WEBVTT

1
00:00:00.021 --> 00:00:03.177
Now we'll move on to a different genus

2
00:00:03.539 --> 00:00:05.539
the Streptococcus genus.

3
00:00:06.050 --> 00:00:07.499
Unlike the Staph genus

4
00:00:07.560 --> 00:00:08.732
which form clusters,

5
00:00:08.825 --> 00:00:11.179
Streptococci grow along a single axis

6
00:00:11.230 --> 00:00:12.972
and form long chains or pairs.

7
00:00:13.867 --> 00:00:15.448
The first group of Streptococcus

8
00:00:15.473 --> 00:00:17.473
that we'll cover is Strep pyogenes

9
00:00:17.622 --> 00:00:19.493
also known as Group A Strep.

1
00:00:20.208 --> 00:00:22.315
So watch as we transform pyogenes

1
00:00:22.357 --> 00:00:23.668
into a scene we'll call

1
00:00:23.761 --> 00:00:25.379
"The Pie Genies Bakery."

1
00:00:25.708 --> 00:00:26.797
Let's get started.

1
00:00:27.463 --> 00:00:30.257
We've got a lot to cram into this video.

1
00:00:30.411 --> 00:00:32.357
So the backdrop will be pretty simple

1
00:00:32.656 --> 00:00:34.656
and I'll also try to keep

1
00:00:34.688 --> 00:00:35.987
as brief as possible.

1
00:00:37.244 --> 00:00:39.674
The pie genies specialize

1
00:00:39.840 --> 00:00:41.540
So let's start by drawing a pie.

2
00:00:41.978 --> 00:00:43.978
And we'll cover it in

2
00:00:43.989 --> 00:00:46.107
that bakers would use

2
00:00:46.851 --> 00:00:48.648
This glass capsule-looking dome

2
00:00:48.670 --> 00:00:51.474
is going to represent that Group A Strep

2
00:00:51.991 --> 00:00:53.991
You'll notice we specify that this is

2
00:00:54.044 --> 00:00:55.422
hot apple pie.

2
00:00:55.746 --> 00:00:58.226
The H and A in hot and apple

2
00:00:58.300 --> 00:01:00.950
actually stand for hyaluronic acid.

2
00:01:01.237 --> 00:01:04.456
Strep pyogenes is made out

2
00:01:04.888 --> 00:01:07.069
And we also actually produce
3
00:01:07.101 --> 00:01:08.497
in our connective tissue.

3
00:01:08.559 --> 00:01:11.545
And this is good to know because

3
00:01:11.581 --> 00:01:12.680
everywhere in our body,

3
00:01:12.825 --> 00:01:14.719
this means that the pyogenes capsule

3
00:01:14.772 --> 00:01:16.247
cannot be immunogenic

3
00:01:16.442 --> 00:01:19.750
or else our own immune system

3
00:01:20.412 --> 00:01:22.647
Now we're drawing a heating lamp

3
00:01:22.966 --> 00:01:24.966
Notice anything special about the bulb?

3
00:01:25.669 --> 00:01:27.936
Yep, that B in the bulb's filaments

3
00:01:27.978 --> 00:01:30.340
means that its our

4
00:01:30.585 --> 00:01:31.996
So Group A Strep

4
00:01:32.021 --> 00:01:33.616
is beta-hemolytic.

4
00:01:34.756 --> 00:01:37.429
Let's dive into some clinical features

4
00:01:37.458 --> 00:01:40.221
and discuss the pyogenic infections

4
00:01:40.832 --> 00:01:42.023
Theyll all be represented
4
00:01:42.065 --> 00:01:44.796
by our first pie genie baker

4
00:01:45.108 --> 00:01:47.397
There are three main ones

4
00:01:47.512 --> 00:01:49.352
The first is impetigo;

4
00:01:49.544 --> 00:01:51.215
a pyogenic skin infection

4
00:01:51.235 --> 00:01:52.904
that is said to look honey crusted.

5
00:01:53.512 --> 00:01:56.391
This is represented by our

5
00:01:57.173 --> 00:01:59.385
But remember, impetigo

5
00:01:59.428 --> 00:02:00.692
by Staph aureus.

5
00:02:01.375 --> 00:02:02.696
So if somebody has impetigo,

5
00:02:02.715 --> 00:02:04.116
it doesn't necessarily mean

5
00:02:04.140 --> 00:02:05.916
they have a Group A Strep infection.

5
00:02:06.502 --> 00:02:09.070
The second pyogenic infection

5
00:02:09.216 --> 00:02:10.551
is pharyngitis

5
00:02:10.854 --> 00:02:13.257
or more commonly known as strep throat.

5
00:02:13.525 --> 00:02:16.222
We'll represent this by drawing

6
00:02:16.526 --> 00:02:19.062
So when you see it,

6
00:02:19.229 --> 00:02:21.282
erythematous and inflamed throat.

6
00:02:21.814 --> 00:02:23.793
Again, that's for pharyngitis.

6
00:02:24.347 --> 00:02:26.814
The third condition is really

6
00:02:26.879 --> 00:02:28.750
cellulitis and erysipela

6
00:02:28.858 --> 00:02:30.042
but they're very similar.

6
00:02:30.474 --> 00:02:32.100
All erysipela is basically

6
00:02:32.122 --> 00:02:34.423
a very superficial cellulitis infection

6
00:02:34.463 --> 00:02:36.570
with well-demarcated borders.

6
00:02:37.028 --> 00:02:39.929
Strep pyogenes is the most common

7
00:02:39.965 --> 00:02:41.408
so we'll represent this two

7
00:02:41.465 --> 00:02:43.701
by drawing big red mittens

7
00:02:43.742 --> 00:02:46.074
which indicates erythema of the skin.

7
00:02:46.604 --> 00:02:49.702
So we've just covered

7
00:02:49.914 --> 00:02:51.416
Now we're going to move on

7
00:02:51.456 --> 00:02:54.675
to infections caused by

7
00:02:54.979 --> 00:02:56.426
The toxin is referred to as

7
00:02:56.457 --> 00:02:59.379
Streptococcal pyrogenic exotoxin

7
00:02:59.490 --> 00:03:00.946
or SPE.

7
00:03:01.671 --> 00:03:03.777
The first condition is scarlet fever.

8
00:03:03.809 --> 00:03:06.161
And there are three main symptoms

8
00:03:06.182 --> 00:03:07.228
that we want you to know.

8
00:03:07.405 --> 00:03:10.222
The first is reddening and

8
00:03:10.353 --> 00:03:12.653
And this is referred to as

8
00:03:13.034 --> 00:03:15.034
And we'll represent this

8
00:03:15.045 --> 00:03:17.045
sticking out his tongue

8
00:03:17.098 --> 00:03:20.212
And the second symptom of

8
00:03:20.472 --> 00:03:23.943
We'll represent this the same way

8
00:03:24.155 --> 00:03:26.155
with a red handkerchief around his neck.
8
00:03:26.592 --> 00:03:29.370
And the third and final symptom

9
00:03:29.401 --> 00:03:30.801
that spares the face.

9
00:03:31.241 --> 00:03:33.241
We'll represent this by having the chef

9
00:03:33.252 --> 00:03:35.369
smearing this gingerbread

9
00:03:35.390 --> 00:03:38.048
that covers everywhere except the face.

9
00:03:38.604 --> 00:03:40.379
Another condition caused by this toxin

9
00:03:40.402 --> 00:03:42.179
is very similar to Staph aureus'

9
00:03:42.210 --> 00:03:43.910
toxic shock syndrome.

9
00:03:44.093 --> 00:03:47.661
And it's referred to as

9
00:03:47.690 --> 00:03:49.170
or TSLS.

9
00:03:49.520 --> 00:03:51.691
This toxin behaves as a superantigen

1
00:03:51.733 --> 00:03:53.669
just as it does for Staph aureus

1
00:03:53.808 --> 00:03:55.286
so we'll use the same cape.

1
00:03:55.403 --> 00:03:57.147
The super cape with a lightning bolt

1
00:03:57.211 --> 00:03:58.140
where "super"
1
00:03:58.231 --> 00:04:01.518
stands for superantigen and

1
00:04:02.180 --> 00:04:04.480
Now there are three toxigenic syndromes

1
00:04:04.499 --> 00:04:05.706
caused by the exotoxin.

1
00:04:05.743 --> 00:04:07.582
We've covered two: scarlet fever

1
00:04:07.775 --> 00:04:09.679
and toxic shock-like syndrome.

1
00:04:10.019 --> 00:04:12.019
So the last one is a very scary one.

1
00:04:12.062 --> 00:04:15.102
It's been referred to in the press as

1
00:04:15.286 --> 00:04:17.565
And this is necrotizing fasciitis

1
00:04:17.968 --> 00:04:21.450
which can be caused by the toxigenic

1
00:04:21.651 --> 00:04:23.395
It invades the fascia

1
00:04:23.427 --> 00:04:25.109
and spreads very rapidly.

1
00:04:25.171 --> 00:04:27.363
So it's a true surgical emergency.

1
00:04:27.778 --> 00:04:30.489
We'll represent this by having

1
00:04:30.513 --> 00:04:31.781
with his leg falling off.

1
00:04:31.863 --> 00:04:33.927
The burn looks like necrotic tissue

1
00:04:33.959 --> 00:04:36.592
and the leg is missing because

1
00:04:36.608 --> 00:04:38.491
to amputate the affected region.

1
00:04:40.056 --> 00:04:41.715
So in a very organize manner,

1
00:04:41.736 --> 00:04:43.972
we've covered all of

1
00:04:43.992 --> 00:04:47.112
caused by pyogenes in this corner

1
00:04:47.440 --> 00:04:49.037
Again, there are scarlet fever,

1
00:04:49.397 --> 00:04:52.037
toxic shock-like syndrome and

1
00:04:52.292 --> 00:04:54.292
And as I mentioned earlier,

1
00:04:54.313 --> 00:04:57.620
by Strep pyrogenic exotoxin or SPE.

1
00:04:57.899 --> 00:05:01.634
However, there are three

1
00:05:01.677 --> 00:05:03.474
and those are A, B, and C.

1
00:05:03.656 --> 00:05:05.527
And I don't believe they're

1
00:05:05.549 --> 00:05:06.877
but you may wanna know them.

1
00:05:06.985 --> 00:05:09.497
SpeA and SpeC

1
00:05:09.677 --> 00:05:11.347
are superantigen toxins

1
00:05:11.368 --> 00:05:13.997
that cause scarlet fever and TSLS.

1
00:05:14.145 --> 00:05:15.825
The SpeB

1
00:05:16.039 --> 00:05:18.540
is a protease that causes

1
00:05:18.880 --> 00:05:20.848
To make this easy,

1
00:05:20.870 --> 00:05:22.870
that the B causes nec fasc

1
00:05:22.891 --> 00:05:24.507
by elimination A and C

1
00:05:24.529 --> 00:05:26.156
cause the other two syndromes.

1
00:05:26.263 --> 00:05:27.963
So you can apply this to our story

1
00:05:27.986 --> 00:05:29.710
by remembering that our gingerbread man

1
00:05:29.741 --> 00:05:31.986
representing nec fasc is burnt;

1
00:05:32.252 --> 00:05:33.507
which starts with B.

1
00:05:33.677 --> 00:05:36.738
So we'll write this B on the nec fasc

1
00:05:36.944 --> 00:05:38.134
And that should be good enough.

1
00:05:39.657 --> 00:05:40.605
We'll move on to cover
1
00:05:40.648 --> 00:05:42.369
two highly tested conditions

1
00:05:42.403 --> 00:05:44.091
pertaining to Strep pyogenes.

1
00:05:44.197 --> 00:05:46.581
And probably the most important things

1
00:05:46.868 --> 00:05:48.268
These are rheumatic fever

1
00:05:48.325 --> 00:05:51.761
and poststreptococcal glomerulonephritis

1
00:05:52.296 --> 00:05:53.946
or PSGN.

1
00:05:54.146 --> 00:05:55.975
Since these are very

1
00:05:56.019 --> 00:05:57.563
of infections with Group A Strep,

1
00:05:57.731 --> 00:06:00.106
the boards may try to get you

1
00:06:00.370 --> 00:06:02.519
We'll do our best to make sure

1
00:06:02.551 --> 00:06:04.615
so that you get all of these

1
00:06:05.264 --> 00:06:07.040
First, we'll cover rheumatic fever.

1
00:06:07.371 --> 00:06:10.507
Since this is arguably the most

1
00:06:10.532 --> 00:06:13.097
we're gonna make this character

1
00:06:13.374 --> 00:06:14.945
He'll be the master chef.
1
00:06:15.300 --> 00:06:17.300
So we'll go ahead and right an "M"

1
00:06:17.492 --> 00:06:19.715
In the story, "M" stands for

1
00:06:20.056 --> 00:06:22.365
But for us, "M" actually has

1
00:06:22.546 --> 00:06:24.546
It stands for M protein.

1
00:06:24.652 --> 00:06:26.843
M protein is a highly antigenic protein

1
00:06:26.886 --> 00:06:28.650
in the Group A Strep cell wall.

1
00:06:29.025 --> 00:06:32.337
And it's a main virulence factor

1
00:06:32.547 --> 00:06:35.442
And there are two ways it really acts

1
00:06:35.794 --> 00:06:37.943
First, in interferes with opsonization

1
00:06:37.986 --> 00:06:39.816
thus it is antiphagocytic.

1
00:06:40.071 --> 00:06:42.220
We'll demonstrate this by having

1
00:06:42.305 --> 00:06:44.081
reaching behind them

1
00:06:44.124 --> 00:06:45.506
and eat one of this cupcakes.

1
00:06:45.570 --> 00:06:46.746
While the master chef

1
00:06:46.835 --> 00:06:49.500
swats him away thus

1
00:06:49.655 --> 00:06:52.202
or having an antiphagocytic action.

1
00:06:52.624 --> 00:06:54.978
And the other aspect of

1
00:06:55.050 --> 00:06:56.528
is that it's very antigenic

1
00:06:56.603 --> 00:06:59.335
and elicits a very strong

1
00:06:59.743 --> 00:07:01.467
Because of the strong response,

1
00:07:01.498 --> 00:07:03.892
there's a great chance that

1
00:07:03.924 --> 00:07:05.988
to a very similar self-antigen

1
00:07:06.179 --> 00:07:08.488
which is the myosin in

1
00:07:08.775 --> 00:07:11.284
And this whole process is called

1
00:07:11.489 --> 00:07:13.606
And again, just because this is

1
00:07:13.702 --> 00:07:14.737
the M protein

1
00:07:14.797 --> 00:07:16.617
mimics the myosin in our heart

1
00:07:16.839 --> 00:07:19.560
and causes our own antibodies

1
00:07:19.776 --> 00:07:21.776
And when this happens,

1
00:07:21.797 --> 00:07:23.540
especially for our heart valves.

1
00:07:23.775 --> 00:07:25.234
You'll notice that this hat

1
00:07:25.285 --> 00:07:27.285
is a little bit different from

1
00:07:27.391 --> 00:07:30.259
Well, we've chosen this hat

1
00:07:30.573 --> 00:07:32.412
This type of hat is called a mitre hat.

1
00:07:32.530 --> 00:07:34.326
Or it's a hat that the pope wears.

1
00:07:34.636 --> 00:07:37.103
And actually, mitral valves

1
00:07:37.147 --> 00:07:39.147
because when they open, their two flaps

2
00:07:39.168 --> 00:07:40.871
kind of look like these mitre hats.

2
00:07:41.147 --> 00:07:43.147
So anyway, we've given him

2
00:07:43.169 --> 00:07:44.721
to remind you of the mitral valves

2
00:07:44.743 --> 00:07:47.697
which are the valves most commonly

2
00:07:47.957 --> 00:07:50.375
specifically causing a mitral stenosis.

2
00:07:51.011 --> 00:07:54.263
Rheumatic fever starts after

2
00:07:54.299 --> 00:07:56.771
but it does not happen
2
00:07:57.066 --> 00:08:00.015
It also doesn't happen if pharyngitis

2
00:08:00.046 --> 00:08:02.417
which is why you see it more

2
00:08:02.451 --> 00:08:04.226
who have little access to health care.

2
00:08:04.707 --> 00:08:06.930
We'll draw the red handkerchief

2
00:08:06.984 --> 00:08:09.453
pharyngitis precipitates RF.

2
00:08:10.283 --> 00:08:11.902
Now the symptoms of rheumatic fever

2
00:08:11.941 --> 00:08:14.272
categorized into five major criteria

2
00:08:14.294 --> 00:08:15.812
called the JONES criteria.

2
00:08:15.975 --> 00:08:17.536
And each letter of JONES

2
00:08:17.559 --> 00:08:19.292
stands for one of the criterion.

2
00:08:19.729 --> 00:08:22.586
So this is a really nice mnemonic

2
00:08:22.816 --> 00:08:25.476
But we're going to elaborate it

2
00:08:25.518 --> 00:08:27.582
Because that's what we do

2
00:08:28.125 --> 00:08:30.517
The first letter J stands for joints.

2
00:08:30.786 --> 00:08:32.562
It causes polyarthritis
2
00:08:32.627 --> 00:08:34.246
which is actually why it was

2
00:08:34.271 --> 00:08:35.831
rheumatic fever in the first place.

2
00:08:36.118 --> 00:08:37.628
We'll draw the baker

2
00:08:37.649 --> 00:08:40.964
having accidentally just bumped

2
00:08:41.129 --> 00:08:42.754
Notice the frosting on his elbow?

2
00:08:42.863 --> 00:08:44.863
This just reinforces joints.

2
00:08:45.555 --> 00:08:46.858
Then there is O

2
00:08:46.927 --> 00:08:48.533
which isn't actually an O.

2
00:08:48.831 --> 00:08:50.343
It's meant to be a shape of a heart.

2
00:08:50.618 --> 00:08:52.480
So we've drawn a nice heart-shape here

2
00:08:52.970 --> 00:08:55.302
and this signifies that it

2
00:08:55.492 --> 00:08:58.839
The heart problems are valvular damage

2
00:08:58.929 --> 00:09:01.270
myocarditis, and pericarditis.

2
00:09:01.686 --> 00:09:02.684
Next, we have N.

2
00:09:02.770 --> 00:09:04.127
N stands for nodules

2
00:09:04.152 --> 00:09:05.927
specifically subcutaneous nodules

2
00:09:05.939 --> 00:09:09.214
that most commonly appear on

2
00:09:09.409 --> 00:09:10.916
or on elbows and knees.

2
00:09:11.441 --> 00:09:13.441
We'll draw these nodules

2
00:09:13.463 --> 00:09:14.816
sitting on top of the cupcake.

2
00:09:15.090 --> 00:09:17.260
E stands for erythema marginatum,

2
00:09:17.484 --> 00:09:20.332
a rash with really nice thick

2
00:09:20.570 --> 00:09:22.378
We did our best to illustrate

2
00:09:22.410 --> 00:09:23.632
on top of this cupcake

2
00:09:23.824 --> 00:09:25.220
but it was a small canvass

2
00:09:25.452 --> 00:09:27.452
so I recommend that you google it

2
00:09:27.494 --> 00:09:29.494
seeing more accurate representations.

2
00:09:30.260 --> 00:09:31.770
Finally, we have S

2
00:09:31.802 --> 00:09:34.111
which stands for Sydenham's chorea

2
00:09:34.217 --> 00:09:36.217
which are rapid, involuntary movements

2
00:09:36.238 --> 00:09:38.195
especially of the hands and face.

2
00:09:38.238 --> 00:09:40.238
And that's really it

2
00:09:40.759 --> 00:09:43.241
We'll move on to the other

2
00:09:43.312 --> 00:09:45.408
poststreptococcal glomerulonephritis.

2
00:09:46.036 --> 00:09:48.132
And I think this is very highly tested

2
00:09:48.164 --> 00:09:50.430
it has a very strong tie into pathology.

2
00:09:50.878 --> 00:09:52.878
Like rheumatic fever,

2
00:09:52.921 --> 00:09:55.271
by our own immune system

2
00:09:55.336 --> 00:09:56.859
However, unlike RF,

2
00:09:57.059 --> 00:10:00.050
the damage isn't a type II

2
00:10:00.092 --> 00:10:01.202
It's a type III.

2
00:10:01.272 --> 00:10:02.920
Which means that the damage is from

2
00:10:02.952 --> 00:10:05.852
circulating antibody antigen

2
00:10:05.878 --> 00:10:08.049
that eventually deposit
2
00:10:08.847 --> 00:10:10.431
To represent glomerular damage,

2
00:10:10.453 --> 00:10:12.453
we'll draw this chef talking

2
00:10:12.730 --> 00:10:14.730
and you'll notice that its cord

2
00:10:14.762 --> 00:10:15.840
into a little ball.

2
00:10:16.149 --> 00:10:18.352
And it looks a lot like a glomerulus.

2
00:10:18.618 --> 00:10:20.682
The two main symptoms that

2
00:10:20.714 --> 00:10:21.850
are dark brown

2
00:10:21.894 --> 00:10:23.304
or cola-colored urine

2
00:10:23.485 --> 00:10:26.015
and facial swelling or puffiness

2
00:10:26.657 --> 00:10:29.823
Since this chef is eating,

2
00:10:29.882 --> 00:10:31.775
to represent the facial puffiness

2
00:10:32.042 --> 00:10:34.170
and we'll draw a bottle of cola

2
00:10:34.223 --> 00:10:36.212
to remind you of cola-colored urine.

2
00:10:36.606 --> 00:10:38.767
You'll need to remember that PSGN occurs

2
00:10:38.787 --> 00:10:41.890
two weeks after the onset of
2
00:10:42.289 --> 00:10:44.536
We've illustrated two weeks

2
00:10:44.576 --> 00:10:46.104
by circling in red a date

2
00:10:46.140 --> 00:10:47.779
that is two weeks from today.

2
00:10:48.001 --> 00:10:49.853
I'm gonna cover two major differences

2
00:10:49.873 --> 00:10:52.227
between rheumatic fever and PSGN

2
00:10:52.459 --> 00:10:54.320
that are commonly tested by examiners

2
00:10:54.364 --> 00:10:55.336
and somewhat tricky.

2
00:10:55.623 --> 00:10:58.314
But I think we do a really good job

2
00:10:58.624 --> 00:11:00.484
The first is that RF only occurs

2
00:11:00.507 --> 00:11:01.874
after pharyngitis.

2
00:11:01.991 --> 00:11:03.620
Whereas PSGN

2
00:11:03.725 --> 00:11:05.333
can occur after pharyngitis

2
00:11:05.352 --> 00:11:07.652
or a superficial infection

2
00:11:08.300 --> 00:11:09.309
To show this,

2
00:11:09.363 --> 00:11:11.363
we, of course, have our

2
00:11:11.384 --> 00:11:12.723
on both of these chefs

2
00:11:13.150 --> 00:11:16.248
but we'll only have the honey crusted

2
00:11:16.386 --> 00:11:19.068
on the chef's face that represents PSGN.

2
00:11:19.355 --> 00:11:21.590
The second major point of confusion

3
00:11:21.621 --> 00:11:23.621
treatment and complication prevention.

3
00:11:24.260 --> 00:11:26.580
Early diagnosis and treatment

3
00:11:26.643 --> 00:11:28.823
can prevent RF but it will not prevent

3
00:11:28.888 --> 00:11:30.771
poststreptococcal glomerulonephritis.

3
00:11:31.059 --> 00:11:33.485
The treatment for strep infections

3
00:11:33.709 --> 00:11:36.499
So we'll have our chef with

3
00:11:36.539 --> 00:11:37.591
holding a pencil

3
00:11:37.772 --> 00:11:39.408
which represents penicillin.

3
00:11:39.911 --> 00:11:41.740
And the way I want you

3
00:11:41.783 --> 00:11:44.359
so that there's no confusion

3
00:11:44.805 --> 00:11:47.908
even though the chef has

3
00:11:48.232 --> 00:11:50.624
he still has symptoms of PSGN

3
00:11:50.743 --> 00:11:53.252
denoted by the puffy face

3
00:11:53.542 --> 00:11:55.275
That should keep things

3
00:11:55.584 --> 00:11:58.167
We still got three more virulence

3
00:11:58.224 --> 00:11:59.184
that we want to cover.

3
00:11:59.276 --> 00:12:00.626
Sorry, I know this is a lot.

3
00:12:00.658 --> 00:12:02.093
It's kind of a marathon session.

3
00:12:02.328 --> 00:12:03.806
You can blame the microbiologist

3
00:12:03.849 --> 00:12:06.158
It's their fault for discovering

3
00:12:06.254 --> 00:12:07.636
But I'll try to be fast.

3
00:12:07.839 --> 00:12:09.253
We'll illustrate all three of them

3
00:12:09.317 --> 00:12:11.720
surrounding this baker over here

3
00:12:12.116 --> 00:12:13.596
First is streptolysin O

3
00:12:13.700 --> 00:12:16.158
which is the virulence factor
3
00:12:16.190 --> 00:12:18.865
to lyse red blood cells and

3
00:12:19.574 --> 00:12:21.222
We'll represent streptolysin O

3
00:12:21.243 --> 00:12:23.733
with some O-shaped donuts

3
00:12:23.765 --> 00:12:25.872
and leaking as if they were just lysed.

3
00:12:26.202 --> 00:12:27.958
It's important to know

3
00:12:28.010 --> 00:12:30.607
because we generate antibodies

3
00:12:30.755 --> 00:12:32.522
called ASO antibodies.

3
00:12:32.787 --> 00:12:34.425
And I'll get back to those in a second.

3
00:12:34.968 --> 00:12:37.256
Next virulence factor is streptokinase.

3
00:12:37.351 --> 00:12:40.369
Kinase means simply to put

3
00:12:40.512 --> 00:12:43.312
So we have little muffins with

3
00:12:43.417 --> 00:12:45.160
Streptokinase is important to know

3
00:12:45.204 --> 00:12:47.556
because it converts plasminogen

3
00:12:47.864 --> 00:12:49.576
Plasmin is fibrinolytic.

3
00:12:49.896 --> 00:12:52.472
So streptokinase is actually
3
00:12:52.525 --> 00:12:54.761
to lyse clots during, say, MI

3
00:12:54.813 --> 00:12:56.309
or ischemic strokes.

3
00:12:56.472 --> 00:12:58.184
Finally, we have our twists.

3
00:12:58.398 --> 00:13:00.931
These are twisted in

3
00:13:01.186 --> 00:13:03.836
This is because they represent DNAses

3
00:13:04.197 --> 00:13:05.391
or dornases

3
00:13:05.431 --> 00:13:07.218
which depolymerize DNA

3
00:13:07.282 --> 00:13:09.526
and really this is the least

3
00:13:09.814 --> 00:13:11.388
In fact, I'm even starting to wonder

3
00:13:11.409 --> 00:13:12.332
we just included it

3
00:13:12.387 --> 00:13:15.176
so that we could show off

3
00:13:15.558 --> 00:13:18.427
Okay now on to something that's

3
00:13:18.773 --> 00:13:20.261
This is a Basset hound.

3
00:13:20.474 --> 00:13:22.601
He's going to teach us

3
00:13:22.634 --> 00:13:24.496
Group A Strep from Group B Strep.

3
00:13:25.124 --> 00:13:27.697
Group A Strep is bacitracin-sensitive.

3
00:13:28.019 --> 00:13:30.780
Whereas Group B Strep is

3
00:13:30.946 --> 00:13:32.615
You see that our Basset hound

3
00:13:32.850 --> 00:13:35.490
or "basset-tracin" hound is able

3
00:13:35.510 --> 00:13:37.276
and munch on our DNA twists?

3
00:13:37.510 --> 00:13:40.117
Well this means that they're sensitive

3
00:13:40.330 --> 00:13:43.151
So Strep pyogenes is

3
00:13:43.629 --> 00:13:45.714
You'll see in our next video

3
00:13:45.757 --> 00:13:47.243
is bacitracin-resistant.

3
00:13:47.512 --> 00:13:49.512
So I promise we only have

3
00:13:49.548 --> 00:13:50.961
and we'll be super quick.

3
00:13:51.225 --> 00:13:52.415
Let's draw this lady

3
00:13:52.426 --> 00:13:54.083
and she's checking a box of donuts

3
00:13:54.128 --> 00:13:55.319
that she just purchased.

3
00:13:55.596 --> 00:13:57.426
Notice she's using similar tongs

3
00:13:57.468 --> 00:13:59.129
to this baker over here on the right.

3
00:13:59.406 --> 00:14:01.868
Well these tongs are supposed

3
00:14:02.301 --> 00:14:05.064
She just purchased the box

3
00:14:05.292 --> 00:14:06.698
and she's checking their amount

3
00:14:06.791 --> 00:14:07.991
or their titers

3
00:14:08.269 --> 00:14:09.862
with ASO antibodies.

3
00:14:10.194 --> 00:14:11.982
These ASO titers can tell us

3
00:14:12.012 --> 00:14:14.225
if we've recently had

3
00:14:14.450 --> 00:14:16.056
which is particularly helpful

3
00:14:16.067 --> 00:14:17.306
when trying to diagnose

3
00:14:17.343 --> 00:14:18.539
acute rheumatic fever

3
00:14:18.565 --> 00:14:20.608
or poststreptococcal glomerulonephritis.

3
00:14:21.290 --> 00:14:22.704
Okay now we're gonna talk about

3
00:14:22.737 --> 00:14:23.933
the ten different chemicals
3
00:14:23.960 --> 00:14:25.960
in the wall of Strep pyogenes.

3
00:14:27.359 --> 00:14:28.979
I'm just kidding.

3
00:14:29.387 --> 00:14:30.607
Onto the next one.