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Respiratory Exam 2 > Fungal Pathogens > Flashcards

Fungal Pathogens Flashcards

1
Q

cell-mediated immunity and fungal infections

A
  • innate - neutrophils

- adaptive - CD4+ TH1 cells

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2
Q

which of the microbes are the opportunists

A
  • yeast and molds
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3
Q

which are the yeast

A
  • candida
  • cryptococcus
  • pneumocystis
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4
Q

which are the molds

A
  • aspergillus

- mucor and rhizopus

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5
Q

which are dimorphics

A
  • histoplasma
  • blastomyces
  • coccidiodes
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6
Q

which are branching bacteria

A
  • actinomyces

- nocardia

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7
Q

what does dimorphic mean

A
  • one phenotype in the environment and another phenotype in the infected host
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8
Q

what are conidia

A
  • spores
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9
Q

candida species are what shape in tissue

A
  • budding yeasts

- pseudohyphae

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10
Q

candida species - _____ formation at 37 degrees C is diagnostic

requires

A
  • germ tube formation

- culture (Sabouraud agar)

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11
Q

candida species - ______ infections are common

which type?

A
  • extra pulmonary
  • chronic mucocutaneous candidiasis
  • blood stream (candidemia)
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12
Q

candida species - candida pneumonia is _____ except in

A
  • rare except in neutropenic patients
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13
Q

candida species - treatment for pneumonia requires

A
  • isolation from tissue biopsy
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14
Q

candida species treatment

A
  • echinocandins
  • amphotericin B for invasive infections

CANDIDA => CABE

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15
Q

cryptococcus neoformans structure

A
  • heavily encapsulated yeast
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16
Q

cryptococcus neoformans - most common manifestation

A
  • meningitis
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17
Q

cryptococcus neoformans - pulmonary symptoms

A
  • nonspecific (cough, fever, malaise)
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18
Q

cryptococcus neoformans - evaluate for ____ or ____ when either one is found

A
  • pneumonia

- meningitis

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19
Q

cryptococcus neoformans - diagnosis by

A
  • direct visualization (India ink)
  • culture
  • antigen detection
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20
Q

cryptococcus neoformans treatment

A
  • amphotericin B
  • flucytosine

Crypt AF

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21
Q

pneumocystis jirovecii structure

A
  • disc-shaped (cyst like) yeast
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22
Q

pneumocystis jirovecii - extrapulmonary infection _____ except in

A
  • rare except in late AIDS
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23
Q

pneumocystis jirovecii - worse outcomes in

A
  • HIV - immunocompromised than HIV+
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24
Q

pneumocystis jirovecii - on CXR

A
  • diffuse interstitial pneumonia with ground glass infiltrates
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25
Q

pneumocystis jirovecii - diagnosis by

most common stain

A
  • direct visualization in lung tissue or bronchoalveolar lavage induced sputum
  • silver stain most common
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26
Q

pneumocystis jirovecii treatment

A
  • sulfamethoxazole and trimethoprim
    a. k.a. bactrim

throw it BAC at club PJP

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27
Q

aspergillus fumigatus structure

A
  • septate hyphae with V shaped brainching
28
Q

aspergillus fumigatus associated with ____ malignancies

A
  • hematologic
29
Q

aspergillus fumigatus associated with these conditions

A
  • catheter associated infections
  • allergic bronchopulmonary aspergillosis
  • brain abscesses
  • sinusitis

Aspergillus = CABS
get yout Ass in the cab(s)

30
Q

allergic bronchopulmonary aspergillosis is what type of hypersensitivity

A
  • IgE mediated type I
31
Q

aspergillus fumigatus grows in what structure

can cause

A
  • cavities in lungs

- can cause hemoptysis

32
Q

aspergillus fumigatus - diagnosis by

A
  • direct observation in tissue
33
Q

aspergillus fumigatus treatment

A
  • voriconazole

AFV (America’s Funniest Videos about Aspergillius Fucking People Up)

34
Q

mucor and rhizopus also known as

A
  • zygomycetes
35
Q

mucor and rhizopus structure

A
  • aseptate hyphae with wide angle branching
36
Q

mucor and rhizopus - hallmark

A
  • necrosis following invasion of blood cells (angioinvasion)
37
Q

mucor and rhizopus - symptoms of pulmonary infection

A
  • prolonged fever
  • airway obstruction
  • hemoptysis
38
Q

mucor and rhizopus - diagnosis by

A
  • direct observation in tissue
39
Q

mucor and rhizopus treatment

A
  • amphotericin B

MR AB

40
Q

histoplasma capsulatum structure

A
  • oval yeast cells inside tissue macrophages
41
Q

what organisms of a fungal homolog of MTB

A
  • histoplasma capsulatum
42
Q

histoplasma capsulatum - high exposure can cause

A
  • pneumonia with cavitary lesions
43
Q

histoplasma capsulatum - diagnosis by

A
  • direct observation in tissue
  • culture
  • urine antigen test

UCT –> urine, culture or tissue observation

44
Q

histoplasma capsulatum - treatment for asymptomatic or mild infection

A
  • none
45
Q

histoplasma capsulatum - treatment for serious disease

A
  • itraconazole
  • amphotericin B

HISTO => IAB

46
Q

histoplasma capsulatum is an intracellular pathogen of

A
  • macrophages
47
Q

blastomyces dermatitidis structure

A
  • thick walled yeast with broad based budding in extracellular spaces
48
Q

blastomyces dermatitidis - acute pneumonia looks like

importance of this

may progress to

A
  • bacterial
  • does not respond to antibacterial therapy
  • ARDS
49
Q

blastomyces dermatitidis - chronic pneumonia looks like

A
  • TB and histo
50
Q

blastomyces dermatitidis - diagnosis by

A
  • direct observation in tissue

- culture

51
Q

blastomyces dermatitidis - treatment

what status of it do we treat?

A
  • intraconazole
  • amphotericin B
  • treat even asymptomatic infections

blasto = b = cover your bases = always treat

52
Q

coccidiodes immitis also known as

A
  • valley fever
53
Q

coccidiodes immitis structure

A
  • spherules (with endospores inside) in tissue and barrels in environment
54
Q

coccidiodes immitis causes (symptoms)

A
  • erythema nodosum (desert bumps)

- lung nodules or lung cavities

55
Q

coccidiodes immitis diagnosis by

A
  • direct observation in biopsy
  • culture (BAL or tissue)
  • skin test
56
Q

coccidiodes immitis - treatment

A
  • fluconzole
  • amphotericin B

COX are FAB

57
Q

actinomycetes israelii structure

A
  • filamentous
  • gram +
  • anaerobe
  • normal oral flora
58
Q

actinomycetes israelii - causes what conditions

A
  • oral/fascial abscesses (sulur granules)

- PID with IUDs

59
Q

actinomycetes israelii - rarely ______

A
  • bronchopulmonary
60
Q

actinomycetes israelii resembles

A
  • neoplasia or TB on CXR
61
Q

actinomycetes israelii diagnosis by

A
  • direct observation in tissue biopsy
62
Q

actinomycetes israelii treatment

A
  • penicillin
63
Q

Nocardia asteroides structure

A
  • beaded filaments
  • gram +
  • weakly acid fast
  • aerobe
64
Q

Nocardia asteroides _____ in immunocompromised patients

A
  • brain abscess
65
Q

Nocardia asteroides - pulmonary disease typical with

A
  • pneumonia or lung abscess with cavity formation
66
Q

Nocardia asteroides diagnosis by

A
  • direct observation

- culture

67
Q

Nocardia asteroides treatment

A
  • sulfamethoxazole/trimethoprim

Respiratory Exam 2 (18 decks)

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