Strep

Question 1

All strep, except 1, are?

Answer 1

GPC in chains

Question 2

GAS colonies are?

Answer 2

beta hemolytic

Question 3

Skin and tissue infection of Strep pyogenes?

Answer 3

Impetigo, cellulitis, erysipelas,

Question 4

Type of cellulitis on skin, esp. on face and leg

Answer 4

erysipelas

Question 5

Skin infections may be accompanied by?

Answer 5

Scarlet fever

GAS

Question 6

Skin rash due to erythrogenic toxin?

Answer 6

Scarlet fever

GAS

Question 7

(streptococcal gangrene, invasive cellulitis, “flesh- eating bacteria”)

Answer 7

Necrotizing fascitis

Question 8

characterized by the rapid destruction of muscle and fat tissue with high fever and prominent pain; highly invasive and life threatening

Answer 8

Necrotizing fascitis

Question 9

Treatment for necrotizing fascitis

Answer 9

IMMEDIATE AND QUICK, Aggressive antimicrobic therapy (penicillin) and surgical intervention (debridement of affected tissue to remove toxin)

Question 10

Also called Streptococcal Toxic Shock Syndrome

BUT

Doesn’t have the TSS toxin

Answer 10

nectrotizing fascitis

Question 11

Sudden onset of fever, sore throat, and exudative tonsillitis or pharyngitis with enlarged and tender cervical lymph nodes

Answer 11

Acute exudative pharyngitis

Question 12

2-4 days incubation

Symptoms last a few days (3-5) without antibiotic treatment

Predominantly occurs in children 5-15 years of age and during the colder months (transmission easier due to the effect of crowding and to dry nasal passages)

Answer 12

Acute exudative pharyngitis

approximately 20% of sore throats cultured

Question 13

Major problem is the possibility of post-streptococcal complications

Answer 13

Acute exudative pharyngitis

Question 14

autoimmune reaction of Ag-Ab complexes on the basal membranes of the affected organs [No live bacteria in heart or kidney tissue.] – Specific antigenic types are responsible.

Answer 14

Post streptococcal complications

Question 15

Rheumatic fever

Acute glomerulonephritis

Answer 15

Post streptococcal complications

Question 16

Most sore throats are viral, but “strep” throat is actually life threatening

Answer 16

due to post-strep complications

Question 17

Ag-Ab complexes attack heart tissue – specific antigenic types; especially follows throat infections

Answer 17

Rheumatic fever

Question 18

Ag-Ab complexes attack kidney tissue – specific antigenic types; usually follows throat or skin infections

Answer 18

Acute glomerulonephritis

Question 19

GAS virulence factors

Answer 19

Numerous invasive enzymes/toxins

Hyaluronic Acid Capsule

Cell wall M protein

Erythrogenic toxin

Streptolysin O/S

Question 20

Cell wall “M” protein is?

Answer 20

antiphagocytic

Question 21

cytotoxic; basis of ASO titer and related tests

Answer 21

Streptolysin O and S

Question 22

appears similar to “self” Ag to host defenses – slow Ab response

Answer 22

Capsule of hyaluronic acid

Question 23

Antigen detection / identification for GAS…

Direct throat swab has ___ sensitivity

Culture confirmation is ___ accurate

Answer 23

low

very

Question 24

Antimicrobic susceptibility tests usually not needed

Answer 24

Can typically treat empirically

Generally susceptible to penicillin

Question 25

Causes pneumonitis and meningitis in neonates due to inoculation from vaginal flora; infection can be quite severe in newborns and leave permanent damage or cause death

Answer 25

Group B Streptococcus

Question 26

Expectant mothers are screened around 35th week to determine if bacteria are present

Answer 26

Group B Streptococcus

Question 27

Gram-positive coccus in pairs

Large, mucoid, alpha-hemolytic colonies

Multiple antigenic types (>90); about 6 are frequently recovered and highly infectious

Answer 27

Streptococcus pneumoniae

Question 28

Normal flora of upper respiratory tract in 30 to 60% of population (esp. when children are in the household). Infection usually results from transmission of normal flora into adjacent sites.

Answer 28

Streptococcus pneumoniae

Question 29

Lobar and bronchial pneumonia (#1 cause)

Answer 29

Streptococcus pneumoniae

Question 30

Large, mucoid, alpha-hemolytic colonies

Answer 30

Streptococcus pneumoniae

Question 31

Invasive strains may lead to empyema, bacteremia, and/or meningitis

Answer 31

Streptococcus pneumoniae

Causes 50-90% of pneumonias; esp. in children under 5 yr and elderly

Mortality: about 5-10%; esp. in children under 5 yr and elderly

Question 32

Strep. pneuminiae can also cause?

Answer 32

sinusitis

otitis media

meningitis

Question 33

*Antiphagocytic capsules

IgA protease

Invasive strains

Increase in penicillin resistance

Answer 33

Strep. pneumoniae virulence factors

Question 34

Strep. pneumoniae virulence factors

Answer 34

Antiphagocytic capsules

IgA protease

Invasive strains

Increase in penicillin resistance

Question 35

Laboratory diagnosis

Answer 35

Culture (alpha hemolytic) and biochemical identification

Antigenic identification from cerebrospinal fluid

Question 36

Lab diagnosis strep. pneumoniae: antigenic ID from ____ fluid

Answer 36

cerebrospinal

Question 37

Other streptococci of occasional pathogenicity

mostly in Groups C, F, G

Answer 37

dysgalactiae, anginosus

beta-hemolytic

Question 38

a group of alpha-hemolytic and non- hemolytic species associated with various low-frequency diseases (abscesses, bacteremia & endocarditis, dental caries, etc)

Answer 38

Viridans streptococci (this is not a species name)

opportunistic infection

Question 39

Gram-positive cocci in chains (formerly a member of group D Streptococcus)

Answer 39

Enterococcus faecalis

Question 40

(1) Frequent cause of nosocomial infections - surgical wounds and urinary tract
(2) Occasional cause of bacteremia (~9%)

Answer 40

Enterococcus faecalis

Multi-drug resistant strains exist with increased frequency, including vancomycin resistance (Vancomycin Resistant Enterococcus = VRE)