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OP - Yield > 6: fungal and protozoal > Flashcards

6: fungal and protozoal Flashcards

1
Q

chronic multifocal candidiasis sites

A

median rhomboid glossitis + other

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2
Q

angular cheilitis causes %

A

20% candida
20% staph
60% both

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3
Q

perioral candidiasis prereq and name

A

moist skin

cheilocandidiasis

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4
Q

mucocutaneous candidiasis genetics

A

AIRE mutation

auto AB against endocrine glands

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5
Q

AIRE mutation

A

mucocutaneous candidiasis

auto AB against endocrine glands

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6
Q

auto AB against endocrine glands

A

AIRE mutation

mucocutaneous candidiasis

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7
Q

APECED signs and risks

A

autoimmune polyendocrinopathy candidiasis ectodermal dystrophy sybdrome
increased risk of oral and esophageal carcinoma

hypothyroidism, hypoparathyroidism, hypoadrenocortism (addisons) and diabetes

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8
Q

most common systemic fungal infx in US

A

histoplasmosi

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9
Q

rich moist soil fungi

A

histoplasmosis and blastomycosis (rivery valleys – Ohio, Missisippi)

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10
Q

desert soil fungus

A

coccidioidomycosis

SW US, mexico

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11
Q

painful erythematous nodules on leg

A

erythe,a nodosum

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12
Q

valley fever

A

coccidiodidomycosis + erythema nodosum

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13
Q

pigeon poop fungus

A

cryptococcosis

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14
Q

pigeon poop meningitis

A

crytpo

headache, fever, vomiting

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15
Q

mucormycosis aka and cause

most important form

A

aka zygomycosis or phycomycosis
zaused by zygomycetes (mucor, absidia)
rhinocerebral form most important

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16
Q

pts at risk for mucor

A

uncontrolled diabetes _ DKA (increased Fe levels)

+ pts with thalassemia using deferoxamine (increases iron levels)

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17
Q

mucor micro

A

non septate brancing hyphae

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18
Q

most common aspergillus

A

90% A fumigatus

but also A flavus

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19
Q

forms of aspergillosis

A

non invasive (allergic fungal sinusitis or fungus ball) or invasive

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20
Q

risk for disseminated aspergillosis

A

leukemia or corticosteroids

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21
Q

aspergillus micro

A

septate brancing hyphae, smaller than mucor

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22
Q

toxoplasma gondii host

A

cat – oocysts in feces

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23
Q

congenital toxoplasmosis

A

blindness, mental retardation, delayed psychomotor development

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24
Q

most common oral fungal infx (how common?)

A

candidiasis

carried by 30-50% of ppl

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25
Q

form of candida

A

dimorphic:

innocuous yeast and invasive hyphae

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26
Q

classic forms of candida (4)

A

pseudomembranous, erythematous, chronic hyperplastic, and mucocutaneous

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27
Q

most common form of candidiasis

A

acute atrophic, often 2/2 abx

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28
Q

central papillary atrophy on tongue

A

median rhomboid glossitis

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29
Q

white plaque that does not wipe off but is fungal

A

chronic hyperplastic cnaididasis

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30
Q

candida tx

A

nystatin, clotrimazole (topical), ketoconazole, fluconazole (systemic)

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31
Q

candida stain

A

PAS 0 carbohydrates, KOH, Grocott-Gomori methenamine silver

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32
Q

histoplasmosis lives in

A

droppings from chickens, pigeons, birds, bats

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33
Q

forms of histoplasmosis

A

acute (most common)
chronic (similar to TB: upper lobe changes, calcifictiona)
disseminated *oral lesions ~ ulcer ~ SCC

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34
Q

histoplasmosis stain

A

PAS or Grocott-Gomori

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35
Q

blastomycosis aka

A

chicago dz

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36
Q

chicago dz aka

A

blastomycosis

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37
Q

blasto habitat

A

similar to histo – humid moist soil (Ohio, Missisippi) but extends north

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38
Q

forms of blastomycosis

A

acute 0 ~pneumonia

chronic (mimics TB)

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39
Q

blastomycosis on skin

A

facial nodules that enlarge and become verrucous or ulcerated
oral similar to SCC

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40
Q

blastomycosis stain

A

PAS or Grocott-Gomori

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41
Q

oral paracoccidioidomycosis

A

mulberry ulcerations

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42
Q

paracoccidiodiomycosis stain, look

A

PAS, Grocott

Mickey mouse ears or mariner’s wheel

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43
Q

mariner’s wheel

A

paracoccidiodiomycosis

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44
Q

mickey mouse ears

A

paracoccidiodiomycosis

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45
Q

desert soil fungus

A

coccidioidomycosis immitis (SW US and Mexico)

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46
Q

forms of coccidioidomycosis

A

acute,
chronic progressive pulmonary (mimics TB)
and disseminated

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47
Q

coccidioidomycosis on skin

A

EM-like skin eruption or erythema nodosum (subQT painful erythe,atous nodules)

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48
Q

coccidioidomycosis + erythema nodosum

A

valley fever

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49
Q

disseminated coccidioidomycosis

A 
skin lesions (papules, abscess, verrucous plaques, granulomatous nodules)
central face, esp nasolabial fold

oral lesions rare

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50
Q

coccidioidomycosis histo

A

large 20-60nm round spherules with numerous endospores

51
Q

large sphersules with endospores

A

coccidioidomycosis

52
Q

coccidioidomycosis stain

A

PAS, Grocott

53
Q

cryptococcus full name

A

cryptococcus neoformans

54
Q

special stain for crypto

A

mucous capsule is mucopolysaccharide (mucicarmine) positive

55
Q

most common locations for crypto

A

meninges and skin

56
Q

crypto meningitis presentation

A

headache, fever, vomiting

57
Q

skin crypto

A

erythematous papules/pustules that may ulcerate and discharge material rich in organisms

58
Q

oral crypto

A

rare – similar to SCC

59
Q

zygomycetes (x2)

A

mucor, absidia

60
Q

oral mucormycosis

A

black and necrotic palate ulceration – extension from sinus involvement

61
Q

mucor histo

A

non-septate branding hyphae at 90 degrees

extensive tissue destruction (predilection for vessels –> infarction and necrosis)

62
Q

non-spetate brandinh hyphae at 90 degrees

A

mucor

63
Q

mucor mortality

A

60% rate

64
Q

invasive aspergillus when

A

AIDS, CT, organ transplant, uncontrolled diabetes

65
Q

antroliths

A

aspergilloma when undergoes dystrophic calcification

66
Q

oral aspergillosis

A

gingival ulcerations and swelling with surrounding gray/violaceous hue

67
Q

feature of eos in aspergillus fungal ball

A

charcot-leyden – eosinophilic hexagonal pyramidal crystals

68
Q

aspergillus fungal ball

A

GMS and fontana-masson

69
Q

tx for aspergillus (x3)

A

aspergilloma - debridement
fungal ball - debridement + corticoids
invasive - voriconazole

70
Q

aspergillus histo

A

fruiting bodies, septate branching hyphae at 40 acute angle

71
Q

rhinosporidiosis cause

A

rhinosporidium seeberi

72
Q

rhinosporidiosis geography

A

90% in India and Sri Lanka

73
Q

rhinosporidium histo

A

100-300um cysts or sporangia with numerous endospores

immature - small, mature - large

74
Q

toxo symptoms

A

like mono in immunocompetent host

75
Q

toxo histo

A

triad of follicular hyperplasia, clusters of eputhelioid histiocytes, plasmacytoid B cells

76
Q

toxoplasmosis diagnosis

A

serum Ab titers

77
Q

cysticercosis cause

A

Taenia solium

78
Q

taenia solium cause

A

cysticercosis

79
Q

how acquire cysticercosis

A

undercooked pork

80
Q

cneruocysticercosis most common symptom

A

epilepsy

81
Q

cysticercosis histo

A

cystic cavity with larvae
scolex at cephalic region and caudal to it, with duct like invagination
invagination lined by eosinophilic membrane
caudal – ovoid basophilic calcified corpuscles

82
Q

mucocutaneous candidiasis eponym

A

whitaker syndrome

83
Q

whitaker syndrome

A

mucocutaneous candidiasis

84
Q

mucocutaneous candidiasis inheritance and genetics

A

most sporadic but AR if familial

Due to IL-17 and IL-22 / Autoimmune regulator gene (AIRE) mutation on chromosome # 21

85
Q

syndromic consequences of AIRE mutation

A 
 Endocrine-candidiasis syndrome ; Autoimmune polyendocrinopathy-candidiasis-
ectodermal dystrophy ( APECED ) / Autoimmune polyendocrinopathy syndrome type 1

 Iron def Anemia
 mucocutaneous candidiasis

86
Q

endocrine and other problems in APECED

A 
 Hypothyroidism
 Hypoparathyroidism
 Hypoadrenocorticism (Addison disease)
 DM
 10% have esophageal cancer
87
Q

external presentation of APECED

A

 Erythematous candida on tongue
 Nail dystrophy
 Corneal keratopathy

88
Q

 Erythematous candida on tongue
 Nail dystrophy
 Corneal keratopathy

A

APECED

89
Q

APECED mutation where

A

21q22.3

90
Q

21q22.3 mutation

A

APECED

91
Q

smallest relevant fungus

A

histoplasma capsulatum

92
Q

largest relevant fungus

A

coccidiodes posadasii/immitis

93
Q

refractory cell wal fungus

A

balstomyces dermatitidis

94
Q

non septate hyphae fungus

A

mucormycotina (absidia, mucor, rhizomucor, rhizopus)

95
Q

endocrine consequence of disseminated histoplasmosis

A

addison disease if affects adrenal

96
Q

psudoepitheliomatous hyperplasia which fungus

A

blastomyces

97
Q

acute blastomycosis clinical course

A

 Resembles PNEUMONIA

 High fever, night sweats, chest pain, malaise, productive cough

98
Q

chronic blastomycosis clinical coure

A

 More common than acute
 Mimic TB but NO CALCIFICTAIONS
 Low grade fever, night sweats, chest pain, malaise

99
Q

ppl at risk for chronic histoplasmosis

A

older, immunosuppressed,

emphysematous white men

100
Q

lungs affected in which histoplasmoses

A

acute and cronic

disseminated starts affecting extrapulmonary sites

101
Q

2-10% of disseminated histoplasmosis in which population

A

HIV

102
Q

paracoccidiomycosis aka and population predilection

A

(South American blastomycosis)

Men >Women 15:1

103
Q

paracoccidiomycosis organ damage

A

Addison Disease

104
Q

which fungus can result in addison disease

A

paracoccidiomycosis

105
Q

paracoccidiomycosis histo

A

Mickey mouse ears = Mariner’s wheel= daughter buds

106
Q

Mickey mouse ears

A

paracoccidiomycosis

107
Q

Mariner’s wheel

A

paracoccidiomycosis

108
Q

4)Coccidioidomycosis aka

A

(San Joaquin Valley Fever

109
Q

(San Joaquin Valley Fever aka

A

Coccidioidomycosis

110
Q

Valley Fever what is

A

Coccidioidomycosis
Fever: Occasionally Allergic response is triggered causing erythema nodosum on
skin of legs that occur in conjugation with cocci

111
Q

Allergic response is triggered causing erythema nodosum on

skin of legs that occur in conjugation with cocci

A

Valley Fever

112
Q

Coccidioidomycosis geography

A

Alkaline , semiarid, desert soil / southwestern States and Mexico

113
Q

chronic Coccidioidomycosis

A

Mimics TB, persistent cough, hemoptysis, chest pain, low grade fever, weight loss.

114
Q

disseminated Coccidioidomycosis

which population

A

extra pulmonary = skin (most common) and LN,

Filipinos, blacks, native
Americans

115
Q

cryptococcosis animal spirit

A

pigeons

116
Q

crypto classic

A

Meningitis/ headache/ vomiting/skin/bone

117
Q

mucormycosis ions

A

Fe! DKA (ketoacidosis due to prevention of binding of Iron to transferrin = HIGH iron) and deferoxamine for thalassemia

118
Q

thalassemia patients at risj for (infx)

A

mucormycosis

119
Q

histo of noninvasive aspergillus

A

allergic fungal sinusitis which have tide lines

or fungal ball

120
Q

disseminated aspergillusw ho’s at rosk

A

leukemia or high steroids

121
Q

primary reservoir for leishmania

A

dogs and other mammals

sandfly vector

122
Q

most common leishmaniasis

A

cutaneous – mexicana

123
Q

kala azar

A

visceral leishmania
donovani old world
braziliensis new world

black discoloration, pancytopenia, hepatosplenomegaly, weight loss

124
Q

leishmania stains

A

giemsa, brown hopp

OP - Yield (19 decks)

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