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Cardiology > Funal Diseases > Flashcards

Funal Diseases Flashcards

1
Q

Are fungal diseases restrictive or obstructive?

A

restrictive

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2
Q

What anatomical alterations occur with fungal infections?

A

alveolar consolidation
alveolar capillary destruction
formation of cavities and caseous tubercles
fibrosis of the lung parenchyma w/ secondary calcification
increased broncial airway secrections

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3
Q

When spores are inhaled they reach the lungs and ______, producing a frothy yeast-like substance that leads to ___________ response.

A

germinate; inflammatory response

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4
Q

Anatomical changes in severe fungal infection mostly commonly involve which lung segments?

A

apical and posterior segments

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5
Q

T/F Humans have a relatively high resistance to fungal infections

A

true

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6
Q

What is the most common fungal infection in the U.S.?

A

histoplasmosis

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7
Q

Ohio Valley Fever is also known as

A

histoplasmosis

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8
Q

H cpsulatum is commonly found in what type of soil?

A

soil enriched with bird droppings

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9
Q

T/F Birds carry histoplasmosis

A

false. (however bats DO carry the spore)

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10
Q

The incubation period for histoplasmosis is

A

about 17 days

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11
Q

Only ____% of those infected demonstrate symptoms and only ___% are ill enough to seek medical treatment

A

40% develop symptoms; 10% are severe enough to seek medical attention

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12
Q

What factors effect the patient response to the infection?

A

The individual’s immune system, the exposure (concentration, time exposed, # of spores inhaled)

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13
Q

The most common form of Ohio Valley Fever is

A

asymptomatic primary histoplasmosis

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14
Q

Signs and symptoms of asymptomatic primary histoplasmosis

A

no signs and symptoms

residual sign of infection may be seen as small healed lesion of the lung parenchyma and/or calcified hilar lymph nodes

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15
Q

Signs and symptoms of acute symptomatic histoplasmosis infection

A

MILD/SEVERE CASES- fever, muscle and joint pain, chills, sweats, headache, dry hacking cough, chest pain, weight loss

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16
Q

Severe actue histoplasmosis pulmonary is also called _____________

A

spelunker’s lung - acquired from excessive exposure to bat guano it is a serious and potential life threatening condition

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17
Q

Chronic pulmonary histoplasmosis is characterized by _____________ and is often self limiting (reaching an equilibrium)

A

cavity formation in the upper lobes;

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18
Q

What patient population is most likely to suffer from chronic pulmonary histoplasmosis?

A

middle aged men who smoke and/or those who already have comorbidity of emphysema or COPD

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19
Q

Disseminated histoplasmosis primarily affects what patient population?

A

very young or very old patients with compromised immune systems

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20
Q

T/F If untreated, disseminated histoplasmosis is usually fatal

A

true

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21
Q

The gold standard test for detecting histoplasmosis is _____

A

fungal culture

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22
Q

T/F Fungal culture is the test of choice to diagnose disseminated histoplasmosis

A

FALSE. Test takes 4 weeks or longer for fungus to grow and could cause fatal treatment delays-
also requires invasive procedure to obtain sample from lymph node, lung or bone marrow

23
Q

What are advantages and disadvantages of fungal stain for diagnostic testing?

A

advantage: 100% accurate

disadvanges- requires invasive procedure such as bronchoscopy for sputum or invasive tissue sampling

24
Q

What are the advantages/disadvantages of serology testing?

A

advantage- blood sample easy to obtain, test for antigen/antibody reaction are relatively fast and fairly accuracte
disadvantage- false negatives may occur in people who have compromised immune systems or who are infectived with other types of fungi

25
Q

What organism causes Valley Fever?

A

coccidioidomycosis

26
Q

Coccidioides immitis are _____ shaped fungi that are spread how?

A

sphere shaped;

carried by windborne dust particles

27
Q

Coccidiodomycosis is also known as

A

California Disease, Desert Fever, San Joaquin Valley Disease, Valley Fever

28
Q

T/F The fungus coccidioidomycosis is found in soils, plants, mammals, birds, reptiles and amphipians

A

true

29
Q

When C. immitis spores are inhaled they germinate in the lungs and form ____

A

thin-walled cells called spherules. The spherules produce endospores that make more spherules

30
Q

What ____ % of patients infected with coccidioidomycosis produce clinical symptoms? What are the s/s?

A

40%

coldlike symptoms such as fever, cough chest pain, headache and malaise

31
Q

One in ____ cases of coccidioidomycosis will not resolve and progresses to a chronic state

A

1 in 200

32
Q

The chronic progressive state of c. immitis is characterized by nodular growths called ___ and formation of what in the lungs?

A

fungomas;

cavities

33
Q

Disseminated coccidioidomycosis occurs in about ________

A

1 in 6000 exposed persons

34
Q

What are some of the characteristics of disseminated coccidioidomycosis

A 
involvement of the lymph nodes, meninges, spleen, liver, kidney, skin, and adrenals
Skin lesions (bumbs on face and chest) are commonly accompanied by arthralgia or arthritis in the knees and ankles (desert rheumatism)
35
Q

If untreated, disseminated coccidioidomycosis can lead to what?

A

meningitis and death

36
Q

Chicago disease aka Gilchrist’s disease is also called ____ and caused by ____

A

blastomycosis caused by blastomyces dermatitidis

37
Q

Blastomycosis inhabits areas high in ____

A

organic matter (forest soil, decaying wood, animal manure, abandoned buildings

38
Q

Blastomycosis is most common among what patient population?

A

pregnant women and middle aged african american men (also found in dogs, cats and horses)

39
Q

How does blastomycosis differ from histoplasmosis in clinical presentation?

A

blastomycosis requently results in productive cough with purulent sputum

40
Q

What are the first signs of blastomycosis infection?

A

subcutaneous nodules and skin lesions

41
Q

T/F Actute pulmonary blastomycosis may be self- limiting or progressive

A

true

42
Q

Progressive blastomycosis - clinical progression

A

nodules and abscesses develop in the lungs. Extrapulmonarye lesions involve skin, bones, reproductive tract, spleen liver kidney or prostate (skin lesions / subcutaneous nodes may be first signs of disease)

43
Q

T/F Standardized testing procedures for blastomycosis include cultures and skin tests

A

False- there are no standardized tests however cultures can be performed
The diagnosis is made from direct visualization of the yeast in sputum smears

44
Q

Name 3 opportunistic yeast pathogens

A

candida albicans,
cryptococcus neoformans
aspergillus

45
Q

Cryptococcus neoformans proliferates in the high nitrogen content of pigeon droppings and is proliferated _____

A

dried droppings scatter in the air and in dust

46
Q

Which patient populations are most likely to be infected with cryptococcus neoformans?

A

patients with HIV and those undergoing steroid therapy

47
Q

What is the most pervasive of all fungi?

A

aspergillus fumigatus

48
Q

What population is at a higher risk of being infected with aspergillus fumigatus?

A

persons breathing the air of granaries, barns, and silos

49
Q

General management of fungal disease (drug therapy)?

A

IV amphotericin B (Fungizone);ketoconazole, fluconazole,itraconazole and echinocandins

50
Q

What are the RT care treatment protocols for fungal infections?

A

O2 therapy to treat hypoxemia and decrease WOB and myocardial work AND bronchopulmonary hygiene therapy to enhance mobilizxation of secretions

51
Q

What is the most common fungal infection in the US?

A

histoplasmosis

52
Q 
Incidence of Histoplasmosis is especially high in which of the following areas?
1 Arizona
2 Mississippi
3 Nevada
4 Texas
A

MISSISSIPPI only

53
Q

Desert bumps, desert arthritis is associated with wich fungal disorder?

A

coccidioidomycosis

54
Q

Which of the following forms of histoplasmosis is characterized by healed lesions in the hilar lymph nodes as well as a positive skin test response?

a. disseminated infection
b. latent asymptomatic disease
c. chronic histoplasmosis
d. self limiting primary disease

A

b- latent asymptomatic disease

Cardiology (6 decks)

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