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Pathology -- Infectious Disease > Infectious Disease -- Streptococci Review > Flashcards

Infectious Disease -- Streptococci Review Flashcards

1
Q

Streptococcal patterns of disease?

A

Spreading of suppurative skin infections

Post-streptococcal hypersensitivity disease

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2
Q

Manifestations of Streptococcal spreading suppurative skin infections

A

Cullulitis
Erisypelas
GABHS
Impetigo

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3
Q

Manifestations of post-Streptococcal hypersensitivity disease?

A

Rheumatic Fever

Immune Complex Glomerulonephritis

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4
Q

Three groups of Streptococcal infections

A

Group A
Group B
Viridans

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5
Q

Whats Group A Strep all about…

A

S. pyogenes
beta hemolytic
Pharyngitis/post streptococcal disease

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6
Q

Whats Group B Strep all about…

A

Perinatal Sepsis/Newborns, UTIs

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7
Q

What is Strep viridans all about…

A

Grouped as alpha hemolytic

Major cause of subacute bacterial endocarditis

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8
Q

Why care about strep mutans?

A

Major cause of dental caries

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9
Q

Streptococcal virulence factors?

A

Call wall polysac./capsules (M Proteins)
Enzymes – streptokinase, streptolysin O, S
Erythrogenic toxins

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10
Q

Purpose of Cell Wall polysaccharides/capsules?

A

Prevention of phagocytosis

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11
Q

Significance of Streptococcal enzymes (streptokinase, streptolysin)

A

Contribute to ability to spread through tissues

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12
Q

What do Streptococcal erythrogenic toxins cause

A

Skin Rash

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13
Q

Initial presentations of Group A streptococcal disease

A

Acute Pharyngitis/URT

Scarlet Fever

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14
Q

Symptoms of Group A Streptococcal Acute Pharyngitis?

A

Reddness, Edema, Pain
Fever, Chills
Punctate abscess in tonsillar crypts
Peritonsillar, retropharyngeal abscess formation

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15
Q

What is Group A Streptococcal Scarlet Fever

A

Severe, prolonged group A pharyngitis

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16
Q

Symptoms of Group A Scarlet Fever

A

Febrile Exanthematous Disorder
Erythrogenic toxin (causes violaceous red rash on trunk)
Strawberry tongue
Desquamination of Skin

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17
Q

What does Febrile Exanthematous Disorder look like

A

Unraised blotches all over body

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18
Q

Describe presentation of post-streptococcal glomerulonephritis

A

1-2 weeks after strep throat
Immune-complex mediated
Can cause renal failure

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19
Q

Describe presentation of rheumatic fever

A

Weeks-months+ after infection
Fever, Joint Disease, Myocardial/Valvular disease
Eventually, long standing damage to mitral/aortic valves

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20
Q

How does acute rheumatic fever happen?

A

Autoimmune reaction that is caused by a cross reaction with M antigens.
Strength of response corresponds to streptolysin O titers in the blood
Abs can cause damage/thickening of valves

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21
Q

What to Streptococcal skin infections look like?

A

Cellulitis, pyoderma

Extensive spreading reddness, swelling, pain

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22
Q

Rare complications of Streptococcal skin infection

A

Abscess, Pustule

Necrotizing fasciitis

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23
Q

Describe impetigo

A

Contagious skin infection in kids involving horny (superficial) skin layers

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24
Q

Who gets erysipelas?

A

Middle aged persons, esp in the Tropics

25
Q

Describe the presentation of an erysipelas patient

A

Superficial infection
Breaks, erythema seeps through and crusts
No suppuration

26
Q

Presentation of necrotizing fasciitis

A

Soft tissue gangrene

Fournier’s gangrene

27
Q

necrotizing fasciitis usually only happens in which patients

A

Diabetics, pre existing immunodeficiency

28
Q

Describe what actually happens to a person’s body in necrotizing fasciitis.

A

The streptococcal infection kills off blood vessels in the tissues, allowing a hypoxic region to develop. At this point , the wound is taken over by anerobes that have to get cut out.

29
Q

Subacute bacterial endocarditis is caused by…

A

S. viridans
transient bacteremia following dental work
why heart damages patients have prophylactic antibiotics

30
Q

Puerperal sepsis is caused by

A

Group B

31
Q

How to diagnose Strep Throat

A

Rapid Strep Test – Group A Strep Carbohydrate antigen

Confirm culture in 12-48 hours

32
Q

How to diagnose Rheumatic Fever

A

Anti-streptolysin O Ab

Even through cross reacting Abs are actually specific for M protein

33
Q

Streptococcal infections are grouped by _____ antigens

A

Lancefield

34
Q

Streptococcal infections are typed by ______

A

ability to hemolyse blood agar

35
Q

Common symptoms of Streptococcal skin infection

A

Cellulitis, Impetigo, Erysipelas

36
Q

Members and important details for Streptococcal Group A.

A

GABHS
S. pyogenes
Pharyngitis/post-streptococcal disease

37
Q

Members and important details for Streptococcal Group B

A

S. agalactiae
Perinatal Sepsis/Newborns
UTIs

38
Q

Members and important details for Streptococcal Group D

A

Anaerobic S. faecalis and enterococcus

39
Q

Members and important details for Strep Viridans

A

Alpha hemolytic
Major cause of subacure bacterial endocarditis
Access to blood stream from mouth colonization with dental work

40
Q

Streptococcal Virulence Factors

A
  1. Cell wall PS/Capsules (M Proteins)
  2. Streptokinase, Streptolysin O, S
  3. Erythrogenic Toxin
41
Q

Antibodies to Group ____ Streptococcal antigens may cross react with human tissue and cause rheumatic fever

A

A

42
Q

Contagious Bacterial Streptococcal pharyngitis is caused by…

A

GABHS

Pyogenes

43
Q

Acute Rheumatic Fever is caused by antibodies to ___, which correlates with ______ titers in the blood

A

M proteins

Anti-streptolysin O

44
Q

Causes of Post-streptococcal glomerulonephritis

Why?

A

Impetigo, Severe Pharyngitis
These are the forms of Streptococcal infection that last for long enough to still have antigen present when the antibodies specific to them are generated.

45
Q

Name the scrotal/perineal form of necrotizing fasciitis

A

Fournier Gangrene

46
Q

Two groups more likely to develop Necrotizing fasciitis

A

Immunodeficient

Diabetics

47
Q

What to look for in an X ray of a patient with a subcutaneous strep infection with necrosis that is overtaken by anerobes

A

Gas formation

48
Q

Subacute bacterial endocarditis

A

Assoc. with S. viridans (transient following dental work)

left sided valvular endocarditis

49
Q

Pathologic features of skin in Streptococcal infection

A

Cellulitis, Characteristic Reddness + Pain

50
Q

Symptoms of strep throat

A

Erythematous, Painful

Collections of pus

51
Q

Superficial, crusting lesions in kids

Name the symptom. Staph or Strep?

A

Impetigo

Either

52
Q

Middle-aged, warm climates; exotoxins; erythematous swelling with well-demarcated, sepiginous boarder.
Name the symptom. Staph or Strep?

A

Erysipelas

Strep

53
Q

Chronic abscesses of the palmar surface of the finger tips

Name the symptom. Staph or Strep?

A

Paronychia

Staph

54
Q

Exfoliative toxins A and B; accompany staph infections of the nasopharynx in kids. Sunburn like rash with exfoliation.
Name the symptom. Staph or Strep?

A

Scalded Skin Syndrome/Ritter Disease

Staph

55
Q

Superantigens, systemic toxins produced by growth of bacteria; hypotension, renal failure, coagulopathy, liver disease, respiratory distress, erythematous rash, soft tissue necrosis
Name the symptom. Staph or Strep?

A

Toxic Shock Syndrome

S. aureus and S. pyogenes

56
Q

Infection of the skin below the epidermisl strep more commonly causes spreading lesions due to VF.
Name the symptom. Staph or Strep?

A

Cellulitis

Both

57
Q

Subcutaneous, deep tissue facial necrosis; GABHS; other bacteria and strep serotypes; M-1 and M-3 antiphagocytic proteins
Name the symptom. Staph or Strep?

A

Necrotizing Fasciitis

Strep pyogenes and anerobes

58
Q

Superantigens released into contaminated food on warming (potato salad at a family picnic); nausea and vomiting immediately following consumption, no real infection
Name the symptom. Staph or Strep?

A

Food Poisoning

S. aureus

Pathology -- Infectious Disease (23 decks)

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