Question 1 ( 0.5 points) ✓ Saved Your patient is a college student who is complaining of a severe sore throat. She tells

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Question 1 0 5 Points Saved Your Patient Is A College Student Who Is Complaining Of A Severe Sore Throat She Tells 1 (76.69 KiB) Viewed 36 times

Question 1 ( 0.5 points) ✓ Saved Your patient is a college student who is complaining of a severe sore throat. She tells you that she had been previously diagnosed with strep throat just 2 years ago, but had not felt particularly ill at that time and had recovered without problem. You give the student a rapid strep test (RST), swabbing the back of her throat and using a kit to immediately determine whether Streptococcus pyogenes, the causative agent of strep throat, is present. The test is negative. You tell the student that you will send the throat swab away for culture and will have a definitive answer for her soon. Meanwhile, you send her home with a prescription for an antibiotic, but tell her not to fill it until she hears back from you. A day later, you have the culture results: the sample had been plated on blood agar and colonies showing clear zones of β hemolysis have grown. These are conclusively identified as S. pyogenes. You call the student and tell her that she does indeed have strep throat and to begin taking the antibiotic immediately. f the student had strep throat within the last 2 years, how can she get it again? Why isn't she immune? Her innate immune system was weakened the first time she had the disease and she cannot fight it the second time. Strep throat can be caused by several different pathogens; this illness may be caused by a different organism from the first time. Her adaptive immune system was weakened the first time she had the disease and she cannot fight it the second time. The causative organism has a polysaccharide capsule; the immune system cannot generate a response to capsule material. The causative organism exhibitis variation in the M protein antigen, which means that a person can get strep throat more than once.
The rapid strep test was negative but the culture test was positive. How can you explain this result? Rapid strep tests never work; you just gave it to the student to make her feel better. The rapid strep test is not as sensitive as bacterial culture, and the result is a false negative. The student doesn't actually have strep throat; β-hemolysis shows the culture result is a false positive. The strep test won't work because she took an antibiotic the last time she had strep throat. There is no rational explanation for this observation. Question 3 (0.5 points) You tell the student not to take the antibiotic until you have the culture results. Why is this? If the culture result is also negative, the student likely does not have step throat: and you do not want her to take an antibiotic unnecessarily. The culture result will determine whether the student is allergic to penicillin; if she is, she cannot take this antibiotic. Penicillin is very toxic; you want the student to take it for as few days as possible so she does not react badly to the drug. You want the infection to develop to a stage that all the bacteria have likely stopped multiplying so that the medication has maximum effectiveness.
Once the strep infection has been confirmed, you tell the student to start taking the antibiotic immediately. Why is this? Although strep throat itself is not a very serious disease, it can lead to poststreptococcal sequelae or other complications; treating with antibiotics may lessen the chance of these complications. Although strep throat itself is not a very serious disease, it can take several months to resolve; treating with antibiotics may lessen the time for the student to recover. The longer the student has the disease, the more likely it is that the causative organism will become resistant to all antibiotics used for treatment. Strep throat is a very serious disease; untreated, it always develops into pneumonia with a very high fatality rate; treating with antibiotics will reduce the chance of this happening. Question 5 (0.5 points) Which would be the most appropriate antibiotic for the student? Amphotericin B - S. pyogenes is a fungal pathogen. Tetracycline - S. pyogenes does not have a peptidoglycan cell wall. Penicillin AND tetracycline - S. pyogenes exhibits mutidrug resistance. Penicillin - S. pyogenes is still sensitive to this antibiotic. Vancomycin - S. pyogenes is resistant to all penicillins.