143 - Streptococcal Infections

Question 1

GAS is responsible for __ and __

Answer 1

pharyngitis

PSGN

Question 2

GBA is responsible for bacterial __and __ in newborn, and __ and __ in parturient women.

Answer 2

meningitis
endometritis
fever

Question 3

Strep __ is the leading strain causing endocarditis.

Answer 3

viridans

Question 4

Streptococcus is a G(_) bacteria

Answer 4

+

Question 5

GAS extracellular products are toxic, including __ and _ streptolysins. They can cause significant diseases such as: 3

Answer 5

S
O
scarlet fever
necrotizing fasciitis
TSSS

Question 6

When looking for streptolysins, we can use __ and __ to identify them. Important in early detection of __ and __

Answer 6

ASLO
anti DNAse
PSGN
rheumatic fever

Question 7

Pharyngitis transmission is via __ and incubation lasts - days. symptoms include: 4

Answer 7

air droplets 
1-4
sore throat
fever/chills
lethargy
abdominal pain/vomiting

Question 8

Viral symptoms such as __,__,__ can push us away from strep pharyngitis diagnosis.

Answer 8

uveitis
cough
aphtha

Question 9

Uncomplicated pharyngitis can resolve __ within - days, but treatment can prevent __ and __ complications.

Answer 9

pustular

rheumatic fever

Question 10

To prevent rheumatic fever we must eradicate the pathogen with Abx for _ days. Possible Abx include: 3

Answer 10

10
2nd gen cephalosporine (cefuroxime/zinat)
erythromycin
azithromycin

Question 11

Scarlet fever is caused by GAS __ exotoxins. The rash appears on the - day on the __ body and __ with __ sparing.

Answer 11

pyrogenic 
1-2
upper
limbs
palm

Question 12

The rash in scarlet fever has __ like texture. Other symptoms include: 3

Answer 12

sandpaper
circumoral pallor
strawberry tongue
Pastia’s lines

Question 13

Scarlet fever rash disappear after - days, and followed by __ of the __

Answer 13

6-9
skin pealing
palms

Question 14

When considering scarlet fever, keep in mind the following DDx: 3

Answer 14

measles
Kawasaki
TTS

Question 15

Name the 3 skin and soft tissue infections GAS can cause:

Answer 15

impetigo (pyoderma)
cellulitis
deep soft tissue infections (necrotizing fasciitis)

Question 16

Impetigo include __ and should be treated with __ or __.

Answer 16

honeycomb crust
dicloxacillin (cloxacillin)
cephalexin

Question 17

Streptococcal TSS is a __ infection with __ and __

Answer 17

GAS
shock
MOF

Question 18

How can you identify STSS?

Answer 18

1- isolation of GAS
2-clinical signs:
  a. hypotension
    PLUS
  b. 1- renal impairment 
  b. 2- liver impairment 
  b. 3- respiratory distress
  b. 4- coagulopathy
  b. 5- generalized erythematous rash
  b. 6- soft tissue necrosis

Question 19

strep TSS causes death at _% rate due to _ and _

Answer 19

30
shock
respiratory distress

Question 20

Treat TSS with intensive __and treatment

Answer 20

supportive

Abx (clindamycin +penicillin)

Question 21

GBS infection in a new born should be treated with empirically with __ and __ until cultures return

Answer 21

ampicillin

gentamycin

Question 22

To prevent GBS in newborn, carrier peripartum women should be treated with prophylaxis of __ or __ (__/__ if she is allergic) during the birth

Answer 22

ampicillin
penicillin
vancomycin/clindamycin