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Disease 3 > Fungal Disease > Flashcards

Fungal Disease Flashcards

1
Q

Describe the etiology of a fungal infection of the lungs

A

Spore produce a frothy yeast like substance
PMN and macrophages engulf spores
Pulmonary capillaries dilate
Alveolar epithelium swells
Regional lymph nodes become involved

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2
Q

Which lung surfaces are most commonly affected by fungal infections?

A

Apical and posterior segments of the upper lobes are most commonly affected

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2
Q

What can be a long term result of fungal infection of the lungs?

A

Fibrosis and calcification of lung parenchyma replaces granulomas
Lung tissue retracts and grows firm

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3
Q

What can severe cases of fungal infection result in?

A

Tissue necrosis
Granulomas
Cavity formation

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4
Q

What kind of disorder are fungal infection survivors left with?

A

Restrictive pulmonary disorder

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5
Q

What are the three most threatening fungal infections of the lungs?

A

Histoplasmosis
Coccodioidomycosis
Blastomycosis

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6
Q

What is the most common fungal infection of the lungs in the united states?

A

Histoplasmosis

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7
Q

What is another name for histoplasmosis?

A

Ohio valley fever

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7
Q

Where is histoplasmosis particularly prevalent?

A

Ohio, michigan, illinois, mississippi, missouri, kentucky, tennessee, georgia, arkansas

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8
Q

What fungus causes histoplasmosis?

A

Histoplasma capsulatum

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9
Q

Where can the spores of histoplasmosis be found?

A

Soil with bird turds

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10
Q

What disease presents similarly to histoplasmosis?

A

Tuberculosis

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11
Q

Why do most people with histoplasmosis not seek medical help?

A

Only 40% demonstrate symptoms
Only 10% feel sufficiently sick enough to seek medical help

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12
Q

What is the most common form of histoplasmosis?

A

Asymptomatic primary histoplasmosis

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12
Q

Who is the most susceptible to a histoplasmosis infection?

A

HIV/AIDS patients

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13
Q

What are the 4 forms that histoplasmosis can take?

A

Asymptomatic primary histoplasmosis
Acute symptomatic histoplasmosis
Chronic histoplasmosis
Disseminated histoplasmosis

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13
Q

What evidence will be present in a patient who had contracted asymptomatic primary histoplasmosis?

A

Smalled healed lesion in lung parenchyma
Calcified hilar lymph nodes
Patients will test positive with distoplasmin skin test

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14
Q

What determines the form that a histoplasmosis infection takes?

A

An individuals immune response dictates the form the histoplasmosis patient takes

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15
Q

What severe symptoms would a patient with acute symptomatic histoplasmosis present with?

A

Acute pulmonary syndrome
Severe SOB

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16
Q

What mild symptoms would a patient with acute symptomatic histoplasmosis present with?

A

Fever
Muscle pain
Headache
Dry hacking cough
Chills
Chest pain
Weight loss
Sweats

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17
Q

What is acute symptomatic histoplasmosis also called?

A

Spelunkers lung
Frequently develops in cave explorers who recessive excessive exposure to bat shit as they raise dust in caves

18
Q

What does the chest xray of a patient with acute symptomatic histoplasmosis?

A

Kind of looks star speckled

19
Q

What occurs in chronic histoplasmosis?

A

Infiltration and cavity formation in the upper lobes of one or both lobes

19
Q

Who is chronic histoplasmosis most commonly seen in?

A

Middle aged men who smoke

20
Q

What patients are more likely to have disseminated histoplasmosis?

A

Vulnerable populations
Very young/old
Compromised immune system

21
Q

What tissues/samples can be used to culture histoplasmosis?

A

Blood
Sputum
Tissue from lymph node
Lung tissue
Bone marrow

22
Q

What is the gold standard for testing and diagnosis histoplasmosis?

A

Fungal culture

23
Q

What tissues are at risk if histoplasmosis disseminated?

A

Pretty much everything

24
Q

What do people infected with Coccidioidomycosis present with?

A

Fever, chest pain, cough, headaches, malaise

25
Q

How long does it take for a histoplasmosis to culture?

A

4 weeks

25
Q

What are the three tests for histoplasmosis?

A

Fungal culture - gold standard, but takes a long time
fungal stain - very accurate but invasive
Serological testing -fast, but not as accurate

26
Q

Where is Coccidioidomycosis endemic to?

A

Hot dry regions

26
Q

Coccidioidomycosis is also known as

A

California fever
Desert rheumatism
San joaquin valley disease
Valley fever

27
Q

How does chronic Coccidioidomycosis present?

A

Nodular growths in lungs
Cavity formation in the lungs

28
Q

How does disseminated Coccidioidomycosis present?

A

Swollen lymph nodes, meninges, spleen, liver, kidney and adrenal glands
Skin lesions accompanied by joint pain in ankles and knees

29
Q

Where is blastomycosis endemic to?

A

South central and midwestern united states and canada

29
Q

How can Coccidioidomycosis be diagnosed?

A

Direct visualization of distinctive spherules in microscopy of patients sputum, tissue exudates, biopsies or spinal fluid
Blood tests that can detect antibodies to the function
Culture the organisms

29
Q

What is blastomycosis also known as?

A

Chicago disease
Gilchists disease
North american blastomycosis

30
Q

How does blastomycosis infection present?

A

Fever, cough, hoarseness, joint and muscle aches, possible pleuritic pain
Productive cough, purulent sputum
Skin lesions

31
Q

How is blastomycosis diagnosed?

A

Relies on direct visualization of yeast in sputum smears
Culturing the fungus

32
Q

What are opportunistic fungal pathogens that infect the lungs?

A

Candida albicans
Cryptococcus neoformans
Asperigillus

33
Q

Where is aspergillus typically found?

A

Soil, vegetation, leaf detritus, food, and compost heap
Air of granaries, barns and silos

33
Q

What can cause a candida albicans infection?

A

Inhaled steroid medications without washing mouth

34
Q

What can an aspergillus infection present as?

A

Allergic bronchopulmonary aspergillus, associated with asthma

34
Q

What distinctive formation can be found in the lungs as a result of aspergillus?

A

Aspergilloma = fungus ball that colonizes in a healed lung scar or abscess from a previous disease

35
Q

What findings would be present on a patient with a fungal infection in their lungs present with?

A

Decreased volumes, flows, capacities

36
Q

What would radiologic findings show in a patient with a pulmonary fungal infection?

A

Increased opacity
Cavity formation
Pleural effusion
Calcification and fibrosis
Right ventricular enlargement

37
Q

What is an RTs role in treating a patient with a pulmonary fungal infection?

A

Supportive treatment
Oxygen therapy
Bronchopulmonary hygiene
Mechanical ventilation

38
Q

What is the treatment of choice for treating pulmonary fungal infections?

A

Amphotercicin B

39
Q

What is an alternative medication that can be used to treat fungal infections?

A

Azole antifungal agents
Fluconazole and itraconazole

Disease 3 (9 decks)

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