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HDID Block 2 > L37 > Flashcards

L37 Flashcards

1
Q

What is the universal property of steptococcus?

A

GP cocci - pairs or cocci

Catalase NEGATIVE

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2
Q

Which strep is group A, beta hemolytic?

A

S. pyogenes

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3
Q

Which strep is group B, beta hemolytic?

A

S. agalactiae

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4
Q

What 4 infections are you thinking about with strep pyogenes?

A 
Pus forming:
1. Pharyngitis = strep throat!
2. Skin infections
Non-pus:
3. Rheumatic fever 
4. Glomerulonephritis
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5
Q

What virulence factor is particularly important for strep pyogenes? (baker’s hat)

A

M protein

  • Inhibits alternative complement
  • But… elicits opsonic Abs
  • Adhesion to keratinocytes (skin infections)
  • *Many different types - you need to have immunity to that specific epitope
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6
Q

How does M protein contribute to rheumatic heart disease?

A

Abs made against M protein are auto-reactive to heart muscle

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7
Q

Describe other virulence factors notable for s.pyogenes.

A
  1. GP capsule = anti-phagocytic
  2. Surface adhesion molecules
  3. Toxins
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8
Q

Which hemolysin toxin released by s.pyogenes is tested for recent infection?

A

Streptolysin O titer
Abs vs this indicate recent infection
Important for RF & glomerularnephritis diagnosis

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9
Q

What are the exotoxins secreted by s.pyogenes? Why do peoples symptoms to these toxins vary?

A

SpeA/B/C = pyrogenic exotoxins
Superantigens
Responsible for Scarlet Fever & TSS
HLA dep response - will intrinsically vary from person to person

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10
Q

How is staph pyogenes transmitted?

A

Oral secretions

Skin lesion contact

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11
Q

Which pus forming skin infections can s.pyogenes cause?

A

Impetigo
Erysipelas
Nec fasc
TSS

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12
Q

How do you test for s.pyogenes in strep throat?

A

Rapid antigen
- V. specific - if positive, you’ve got it
Also take swab culture in case false negative

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13
Q

Why do you treat strep throat?

A

Prevent Scarlet Fever!

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14
Q

Drugs for pharyngitis

A

Penicillin
Allergic:
- Macrolides
- Clindamycin

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15
Q

What are the presenting symptoms of scarlet fever?

A

Rash started on trunk
Strawberry tongue
Broken capillaries –> skin folds
Peeking skin (desquamation)

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16
Q

What are some tell tale symptoms of impetigo?

A

Honey crusted skin lesions

- Look like this b/c of pus coming out of the wounds

17
Q

Drugs for impetigo

A 
TOPICAL
Bacitracin
Mupirocin 
MRSA/more extensive disease
Amoxicillin/clavulanic acid
Cephalexin
18
Q

What is erysipelas?

A

MENTAL TIE TO S.PYOGENES
Red, swollen rash w/ sharp edges
Form of cellulitis
+ “Fever and I don’t feel good”

19
Q

What could result for s.pyogenes weird tie to lymphatics?

A

Cellulitis w/ lymphagitis

= Streaking to draining lymph node

20
Q

What are the clinical symptoms for nec fasc?

A

Pain out of proportion
Hemorrhagic bullae
May have progressed to septic shock

21
Q

Explain how s.pyogenes can cause toxic shock syndrome?

A

Had s.pyogenes skin infection
SpeC toxin = superantigen
+ you have the right HLA to react
Cytokine storm

22
Q

Which s.pyogenes infection can progress to cause RF?

A

Strep throat ONLY!

23
Q

What are you concerned about if you don’t clear the s.pyogenes infection causing RF?

A

Repeated RF –> rheumatic heart disease

Irreversible damage

24
Q

How long does glomerulonephritis present after the primary s.pyogenes infection? What types of s.pyogenes infections can cause this complication?

A

2 weeks post pharyngitis OR skin infection

25
Q

Where does s.agalactiae colonize the body?

A

GI

Female GU

26
Q

What patient population are you likely to see with s.agalactiae infections?

A

Neonates!!!

27
Q

How do you treat mom with colonization for s.agalactiae?

A

Penicillin before birth

Vanco or clinda if allergic

28
Q

What type of hemolysis does s.anginosis display? Clinical presentation?

A

= type of viridans strep
Can do B, G, or A hemolysis
Causes abscesses: liver, brain, teeth

29
Q

What is viridans strep?

A

Can be A or G hemolytic
Subdivided into MANY groups
Colonizes mucous surfaces but NOT skin

30
Q

Which viridans strep cause bactermia & endocarditis in patients with colonic neoplasia?

A

S.bovis group

- S.gallolyticus

31
Q

Drugs for viridans strep

A
  1. Penicillin
    Allergic:
  2. Vanco
32
Q

Does strep viridans cause pneumonia?

A

NO
It is on the mucosal surfaces of the mouth - you contaminated the scope as you went down to stake culture sample
Don’t chose your antibiotic based on its presence in the pneumo culture

33
Q

Why might someone present with strep viridans bactermia and endocarditis?

A

Post dental work if got into blood

34
Q

Which clinical diseases make you think of strep agalactiae?

A 
Neonates:
- Meningitis
- Pneumonia
- Sepsis
Adults w/ underlying disease

HDID Block 2 (39 decks)

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