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8th > Chapter 160- Superficial Fungal infection > Flashcards

Chapter 160- Superficial Fungal infection Flashcards

1
Q

Most common cause of dermatophytosis in the skin

A

Trichophyton rubrum

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2
Q

Most common cuase of tinea capitis in the United States

A

Trichophyton tonsurans

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3
Q

Asymptomatic superficial fungal infection of hair shaft

A

Piedra

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4
Q

Dermatophytes have ability to attach to, invade, and use ___ as source of nutrition

A

Keratin

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5
Q

Matching type

  1. Trichophyton
  2. Microsporum
  3. Epidermophyton
  4. Tinea nigra
  5. Black piedra
A. Skin
B. Hair
C. Nails
D. A and B
E. A and C
F. All of the above
A
  1. F
  2. D
  3. E
  4. A
  5. B
  6. B
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6
Q

Asexual spore produced by by segmentation of hyphae

A

Arthroconidia

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7
Q

Melanin in the cell walls of its conidia, hyphae or both results in darkly colored fungus

A

Dematiaceous

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8
Q

Dermatophyte growth pattern with hyphae and air spaces within hair shaft

A

Favus

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9
Q

Long filamentous fungus cells forming a branching network called mycelium

A

Hyphae

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10
Q

Unlike the ___ geophilic and zoophilic infections, anthropophilic infections are often ___ in nature

A

Sporadic; epidemic

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11
Q

Most common geophilic dermatophyte cultured from humans

A

Microsporum gypseum

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12
Q

Most common cause of tinea capitis in Europe

A

Microsporum canis

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13
Q

Prevalence and severity of fungal infections increase with HIV infection.
True or False

A

False, only severity

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14
Q

Dermatophyte infections are ___ times more prevalent in males than females

A

5

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15
Q

Tinea means Latin for

A

Worm

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16
Q

First step of dermatophyte infection

A

Successful adherence of arthroconidia to keratin via adhesin to result in alteration of gene expression

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17
Q

Defective ___ cell-mediated immunity results in chronic or recurrent dermatophytosis

A

TH1

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18
Q

__ response does not appear to be protective for fungal infections

A

TH2

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19
Q

__ promote development of TH17 cells from naive T cells via STAT3 to induce transcription

A

IL1B, TGFB, IL6

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20
Q

Polymorphisms of ___ and ___ are associated with increased risk of invasive fungal diseases

A

TLR 1 and TLR4

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21
Q

Polymorphisms of ___ are associated with cutaneous candidiasis

A

TLR3

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22
Q

Contents of modified Sabouraud medium

A 
4% peptone
1% glucose
Agar
Water
\+
Chloramphenicol
Cycloheximide
Gentamicin
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23
Q

Modified Sabouraud medium inhibits growth of (6)

A 
NonCandida albicans
Cryptococcus
Prototheca sp
Phaeoanellomyces werneckii
Scytalidum
Ochroconis gallopava
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24
Q

Dermatophyte test medium makes use of indicator ___ which turns from ___ to ___ in presence of dermatophytes due to highly ___ environment

A

Phenol red
Yellow to bright red
Alkaline (ammonium)

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25
Q

Fungal HPX stains (2)

A

PAS (pink)

Grocott methenamine silver (black)

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26
Q

KOH examination may yield false negative in up to __% of cases

A

15

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27
Q

Most commonly used isolation medium for dermatophytes and serves as medium on which most morphologic descriptions are based

A

Sabouraud dextrose agar

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28
Q

Matching type

  1. Smooth walled microconidia; used for ID
  2. Smooth walled macroconidia; used for ID
  3. Rough walled macroconidia; used for ID

A. Trichophyton
B. Microsporum
C. Epidermophyton

A

A
C
B

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29
Q

Equivocal KOH results should be biopsied before treatment.

True or False

A

False, may be treated despite lack of confirmation

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30
Q

Most specific test for onychomycosis

A

Culture

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31
Q

Most sensitive test for onychomycosis

A

PAS examination of nail clippings

32
Q

Used to differentiate T. Rubrum from T. Interdigitale

A 
1. Urease test ; 2. Hair perforation test
\+ : interdigitale
- : rubrum
3. Potato dextrose agar
None: interdigitale
Cherry red: rubrum
33
Q

Matching type

  1. T. Tonsurans
  2. T. Concentricum
  3. T. Violaceum
  4. T. Verrucosum
  5. T. Equinum
  6. T. Megninii

A. Histidine
B. Inositol
C. Nicotinic acid
D. Thiamine

A

1-3 D
4 B &;; D
5 C
6 A

34
Q

Examples of endothrix (5)

A 
T. Tonsurans
T. Violaceum
T. Soudanense
T. Gourvilii
T. Yaoundei
35
Q

Examples of ectothrix with yellow green fluorescence (4)

A

M. Canis
M. Audouinii
M. Distortum
M. Ferrugineum

36
Q

Reveal pteridine flourescence of hair infected with fungal pathogens

A

Wood lamp (365nm)

37
Q

Dermatophytoses involving hair bearing skin and nails can be treated with topical antifungals.
True or False

A

False, oral antifungals

38
Q

Matching type wirh pregnancy category

  1. Fluconazole
  2. Griseofulvin
  3. Itraconazole
  4. Terbinafine
A A
B B
C C
D D
E X
A

D
E
C
B

39
Q

Matching type

  1. Amorolfine
  2. Butenafine
  3. Ciclopirox
  4. Clotrimazole
  5. Econazole
  6. Zinc pyrithione
A A
B B
C C
D D
E X
A 
- 
 C
 B
 B
 C
C
40
Q

Matching type

  1. Efinaconazole
  2. Gentian violet
  3. Ketoconazole
  4. Miconazole
  5. Povidone iodine
  6. Selenium sulfide
A A
B B
C C
D D
E X
A 
C
-
C
-
C
C
41
Q

Most common genera isolated in the United Stated

A

Trichophyton
T. Rubrum
T. Interdigitale

42
Q

Microsporum species that are anthropophilic (2)

A

M. Audouinii

M. Ferrugineum

43
Q

Matching type

  1. T. Simii
  2. M. Canis
  3. T. Interdigitale
  4. T. Verrucosum
  5. T. Erinacei
A. Rodents
B. Hedgehogs
C. Primates
D. Cattle
E. Cats, dogs, horses
A 
C
E
A
D
B
44
Q

In Africa, the most common cause of tinea capitis are the ff (3)

A

M. Audouinii
T. Soudanense
T. Violaceum

45
Q

Dermatophyte, Greek word for

A

Skin plant

46
Q

Acute inflammatory dermatitis at sites distant from primary inflammatory fungal infection

A

Dermatophytid or id reaction

47
Q

Pathogenesis of superficial fungal infection involves 3 steps:

A

Adherence
Invasion
Host reaction

48
Q

Components of fungal cell wall that inhibits keratinocyte proliferation and cell mediated immunity (3)

A

B glucan
Galactomannan
Chitin

49
Q

TLRs located on cell surface

A

1,2,4,5,6

50
Q

TLRs in the endosomes

A

3,9

51
Q

Macrophage ingest but is unable to digest T. Rubrum conidia due to increase (2) but no increased (2)

A

TNFA, IL10

IL12, NO

52
Q

Critical for inducing TH17 responses

A

Dectin 2

53
Q

TH17 secretion of (3) activates epithelial cells, granulopoiesis, neutrophil recruitment, production of chemokines crucial for epithelial immuniry against fungi

A

IL17A
IL17F
IL22

54
Q

Mutations associated with chronic mucocutaneous candidiasis and chronic dermatophyte infections (3)

A

Polymorphisms of C type lectin receptor Dectin 1
Mutations of CamARD9
Decreased IL17 production

55
Q

KOH does not allow for speciation of fungal species.

True or False

A

True

56
Q

Aids penetration of KOH into keratin (2)

A

DMSO

Low intensity flame

57
Q

Used for speciation of superficial fungi based on macro-/microscopic and metabolic characteristics

A

Culture

58
Q

Development of colonies can take ___ days for E. Floccosum and ___ weeks for T. Verrucosum

A

5-7 days

4 weeks

59
Q

For isolation of dermatophytes but does not allow for direct identification

A

Dermatophyte test medium

60
Q

ID of isolated fungi is facilitated by subculture on specific media such as (2)

A

Potato dextrose agar

Borelli Lactritmel agar

61
Q

Matching type (PDA pigment)

  1. T. Rubrum
  2. T. Interdigitale
  3. M. Audouinii
  4. M. Canis

A. Cherry red
B. Salmon pink
C. Yellow
D. None

A

A
D
B
C

62
Q

Diff. M. Audouinii and M. Canis

A

Polished rice
+: M. Canis
-. M. Audouinii

63
Q

Biopsy is useful in ff settings (3)

A
  1. Tx of recalcitrant or widespread eruption
  2. Majocchi granuloma
  3. Presence of hyphae in hair shafts on scalp
64
Q

All oral antifungal agents can be used for onychomycosis except

A

Griseofulvin

65
Q

First line Tx for onychomycosis

A

Terbinafine 250mg/ day for 6-12 weeks

66
Q

First line for tinea capitis (Microsporum)

A

Griseofulvin 20-25mkday for 2-8 weeks (micro), if 2 years old and above
10-15mkday for 2-8 weeks (ultramicro), 2 years old and above
10mkday, 1 mo to 2 years

67
Q

Topical antifungal for onychomycosis (4)

A

Ciclopirox 8% solution x 1 week
Amorolfine 250mg/5ml x 6-12 mos
Tioconazole 28% BID x 12 mos
Eficonazole 10% solution x 12 mos

68
Q

All topical antifungals are pregnancy Category C except

A

Clotrimazole
Ciclopirox
Cat. B

69
Q

All topica imidazoles are 1% except

A

Sertaconazole
Ketoconazole
Miconazole

70
Q 
Matching type
Moa
1. Inhibits DNA, RNA, protein synthesis
2. Broad spectrum germicidal agent
3. Cytostatic effects on keratinocytes
4. Distorts hyphae and mycelial growth
5. Keratolytic
A. SeS 1-2.5%
B. Zn pyrithione 1-2%
C. Povidone iodine 7.5%
D. Ciclopirox 8%
E. Tolnaftate 1%
A 
D
C
A
E
B
71
Q

Only topical triazole available

A

Efinaconazole 10%

72
Q

Can be used in children >/= 12 years old (4)

A

Terbinafine/ Butenafine

Ketoconazole/ Econazole

73
Q

Used in children older than 2 years old

A

SeS

Tolnaftate

74
Q

Ciclopirox 0.77% cream and suspension can be used in children more than ___

A

10 years old

75
Q

Ciclopirox 0.77% gel and 0.1% shampoo can be used in children more than ___

A

16 years old

76
Q

Ciclopirox 8% solution can be used in children more than ___

A

12 years old

8th (28 decks)

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