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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
Fungal HPX stains (2)
PAS (pink) | Grocott methenamine silver (black)
26
KOH examination may yield false negative in up to __% of cases
15
27
Most commonly used isolation medium for dermatophytes and serves as medium on which most morphologic descriptions are based
Sabouraud dextrose agar
28
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 C B
29
Equivocal KOH results should be biopsied before treatment. | True or False
False, may be treated despite lack of confirmation
30
Most specific test for onychomycosis
Culture
31
Most sensitive test for onychomycosis
PAS examination of nail clippings
32
Used to differentiate T. Rubrum from T. Interdigitale
``` 1. Urease test ; 2. Hair perforation test + : interdigitale - : rubrum 3. Potato dextrose agar None: interdigitale Cherry red: rubrum ```
33
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
1-3 D 4 B &;; D 5 C 6 A
34
Examples of endothrix (5)
``` T. Tonsurans T. Violaceum T. Soudanense T. Gourvilii T. Yaoundei ```
35
Examples of ectothrix with yellow green fluorescence (4)
M. Canis M. Audouinii M. Distortum M. Ferrugineum
36
Reveal pteridine flourescence of hair infected with fungal pathogens
Wood lamp (365nm)
37
Dermatophytoses involving hair bearing skin and nails can be treated with topical antifungals. True or False
False, oral antifungals
38
Matching type wirh pregnancy category 1. Fluconazole 2. Griseofulvin 3. Itraconazole 4. Terbinafine ``` A A B B C C D D E X ```
D E C B
39
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 ```
``` - C B B C C ```
40
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 ```
``` C - C - C C ```
41
Most common genera isolated in the United Stated
Trichophyton T. Rubrum T. Interdigitale
42
Microsporum species that are anthropophilic (2)
M. Audouinii | M. Ferrugineum
43
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 ```
``` C E A D B ```
44
In Africa, the most common cause of tinea capitis are the ff (3)
M. Audouinii T. Soudanense T. Violaceum
45
Dermatophyte, Greek word for
Skin plant
46
Acute inflammatory dermatitis at sites distant from primary inflammatory fungal infection
Dermatophytid or id reaction
47
Pathogenesis of superficial fungal infection involves 3 steps:
Adherence Invasion Host reaction
48
Components of fungal cell wall that inhibits keratinocyte proliferation and cell mediated immunity (3)
B glucan Galactomannan Chitin
49
TLRs located on cell surface
1,2,4,5,6
50
TLRs in the endosomes
3,9
51
Macrophage ingest but is unable to digest T. Rubrum conidia due to increase (2) but no increased (2)
TNFA, IL10 | IL12, NO
52
Critical for inducing TH17 responses
Dectin 2
53
TH17 secretion of (3) activates epithelial cells, granulopoiesis, neutrophil recruitment, production of chemokines crucial for epithelial immuniry against fungi
IL17A IL17F IL22
54
Mutations associated with chronic mucocutaneous candidiasis and chronic dermatophyte infections (3)
Polymorphisms of C type lectin receptor Dectin 1 Mutations of CamARD9 Decreased IL17 production
55
KOH does not allow for speciation of fungal species. | True or False
True
56
Aids penetration of KOH into keratin (2)
DMSO | Low intensity flame
57
Used for speciation of superficial fungi based on macro-/microscopic and metabolic characteristics
Culture
58
Development of colonies can take ___ days for E. Floccosum and ___ weeks for T. Verrucosum
5-7 days | 4 weeks
59
For isolation of dermatophytes but does not allow for direct identification
Dermatophyte test medium
60
ID of isolated fungi is facilitated by subculture on specific media such as (2)
Potato dextrose agar | Borelli Lactritmel agar
61
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 D B C
62
Diff. M. Audouinii and M. Canis
Polished rice +: M. Canis -. M. Audouinii
63
Biopsy is useful in ff settings (3)
1. Tx of recalcitrant or widespread eruption 2. Majocchi granuloma 3. Presence of hyphae in hair shafts on scalp
64
All oral antifungal agents can be used for onychomycosis except
Griseofulvin
65
First line Tx for onychomycosis
Terbinafine 250mg/ day for 6-12 weeks
66
First line for tinea capitis (Microsporum)
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
Topical antifungal for onychomycosis (4)
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
All topical antifungals are pregnancy Category C except
Clotrimazole Ciclopirox Cat. B
69
All topica imidazoles are 1% except
Sertaconazole Ketoconazole Miconazole
70
``` 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% ```
``` D C A E B ```
71
Only topical triazole available
Efinaconazole 10%
72
Can be used in children >/= 12 years old (4)
Terbinafine/ Butenafine | Ketoconazole/ Econazole
73
Used in children older than 2 years old
SeS | Tolnaftate
74
Ciclopirox 0.77% cream and suspension can be used in children more than ___
10 years old
75
Ciclopirox 0.77% gel and 0.1% shampoo can be used in children more than ___
16 years old
76
Ciclopirox 8% solution can be used in children more than ___
12 years old

8th (28 decks)

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