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FA - Micro - Mycology Flashcards

0
Q

Treatment for systemic mycosis?

A
  1. Fluconazole (local infection)
  2. Itraconazole (local infection)
  3. Amphotericin B (systemic infection)
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1
Q

3 features about systemic mycoses?

A
  1. ALL can cause pneumonia
  2. Can disseminate
  3. ALL caused by dimorphic fungi: cold (20C)=mold, heat(37C)=yeast.
    Only exception: Coccidioidomycosis - spherule (not yeast) in tissue.
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2
Q

Systemic mycosis can mimic what?

A

TB (granuloma formation), EXCEPT, unlike TB, have no person-person transmission.

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3
Q

Histoplasmosis - Endemic location?

A

Mississippi and Ohio river valleys.

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4
Q

Histoplasmosis cause?

A

Pneumonia.

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5
Q

Histoplasmosis special feature?

A

Macrophage filled with Histoplasma (smaller than RBC) - Histo Hides (within macros).
BIRDS (eg starlings) and BATS droppings.

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6
Q

Blastomycosis - Endemic location?

A

States east of Mississippi River and Central America.

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7
Q

Blastomycosis - cause?

A

Inflammatory lung disease - can disseminate to skin and bone.
Forms granulomatous nodules.

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8
Q

Blastomycosis - Special feature?

A

Broad-base budding (same as RBC).

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9
Q

Coccidioidomycosis - Endemic location?

A

Southwestern US, California.

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10
Q

Coccidioidomycosis - cause?

A
  1. Pneumonia
  2. Meningitis
  3. Can disseminate to bone and skin.
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11
Q

Coccidioidomycosis - Special features?

A
  1. Case rate UP after earthquakes (spores in dust are thrown up in the air and become spherules in the lungs).
  2. Spherule (MUCH LARGER than a RBC) filled with endospores.
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12
Q

Paracoccidioidomycosis - Endemic location?

A

Latin America.

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13
Q

Paracoccidioidomycosis - Special feature?

A

Budding yeast with “captain’s wheel” formation (MUCH LARGER THAN RBC).

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14
Q

Tinea versicolor - Cause?

A

Malassezia spp. (Pityrosporum spp.) ==> A yeast-like fungus (NOT A DERMATOPHYTE despite being called tinea).

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15
Q

Tinea versicolor - Pathogenesis?

A

Degradation of lipids produces acids that damage MELANOCYTES –> hypopigmented and/or PINK patches.

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16
Q

Tinea versicolor - When?

A

Can occur ANY TIME of year, but more common IN SUMMER ==> Hot, humid weather.

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17
Q

Tinea versicolor - treatment?

A
  1. Topical miconazole

2. Selenium sulfide (Selsun)

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18
Q

Tinea versicolor - Microscopic morphology?

A

“Spaghetti and meatball” appearance.

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19
Q

Other tineae?

A 
Tinea pedis 
Tinea cruris (groin)
Tinea corporis
Tinea capitis 
Tinea unguium (onychomycosis, on fingernails)
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20
Q

Other tineae - Features?

A

Pruritic lesions with central clearing resembling a RING.

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21
Q

Other tineae - causes?

A

By dermatophytes - Microsporum, Trichophyton, Epidermophyton.

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22
Q

Dermatophytes - Microscopic morphology?

A

BRANCHING SEPTATE HYPHAE visible on KOH preparation with BLUE FUNGAL STAIN.

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23
Q

C.albicans - causes?

A
  1. Oral-esophageal thrush in immunocompromised (Neonates+ Steroids + Diabetics + AIDS).
  2. Vulvovaginitis (diabetes, use of antibiotics).
  3. Diaper rash
  4. Endocarditis in IVDA
  5. Disseminated candidiasis (any organ)
  6. Chronic mucocutaneous candidiasis
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24
C.albicans - Treatment?
Vaginal --> Topical azole. Oral/esophageal --> Nystatin, fluconazole, or caspofungin. Systemic --> Fluconazole, ampho B, caspofungin.
25
C.albicans - dimorphic?
YES: 1. Pseudohyphae and budding yeasts at 20C. 2. Germ tubes at 37C.
26
Aspergillus fumigatus - causes?
1. Invasive aspergillosis 2. Allergic bronchopulmonary aspergillosis (ABPA) 3. Aspergillomas in lung cavities (especially after TB) 4. Some produce aflatoxins --> HCC.
27
Invasive aspergillosis - features?
1. In immunocompromised | 2. In Chronic granulomatous disease
28
Allergic bronchopulmonary aspergillosis - features?
1. Asthma - CF associations. | 2. May cause bronchiectasis/eosinophilia.
29
A.fimugatus - Dimorphic?
NO - Septate hyphae that branch at 45 degree angle ==> Produces conidia in radiating chains at END of CONIDIOPHORE.
30
C.neoformans - causes?
1. Cryptococcal meningitis. | 2. Cryptococcal encephalitis ("soap bubble" lesions in brain), primarily in IMMUNOCOMPROMISED.
31
C.neoformans - Morphology + Capsule?
Heavily encapsulated yeast. | 5-10μm with NARROW BUDDING.
32
C.neoformans - Dimorphic?
NO!!!
33
C.neoformans - where?
In soil, PIGEON droppings.
34
C.neoformans - transmission?
Inhalation with hematogenous dissemination to meninges.
35
C.neoformans - Culture?
Sabouraud agar.
36
C.neoformans - Stain?
1. India ink ==> Clear halo. | 2. Mucicarmine ==> Red INNER CAPSULE.
37
C.neoformans - diagnostic test?
Latex agglutination test detects polysaccharide capsular antigen and is more specific.
38
Mucormycosis - target group?
1. Ketoacidotic diabetics. | 2. NEUTROPENIC patients (Eg leukemia).
39
Mucormycosis - Pathogenesis?
Fungi proliferate in blood vessel WALLS when there is excess ketone and glucose ==> Penetrate cribriform plate ==> Enter brain.
40
Mucormycosis - Features?
1. Rhinocerebral, frontal lobe abscesses. 2. Headache 3. Facial pain 4. Black necrotic eschar on face. 5. May have cranial nerve involvement. 6. CAVERNOUS SINUS THROMBOSIS.
41
Mucormycosis - Treatment?
Surgical debridement + Amphotericin B.
42
Mucor - Microscopy?
Irregular, broad, nonseptate hyphae branching at wide angles.
43
P.jirocevii?
Pneumocystis pneumonia - Diffuse interstitial pneumonia.
44
P.jirovecii - transmission?
Inhaled.
45
P.jirovecii - CXR/CT appearance?
Diffuse, BILATERAL ground-glass opacities on CXR/CT.
46
P.jirovecii - Diagnosis?
Lung biopsy or lavage.
47
P.jirovecii - microscopy?
Disc-shaped yeast forms on METHENAMINE SILVER stain of lung tissue.
48
P.jirovecii - treatment?
1. TMP-SMX 2. Pentamidine 3. Dapsone (proph only) 4. Atovaquone (proph only)
49
P.jirovecii - prophylaxis in AIDS patients?
Start when CD4 count drops <200cells/mm^3 in HIV patients.
50
Sporothrix schenckii - Causes?
Sporotrichosis.
51
Sporothrix schenckii - Morphology?
Dimorphic - CIGAR-SHAPED budding yeast that grows in branching hyphae with rosettes of CONIDIA. ==> Lives on vegetation.
52
Sporothrix schenckii - pathogenesis?
Spores are traumatically intoduced into the skin, typically by a thron (rose gardener's disease) --> Local pustule or ulcer with nodules along draining lymphatics --> Ascending lymphangitis. Little systemic illness. ==> DISSEMINATED DISEASE possible in IMMUNOCOMPROMISED host.
53
Sporotrichosis - treatment?
Itraconazole or potassium iodide.
54
"(San Joaquin)" Valley fever:
CODDIDIOIDOMYCOSIS.
55
Tinea capitis:
Head + Scalp: 1. Associated with LYMPHADENOPATHY. 2. Alopecia. 3. Scaling.
56
Tinea corporis:
Torso: | ==> Erythematous scaling rings ("ringworm") + Central clearing.
57
Tinea corporis can be acquired from contact with ...?
An infected CAT or DOG.
58
Tinea cruris - Occurs in ...?
INGUINAL AREA.
59
Tinea cruris - Often does NOT show ...?
The CENTRAL clearing seen in tinea corporis.
60
Tinea pedis - 3 varieties:
1. Interdigital (MC). 2. Moccasin distribution. 3. Vesicular type.
61
P.jirovecii - Originally classified as ...?
PROTOZOAN. Now, yeast-like FUNGUS.

Microbiology (46 decks)

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