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PHA 415 - Remediation > Exam 6 - Invasive Fungal Infections > Flashcards

Exam 6 - Invasive Fungal Infections Flashcards

1
Q

Which type of fungal pathogen is a frequent nosocomial infectious pathogen?

A

Candida

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2
Q

Name the two types of microbial resistance.

A

1) Primary - prior to exposure

2) Secondary - after exposure

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3
Q

Name the 5 primary pathogens of systemic infections.

A

1) Histoplasma
2) Blastomycosis
3) Coccidioides
4) Sporotrichosis
5) Crytpococcus

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4
Q

Name the 5 opportunistic pathogens in systemic infections.

A

1) Candida
2) Aspergillus
3) Mucor (Zygomycetes)
4) Fusarium
5) Trichosporon

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5
Q

What is the name of the nonspecific diagnostic test for any fungal pathogen?

A

B, D-glucan (Fungitel)

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6
Q

What type of test is the B, D-glucan (Fungitel) diagnostic test?

A

A nonspecific test for any fungal pathogen

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7
Q

What is the name of the diagnostic test that is specific for Aspergillus spp?

A

Galactomannan test

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8
Q

What type of diagnostic test is the Galactomannan test?

A

One that is specific for Aspergillus spp.

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9
Q

Which two types of pathogens have urinary antigen tests?

A

Cryptococcal

Histoplasma

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10
Q

The following are risk factors for which pathogen:

  • Indwelling catheter/IV line
  • Surgery
  • Broad-spectrum antibiotics
  • TPN therapy
  • IV drug users
  • Immunocompromised pts
  • -Neutropenic, Immunosuppressed, HIV/AIDS?
A

Systemic candidiasis

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11
Q

A ____ ____ provides a definitive diagnosis of systemic candidiasis.

A

A BLOOD CULTURE provides a definitive diagnosis of systemic candidiasis.

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12
Q

In both immunocompromised and immunocompetent adults, what is the initial/empiric treatment for Systemic Candida?

A

Echinocandin - i.e., Micafungin

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13
Q

In the treatment of systemic candida, if the species is albicans what is the next step?

A

To convert to an AZOLE - i.e., Fluconazole

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14
Q

How long do you treat a systemic candida infection for?

A

14 days after the FIRST negative blood culture

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15
Q

Where is Aspergillosis found?

A

Soil, plant debris, air

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16
Q

Who is at risk for Aspergillosis infections?

A

Immunocompromised pts

  • Stem cell transplant
  • Solid organ transplant
  • Immunodeficient pts
  • Bone marrow cancers
  • Steroid use
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17
Q

What 3 ways can Aspergillosis present?

A

1) Allergic bronchopulmonary aspergillosis
2) Aspergilloma
3) Invasive Aspergillosis (IA)

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18
Q

How are Aspergillosis infections diagnosed? (4)

A

1) Tissue/specimen cultures
2) Chest x-rays, CT scans
3) Bronchial alveolar lavage
4) Galactomannan assay

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19
Q

What is the name of the diagnostic test that tells you if the fungi is Aspergillosis spp.?

A

Galactomannan test

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20
Q

What is FIRST LINE TREATMENT for Invasive Aspergillosis?

A

VORICONAZOLE

-IV, then PO x 6-12 weeks

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21
Q

How long is Voriconazole used in Invasive Aspergillosis?

A

IV, then PO x 6-12 weeks

22
Q

Name 2 alternatives to treating Invasive Aspergillosis.

A

1) AmphoB (lipid)

2) Isavuconazole

23
Q

Name the 4 salvage treatments in treating Invasive Aspergilosis.

A

1) Caspofungin
2) Micafungin
3) Posaconazole
4) Itraconazole

24
Q

Name the 2 options for FIRST LINE TREATMENT of allergic bronchopulmonary Aspergillosis.

A

1) Itraconazole
2) Voriconazole

with steroid

25
Q

Name the 3 options of FIRST LINE TREATMENT for Aspergilloma.

A

1) Surgery, then ….

2) Itraconazole OR
3) Voriconazole

26
Q

Who is primarily impacted by Histoplamosis?

A

Immunocompromised pts

27
Q

What are the S/S associated with Histoplasmosis?

A
  • Fever
  • Cough
  • Fatigue
  • Chills
  • HA
  • Chest pain
  • Body aches within 3-17 days after inhaling fungal spores
28
Q

T/F: For some pts, histoplasmosis is self-limiting.

A

TRUE - Immunocompetent pts

29
Q

Name two types of pts that need treatment for Histoplasmosis.

A

1) Chronic histoplasmosis in the lungs

2) Disseminated histoplasmosis (immunosuppressed pts)

30
Q

What is the treatment for severe or moderately severe Histoplasmosis treatment?

A

Lipid Amphotericin B for 1-2 weeks, followed by Itraconazole for 12 weeks

-May also need a steroid for 1-2 weeks for the lungs

31
Q

What is the treatment for Disseminated Histoplasmosis?

A

Lipid Amphotericin B for 1-2 weeks, followed by Itraconazole FOR 12 MONTHS

32
Q

How is CNS histoplasmosis treated?

A

Lipid Amphotericin B for 4-6 weeks, followed by Itraconazole for 12 months

33
Q

Name the 3 concerning SE associated with Amphotericin B.

A

1) Nephrotoxicity
2) Hypokalemia
3) Hypomagnesia

34
Q

What causes hypokalemia and hypomagnesia in using Amphotericin B?

A

Distal tubular acidosis

35
Q

What is the mechanism of nephrotoxicity in Amphotericin B?

A

Proximal tubular damage

36
Q

Where can Coccidioidomycosis be found?

A

Soil and dirt

37
Q

How do pts obtain a Coccidioidomycosis infection?

A

Inhaling arthroconidium

38
Q

What do pts complain of with a Coccidioidomycosis infection?

A

Respiratory illness

39
Q

Name the primary treatment in Coccidioidomycosis infections.

A

FLUCONAZOLE

40
Q

Who is at risk for Coccidioidomycosis infections?

A

Pt with winter homes in AZ, southern CA

41
Q

T/F: For immunocompetent pts, a blastomycosis infection can be self-limiting.

A

TRUE

42
Q

What is the treatment for Blastomycosis infections?

A

Lipid Amphotericin B for 1-2 weeks until improvement, then LD Itraconazole followed by maintenance for 6-12 months

43
Q

T/F: Cryptococcus neoformans is rare in immunocompetent pts.

A

TRUE

44
Q

What two organ systems does Cryptococcus neoformans affect?

A

Lungs

CNS

45
Q

What is the GOLD standard for diagnosing Cryptococcus neoformans?

A

Culture the organism

-Antigen detection on CSF or serum

46
Q

What is the treatment for mild to moderate Cryptococcus neoformans in the lungs?

A

FLUCONAZOLE

47
Q

What is the treatment of severe infection in the lungs of Cryptococcus neoformans or CNS infection?

A

Amphotericin B + Flucytosine

48
Q

What is the name of the common skin infection caused by rose bushes or other plant material?

A

Sporotrichosis

49
Q

What is the causative organism of Sporotrichosis?

A

Sporothrix schenckii

50
Q

How is Sporotrichosis treated?

A

Itraconazole (Sporonox) for 3-6 months

PHA 415 - Remediation (11 decks)

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