Fungal Infections Flashcards

1
Q

What commonly causes fungal infections on the skin, hair and nails?

A

Dermatophytes, yeast (Candida, Malassezia)

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2
Q

How are fungal infections spread?

A

Direct contact from other people, animals, soil and from formites

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3
Q

What are the most common genres of dermatophytes?

A

Trichophyton, Microsporum, Epidermophyton

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4
Q

What parts do fungus target?

A

Stratum corner of epidermis and nail keratin

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5
Q

Where does tinea pedis most commonly occur?

A

Between the toes (can spread to instep or sole)

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6
Q

What is the recommended frequency and duration for treatment of tinea pedis/cruris/corporis?

A

OD-BD, 2-6 weeks + ≥1 week after sx resolved

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7
Q

How many days should combination of antifungal and corticosteroid be used for?

A

7-10 days, then use antifungal alone

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8
Q

Why does tinea capitis require systemic treatment?

A

Dermatophytes are found at the hair follicle root, which is not accessible by topical treatments

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9
Q

Adjunctive tinea capitis treatment? and duration

A

Selenium sulfide (1-2.5%), ketoconazole (2%), povidone iodine for the first 2 weeks

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10
Q

Is oral or topical treatment better for onychomycosis? Why?

A

Oral (systemic)
Topical penetrate poorly to the nail bed

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11
Q

What is monotherapy of topical lacquers most suitable for?

A

Distal subungual onychomycosis affecting <50% of nail without involvement of lunula, white superficial onychomycosis and when less than 3 nails are affected

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12
Q

How often should you apply clotrimazole powder? Can it be used as main treatment?

A

BD-TDS, continue for 2 weeks after disappearance of symptoms

Only used as adjunct to cream or prophylactic in preventing new or recurrent infection (not rubbed into skin -> less effective)

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13
Q

Administration and frequency of nystatin suspension?

A

Swish and swallow QDS, up to 14 days

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14
Q

Nystatin is a P+ drug. What are the requirements and maximum dose and duration?

A

Indication: treatment of oral candidiasis

Minimum age: 6 months

Maximum daily dose:
· Infants and children 6 months and older: 400,000 units
· Adults: 2.4 million units

Maximum supply: 2 weeks

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15
Q

Frequency of topical itraconazole, ketoconazole, clotrimazole, miconazole, sertaconazole?

A

Itraconazole: OD
Ketoconazole: OD
Clotrimazole: BD (powder: BD-TDS)
Miconazole: BD-TDS (powder: BD but OD if used with cream; oral gel QDS)
Sertaconazole: OD-BD

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16
Q

Frequency and duration of topical tolnaftate, terbinafine?

A

Tolnaftate: BD for 2-4w
Terbinafine: OD for 7 days

17
Q

Frequency and duration of topical combination of anti fungal and corticosteroid?

A

OD-BD, 7 days (if symptoms still persist, continue with steroid-free preparation)

18
Q

Frequency and duration of amorolfine for nail fungus infection?

A

1-2 times per week
6 months for fingernails
9-12 months for toenails

19
Q

Fluconazole is a P+ drug. What are the criteria for purchase?

A

· Indication: Vaginal Candidiasis
· Maximum daily dose: 150mg
· Maximum supply: 1 tablet (150mg)
· Min age: 16 years. Not recommended in adults older than 60 years of age. (max)

20
Q

How to differentiate between bacterial vaginosis, trichomoniasis and candidiasis?

A

Bacterial: off-white / discoloured discharge (green, grey, tan), sometimes foamy, fishy smell, no itch
Trichomoniasis: scanty to profuse yellow greenish discharge (frothy), offensive smell, itch
Candidiasis: thick curdish discharge, non-offensive smell, itch & soreness