Error in UW 2CK QID 3325?

[johndoe3344]

It's a question that basically says:

35 year old man with a "NOT clean and minor wound" from cutting himself with a rusty fence. He received all his childhood vaccinations, and his last dose of Td was > 10 years ago. How would you manage him?

UW seems to think that you would give him toxoid and TIG. This is incorrect. If any of you have UpToDate, their table states that for anyone that have received all of their childhood vaccines (>=3 doses), you NEVER give TIG. Also, the information from UpToDate is reproduced here: http://www.michigan.gov/documents/mdch/Tetanus_Prophy_All_Ages_Final_060412_388045_7.pdf

Am I misinterpreting this? Or is there an error in UW?

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[Transposony]

If I remember correctly, anyone with vaccinations > 10yrs is taken as not immunized and hence TIG.

 

[link2swim06]

It's a question that basically says:

35 year old man with a "NOT clean and minor wound" from cutting himself with a rusty fence. He received all his childhood vaccinations, and his last dose of Td was > 10 years ago. How would you manage him?

UW seems to think that you would give him toxoid and TIG. This is incorrect. If any of you have UpToDate, their table states that for anyone that have received all of their childhood vaccines (>=3 doses), you NEVER give TIG. Also, the information from UpToDate is reproduced here: http://www.michigan.gov/documents/mdch/Tetanus_Prophy_All_Ages_Final_060412_388045_7.pdf

Am I misinterpreting this? Or is there an error in UW?

I have seen that table from your link on the CDC website.

CDC > uworld.

However, what does the uworld explanation say? Maybe there is some weird criteria or situation you would give TIG not shown on the table. Or another part of the question we aren't seeing?

 

[je355804]

I have seen that table from your link on the CDC website.

CDC > uworld.

However, what does the uworld explanation say? Maybe there is some weird criteria or situation you would give TIG not shown on the table. Or another part of the question we aren't seeing?

I have to wonder what's up with that also... because I was almost certain that UWorld used to say something different (i.e. they used to say what the link you provided says.)

@Transposony

The only time you give TVIg is if they have never received the vaccination completely or are unsure and the wound is dirty.

 

[Transposony]

I have to wonder what's up with that also... because I was almost certain that UWorld used to say something different (i.e. they used to say what the link you provided says.)

@Transposony

The only time you give TVIg is if they have never received the vaccination completely or are unsure and the wound is dirty.

During my prep for CK I came across this question many times and could not understand why either and it bothered me a lot.
I, therefore, did extensive research on this topic and came to the conclusion that a person who was immunized over 10 yrs ago is considered unimmunized for all practical purposes since the levels of Ab are very low to prevent the person with a dirty wound from getting tetanus.
The key phrase here is over 10 yrs which is not mentioned specifically in the immunization table.
I just consulted my notes again and that's what is written there. You can, however, do your own research if you are not convinced.
Hope this helps.

 

[je355804]

During my prep for CK I across this question many times and could not understand why either and it bothered me a lot.
I, therefore, did extensive research on this topic and came to the conclusion that a person who was immunized over 10 yrs ago is considered unimmunized for all practical purposes since the levels of Ab are very low to prevent the person with a dirty wound from getting tetanus.
The key word here is over 10 yrs which is not mentioned specifically in the immunization table.
I just consulted my notes again and that's what is written there. You can, however, do your own research if you are not convinced.
Hope this helps.

Eh I remember searching around for it also... Pestana (sp?) says >10 yr w/ prior vaccine record only give Vaccine.

I also saw a few other sources agree, but it isn't very clear it seems. Once you have immunity, even if Ig levels are undetectable you still theoretically have immunity because you still have lymphocyte memory... I'm sure if it's a debatable fact that step either won't ask it or will ask it (subsequently wasting your time) and then not count it... Who knows?

That's what is messed up about step 2, especially in the day we live in. **** changes every 2 seconds and we're constantly left guessing... I feel bad for people who are taking this test in 10 years.