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Infect & Immune 2 AW, DJT & ISB > DJT L1 Fungal infections > Flashcards

DJT L1 Fungal infections Flashcards

1
Q

What are fungi?

A

Eukaryotic organisms - have true nuclei

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2
Q

Fungi are divided into (2)

A

Yeast and moulds

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3
Q

yeasts are uni or multicellular?

moulds “ “ “ “

A

Yeast - unicellular

Mould - multi-cellular

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4
Q

Yeast have what shaped cells?

A

Round/oval

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5
Q

Yeasts reproduce by

A

budding or fission

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6
Q

Moulds are also called……

and produce ………

A

filamentous fungi

produce hyphae

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7
Q

Fungi are carbon heterotrophs and therefore require…..

A

preformed organic compounds as carbon sources

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8
Q

Fungi may be geophilic, ………………. or ……………..

A

zoophilic or anthrophilic

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9
Q

Why is there a higher chance of side effects with fungal therapies

A

because eukaryotes

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10
Q

moulds replicate via

A

spore formation

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11
Q

Dermatophytes are ……… with an affinity for ……………

A

moulds

keratin - (skin, nails, hair)

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12
Q

How are dermatophyte infections diagnosed?

A

visually

or clippings for analyze cause and monitor treatment progress

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13
Q

Common symptoms of dermatophytes?

A

itching
burning
pain
irritation

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14
Q

ring worm is also called…

and may occur (3)

A

tinea

scalp, groin, skin

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15
Q

First line treatment for tinea corporis and crusis?

Second line?

A

1st - Topical imidazole
(but also terbinafine creams)
bd until 2 weeks after inprovment

2nd - Terbinafine
(or itraconazole)
- for immunocompromised or therapy fails

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16
Q

Tinea capitis treatment

A

Sensitivity testing advised!

oral (griseofulvin/terbinafine)
and
ketoconazole shampoos (or terbinafine creams to prevent risk of transmission)

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17
Q

Griseofulvin/terbinafine are effective against which tineas?

A

Gris - trichophyton tonsurans und microsporum spp

Terb - trichophyton tonsurans

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18
Q

Griseofulvin has a broad/narrow therapeutic range?

And is only effective against ……. infections

A

narrow

dermatophyte

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19
Q

Griseofulvin is c/i in patients with (4)

A
  • severe liver disease
  • systemic lupus erythematosus (SLE)
  • breastfeeding
  • pregnancy (men should not father children in 6 months)
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20
Q

Why are long courses of gris needed?

A

because it does not persist in keratinous tissue after the end of therapy

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21
Q

Griseofulvin s/e (4)

A 
MAIN
-may impair skilled tasks
-GI
-cognitive
-hypersensitivity
ALSO peripheral neuropathy, leucopenia photosensitivity
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22
Q

When to take griseofulvin?

A

with or after fatty food

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23
Q

Does griseofulvin interact with other drugs?

A

Yes

  • potentiates alcohol
  • decreased efficacy of COC, coumarins, ciclosporin
24
Q

Tinea pedis is also known as

and is usually found…

A

athletes foot

interdigit
skin becomes scaled, macerated and fissuring

25
Q

3 causative organisms of athletes foot

A
  • trichophyton rubrum
  • trichophyton mentagrophytes
  • epidermophyton floccosum
26
Q

1st line treatment of athlete’s foot?

2nd line?

A

-Imidazole cream 2-4 weeks
(or terbinafine or undecorated)

-oral treatment (terbinafine/itraconazole)

27
Q

What is the daily dose of terbinafine?

A

250mg (6 weeks)

28
Q

What is the daily dose of itraconazole

A

100mg (30 days)

29
Q

What is the daily dose of Griseofulvin?

A

500mg (4 weeks)

30
Q

Terbinafine has ……% oral BA

A

80%

31
Q

Terbinafine is contraindicated in (2)

A

pregnancy

liver disease

32
Q

Terbinafine concentrates itself where in the body?

A

keratinous tissues

33
Q

s/e terbinafine (4)

A

GI
hepatotoxicity with prolong therapy
serious skin reactions
rare psychiatric disturbances

34
Q

Interactions with terbinafine (2)

A

OCP - breakthrough bleeding
Rifampicin reduces levels

(generally show negligible inhibition of P450)

35
Q

Causative species of fungal nail (4)

onychomycosis

A
  • Trichophyton rubrum
  • Epidermophyton floccosum
  • Trichophyton mentagrophytes
  • Candida
36
Q

There are 6 subtypes of fungal nail infection but ……… is the most common

A

DLSO

37
Q

What is necessary in fungal nail treatments?

A

clippings as treatment is diffuclt

38
Q

Management of systemic fungal nail infections

A

Terbinafine 250mg 6 weeks - 6 months
or
Itraconazole 200mg daily -3 months
(or alternative ‘pulse’ therapy’ as it stays in keratin)

39
Q

When is topical treatment of fungal nails suitable (2)

A

2 nails or superficial or early
OR
people who cannot take systemic

40
Q

2 options for local treatment of fungal nails

A

Tioconazole (bd 6-12 months)

Amorolfine (once/twice weekly up to 12 months)

41
Q

What is pityriasis versicolor?

A

Yeast infection - colonisation of the stratum corneum

causes pigmentation disorder

42
Q

Why does pityriasis occur at puberty?

A

yeast has a high affinity for fatty acids in the sebum

common in hot climate
relapse is common

43
Q

Treatment for pityriasis

A

Topical - ketoconazole/selenium shampoo,
imidazole/terbinafine creams

Systemic (if wide spread or topical fails)

  • itraconazole
  • fluconazole
44
Q

Daily dose of fluconazole?

A

5omg

45
Q

Diagnostic test for pityriasis?

Also may present as….

A

UV lamp

may also present as seborrheic dermatitis

46
Q

Oral ketacoconazole MHRA durg safey updats says

A
  • no longer suitable for first line therapy or for an superficial conditions
  • specialist use only
  • risk v benefits
  • serious hepatotoxicity increases with duration of treatment
  • monitor liver function
47
Q

Superficial candida infection species: (3)

A

c. albicans
c. glabrata
c. krusei
and many more

48
Q

Treatment for oral candida depends on….? (3)

A

other medications
HIV status
and multiple sites of infection

49
Q

Topical therapies for candida? (2)

A
  • imidazole antifungals (miconazole oral gel)

- polyene antifungals (nystatin suspension)

50
Q

Oral therapies for candida

A

Fluconazole

50mg daily for 7-14 days

51
Q

vaginal thrush is common when (3)

A

pregnancy
diabetes mellitus
broad spec antibiotics

(>4 cases/year needs investigating)

52
Q

most common cause of genital candida

A

c albicans

53
Q

Diagnosis of vaginal thrush is…

A

symptomatic unless there is an STI risk

54
Q

Treatment of vaginal thrush

A 
topical imidazoles (1-3 days)
oral fluconazole (150mg stat)
55
Q

Cutaneous candidiasis occurs in whom? (4)

A

babies with nappy rash
immuno compromised
systemic antibiotics
skin maceration

56
Q

Management if cutaneous candidiasis?

A
  • Skin care advice
  • topical imidazole

-oral fluc only when severe (and not in children)

Infect & Immune 2 AW, DJT & ISB (9 decks)

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