Endemic Mycoses

Question 1

in environment, histo, blasto, and cocci exist as

they convert to (morphology)

Answer 1

free living molds

histo, blasto convert to budding yeast

cocci converts to endosporulating spherules with endospores

Question 2

regionality blastomycosis

Answer 2

midwest, detla south, non-coastal NE

Question 3

regionality coccidiomycosis

Answer 3

desert south

Question 4

regionality histplasmosis

Answer 4

MI river delta south+southern midwest

Question 5

in host morphology, histoplasma capsulatum

Answer 5

oval budding yeast

narrow bund neck

inside phagoctytes+extracellular

Question 6

histoplasma capsulatum convert to yeast form in

Answer 6

deep lung alveoli

Question 7

if symptoms occur in histoplasma capsulatum, occur at ___ days

Answer 7

3-17 days post exposure

Question 8

symptomology histoplasmosis

Answer 8

pulmonary - coin lesions and “buck shot” TB-like appearance on CXR

acute pericarditis

**disseminated **- spread via lymphatics, sites reach in mononuclear phagocytes

**ocular histoplasmosis syndrome - **blindness, ocular scaring due to fibrosing inflammatory response

**fibrosing mediastinitis - **enlargement of lymph nodes > leakage of caeous nodes into mediastinum

Question 9

ocular histoplasmosis syndrome

Answer 9

blindness due to retinatl scaring resulting from fibrosing inflammatory resposne angainst yeast

Question 10

fibrosing mediastinitis in histoplasmosis

Answer 10

excessive fibrotic response

lymph enlargement > leakage of antigen from caseous lymph nodes > inflammatory response > fibrosis

Question 11

in histoplasmosis infection, mitocondria have receptors for _____ on the surface of ____ facilitating pahgocytosis

Answer 11

receptors for CD2/CD18 integrins on surface of macrophagees

Question 12

treatment histoplasmosis infection

Answer 12

anti-fungal drug as adjunct

typically self-limited

Question 13

for ___ in endemic areas, skin test reactivity does not indicate “active infection” because most have been exposed

Answer 13

histoplasmosis

Question 14

histoplasma capsulata can be seen in ___ and ___ specimens

Answer 14

PAS and GMS stained specimens

Question 15

outbreak locations, (qualitiy) blastomyces dematidis

Answer 15

stream, river areas vordered by rich moist soil

Question 16

morphology blastomycecs dermatidis in host

Answer 16

large budding yeast (8-30 micrometers) with broad neck

Question 17

infection of blastomyces dermatidis occurs via

incubation time

Answer 17

inhalation of microconidia, transmoring at body temperature to yeast

incubaion time is 4-6 weeks

Question 18

symptomology blastomycosis

Answer 18

self-limited or chronic granulomatous suppurative mycosis

bronchogenic corcinoma

histoplasmosis

tuberculis

cataneous: painless, subcutaneous nodules or papules

Question 19

blastomycosis vs TB

Answer 19

unlike TB, blasto lesions rarely caseate or calcify

Question 20

in ___, phagocytosis may not occur due to size of the yeast cell

Answer 20

blastomycosis infection

Question 21

coccidiodies immitis, posadasii, outbreak areas (quality)

Answer 21

soil rich in organic material

calcium sulfate and borates

hot arid or semi-arid climates

Question 22

morphology in host coccidiodes

Answer 22

arthroconidia converting within 72 hours to spherules containing small endospores

Question 23

morphology in environment coccidiodes

Answer 23

septate mulicellular hyphae

alternate cells developing into barrel shaped arthrocondidia