Fungal Infections

Question 1

Most common causative fungi for oral/esophageal candidiasis:

Answer 1

Candida albicans

Question 2

Symptoms of oral candidasis include:
1. cotton mouth
2.
3. burning sensation on tongue
4.
5.dysphagia

Answer 2

2. pain on eating/swallone
3. metallic taste

Question 3

Hallmark symptom of esophageal candidasis?

Answer 3

Odynophagia (pain on swallowing) = HALLMARK

also dysphagia ( difficulty swallowing )

Question 4

Common risk factors include:
1
2
3
4 chemo, immunocompromised, HIV/AIDS

Answer 4

1 steroids/abx
2 dentures
3 anticholinergic side effects

Question 5

True or false:
Diagnosis of candidasis involves scraping and a biopsy ?

Answer 5

False, rare

Question 6

Examples of drug related causes of fungal infection in mouth ?
1
2
3
4

Answer 6

1 steroids
2 xerostomia inducing agents
3 antibiotics
4 chemotherapy
5 ppi

Question 7

First line in uncomplicated oral candidasis with no underlying conditions:
1

Answer 7

Oral rinses (Nystatin)

2. troches (need enough saliva to dissolve)

Suspensions may be better for patients with dry mouth

Question 8

System therapy is needed for _________ candidasis

Answer 8

esophagealP

Question 9

Primary therapy options for oropharyngeal candidiasis:
1
2
3

Answer 9

1 Nystatin
2 Clotrimazole troches
3 fluconazole (tablets)

Question 10

Primary therapy for esophageal candidasis?
1
2

Answer 10

1. Fluconazole
2. Itraconazole ($$, hepatotoxic, DDI)

PO , no topical

Question 11

Examples of echinocandin anti fungal agents include
1
2
3 andulafungin

Answer 11

1 capsofungin
2 micafungin

Question 12

Example of polyene anti fungal agents include
1
2

Answer 12

1 nystatin
2 amphotericin B

Question 13

Itraconazole, Posaconazole, Voriconazole inhibit CYP ____

Answer 13

CYP3A4

Question 14

fluconazole inhibits CYP ____, ___/____

Answer 14

CYP3A4, 2C9/19

Question 15

fluconazole requires ____ dose adjustment

Answer 15

renal

Question 16

Common side effects of AZOLES includes:
1
2
3

Answer 16

Nausea
Vomiting
Gynecomastia

Question 17

This AZOLE is the least drug interacting agent compared to all azoles

Answer 17

FLUCONAZOLE

Question 18

This AZOLE is really excreted

Answer 18

fluconazole

Question 19

Wich of the following is NOT a side effect associated with VORICONAZOLE?
a. vision changes
b. neurologic toxicity
c. intereased intraocular pressure
d. alopecia

Answer 19

C

“Vori” think vision

Question 20

Posaconazole is only available as an oral formulation while __________ and _________ are both available as PO / IV

Answer 20

Voriconazole
fluconazole

Question 21

This azole is not systemically used because of greater toxicity, lower efficacy, ++drug interactions, gynecomastia

Answer 21

Ketoconazole

Question 22

All patients with candidemia regarledess of symptoms should have this type of examination done:

Answer 22

Eye

Question 23

Amphotericin B should be used with caution as it is a _________ drug

Answer 23

nephrotoxic