Fungal infections Flashcards

1
Q

What are fungi?

A

Eukaryotic organisms with a true nuclei

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2
Q

What are the two types of fungi?

A

Yeasts and moulds

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3
Q

What are yeasts?

A

unicellular, round or oval cells which reproduce by budding or fission

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4
Q

What are moulds?

A

multi-cellular also called filamentous fungi, produce hyphae

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5
Q

What are dermatophytes?

A

Moulds

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6
Q

What are dermatophytes associated with?

A

infections of skin, nail and hair

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7
Q

What common symptoms do dermatophytes cause?

A

itching, burning, pain and irritation

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8
Q

What is tinea corporis?

A

Ringworm of the skin

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9
Q

What is tinea cruris?

A

Ringworm of the groin

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10
Q

What is tinea capitis?

A

Ringworm of the scalp

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11
Q

What is first line treatment for tinea corporis and cruris?

A

Topical imidazole:
clotrimazole or miconazole
Terbinafine is an alternative

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12
Q

What oral therapy can be used for ringworm if needed?

A

Terbinafine 250mg OD
Itraconazole 100mg OD
Griseofulvin rarely given

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13
Q

What is the treatment for Tinea Capitis?

A

Ketoconazole, selenium sulphide shampoos or terbinafine cream twice weekly for 2 weeks.
Oral:
Griseofulvin 1g OD
Terbinafine 250mg OD for up to 4 weeks

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14
Q

What is Griseofulvin active against?

A

Microsporidium

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15
Q

What is Terbinafine effective against?

A

Trichophyton tonsurans

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16
Q

What is Griseofulvin only active against?

A

Dermatophytes

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17
Q

Does Giseofulvin persist in keratinous tissue after end of therapy?

A

No

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18
Q

What is griseofulvin contraindicated in?

A

Patients with severe liver disease & SLE

19
Q

Can griseofulvin be used if breastfeeding?

A

No

20
Q

How long should women avoid pregnancy for after taking griseofulvin?

A

one month

21
Q

How long should men not father a child for after taking griseofulvin?

A

6 months

22
Q

What are the main side effects of griseofulvin?

A

GI & headache, cognitive

23
Q

What does griseofulvin interact with?

A

oral contraceptives
coumarins
possibly cyclosporin

24
Q

What should griseofulvin be taken with or after?

A

Fatty food

25
Q

What is Tinea pedis?

A

Athlete’s foot

26
Q

What species can cause athletes foot?

A

Trichophyton rubrum
Trichophyton mentagrophytes
Epidermophyton floccosum

27
Q

What is first line treatment for athlete’s foot?

A

Imidazole cream 2-4 week

Terbinafine cream 1 week

28
Q

What is the oral treatment for athlete’s foot?

A

Terbinafine 250mg OD 2-6 weeks
Itraconazole 100mg OD for 30 days or 200mg BD for 7 days
Griseofulvin 500mg OD in divided doses for 4-8 weeks

29
Q

Does terbinafine concentrate in keratinous tissue?

A

Yes

30
Q

What should terbinafine be avoided in?

A

Pregnancy
Liver disease
Renal impairment

31
Q

What are the side effects of terbinafine?

A

GI disturbances
Hepatotoxicity
Serious skin reations

32
Q

What interacts with terbinafine?

A

Rifampicin

OCP

33
Q

What species comonly cause onchomycosis?

A

Trichophyton rubrum
Epidermophyton floccosum
Trichophyton mentagrophytes
Candida

34
Q

What is 1st line treatment for onchmycosis?

A

Terbinafine 250mg OD for 6 weeks to 3 months for finger nails (3-6 months for toe)
Itraconazole 200mg BD for 7 days subsequent courses at 21 day intervals. 2 pulses for giners, 3 pulses for toes

35
Q

What is the topical treatment for onchomycosis?

A

Amorolfine once or twice weekly. 6 months nails, 9-12 months toe nails

36
Q

What is pityriasis versicolor?

A

Colonisation of the stratum corneum by Malassezia

37
Q

Where is pityriasis versicolor usually found?

A

patches on the trunk, neck and shoulders

38
Q

What is the topical treatment for pityriasis versicolor?

A

Ketoconazole shampoo
Selenium sulphide shampoo
Clotrimazole, econazole, ketoconazole or miconazole creams

39
Q

What is the systemic treatment for pityriasis versicolor?

A

Itraconazole 200mg OD 7 days

Fluconazole 50mg OD for 2 to 4 weeks

40
Q

What is the topical treatment of Oropharyngeal candidia ?

A

Miconazole oral gel 7 days

Nystatin suspension 7 days

41
Q

What is the oral treatment for Oropharyngeal candidia ?

A

Fluconazole 50mg OD for 7-14 days

42
Q

What are the risk factors for cutaneous candidiasis?

A

Systemic antibiotics, HIV, skin conditions, skin maceration

43
Q

How does cutaneous candidiasis present?

A

Prutitus and irritation, burning and pain

44
Q

What is the oral treatment for cutaneous candidiasis?

A

Fluconazole 50mg OD 2-4 weeks