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MBBS CPRS > CPRS 24: Streptococcal Infection and Rheumatic Heart Disease > Flashcards

CPRS 24: Streptococcal Infection and Rheumatic Heart Disease Flashcards

1
Q

Streptococcus pyogenes
Which group under lancefield grouping?
Which type of haemolysis?
Is it susceptible to bacitracin?

A

Group A
Beta Haemolysis
Bacitracin susceptible

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2
Q

Streptococcus agalactiae
Which group under lancefield grouping?
Which type of haemolysis?
Is it susceptible to bacitracin?

A

Group B
Beta Haemolysis
Bacitracin resistant

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3
Q

Streptococcus dysgalactiae
Which group under lancefield grouping?
Which type of haemolysis?
Is it susceptible to bacitracin?

A

Group C/G
Beta Haemolysis
Bacitracin resistant

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4
Q 
Streptococcus pneumoniae
Which group under lancefield grouping?
Which type of haemolysis?
Optochin sensitive or resistant?
Bile soluble or insoluble?
A

non-groupable
Alpha/Gamma Haemolysis
Optochin sensitive
Bile soluble

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5
Q 
Viridans streptococci
Which group under lancefield grouping?
Which type of haemolysis?
Optochin sensitive or resistant?
Bile soluble or insoluble?
A

Groups A/C/F/G
Alpha/Gamma Haemolysis
Optochin Resistant
Bile insoluble

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6
Q 
Streptococcus bovis
Which group under lancefield grouping?
Which type of haemolysis?
Optochin sensitive or resistant?
Bile soluble or insoluble?
A

Group D
Alpha/Gamma Haemolysis
Optochin Resistant
Bile insoluble

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7
Q

Enterococci

Which group under lancefield grouping?

A

Group D

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8
Q 
Streptococcus pyogenes
- Which type of cocci? in what?
- Which type of haemolysis
- Susceptible to \_\_\_\_\_\_\_\_\_\_\_
- Virulence factors: 
\_\_\_\_\_\_\_\_\_\_ for systemic toxicity
\_\_\_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_\_\_ for invasion and spread
\_\_\_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_ for adhering
A 
Streptococcus pyogenes
- Gram positive cocci in chains
- Which type of haemolysis: Beta
- Susceptible to bacitracin 
- Virulence factors: 
Streptolysin O for systemic toxicity
hyaluronidase and streptokinase for invasion and spread
M protein and Capsule for adhering
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9
Q

Name 3 most important diseases caused by Streptococcus pyogenes

Name 2 serious diseases by Streptococcus pyogenes

A

Name 3 most important damages of Streptococcus pyogenes

  • Scarlet fever
  • Pharyngitis
  • Streptococcal Toxic Shock Syndrome

Name 2 more important complications of infection by Streptococcus pyogenes

  • Rheumatic fever
  • Glomerulonephritis
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10
Q

Clinical Manifestation of Group A Streptococcus
For throat: Suggesting pharyngitis and Scarlet fever
Name 3

A

Clinical Manifestation of Group A Streptococcus
For throat: Suggesting pharyngitis and Scarlet fever
Name 3
- Strawberry tongue
- Facial flushing with perioral pallor (White around the mouth region)
- Day 2 rash: Deep bluish rash over the upper part of the chest, spreading centrifugally

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11
Q

Clinical Manifestation of Group A Streptococcus
For skin: Name 2
For soft tissue: Name 1

A

Clinical Manifestation of Group A Streptococcus
For skin: Name 2
- Erysipelas (Infection of upper skin layer)
- Cellulitis (Skin infection causing redness, swelling and pain)

For soft tissue: Name 1
- Necrotizing fasciitis (Infection of fascia, thin casing of the connective tissue)

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12
Q

Clinical Manifestation of Group A Streptococcus
Consider Streptococcal Toxic Shock Syndrome (STSS)
It has multiorgan involvement: Name the 2 organs

Name another syndrome that it would result

A

Kidneys, liver

Acute Respiratory Distress Syndrome

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13
Q

For diagnosis of Group A Streptococcus infection, we can use the following

  • Blood culture
  • Throat swab/ Skin Swab
  • Rapid antigen detection test

Why is Anti-streptolysin O (ASO) titer NOT useful for acute stage diagnosis

A

Antibodies need time to develop

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14
Q

Treatment of Group A Streptococcus infection
Which antibiotic?
For Streptococcal Toxic Shock Syndrome, what antibiotics shall we add? Why?

A

Treatment of Group A Streptococcus infection
Which antibiotic? Penicillin

For Streptococcal Toxic Shock Syndrome, what antibiotics shall we add?
Clindamycin, Linezolid
They inhibit the toxin production

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15
Q

Acute Rheumatic Fever is caused by abnormal response to Group A Streptococcal infection. The consequence may result in _____________.

A

Rheumatic heart disease

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16
Q

To diagnose Acute Rheumatic Fever

You need 2 Major Criteria, or 1 major criteria plus 2 minor criteria.

Name the 5 Major criteria (CASSE)

A 
Major (CASSE)
Carditis 
Arthritis
Subcutaneous nodules
Sydenham's chorea (Muscle weakness)
Erythema marginatum
17
Q

To diagnose Acute Rheumatic Fever

You need 2 Major Criteria, or 1 major criteria plus 2 minor criteria.

Name the 4 Minor Criteria (FARP)

A 
Minor (FARP)
Fever
Arthralgia
Raised Erythrocyte Sedimentation Rate
Prolonged PR interval
18
Q

To have supportive evidence for Acute Rheumatic Fever

Name 2

A
  • Elevated ASO (antibody against Group A Strept)

- Positive throat culture for Group A Strept

19
Q

To treat Acute Rheumatic Fever

  • to Clear group A streptococcus: _____
  • to relive symptoms through anti-inflammatory ways: ________ and ________
  • if there is uncontrolled heart failure _______
A

To treat Acute Rheumatic Fever

  • to Clear group A streptococcus: Penicillin for 10 days
  • to relive symptoms through anti-inflammatory ways: Aspirin and Corticosteroid
  • if there is uncontrolled heart failure: Surgery
20
Q

What is the difference between primary prophylaxis and secondary prophylaxis

A

Primary: Prevent first attack of acute rheumatic fever
Secondary: Prevent the recurrence of acute rheumatic fever to result in rheumatic heart disease

21
Q

A delayed sequelae of Group A Streptococcus pharyngitis will lead to _____

A

Glomerulonephritis

22
Q

Streptococcus agalactiae infection is due to ________

A

Raw fish consumption

23
Q

Streptococcus agalactiae infection, what do the following groups present?

  • Infants
  • Pregnant woman
  • Non-pregnant woman
A

Streptococcus agalactiae infection, what do the following groups present?

  • Infants: Bacteremia without a focus
  • Pregnant woman: Urinary Tract Infection
  • Non-pregnant woman: Skin and Soft tissue infection, Septic arthritis, Osteomyelitis
24
Q 
Streptococcus dysgalactiae infection
Name 3 clinical manifestations
1.
2.
3.
A 
Streptococcus dysgalactiae infection
Name 3 clinical manifestations
1. Pharyngitis
2. Skin and soft tissue infection
3. Septic arthritis
25
Q

Consider streptococcus pneumoniae

  • What shape? Gram positive or negative?
  • Name 2 features
  • Name 2 syndromes associated
  • Name 1 prevention method
A

Consider streptococcus pneumoniae

  • Gram positive diplococci
  • Heavily encapsulated + Mucoid
  • Otitis Media + Pneumonia/ Asthma/ COPD
  • Name 1 prevention method: Vaccination (PPV or PCV)
26
Q

Viridans Streptococci is

  • A common ______ flora
  • Name 2 clinical syndromes
  • Suggest 1 treatment using antibiotics
A

Viridans Streptococci is

  • A common oral flora
  • Name 2 clinical syndromes: Dental caries, Endocarditis
  • Suggest 1 treatment using antibiotics: Penicillin and Gentamicin (Synergistic effect with better treatment result)
27
Q

Which type of Viridans Streptococci has a characteristic caramel smell

A

Streptococcus anginosus

28
Q

Consider Streptococcus bovis

What is the difference between Biotype I and Biotype II

A

Consider Streptococcus bovis
What is the difference between Biotype I and Biotype II

Biotype I: Ferment Mannitol
Biotype II: Do not ferment Mannitol

29
Q

Consider Enterococci

  • Shape? G+ or G-?
  • Name 2-3 clinical syndromes
  • Sensitive to ________ (antibiotic)
  • Resistant to _________ (antibiotic)
A

Consider Enterococci

  • Gram positive cocci in chains
  • Name 2-3 clinical syndromes: Urinary tract infection, Bacteremia, Endocarditis
  • Sensitive to Ampicillin (antibiotic)
  • Resistant to Nitrofurantoin (antibiotic)

MBBS CPRS (44 decks)

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