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CM Infectious Disease Objective Questions > STREP > Flashcards

STREP Flashcards

1
Q

What kind of pathogen is Strep?

A

bacteria

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2
Q

Is Strep Gram positive or negative?

A

Gram positive

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3
Q

Is Strep oxalase positive or negative (lab test)?

A

Negative

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4
Q

Is strep catalase positive or negative (lab test)?

A

Negative

fun fact: catalase is an enzyme that bacteria use to avoid hydrogen peroxide by turning it into oxygen and water

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5
Q

What would Strep look like on a microscope slide?

A

Purple spheres (cocci) in chains or pairs

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6
Q

What is a Group A Strep strain?

A

S. pyogenes

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7
Q

What is the epidemiology/distribution of group A (S. pyogenes) Strep?

A

-10% in mucosa
-Commonly found on the skin
-Beta hemolytic (destroys red blood cells)

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8
Q

How can Strep pyogenes (Group A) infect the host (pathogenesis)?

A

Can adhere to mucosal surfaces and invade

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9
Q

What is the presentation of a Strep pyogenes (Group A) infection?

A

-Pharyngitis (strep throat)

-Skin/soft tissue infections: non-purulent cellulitis, impetigo

-May lead to necrotizing fascitis (flesh eating disease): extreme pain, rapid, deadly, surgical intervention may be necessary

-Toxins released may cause Scarlet fever, Toxic shock

-Post infection syndromes: rheumatic fever, glomerulonephritis

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10
Q

What are symptoms of Scarlet fever caused by group A strep pyogenes?

A

-Strawberry (red) tongue
-Scarlatina rash: macular and stretchy (sandpaper rash)

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11
Q

What are the symptoms of Toxic shock caused by group A strep pyogenes?

A

-Nilosky sign from toxin release
-decrease in BP
-Extreme sickness

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12
Q

What are the symptoms of a post-infection Rheumatic fever caused by group A strep pyogenes?

A

Autoimmune response causing the body to attack its own cells (common in 5-15 year olds), onset in about 3 weeks

-Myocarditis (inflammation of the heart/valves)

-Arthritis, Syndenham’s chorea (involuntary movements), subcutaneous nodules, erythema marginatum (pink circular rash on limbs/trunk)

JONES CRITERIA used to diagnose
Joints (arthritis)
Ocarditis (heart)
Nodules (subcutaneous)
Erythema marginatum (rash)
Syndenham’s chorea (involuntary movement)

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13
Q

What are the symptoms of a post-infection glomerulonephritis caused by group A strep pyogenes?

A

Type III hypersensitivity reaction when body is trying to eliminate the bacteria

-hematuria (blood in urine)
-oliguria (less urine output)
-Hypertension
-fever

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14
Q

How can we diagnose a group A strep pyogenes infection?

A

-Strep test for throat
-can do culture if needed
-lab tests (oxalase, catalase)
-symptom evaluation (JONES, etc.)

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15
Q

What treatments are available for Group A strep pyogenes infections?

A

-Penicillin or Amoxicillin (amox more in peds)
-Cephalexin
-Clindamycin
-Azithromycin can be used, but not recommended due to increased resistance of macrolide

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16
Q

What is a group B Strep strain?

A

Strep agalactiae

17
Q

Is group B strep beta-hemolytic?

A

Yes

18
Q

What is Strep agalactiae?

A

Group B strep which can cause neonatal sepsis (soft tissue infections, bacteremia)

-pregnant women are swabbed for this before birth so they cannot transmit it to the newborn

19
Q

What is the treatment for Group B Strep agalactiae infections?

A

-Penicillin/Amoxicillin
-Cephalexin
-Clindamycin
-Azithromycin not recommended due to increasing resistance of macrolide

20
Q

Why might Beta lactam antibiotics like penicillins sometimes not work as well on strep pneumoniae?

A

Group B strep is becoming more resistant to these antibiotics (30% resistant)

21
Q

What could be seen on a culture of strep pneumoniae?

A

purple diplococcus (pairs of spheres)

22
Q

What kind of infections can Strep pneumoniae cause?

A

-Otitis media (middle ear infection)
-Pneumonia
-Sinusitis
-Conjunctivitis (pink eye)
-Can cause meningitis (we have vaccines for this: Prevnar and Pneumovax)

23
Q

Who is more susceptible to Staph pneumoniae infections?

A

Elderly, immunocompromised, those with other critical infections

24
Q

What is the treatment for S. pneumoniae infection?

A

-Ceftriaxone (IV)
-Cefdinir (IV)
-Cefuroxime (IV)

*if beta-lactam antibiotic resistant/allergy:
-Levofloxacin
-Vancomycin
-Linezolid

***Only different treatment line than other types of strep in this lecture

25
Q

What is Viridans strep?

A

-Oral/GI flora which can contaminate cultures
-MAY cause wound infection, skin/soft tissue infections, and bacteremia with endocarditis

26
Q

Is Viridans strep beta hemolytic?

A

NO! alpha hemolytic

27
Q

How can Viridans Strep infections be treated?

A

-Penicillin/Amoxicillins
-Cephalexin
-Clindamycin
-Azithromycin not recommended due to increased resistance of macrolide

28
Q

What is group D strep (GDS)?

A

A strep infection associated with GI malignancy

29
Q

What is the FIRST LINE treatment for Strep groups A-G?

A

Penicillin and Amoxicillin

CM Infectious Disease Objective Questions (39 decks)

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