudomembrane in the throat and a 'bull neck' appearance, not the muscular spasms described.
Option B: Plague is characterized by high fever and painful, swollen lymph nodes (buboes), which are unrelated to the symptoms of tetanus.
Option C: Q-fever typically presents as a flu-like illness with high fever and headache, or as atypical pneumonia. It does not cause tonic muscle spasms.

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 and intensive care. Nursing care is critical and focuses on managing spasms, maintaining a clear airway, and providing supportive care.
Nurses must maintain a quiet, dark, and low-stimulus environment for patients with tetanus, as noise, light, or touch can trigger painful and life-threatening spasms.
Tetanus is almost entirely preventable through vaccination with the tetanus toxoid. Nurses play a key role in immunization schedules and educating patients on the importance of booster shots, especially after a wound.

How to Approach the Question

First, identify the key clinical signs presented in the question: trismus, risus sardonicus, and opisthotonus.
Recognize that this is a classic triad of symptoms. Your goal is to recall which disease is associated with this specific presentation.
Systematically evaluate each option. Does Diphtheria cause these symptoms? No, it causes a pseudomembrane.
Does Plague cause these symptoms? No, it causes buboes.
Does Q-fever cause these symptoms? No, it's a flu-like illness.
Does Tetanus cause these symptoms? Yes, this triad is the hallmark of tetanus.

Concept Tested & Keywords

Qy5vQcbOgFISe2C2Ox1AZb

E6 Medicine Davidson Principles Practice 24e p. 1146-1148

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 269-271

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1826-1828

Practise the full UPRVUNL - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.