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Neville and Damm > Ch6 Fungal and Protozoal > Flashcards

Ch6 Fungal and Protozoal Flashcards

1
Q

Candida albicans is dimorphic. Which form is innoculous and which form is pathologic?

A

Yeast = innoculous…hyphal = invasion of host tissue

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2
Q

What % of people carry candida as normal oral flora?

A

up to 50%

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3
Q

__________ is typically responsible for an ACUTE(rapid) expression of pseudomembranous candidiasis WHEREAS __________ usually produce a CHRONIC (slow-onset, long-standing) form.

A

Antibiotic exposure….immunologic problems

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4
Q

What are the 9 clinical types of oral candidiasis?

A
  1. Pseudomembranous (thrush) 2.Erythematous: 2a: acute atrophic candidiasis… 2b: Central Papillary atrophy/median rhomboid glossitis 2c: Chronic multifocal 2d: Angular chelitis 2e: Denture stomatitis (chronic atrophic candidiasis, denture sore mouth) 3. Hyperplastic (candidal leukoplakia) 4. Mucocutaneous 5. Endocrine-candidiasis syndromes
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5
Q

Which form of candidiasis is associated with a “bald” appearance of the tongue? What is the alternate name?

A

erythematous candidiasis (acute atrophic candidiasis)

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6
Q

What is the term for an erythematous candidiasis that presents with central papillary atrophy AND mucosal candidal infection at other sites?

A

Chronic multifocal candidiasis

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7
Q

What is an alternate name for angular chelitis?

A

Perleche (PER - Le - CHE)

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8
Q

What are the % break downs for the culprit organisms in angular chelitis?

A

20% candida alone, 60% candida + staph aureus, 20% staph aureus alone

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9
Q

What is the term for perioral angular chelitis?

A

CHEILO-CANDIDIASIS

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10
Q

Where is candidal leukoplakia typically located?

A

anterior buccal mucosa

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11
Q

Which cytokine is critical to mucosal immunity related to C. Albicans?

A

IL-17

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12
Q

In some patients with mucocutaneous candidiasis, mutations in WHICH GENE have been found?

A

AIRE (autoimmune regulator)

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13
Q

Young patients with mucocutaneous candidiasis should be evaluated periodically because any one of a variety of _______ abnormalities (i.e., endocrine-candidiasis syndrome, autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy [APECED] syndrome/autoimmune polyendocrinopathy syndrome, type 1), as well as ________, may develop in addition to the candidiasis

A

ENDOCRINE…iron deficiency anemia

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14
Q

What 4 endocrine disturbances are associated with mucocutaneous candidiasis?

A

Hyopthyroidism, hypoparathyroidism, hypoadrenocorticism (addison’s disease), and diabetes mellitus

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15
Q

Besides PAS and GMS stains to find candida, what other technique can be used?

A

KOH prep

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16
Q

What is the organism responsible for histoplasmosis?

A

Histoplasma capsulatum

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17
Q

What is the treatment for acute and chronic histoplasmosis?

A

none for acute, chronic gets treated with IV amphoteracin B

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18
Q

What is the causative agent for Blastomycosis?

A

Blastomyces dermatitidis

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19
Q

What type of agar is used to grow blastomyces?

A

Sab-our-aud agar

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20
Q

Which fungal infection most closely mimics SCC when it manifests in the oral cavity?

A

Histoplasmosis

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21
Q

Which 3 fungal infections are known for producing granulomatous inflammation?

A

Histoplasmosis, Blastomycosis, Aspergillosis

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22
Q

Actue blastomycosis most closely resembles which disease? What about chronic blastomycosis?

A

active = pneumonia…chronic = TB

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23
Q

What type of cough is seen with blastomycosis?

A

productive cough

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24
Q

What type of cough is seen with histoplasmosis?

A

dry cough

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25
Q

Which fungus is known for a doubly refractile cell wall?

A

blastomyces dermatitdis

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26
Q

Which fungus is known for having pseudoepitheliomatous hyperplasia overlying the infection?

A

blastomycosis

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27
Q

Which fungal infection: blasto or histo can be discovered with serologic testing?

A

Histo = serology…blasto won’t show

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28
Q

What animal is known for transmitting the paracoccidiomycosis fungus?

A

the 9 banded armadillo

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29
Q

What is the male:female ratio of paracoccidio infection?

A

Male 15:1 Female

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30
Q

What is the name for the oral lesion associated with paracoccidio?

A

“mulberry-like ulceration”

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31
Q

What are two buzzwords for paracoccidio histology?

A

“mickey-mouse ears” OR “mariner’s wheel”

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32
Q

What is the name for the causative agent in paracoccidiomycosis?

A

paracoccidioides brasiliensis

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33
Q

What is the alternate name for paracoccidioides brasiliensis?

A

South American blastomycosis

34
Q

What is the causative agent(s) in valley fever (AKA San Joaquin Valley fever)?

A

coccidioides immitis, coccidioides posadasii

35
Q

Where in the world is coccidiodes immitis found?

A

alkaline, semiarid, desert soil of the SOUTHWESTERN United States and Mexico

36
Q

Where in the world is coccidiodes posadasii found?

A

Central & South America

37
Q

Coccidiodes is dimorphic. What form are they in nature? What form are they when they cause an infection in a host?

A

mold in nature, YEAST in an infected host

38
Q

Define mold & yeast

A

mold: one organism with many filaments called hyphae and many identical nuclei as well. Yeast: one cell organism

39
Q

Which fungal infection can cause an EM-like cutaneous eruption? OR Erythema nodosum

A

Coccidiodes

40
Q

What two stains help identify coccidio?

A

PAS and GMS (gomori methiamaine silver)

41
Q

What organism transmitts Cryptococcus?

A

birds, most commonly pigeons (because they live in other bird shit)

42
Q

What is the morphology of an infectious crypto?

A

YEAST

43
Q

Which fungi infect as YEAST?

A

HBPCC: Histo, Blasto, Paracoccidio, Coccidio, Crypto

44
Q

Which fungi infect as HYPHAE (mold)?

A

CAM: Candida, Aspergillosis, Mucor

45
Q

What two organisms cause Aspergillosis? Which one is MOST common?

A

Flavus, fumigatus… fumigatus is most common

46
Q

What is the organism responsible for crypto infection?

A

cryptococcus neoformans

47
Q

What was the most life threatening fungal infection in the 1990’s AIDS population?

A

Crypto

48
Q

What is unique about crypto’s natural and infectous morphology?

A

its a YEAST in both nature and in pathologic form

49
Q

Which fungus can you stain with mucicarmine? Why?

A

Crypto becuase it has a mucopolysaccharide capsule

50
Q

What is the bastard stepchild of cryptococcus neoformans that also can cause infection, mostly found in tropical/subtropical environments but outbreaks have been found in the pacific northwest?

A

Cryptococcus Gattii

51
Q

What is the key for crypto’s histology?

A

round/ovoid surrounded by a “halo” (the mucopolysaccharide capsule)

Looks similar to Blasto witht the double-refractile cell wall

52
Q

What metal is associated with growth of mucor? What two conditions put patients at risk?

A

iron…insulin dependent diabetics (iron spikes during DKA), thalassemia (pts given deferoxamine to chelate iron)

53
Q

What is unique about mucor histology? What effect does this have on bodily tissues?

A

90deg branching…causes necrosis by invading small vessles

54
Q

What stain can be used at frozen section to point out mucor?

A

Cal-co-fluor White

55
Q

What is the second most common fungal infection (behind candidiasis)?

A

Aspergillosis

56
Q

Which fungal infection is associated with nosocomial infection?

A

Aspergillosis

57
Q

What is the term for the clinical appearance of an allergy affecting the sinuses? What appears histologically?

A

allergic fungal sinusitis…eosinophilic inspissated mucin with sheets of lymphocytes and eosinophils

58
Q

What are the 3 names for a mass of aspergillus fungal hyphae?

A

fungus ball, mycetoma, aspergilloma

59
Q

What is an aspergilloma called that has undergone dystrophic calcification?

A

antrolith

60
Q

What two immunocompromised patients are at highest risk for disseminated aspergillosis?

A

leukemia or high dose corticosteroids

61
Q

Where is disseminated aspergillosis first symptomatic?

A

lungs (site of innoculation)

62
Q

What is the histology of an aspergillosis hyphae?

A

branching at acute angles

63
Q

What is the buzzword for the histology of a fungus ball (aspergilloma) in the paranasal sinus?

A

spore-bearing structures called fruiting bodies

64
Q

What stain can help you find aspergillosis?

A

GMS (Gomori Methenanine Silver)

65
Q

What is the infectous organism in toxoplasmosis?

A

toxoplasma gondii

66
Q

What are two very susceptible populations to toxo?

A

immunocompromised and fetuses

67
Q

What animal is the definitive host of toxo? Where in this animal does it mutiply?

A

cat…GI…excreted in the feces

68
Q

When does a Toxo infection yeild the most severe effects on a fetus?

A

1st trimester

69
Q

What are the TORCH organisms that can be passed from mother to fetus and cause congenital anomalies?

A

Toxo….Other (syphilis, VZV, Parvo)….Rubella….CMV….Herpes

70
Q

What are the key histological findings of toxo?

A

eosinophilic macrophages in germinal centers, subcapsular, and sinusoidal regions of a lymph node

71
Q

What organism transmits Leishmaniasis? What organism is the natural reservoir?

A

sandfly = transmission….dogs = reservior

72
Q

What are the 7 countries most likely to host leishmania?

A

India, Afghanistan, Saudi Arabia, Syria, Algeria, Peru, and Brazil

73
Q

What is the name for the female leishmania? What is the name for the flagellated form?

A

amastigote (no flagella)…promastigotes

74
Q

Which Leish causes CUTANEOUS Leish in the NEW world?

A

Leishmania mexicana

75
Q

Which Leish causes MUCOCUTANEOUS in the new world?

A

Leishmania braziliensis

76
Q

Which Leish causes VISCERAL infection in the OLD WORLD?

A

Leishmania donovani

77
Q

Which Leish causes VISCERAL infection in the NEW WORLD?

A

Leishmania braziliensis

78
Q

Which is the most common form of Leishmaniasis? What is its characteristic skin lesion?

A

cutaneous…VOLCANO

79
Q

What is the buzzword for visceral leishmaniasis??

A

kala-azar = black fever

80
Q

What morphology of Leishmania is seen on histology?What three special stains can show Leishmania?

A

The amastigote….Giemsa, Brown-Hopps Gram Stain, or Leishman stain

81
Q

Since the 1920’s what type of meds were used for Leishmaniasis?

A

Antimony (heavy metals)

Neville and Damm (72 decks)

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