Tetanus-prone puncture wound — MCCQE Part 1 MCQ

Correct answer: A — Give tetanus-containing vaccine and tetanus immune globulin after wound care

Give tetanus-containing vaccine and tetanus immune globulin after wound care is the single best answer because the age, timing, examination findings and investigations in the vignette fit Tetanus-prone puncture wound better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Immunization Guide, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Immunization Guide