Surgical infections: tetanus prophylaxis: practice question

A General Surgery 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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General Surgery · Surgical infections: tetanus prophylaxis

Sample item

A farmer has a contaminated, deep puncture wound from a rusty nail and has never been vaccinated against tetanus. What is the correct prophylaxis?

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

The answer and the reasoning

D. Wound debridement, tetanus toxoid and human tetanus immunoglobulin at a separate site

For a tetanus-prone wound in an unimmunised patient both active immunisation with toxoid and passive immunisation with human tetanus immunoglobulin (250 IU) are given at different sites, along with surgical wound cleaning. The toxoid course is completed later. Antibiotics such as metronidazole or penicillin may be added.

Option by option

  • A. Immunoglobulin alone

    Immunoglobulin alone does not induce lasting immunity.

  • B. No treatment needed

    An unimmunised patient with a dirty wound is at high risk.

  • C. Toxoid alone

    Toxoid alone is slow and leaves the patient unprotected initially.

  • D. Wound debridement, tetanus toxoid and human tetanus immunoglobulin at a separate site (correct)

    Correct. Active and passive immunisation plus debridement are required.

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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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Wound debridement, tetanus toxoid and human tetanus immunoglobulin at a separate site. For a tetanus-prone wound in an unimmunised patient both active immunisation with toxoid and passive immunisation with human tetanus immunoglobulin (250 IU) are given at different sites, along with surgical wound cleaning.

Why is "Immunoglobulin alone" not the answer?

Immunoglobulin alone does not induce lasting immunity.

Why is "No treatment needed" not the answer?

An unimmunised patient with a dirty wound is at high risk.

Why is "Toxoid alone" not the answer?

Toxoid alone is slow and leaves the patient unprotected initially.

What concept does this question test?

It tests Surgical infections: tetanus prophylaxis in General Surgery. The toxoid course is completed later. Antibiotics such as metronidazole or penicillin may be added.

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 Surgical infections: tetanus prophylaxis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.