Streptococci Flashcards

(50 cards)

1
Q

How do streptococci differ from staphylococci on gram stain?

A

Strep- gram + chains

Staph- gram + clusters

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2
Q

Are streptococci catalase positive?

A

No

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3
Q

Certain species of streptococci can either completely or partially hemolyze RBCs. The streptococci are divided into 3 groups based on their specific hemolytic ability, what are these 3 groups?

A

Alpha- partially lyse RBCs (green zone around colony)

Beta- completely lyse RBCs (clear zone around colony)

Gamma- non-hemolytic

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4
Q

Streptococci can be classified based on the antigenic characteristics of the C carbohydrate (Lancefield antigen), what 2 pathogenic species of the streptococcal genus do not have Lancefield antigens?

A

Streptococcus pneumoniae

Strep Viridans

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5
Q

Streptococci can be classified based on the antigenic characteristics of the C carbohydrate (Lancefield antigen), what pathogenic species of Strep has Lancefield group A antigen?

A

Streptococcus pyogenes

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6
Q

What diseases are caused by Streptococcus pyogenes?

A

Strep throat (pharyngitis)

Skin infections (erysipelas, cellulitis, impetigo, necrotizing fasciitis)

Scarlet fever

Toxic shock-like syndrome

Acute rheumatic fever

Post streptococcal glomerulonephritis

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7
Q

What components of the streptococcal cell wall are antigenic?

A

C-carbohydrate (Lancefield antigen)

M protein (major virulence factor)

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8
Q

What is the function of M protein?

A

Inhibits phagocytosis

Inhibits complement activation

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9
Q

Immunity to streptococci infection is based on development of antibodies directed against which protein?

A

M protein (protection is M-type specific)

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10
Q

What cells are destroyed by streptolysin O?

A

RBCs

Neutrophils

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11
Q

What is the mechanism of action of the streptococcal enzyme streptokinase?

A

Activates plasmin which breaks up fibrin

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12
Q

In addition to scarlet fever, what syndrome is mediated by Exotoxin A?

A

Streptococcal toxic shock syndrome

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13
Q

What diseases caused by group A Strep directly result from local invasion and/or exotoxin release?

A

Strep throat

Skin infection

Scarlet fever

Toxic shock like syndrome

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14
Q

What diseases caused by group A strep are a direct result of delayed antibody mediated responses?

A

Acute rheumatic fever

Post streptococcal glomerulonephritis

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15
Q

What test should be ordered to diagnose streptococcal pharyngitis?

A

RADT- rapid antigen detection test

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16
Q

A 9 year old child presents with red swollen tonsils and pharynx, and purulent tonsils. A RADT is negative. What is your next step in management?

A

Throat culture- RADT has high specificity, but only moderate sensitivity

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17
Q

Antibiotic therapy of streptococcal pharyngitis is directed primarily at preventing what complication?

A

Acute rheumatic fever

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18
Q

Skin infections caused by group A Strep can range from folliculitis, pyoderma, cellulitis, erysipelas, and impetigo. These infections can also be caused by S. aureus, thus, what type of therapy should be initiated?

A

Penicillinase resistant penicillin (dicloxacillin)

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19
Q

Erysipelas is a superficial bacterial infection of the skin most often caused by beta-hemolytic group A streptococci (Streptococcus pyogenes). It involves the lymphatics of the superficial dermis. Describe the rash associated with this condition.

A

Bright red

Well demarcated border

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20
Q

Impetigo is a superficial skin infection caused by inoculation of streptococci through scratches or other breaks in the skin. Describe the rash associated with this condition.

A

Honey crusted plaques, often found around the mouth

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21
Q

Detail the clinical findings of scarlet fever.

A

Sandpaper-like scarlet rash which begins on the neck, moves to the trunk, and finally to the extremities.

Strawbery tounge

Fever

22
Q

Define exanthem.

23
Q

What disease refers to necrotizing fasciitis of the genital region?

A

Fournier gangrene

24
Q

How do you treat severe Streptococcal pyogenes infections?

A

High doses of penicillin

Clindamycin- inhibits bacterial ribosome which shuts down protein production

25
What are the 6 major manifestations of acute rheumatic fever?
Fever Arthritis Myocarditis Subcutaenous nodules Erythema marginatum Chorea
26
Are group B strep hemolytic?
Yes, beta-hemolytic
27
What is another name for group B streptococci?
Streptococcus agalactiae
28
What diseases are caused by group B strep?
Neonatal: meningitis, pneuomnia, sepsis
29
Neonates with meningitis do not present with the classic sign seen in adults, a stiff neck. What organisms must be covered if you suspect meningitis in the newborn?
Streptococcus agalactiae E. coli Listeria monocytogenes
30
Two bacteria cause meningitis later in life after maternal antibodies given to the fetus wane and prior to new antibody formation. What are these bacteria?
Neisseria meningitidis (Meningococcus) Haemophilus influenzae
31
What 2 diseases are caused by Viridans group streptococci?
Dental infections- S. mutans Endocarditis- S. sanguinis
32
Contrast the endocarditis due to Viridans group strep to that due to Staph.
Viridians group- subacute bacterial endocariditis (SBE), pt develops low grade fevers, fatigue, anemia, heart murmur Staph- abrupt onset of chills, spiking fever, and rapid valve destruction
33
Group D streptococci were divided into two groups for many years: Group D enterococci and Group D nonenterococci. This classification was changed because recent DNA and rRNA homology studies demonstrated that enterococci are not closely related to other streptococci. How has this altered the classification of group D streptococci?
Many former group D streptococci have been reclassified and placed in the genus Enterococcus
34
What are the primary pathogenic enterococci?
Enterococcus faecalis Enterococcus faecium
35
Enterococci are identified in the lab based on unique characterisitcs. What are these characterisitcs?
Grow well in 6.5% NaCl Grow well in 40% bile Hydrolyze esculin
36
Group D organisms share several features with enterococci, including the group D antigen. How do they differ based on their ability to grow in different solutions?
Group D strep can not grow in 6.5% NaCl Both can grow in 40% bile
37
What diseases are commonly caused by enterococci?
UTIs Biliary tract infections Bacteremia Subacute bacterial endocariditis
38
Streptococcus bovis is associated with what malignancy?
Colon cancer
39
What Lancefield antigen is associated with Viridans group streptococci?
None
40
What diseases are commonly caused by pneumococcus?
Adults: meningitis, pneumonaie, sinusitis Children: otitis media (Most common cause of these infections)
41
What is the major virulence factor of pneumococcus?
Polysaccharide capsule- protects organism from phagocytosis
42
How can you distinguish between Strep viridans and pneumococcus when both are alpha hemolytic, gram + cocci?
Viridans- optochin insensitive Streptococcus pneumoniae- optochin sensitive
43
What is the most common cause of pneumonaie in adults?
Strep pneumoniae
44
What does a CXR show in a patient with pneumoniae?
Consolidation
45
What bug is the most common cause of bacterial meningitis in adults?
Streptococcus pneumoniae
46
Contrast the bacitracin sensitivity of group A and B strep.
Group A- bacitracin sensitive Group B- bacitracin resistant
47
Do Viridans group Strep have a capsule?
No
48
What is the Lancefield group of S. bovis?
Group D
49
What region of the body are Enterococci part of the normal flora?
GI tract
50
Which alpha hemolytic Strep are bile soluble/insoluble?
Bile soluble- S. pneumoniae Bile insoluble- Viridians group strep