#13 Buxton - Fungal Pneumonias

Question 1

Identify

Answer 1

Pneumocystis jiroveci

Question 2

Identify

Answer 2

Aspergillus

Question 3

Identify

Answer 3

Candida albicans

Acutely branching hyphae

Question 4

Identify

Answer 4

Coccidioidomycosis

Spherule containing endospore

Old person got attacked by a CACTUS which had COCCIDIOIDOMYCOSIS.

Question 5

Identify

Answer 5

Blastomyces dermatitidis

Broad Based Budding yeast

Question 6

Identify

Answer 6

HistOplasMosis capsulatum

Ohio and Mississippi River Valley

Question 7

Identify

Answer 7

HistOplasMosis capsulatum

Ohio and Mississippi River Valley

Question 8

A 30 year old patient with advanced HIV infection comes into clinic complaining that food is sticking in the back of his throat and in his chest when he tries to swallow. You look in his mouth and see patches of whitish material on the surface that can easily be removed and leaves a red base. The organism most likely to cause this is:

Answer 8

Candida albicans

Question 9

Some fungi have two different morphological forms, yeast and molds. If they do, it is likely that:
A. The yeast form appears in the environment, the mold form in tissue
B. The mold form appears in the environment, the yeast form in tissue
C. Both forms appear in tissue
D. Neither form appears in tissue since these are nonpathogenic organisms

Answer 9

B. The mold form appears in the environment, the yeast form in tissue

Question 10

A 20 year old college student is part of an archeological team traveling to northeastern Arizona to help excavate Indian ruins. One month after returning she develops a flu-like illness with cough, myalgias, and low grade fever. A chest x-ray shows a small localized infiltrate in the right mid lung field. An organism to consider would be:
A. Histoplasma
B. Coccidioides
C. Legionella
D. Brucella

Answer 10

B. Coccidioides

Question 11

Three weeks after traveling to California to study desert flowers, a 32-year-old man develops a fever, chest pain, and sore muscles. Two days later, red tender nodules appear on the shins, and the right ankle is painful and tender. An x-ray of the chest shows a left pleural effusion. Which of the following is the most likely diagnosis?

(A) Blastomycosis

(B) Coccidioidomycosis

(C) Histoplasmosis

(D) Mycobacterium marinum infection

(E) Mycoplasma pneumoniae infection

Answer 11

(B) Coccidioidomycosis

Question 12

A patient has been awaiting a culture result for Candida. In the past the patient has had a reaction to Amphoteracin B. What other medication could you prescribe?

Answer 12

EchninoCANDIns

CANDida

Question 13

You have a patient that is neutropenic. What fungal infections would you want to watch out for?

Answer 13

Aspergillus

Candida

Question 14

Your patient has been on long-term corticosteroids and comes in with fever, chest pain, and hemoptosis. You believe she has developed an aspergillus infection. How would you treat the fungal infection?

Answer 14

Voriconazole

Question 15

You are in residency in Ohio and a patient comes in with pustular lesions on the skin with a mild lung infection. After a lung biopsy you see broad based budding yeast and determine that there is a mild blastomyces infection. How would you treat this patient?

Answer 15

Itraconazole

(Severe - Amphotericin B)

Question 16

A 24-year-old male presents with fever, headache,
chills, cough, and chest pain a few weeks after visiting
caves in the Ozark Mountains of northern Arkansas.
A chest radiograph reveals patchy lung infi ltrates and
hilar lymphadenopathy. An immunodiffusion test
detects antibodies in the patient’s serum to the H antigen
of the causative fungal agent. Which organism
caused the patient’s clinical manifestations?
(A) Candida albicans
(B) Histoplasma capsulatum
(C) Blastomyces dermatitidis
(D) Coccidioides immitis
(E) Cryptococcus neoformans

Answer 16

Histoplasm capsulatum