A 52-year-old man presents to the emergency department with jaw stiffness and severe generalized muscle spasms 1 week after a puncture wound from a rusty nail. Vital signs show BP 152/94, HR 110, RR 22, temperature 37.8°C, SpO2 98% on room air. Examination reveals risus sardonicus, opisthotonos, and rigid back muscles. Serum electrolytes are normal; EMG shows characteristic "motor unit action potentials." He denies recent antibiotic use. Which neurotransmitter is most directly affected by this toxin?
- A)Acetylcholine and serotonin
- B)Glycine and GABAGABARITO
- C)Dopamine and norepinephrine
- D)Histamine and acetylcholine
- E)Glutamate and aspartate
Explicação
Tetanospasmin travels retrograde to the CNS and cleaves SNARE proteins in inhibitory interneurons, preventing release of glycine and GABA. Loss of inhibition causes spasticity, trismus, and muscle spasms. Ver explicação completa e trilha adaptativa →