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infectious diseases > strep infections > Flashcards

strep infections Flashcards

1
Q 
Impetigo
Increased risk with what
describe lesions
contagious?
Treatment?
A 
Increased risk with poor hygiene
Golden or honey crusted lesions
Very contagious – think  preschools
Cleaning the wounds
Augmentin
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2
Q

Golden or honey crusted lesions

-tx

A

Impetigo, tx with augmentin

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3
Q

Painful erythema
Borders are visible but not well defined
-organism
-Treatment?

A

Cellulitis
Group A strep are the number one cause of cellulitis in the U.S.
Treatment – penicillin

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4
Q 
Strep throat with a rash
Diffuse erythema
Blanches
Fine papules (Sandpaper rash)
Circumoral pallor
Strawberry tongue
A

Scarlet Fever

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5
Q

Pharyngitis

The majority of pharyngitis is caused by ___ infections
The most important bacteria here is ___

A

The majority of pharyngitis is caused by viral infections

The most important bacteria here is strep pyogenes

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6
Q

I came in to see my physician assistant today because of…
Sudden onset of sore throat
Odynophagia
Fever / Chills

A

Pharyngitis

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7
Q 
Physical exam
Fever
Tonsillopharyngeal erythema
Exudates
Beefy red swollen uvula
Tender anterior cervical lymphadenopathy
Petechiae on the palate
A

Pharyngitis

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8
Q

Pharyngitis pt complaints (3)

A

Sudden onset of sore throat
Odynophagia
Fever / Chills

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9
Q

Pharyngitis exam findings (6)

A 
Fever
Tonsillopharyngeal erythema
Exudates
Beefy red swollen uvula
Tender anterior cervical lymphadenopathy
Petechiae on the palate
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10
Q

Erysipelas
More superficial than ___
organism

A

Erysipelas

  • More superficial than cellulitis
  • Strep pyogenes
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11
Q

Historically found on the face but now most common on the legs
Painful
Itching / burning

A

Erysipelas

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12
Q

I came in to see my physician assistant today because of…
Possible history of sore throat
Fever malaise
Rash

Historically found on the face but now most common on the legs
Painful
Itching / burning

A

Erysipelas

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13
Q

Erysipelas Diagnosis
____help make the diagnosis
Pus?

A

Diagnosis is made clinically
Well demarcated rash help make the diagnosis
No pus, only serous fluid

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14
Q

Erysipelas Treatment (6)

A 
Antibiotics: Penicillin x 5 days
Supportive care
Hydration
Cold compresses
Elevation of affected limb
Surgical debridement may be necessary
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15
Q

Acute Rheumatic Fever
- Occurs after a ___ infection
Symptoms begin about___ after initial infection
Common cause of ___ issues in childhood.

A

Occurs after a Streptococcus pyogenes infection
Symptoms begin about 1 to 5 weeks after initial infection
Common cause of cardiac issues in childhood.

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16
Q 
Common cause of cardiac issues in childhood. May cause:
valve stenosis
valve regurgitation
heart muscle damage
atrial fibrillation
heart failure
Children aged 5 to 15 years old
A

Acute Rheumatic Fever

17
Q

I came in today to see my physician assistant because…
Fever
Painful polyarthritis – multiple large joints
Weird involuntary movements – Chorea
Pink ringed rash – Erythema marginatum
Subcutaneous nodules

A

Acute Rheumatic Fever

18
Q

Acute Rheumatic Fever S/S (8)

A

New or changing murmur
Fever
Painful polyarthritis – multiple large joints
Chorea – unlikely to see this in the office
Erythema marginatum (< 10% of patients)[Pink ringed rash]
Subcutaneous nodules (< 10% of patients)
Signs of CHF
Pericarditis

19
Q 
Physical Exam
Fever
Chorea – unlikely to see this in the office
Erythema marginatum (< 10% of patients)
Subcutaneous nodules (< 10% of patients)
New or changing murmur
Signs of CHF
Pericarditis
A

Acute Rheumatic Fever

20
Q

Chorea

A

Weird Involuntary large muscle movements – Chorea

think acute rheumatic fever

21
Q

Acute Rheumatic Fever Labs and studies (6)

A 
Anti-streptococcal antibody test
C-reactive protein
ESR
CXR
ECG
Echo
22
Q

JONES: Major Diagnostic Criteria (5)

A 
Carditis
Polyarthritis
Chorea
Erythema marginatum
Subcutaneous Nodules

Acute Rheumatic Fever

23
Q

Jones Criteria

Should have history of ___ infection and __ Major Criteria OR __ Major Criteria, __ Minor Criteria

A

Acute Rheumatic Fever

Should have history of Strep infection and 2 Major Criteria OR 1 Major Criteria, 2 Minor Criteria

24
Q

JONES: Minor Diagnostic Criteria (5)

A

Fever
Arthralgia
Previous rheumatic fever or rheumatic heart disease
Acute phase reactions: Elevated ESR / CRP / Leukocytosis
Prolonged PR interval

Acute Rheumatic Fever

25
Q

Acute Rheumatic Fever Treatment (3)

A

Antibiotics: Penicillin
Anti-inflammatory
Aspirin

26
Q

Strawberry tongue?

A skin infection with an extremely clear margin – cellulitis or erysipelas?

A

Strawberry tongue? Scarlet fever

A skin infection with an extremely clear margin – cellulitis or erysipelas? Erysipelas

27
Q

Necrotizing fasciitis

  • organism
  • Clinical findings?
  • Tx (2)
A

-many types of bacteria can cause this, but Strep pyogenes is a particularly nasty one
the bacteria produce toxins which kill tissue
-Clinical findings:local swelling, reddish, painful bump or bumps
dark skin with bullae
yellowish fluid
-Tx:IV broad spectrum antibiotics
surgical debridement

28
Q

Scarlet Fever (____ plus rash)

  • describe rash
  • last how many days
  • Tx?
A

Scarlet Fever (Strep throat + a rash)
Clinical findings:
Symptoms of strep throat and Rash
Like a painful sunburn with tiny bumps that blanch with pressure. They may also be itchy.
Feels like “sandpaper”
Starts on NECK, FACE and Chest! with circumoral palor.
Lasts about 6 days and desquamtes (peels)
Tx: Antibiotics x 10 days

29
Q

Symptoms of strep throat
Rash
Like a painful sunburn with tiny bumps that blanch with pressure. They may also be itchy.
Feels like “sandpaper”
Starts on NECK, FACE and Chest! with circumoral palor.
Lasts about 6 days and desquamtes (peels)

A

scarlet fever

30
Q

Key Word: patients may present with a bright red swollen Strawberry tongue

A

scarlet fever

31
Q

(Rheumatic Fever)

Occurs typically ___ after an infection with Strep
Most commonly affects children ages ____

A

Occurs typically 2-3 weeks after an infection with Strep

Most commonly affects children 6-15

infectious diseases (7 decks)

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