Streptococcal throat infection can later lead to?

NCL (MP) Nursing Officer - 2019

Medical & Surgical Nursing

Easy

Appeared in: NCL (MP) Nursing Officer - 2019

Explanation

Rheumatic heart disease (RHD) is a well-known, non-suppurative (not pus-forming) complication of a preceding Group A Streptococcal (GAS) throat infection.
The underlying mechanism is an autoimmune reaction called molecular mimicry, which occurs about 2-3 weeks after the initial infection.
Antibodies created by the body to fight the streptococcal bacteria cross-react with and attack the heart valve tissue, leading to inflammation (carditis) during acute rheumatic fever (ARF).
Over time, repeated inflammation and subsequent scarring (fibrosis) cause permanent damage to the heart valves, resulting in RHD, with the mitral valve being the most commonly affected.

Option A: Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis, not Streptococcus. It primarily affects the lungs and is transmitted via airborne droplets.
Option B: Leprosy (Hansen's disease) is caused by Mycobacterium leprae. It is a chronic infectious disease that mainly affects the skin, peripheral nerves, and upper respiratory tract.
Option D: Malaria is a parasitic disease caused by Plasmodium species and is transmitted through the bite of an infected Anopheles mosquito. It has no connection to bacterial throat infections.

Clinical Relevance

Nursing practice connection: Knowing Long-term complications of streptococcal infections helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The primary nursing role is in prevention through patient education. Emphasize the importance of seeking medical attention for sore throats and completing the full course of prescribed antibiotics to eradicate the streptococcal infection.
For patients diagnosed with acute rheumatic fever, nurses administer antibiotics and anti-inflammatory medications, monitor for signs of carditis (e.g., new murmurs, tachycardia, chest pain), and provide comfort measures for joint pain.
Patients with established RHD require long-term management and secondary prophylaxis (regular penicillin injections) to prevent recurrent ARF attacks and further heart damage.

How to Approach the Question

First, identify the core concept of the question, which is a long-term complication or sequela of a specific infection (streptococcal throat infection).
This is a factual recall question. Access your knowledge about the pathophysiology of common infectious diseases.
Evaluate each option by considering its cause. Ask yourself, 'What causes Tuberculosis? Leprosy? Rheumatic heart disease? Malaria?'
Recall that streptococcal infections can trigger an autoimmune response. This specific mechanism is known as molecular mimicry.
Connect this mechanism to the options. Rheumatic heart disease is the classic example of a post-streptococcal autoimmune complication affecting the heart.
Eliminate the other options as they are caused by distinctly different pathogens (Mycobacterium, Plasmodium) and have different modes of transmission.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 565-567

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 2 (215-514) p. 12-14