MCN 548- Comprehensive Final- Review
from Study Guide 2 Correctly Answered.
Most common bacterial cause of pharyngitis and tonsillitis in children & adolescents is _______. -
CORRECT ANSWER GABHS, which accounts for 15-30% of infections in children with sore throat and
fever
Group C and group B streptococci can cause pharyngitis, but abx treatment does not prevent
__________, which is its only nonsuppurative complication. - CORRECT ANSWER glomerulonephritis
A haemolyticum is more common in __________________________ and is ___________________. -
CORRECT ANSWER adolescents, and is difficult to culture due to slow growth
N. gonorrhoeae is a cause of adolescent pharyngitis if involved in __________________. - CORRECT
ANSWER oral sex
M. pneumoniae and Chlamydophila pneumoniae are associated with ___________________ along with
______________. - CORRECT ANSWER cough along with pharyngitis
The following characterize GABHS infection: - CORRECT ANSWER Most commonly found in 5-13 year old
children, infrequent in <3 yr old. Abrupt onset without nasal symptoms, Constitutional symptoms, such
as arthralgia, myalgia, headache, Moderate to high fever, malaise, prominent sore throat, dysphagia,
Nausea, abdominal discomfort, vomiting, headache, Presentation in the later winter or early spring, Lack
of cough or nasal symptoms, alone with an exudative, erythematous pharyngitis with a follicular pattern
and typical historical finding point to GABHS
Clinical Findings, Physical Exam: The following may be seen with GABHS: - CORRECT ANSWER Petechiae
on the soft palate and pharynx, swollen beefy-red uvula, red enlarged tonsillopharyngeal tissue
Tonsillipharyngeal exudate that is yellow, blood-tinged (frequently), Tender and enlarged anterior,
cervical lymph nodes, Bad breath, Stigmata of scarlet fever may be seen, scarlatiniform rash, strawberry
tongue, circumoral pallor, Other bacterial infections may present with similar clinical findings:
A. haemolyticum causes - CORRECT ANSWER an exuative pharyngitis with marked erythema and a
pruritic, fine, scarlantiniform rash
, Adolescents and young adults with pharyngitis caused by A. haemolyticum may present with a -
CORRECT ANSWER scarlatiniform rash similar to scarlet fever
Variable presentation, may have mild pharyngeal erythema without - CORRECT ANSWER tonsillar
exudate or cervical adenopathy
Important to use RADT for patients with clinical features consistent with GABHS to - CORRECT ANSWER
increase the yield of positive tests and avoid false-positive tests on patients who are carriers of
streptococcus and do not need treatment
RADT - CORRECT ANSWER has a high specificity but variable sensitivity, therefore a positive test
indicates that a symptomatic person has strep infection and should be treated
A negative test - CORRECT ANSWER does not mean that strep infection is not present
It is important not to do a strep test unless the patient has - CORRECT ANSWER signs and symptoms, b/c
a positive strep test or a positive throat culture can identify a carrier state
Anti-streptococcal antibody titers, such as antistreptolysin O (ASO) and anti-deoxyribonuclease B tests
(anti-DNase B), are - CORRECT ANSWER not useful in the dx of acute pharyngitis, b/c titers remain
elevated for months after an acute infection
ASO titer rises - CORRECT ANSWER 1 week post infection and peaks 3-6 weeks after infection
Measurement of _____________________ is useful in the diagnosis of the nonsuppurative
complications of GABHS, such as rheumatic fever or acute glomerulonephritis. - CORRECT ANSWER anti-
streptococcal antibody titers
The anti-DNASE B test rises 1-2 weeks after infection, peaks ______________________, and remains
elevated for months even in the face of a mild infection with GABHS. - CORRECT ANSWER 6-8 weeks
following infection
from Study Guide 2 Correctly Answered.
Most common bacterial cause of pharyngitis and tonsillitis in children & adolescents is _______. -
CORRECT ANSWER GABHS, which accounts for 15-30% of infections in children with sore throat and
fever
Group C and group B streptococci can cause pharyngitis, but abx treatment does not prevent
__________, which is its only nonsuppurative complication. - CORRECT ANSWER glomerulonephritis
A haemolyticum is more common in __________________________ and is ___________________. -
CORRECT ANSWER adolescents, and is difficult to culture due to slow growth
N. gonorrhoeae is a cause of adolescent pharyngitis if involved in __________________. - CORRECT
ANSWER oral sex
M. pneumoniae and Chlamydophila pneumoniae are associated with ___________________ along with
______________. - CORRECT ANSWER cough along with pharyngitis
The following characterize GABHS infection: - CORRECT ANSWER Most commonly found in 5-13 year old
children, infrequent in <3 yr old. Abrupt onset without nasal symptoms, Constitutional symptoms, such
as arthralgia, myalgia, headache, Moderate to high fever, malaise, prominent sore throat, dysphagia,
Nausea, abdominal discomfort, vomiting, headache, Presentation in the later winter or early spring, Lack
of cough or nasal symptoms, alone with an exudative, erythematous pharyngitis with a follicular pattern
and typical historical finding point to GABHS
Clinical Findings, Physical Exam: The following may be seen with GABHS: - CORRECT ANSWER Petechiae
on the soft palate and pharynx, swollen beefy-red uvula, red enlarged tonsillopharyngeal tissue
Tonsillipharyngeal exudate that is yellow, blood-tinged (frequently), Tender and enlarged anterior,
cervical lymph nodes, Bad breath, Stigmata of scarlet fever may be seen, scarlatiniform rash, strawberry
tongue, circumoral pallor, Other bacterial infections may present with similar clinical findings:
A. haemolyticum causes - CORRECT ANSWER an exuative pharyngitis with marked erythema and a
pruritic, fine, scarlantiniform rash
, Adolescents and young adults with pharyngitis caused by A. haemolyticum may present with a -
CORRECT ANSWER scarlatiniform rash similar to scarlet fever
Variable presentation, may have mild pharyngeal erythema without - CORRECT ANSWER tonsillar
exudate or cervical adenopathy
Important to use RADT for patients with clinical features consistent with GABHS to - CORRECT ANSWER
increase the yield of positive tests and avoid false-positive tests on patients who are carriers of
streptococcus and do not need treatment
RADT - CORRECT ANSWER has a high specificity but variable sensitivity, therefore a positive test
indicates that a symptomatic person has strep infection and should be treated
A negative test - CORRECT ANSWER does not mean that strep infection is not present
It is important not to do a strep test unless the patient has - CORRECT ANSWER signs and symptoms, b/c
a positive strep test or a positive throat culture can identify a carrier state
Anti-streptococcal antibody titers, such as antistreptolysin O (ASO) and anti-deoxyribonuclease B tests
(anti-DNase B), are - CORRECT ANSWER not useful in the dx of acute pharyngitis, b/c titers remain
elevated for months after an acute infection
ASO titer rises - CORRECT ANSWER 1 week post infection and peaks 3-6 weeks after infection
Measurement of _____________________ is useful in the diagnosis of the nonsuppurative
complications of GABHS, such as rheumatic fever or acute glomerulonephritis. - CORRECT ANSWER anti-
streptococcal antibody titers
The anti-DNASE B test rises 1-2 weeks after infection, peaks ______________________, and remains
elevated for months even in the face of a mild infection with GABHS. - CORRECT ANSWER 6-8 weeks
following infection
