I’m entering a few months prep for the UK and Ireland exit exam in Emergency Medicine: the FRCEM. I’ll be adding lots of little notes on pearls I’ve learned along the way. A lot of my revision is based around the Handbook of EM as a curriculum guide and review of contemporary, mainly UK guidelines. I also focus on the areas that I’m a bit sketchy on. With that in mind I hope they’re useful.
You can find more things on the FRCEM on this site here
Group A strep (or strep pyogenes) causes all kinds of interesting infections with some even more interesting and weird post infectious complications.
What Types of infection does GAS cause?
- Invasive
- toxic shock (can be strep or staph)
- necrotising fasciits
- pneumonia
- osteo
- bacteraemia
- Non invasive
- strep throat
- impetigo
- scarlet fever
- cellulitis
- erisipelas
[collapse]
describe some Post strep issues?
- erythema nodosum
- strep
- mycoplasma
- sarcoid
- TB
- inflammatory bowel disease
- OCP and even NSAIDS
- rheumatic fever
- glomerulonephritis
- coke urine
- +ve BLD/PROT on dipstick
- hypertension
- the funny neuro one – PANDAS (though there’s some controversy there)
[collapse]
what is rheumatic fever and how is it treated?
of note we covered this before… were you not paying attention…
- migratory polyarthritis
- Jones Criteria
- evidence of prior strep (basically an ASOT but can be clinical)
- plus 2 major or 1 major and 2 minor
- Major
- carditis
- arthritis
- chorea
- SC nodules
- erythma marginatum
- Minor
- raised inflammatory markers
- arthralgia
- fever
- 1 degree block
- Major
- Give penicillin (GAS has never been able to form resistance)
- Of note penicillin for strep infections can prevent rheumatic fever but none of the other post strep diseases
[collapse]