NR-509-APEA-3P-Exam-
Week-8 QUESTIONS AND
VERIFIED AND EXPLAINED
ANSWERS 2025
Pediatric GAS Pharyngitis Focus
Q1: What is the most common age group for Group A Strep
pharyngitis?
A: Children 5–15 years old.
Q2: Which clinical finding best differentiates strep pharyngitis from
viral sore throat?
A: Absence of cough with presence of tonsillar exudates, tender
anterior cervical lymphadenopathy, and fever.
Q3: What diagnostic test is recommended to confirm strep throat?
A: Rapid antigen detection test (RADT); if negative and high
suspicion, follow with throat culture.
Q4: What is the first-line antibiotic for confirmed GAS pharyngitis in
children?
A: Amoxicillin or Penicillin V.
,Q5: How long after starting antibiotics is a child no longer
considered contagious?
A: After 24 hours of antibiotic therapy and afebrile.
Q6: Why is it important to complete the full 10-day antibiotic
course?
A: To prevent complications such as rheumatic fever, peritonsillar
abscess, and post-streptococcal glomerulonephritis.
Q7: What are red-flag symptoms requiring urgent reassessment?
A: Difficulty breathing, drooling, inability to swallow fluids, stridor,
or signs of airway obstruction.
Q8: What adjunctive treatments help relieve symptoms?
A: Analgesics (acetaminophen/ibuprofen), hydration, throat
lozenges (if age-appropriate), warm salt water gargles, humidifier.
Q9: What is the Centor (or Modified Centor/McIsaac) score used
for?
A: To assess the likelihood of GAS pharyngitis and determine
whether diagnostic testing is indicated.
Q10: What patient education should be provided to parents?
A: Importance of completing antibiotics, infection control
(handwashing, no sharing cups/utensils), replacing toothbrush after
48 hours of antibiotics, expected recovery in 2–3 days, and when to
return for care if worsening.
Diagnosis & Assessment
Q11: What is the gold standard test for diagnosing GAS pharyngitis?
A: Throat culture.
,Q12: How quickly do results from a rapid antigen detection test
(RADT) return?
A: Within minutes (in-office).
Q13: What is the sensitivity of RADT compared to culture?
A: RADT is highly specific but less sensitive; false negatives are
possible.
Q14: In children, what should be done if RADT is negative but
clinical suspicion is high?
A: Obtain a confirmatory throat culture.
Q15: What are common viral signs that suggest it is NOT strep
throat?
A: Cough, rhinorrhea, hoarseness, oral ulcers, conjunctivitis.
Q16: What lymph nodes are typically enlarged in GAS pharyngitis?
A: Tender anterior cervical nodes.
Q17: What physical exam finding often accompanies strep throat but
not viral sore throat?
A: Tonsillar exudates.
Q18: What systemic symptom is more common with GAS compared
to viral pharyngitis?
A: High fever (>38°C/100.4°F).
Q19: What condition presents with a “strawberry tongue”?
A: Scarlet fever, a complication of GAS infection.
Q20: Why is it important to distinguish strep from viral pharyngitis?
A: To avoid unnecessary antibiotic use and reduce resistance.
Pharmacology & Management
, Q21: What is the drug of choice for penicillin-allergic patients (non-
anaphylactic)?
A: Cephalosporins (e.g., cephalexin).
Q22: What antibiotic is used for patients with severe penicillin
allergy (anaphylaxis)?
A: Azithromycin or clindamycin.
Q23: How many days should amoxicillin or penicillin be taken for
GAS pharyngitis?
A: 10 days.
Q24: What is the typical duration of azithromycin therapy for strep
throat?
A: 5 days.
Q25: Why is amoxicillin often preferred over penicillin V for
children?
A: Better taste and ease of dosing (suspension form).
Q26: What side effect is most concerning with antibiotics?
A: Allergic reaction (rash, hives, anaphylaxis).
Q27: What is a common non-allergic side effect of amoxicillin?
A: Diarrhea or mild GI upset.
Q28: How soon should clinical improvement occur after starting
antibiotics?
A: Within 24–72 hours.
Q29: What should parents do if their child’s symptoms do not
improve after 72 hours of antibiotics?
A: Contact the healthcare provider.
Week-8 QUESTIONS AND
VERIFIED AND EXPLAINED
ANSWERS 2025
Pediatric GAS Pharyngitis Focus
Q1: What is the most common age group for Group A Strep
pharyngitis?
A: Children 5–15 years old.
Q2: Which clinical finding best differentiates strep pharyngitis from
viral sore throat?
A: Absence of cough with presence of tonsillar exudates, tender
anterior cervical lymphadenopathy, and fever.
Q3: What diagnostic test is recommended to confirm strep throat?
A: Rapid antigen detection test (RADT); if negative and high
suspicion, follow with throat culture.
Q4: What is the first-line antibiotic for confirmed GAS pharyngitis in
children?
A: Amoxicillin or Penicillin V.
,Q5: How long after starting antibiotics is a child no longer
considered contagious?
A: After 24 hours of antibiotic therapy and afebrile.
Q6: Why is it important to complete the full 10-day antibiotic
course?
A: To prevent complications such as rheumatic fever, peritonsillar
abscess, and post-streptococcal glomerulonephritis.
Q7: What are red-flag symptoms requiring urgent reassessment?
A: Difficulty breathing, drooling, inability to swallow fluids, stridor,
or signs of airway obstruction.
Q8: What adjunctive treatments help relieve symptoms?
A: Analgesics (acetaminophen/ibuprofen), hydration, throat
lozenges (if age-appropriate), warm salt water gargles, humidifier.
Q9: What is the Centor (or Modified Centor/McIsaac) score used
for?
A: To assess the likelihood of GAS pharyngitis and determine
whether diagnostic testing is indicated.
Q10: What patient education should be provided to parents?
A: Importance of completing antibiotics, infection control
(handwashing, no sharing cups/utensils), replacing toothbrush after
48 hours of antibiotics, expected recovery in 2–3 days, and when to
return for care if worsening.
Diagnosis & Assessment
Q11: What is the gold standard test for diagnosing GAS pharyngitis?
A: Throat culture.
,Q12: How quickly do results from a rapid antigen detection test
(RADT) return?
A: Within minutes (in-office).
Q13: What is the sensitivity of RADT compared to culture?
A: RADT is highly specific but less sensitive; false negatives are
possible.
Q14: In children, what should be done if RADT is negative but
clinical suspicion is high?
A: Obtain a confirmatory throat culture.
Q15: What are common viral signs that suggest it is NOT strep
throat?
A: Cough, rhinorrhea, hoarseness, oral ulcers, conjunctivitis.
Q16: What lymph nodes are typically enlarged in GAS pharyngitis?
A: Tender anterior cervical nodes.
Q17: What physical exam finding often accompanies strep throat but
not viral sore throat?
A: Tonsillar exudates.
Q18: What systemic symptom is more common with GAS compared
to viral pharyngitis?
A: High fever (>38°C/100.4°F).
Q19: What condition presents with a “strawberry tongue”?
A: Scarlet fever, a complication of GAS infection.
Q20: Why is it important to distinguish strep from viral pharyngitis?
A: To avoid unnecessary antibiotic use and reduce resistance.
Pharmacology & Management
, Q21: What is the drug of choice for penicillin-allergic patients (non-
anaphylactic)?
A: Cephalosporins (e.g., cephalexin).
Q22: What antibiotic is used for patients with severe penicillin
allergy (anaphylaxis)?
A: Azithromycin or clindamycin.
Q23: How many days should amoxicillin or penicillin be taken for
GAS pharyngitis?
A: 10 days.
Q24: What is the typical duration of azithromycin therapy for strep
throat?
A: 5 days.
Q25: Why is amoxicillin often preferred over penicillin V for
children?
A: Better taste and ease of dosing (suspension form).
Q26: What side effect is most concerning with antibiotics?
A: Allergic reaction (rash, hives, anaphylaxis).
Q27: What is a common non-allergic side effect of amoxicillin?
A: Diarrhea or mild GI upset.
Q28: How soon should clinical improvement occur after starting
antibiotics?
A: Within 24–72 hours.
Q29: What should parents do if their child’s symptoms do not
improve after 72 hours of antibiotics?
A: Contact the healthcare provider.
