GROUP-A BETA HEMOLYTIC STREP (GABHS) PHARYNGITIS

Photo Credit: Dr. James Heilman from Wikipedia

PHARYNGITIS

: MC caused (30-60%) by viral infection in adults – rhinovirus

: caused by bacterial infection in adults in only in 5-10% - GABHS

: accounts for 30-40% of case in children

: prevents rheumatic fever – by starting antibiotics 10 days after onset of symptoms

: SORE THROAT from Epstein-Barr virus (82%) – found in pxs with Infectious Mononucleosis –

• Tx mostly consist of

1. Supportive care

2. Rest

3. Antipyretics

4. Analgesics

 

GABHS-PHARYNGITIS

: MC pathogen responsible for most case of bacterial pharyingitis – BUT accounts only 10% of adult cases

            : Symptoms – usually rapid onset:

- Severe sore throat

- Odynophagia

- Cervical lymphadenopathy

- Fever

- Chills

- Malaise

- Headache

- Mild neck stiffness

- Anorexia

Coronary Artery Atherosclerosis

Coronary artery atherosclerosis is the principal cause of coronary artery disease (CAD) and is the single largest killer of both men and women in the United States.

Approximately 14 million Americans have CAD. Each year, 1.5 million individuals develop acute myocardial infarction (AMI), the most deadly presentation of CAD, and more than 500,000 of these individuals die. Survivors of myocardial infarction (MI) continue to have a poor prognosis, and their risk of mortality and morbidity is 1.5-15 times greater than that of the rest of the population. This fact remains true despite a 30% reduction in mortality from CAD over the past 3 decades. Many factors have led to a decrease in mortality and morbidity from AMI, including the introduction of coronary care units, coronary artery bypass grafting, thrombolytic therapy, percutaneous coronary intervention (eg, percutaneous transluminal coronary angioplasty [PTCA]), and a renewed emphasis on lifestyle modification.

Atherosclerosis

Atherosclerosis is a disease of large and medium-sized muscular arteries and is characterized by endothelial dysfunction, vascular inflammation, and the buildup of lipids, cholesterol, calcium, and cellular debris within the intima of the vessel wall. This buildup results in plaque formation, vascular remodeling, acute and chronic luminal obstruction, abnormalities of blood flow, and diminished oxygen supply to target organs.

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Angina Pectoris

ANGINA PECTORIS is a clinical syndrome due to transient myocardial ischemia caused by an imbalance between myocardial blood supply and oxygen demand. Myocardial oxygen demand actually exceeds oxygen supply. It comes from the latin words: "Angere" meaning "to choke" and "Pectus" meaning "chest".

Angina Pectoris has a wide range of clinical symptoms but the most common complaint described by patients is a squeezing, central, substernal chest pressure or tightening most often radiating to the arms, shoulders or jaws.

The most common clinical sign observed in patients is the clutching of the patient's chest or what we call as Levine Sign.