streptococcus related diseases Flashcards
1
Q
Jones Major + minor criteria for rheumatic fever
A
JONES FAIL major J -joints involved (polyarthritis) O - carditis N - subcutaneous nodules E - erythema marginatum S - sydenham's chorea
minor F - fever > 38C A - mono(A)rthralgia I - raised (I)nflammatory markers esr/crp > 30 L - pro(L)onged PR interval
2
Q
how to dx. rheumatic fever
A
signs of strep infection
- recent strep infection
- raised ASOT or anti-DNaseB
- +ve throat swab
AND
2 major, or 1 major 2 minor, or 3 minor
3
Q
acute post-streptococcal glomerulonephritis
- clinical findings (3)
- lab findings (3)
A
clinically, at least 2 of
- facial or periorbital oedema
- hypertension
- > = 2+ red blood cells on dipstick (haematuria)
lab
- UM shows RBC >10
- recent streptococcal infection (positive group A strep from throat or skin, elevated ASOT, elevated Anti-DNase B titre)
- reduced C3 complement level
4
Q
impetigo - management in non-endemic settings
- mild
- moderate
- penicillin allergy
A
mild
- mupirocin 2% TDS for 5 days
moderate
- flucloxacillin 12.5mg/kg, up to 500mg QID up to 7 days - stop early if rash resolved
- keflex 12.5mg/kg up to 500mg QID, up to 7 days
penicillin allergy
- bactrim ds (trimethoprim/sulfamethoxazole) 4+20 mg/kg, up to 160/800mg, OD for 5 days
5
Q
impetigo - management in endemic settings
A
benzathine benzyl penicillin IM, 1 dose
- 2.3mL in adults, kids over 20kg
- 16-19kg - 1.7mL
- 12-15kg - 1.2mL
- 6-11kg - 0.9mL
- 0-5kg - 0.3mL
bactrim DS (trimethoprim/sulfamethoxazole) 4+20mg/kg, up to 160/800mg, BD for 5 days
bactrim DS (trimethoprim/sulfamethoxazole) 8+40, up to 320/1600mg, OD for 5 days
6
Q
GP level management of acute rheumatic fever (4)
A
- arrange hospital admission within 24 hours
- ECG and baseline bloods (ASOT, antiDNAse, ESR, CRP)
- administer intramuscular benzathine penicillin G to treat GAS throat infection (600,000 if < 20kg, 1,200,000 if >=20kg
- defer NSAID use. use panadol for analgesia
