Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DERM > Fungal Infections > Flashcards

Fungal Infections Flashcards

1
Q

what are the means of which to dx fungal infections?

A
  • potassium hydroxide (KOH)
  • culture
  • biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

discuss the proper use KOH preparation

A
  • rub alcohol to site
  • use a #15 surgical blade & gently scrape
    • if it scales, scrape it!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

azoles

  • MOA
  • include what drugs?
  • clinical uses of each?
  • AEs?
A

“azoles”

  • MOA: demethylation of C14a in of lanasterol, a precursor of ergosteral (steroid in fungal cell walls)
  • specific uses:
    • fluconazole: all types of candida
    • itraconazole: blasomyces, coccididiodes, histoplasma
    • clotrimazole, miconazole: superficial fungal infections
    • voriconazole, isavuconazole: asperilligus
  • adverse effects (AE):
    • gynocomastia
    • impotence
    • liver dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which azole has the most severe AEs?

what are they?

A

ketoconazole

  • gynecomastia
  • impotence
  • liver dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

terbinafine

  • what kind of drug?
  • MOA?
  • have what clinical uses?
  • have what adverse effects?
A
  • includes: allyamine
  • MOA: inhibits squalene epoxidase -> decreases ergosterol
  • clinical uses:
    • onchomycosis - nail fungus
    • tinea capitis adults - scalp fungus
      • griseofulvin m/c used in children*
  • adverse effects:
    • GI upset
    • liver abnormalities
    • drug induced lupus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

griseofulvin

  • MOA?
  • have what clinical uses?
  • have what adverse effects?
A
  • MOA: disrupts microtubule formation → inhibiting mitosis
  • clinical uses: TOC for tinea capitis in children
  • adverse effects (AE): reduces efficacy of
    • oral contraceptives
    • warfarin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

polyenes

  • includes what drugs?
  • MOA?
  • have what clinical uses?
  • have what adverse effects?
A
  • includes: nystatin, amphotericin B
  • MOA: irreversibly finds to ergosterol -> increasing cell membrane permeability
  • clinical uses:
    • nystatin: candida infections
      • oral candidasis* “swish & swallow”*
      • topical for diaper rash
    • amphotericin B: serious systemic mycosis
  • AEs (amphotericin B)
    • NEPHROTOXICITY
    • fever/chills + hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does tinea look like on a KOH preparation?

A

branching, with septate hyphae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

tinea capitis

  • definition
  • demographics
  • presentation:
  • treatment:
A
  • pathogenesis: dermatophyte infection scalp and beard​
    • endothrix: arthroconidia on nterior of hair shaft
    • ectothrix: arthroconidia on exterior of hair shaft
  • demographics: childhood, M > F
  • presentation: scaling, pruritis, eventual -> loss of (hair)
  • treatment:
    • children: griseofulvin
    • adults: terbinifine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

kerion

  • pathogenesis
  • demographics
  • presentation
  • complications
  • treatment
A
  • pathogenesis: tinea capitis that progresses into furuncle
  • demographics: farm animal exposure
  • presentation: furuncle = painful, boggy, puritic
  • complications: may evolve into permanent alopecia so treat early!!
  • treatment: steroids ( & griseofulvin?)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

tinea barbae

  • pathogenesis
  • demographics
  • presentation
A
  • demographics: rare - always ask about farm animal exposure
  • presentation: unilateral involvement of the neck + face
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

tinea faciei

  • demographics
  • presentation
  • treatment
A
  • demographics:
    • female and children
    • possible hx of animal exposure
  • presentation:
    • annular configuration + pustules in the border
    • frequently on the upper lip + chin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

tinea corporis

  • pathogenesis
  • presentation
  • treatment
A
  • pathogenesis: dermatophyte (m/c T. rubum) infects the body/trunk
  • presentation: plaques on body / trunk that are
    • annular with central clearing
    • scaly
    • have advancing edge
  • treatment: azoles
    • ​localized - econazole, ketoconazole (topicals)
    • extensive - fluconazole (oral)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what can you NOT use to treat tinea corporis?

A

lotrisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

tinea cruris

  • demographics
  • presentation
  • treatment
A
  • demographics: M>F
  • presentation: plaques on groin, perineal & perianal skin that are
    • party clear in center (but not annular w/ central clearing like corporis)
    • scaly
    • erythematous
  • treatment:
    • meds: azoles (like corporis)
    • lifestyle: reduce perspiration / moisture + loose fitting clothing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how are tinea cruris lesions different differ from tinea corporis lesions?

A
  • both: scaly, erythematous plaques
    • corporis: annular with central clearing - on body / trunk
    • cruris: spreads peripherally with moderate clearing in center - on groin, perineum, perianal
17
Q

what distinguish tinea cruris from candidal intertrigo?

A
  • tinea cruris
    • spares scotrum
    • plaques with partial central clearing
    • more scaling / less fissuring than c. albicans
  • c. albicans
    • involves scotum
    • beefy red plaques with satellite lesions
    • more fissuring / less scaling than tinea cruris
18
Q

tinea pedis

  • presentation
  • diagnosis
  • treatment:
A
  • presentation: often “seeded” by onchomycosis
    • erythema and desqmation
      • interdigital type (m/c): between the toes
      • mocassin type: “two foot + one hand” - often seen with tinea manuum (rash on palmer / interdigital hand)
  • diagnosis: KOH - branching, septate hyphae
  • treatment: azoles (like corporis, crura)
19
Q

onchomycosis

  • pathogenesis
  • presentation
  • diagnosis
  • treatment
A
  • pathogenesis: m/c T. rubum
  • presentation: yellow discloration that spreads from distal → proximal
    • eventual separation from nail bed
    • subungual hyperkeratosis
  • diagnosis: sabaroud agar
  • treatment: terbinafine - esp for pts with
    • DM
    • perpireral neuropathy
20
Q

discuss the characterics of candida albicans

A
  • growth on sabroud agar
  • dimorphic fungi:
    • 20 degrees: psuedohyphae + budding yeast
    • 37 degrees: germ tubes
  • psuedohyphae at right angles on histopathology
21
Q

candidiasis:

  • demographics:
  • presentation:
  • diagnosis
A
  • demographics: I/C - DM, AIDS, on abx (esp in oral candidasis)
  • presentation:
    • oral: gray-white membranous plaques that bleed w/ scraping
    • rash (interiginous / vulvovaginitis / diaper): beefy red plaques with satellite lesions + fisssuring
  • diagnosis:
    • at 20 C: psuedohyphae + budding yeast
    • at 37 C: germ tubes
    • sabraud’s agar: growth
    • histopathology: vertically oriented psuedohyphae
22
Q

oral candidias (thrush)

  • demographics
  • presentation - gross & clinical
  • treatment
A
  • demographics:
    • newborns - m/c
    • in children/adults: after Abx course (I/C)
    • in adults with no predisposing factors (no Abx, not I/C): may be first manifestation of AIDS - they need a workup!
  • gross presentation: grayish white membranous plaques with red, moist, macerated base
  • clinical: metallic taste +/- dysphagia / odynophagia (if esophageal extension, which is m/c in AIDs pts)
  • treatment:
    • infants: oral nyastatin suspension
    • adults: oral nyastatin suspension OR fluconzole single dose 150 mg
23
Q

perleche (angular chelitis)

  • pathogenesis:
  • demographics
  • presentation
A
  • pathogenesis: C. albicans OR S. aureus
    • if S. aureus, “honey colored crust” likely present
  • demographics: elderly, due to:
    • ill-fitting dentures
    • exaggerated skin folds
    • dry mouth
  • presentation: oral commissures have ill-defined, grayish-white thickened areas with erythema (like thrush)
24
Q

candida vulvovaginitis

  • demographics
  • presentation - gross & clinical
  • treatment
A
  • demographics: like oral / interigo - DM, prior Abx, AIDS
  • gross: beefy red with satellite lesions + discharge that is thick / white & curd-like
  • clinical: severe pruritis + burning
  • treatment:
    • topical: miconazole, clotrimazole
    • oral: fluconazole 150 mg oral dose
25
Q

paronchyia

  • pathogenesis
  • presentation
A
  • pathogenesis: d/t C. albicans OR staph
    • if acute = s. aureus
    • if chronic = candida (c for candida)
  • presentation: inflammation of nail-fold
26
Q

candidal intertrigo / diaper candidiasis

  • presentations
  • what differential dx to r/o and how
A
  • both: beefy red patches surrounded by satellite lesions
    • intertrigo: involes scotrum & higly fissured
      • ​vs tinea cruris: NO SCTORUM, SCALY, LESS FISSURED
    • ​diaper: involves fold
      • ​vs contact dermatitis: SPARES THE FOLDS
27
Q

tinea versicolor

  • pathogenesis
  • presentation
  • diagnosis
  • treatment
A
  • pathogenesis: malassezia globosa
  • demographics: tropical demographic - esp summer months
  • presentation: macules that are
    • hyper OR hypo-pigmented
    • on upper trunk
    • scaly, non-blanching and -> coalescing
  • diagnosis:
    • KOH: short fungae + variably sized spores (“spaghetti and meatballs”)
    • wood’s lamp: yellow-green
  • treatment:
    • topical: azoles OR selenium sulfied
    • oralL: fluconazole
28
Q

identify

A

tinea versicolor (malassezia)

wood’s light examination: yellow-green flourescence

KOH prep: spaghetti and meatballs

29
Q

how does tinea versicolor present in council patients?

A

relapses are common

30
Q

what to NOT use to tx tinea vericolor?

A

oral ketoconazole

31
Q

sporotrichosis

  • pathogenesis
  • presentation
  • treatment
A
  • pathognenesis: sporothrix schenkii:
    • ​dimorphic, cigar shaped budding yeast
    • branching hyphae with rosettes of conidia
  • demographics: gardeners - it lives on vegetations
  • presentation: ascending lymphangitis - nodules that form along draining lymphatics
  • teatment: itraconazole
32
Q

identify

A

sporothrix schenckii - “rose gardeners rash”

dimorphic, cigar shaped yeast that grows into -> branching hyphae with rosettes of conidia

33
Q

which predisposing factors are often present in a adult with oral candidasis?

what should you do if these factors are absent?

why?

A
  • pt is typically I/C or has had a recent Abx course
  • if neither of these are the case, patient needs an immediate workup, since their oral thrush may be the first sign of AIDS

DERM (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions