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Respiratory Week 1 > Fungal Pneumonia and Antifungals > Flashcards

Fungal Pneumonia and Antifungals Flashcards

1
Q

what type of patients usually suffer from fungal infections?

A

immunocompromised

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2
Q

name three types of acquired immunodeficiencies that predispose to fungals

A

HIV
Cancer
Transplant

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3
Q

what are the three respiratory pathogenic yeasts?

A

candida
cryptococcus
pneumocystis

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4
Q

what are the three respiratory pathogenic molds?

A

aspergillus
Mucor
rhizopus

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5
Q

what are the three respiratory dimorphics that are pathogenic?

A

histoplasma
blastomyces
coccidioides

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6
Q

what is the key pearl on candida albicans?

A

germ tube formation

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7
Q

what type of disorder leads to risk for candida albican pneumonia?

A

neutropenic patients

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8
Q

which two antifungals are used for treating candida respiratory infections?

A

echinocandins and amphotericin B

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9
Q

what type of cell is cryptococcus?

A

encapsulated yeast

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10
Q

where are the two common sites for cryptococcus infection?

A

meningitis and respiratory (pneumonia)

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11
Q

what two drugs to treat cryptococcal infection?

A

amphotericin B and flucytosine

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12
Q

with PCP or PJP what is the characteristic shape that forms as yeast?

A

cyst like yeast forms…looks like hamburger

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13
Q

what type of pneumonia do you see with PJP on Xray?

A

interstitial pneumo with ground glass infiltrates

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14
Q

where does PJP usually occur as infection?

A

mainly in lungs…outside if super immunocomp like AIDS

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15
Q

what are the two drugs used to treat PJP usually? why these?

A

sulfamethoxazole and trimethoprim

antibiotics because resistant to antifungals

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16
Q

is aspergillus septate or aseptate hyphae?

A

septate hyphae!

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17
Q

what is a disease that aspergillus is commonly seen with?

A

hematologic malignancies

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18
Q

what is the best drug to treat aspergillus?

A

voricanizole

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19
Q

are mucor/rhizopus septate or aseptate?

A

aseptate

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20
Q

what is the best drug to treat mucor/rhizopus?

A

amphotericin B

21
Q

what is the stain used to see cryptococcus?

A

india pink stain

22
Q

what is the buzz word that describes how candida grows?

A

budding yeast or pseudohyphae

23
Q

what must you get to treat a candida pneumonia?

A

a tissue biopsy

24
Q

what stain is commonly used to see PJP?

A

silver stain

25
Q

what three laboratory techniques are used to see PJP?

A

direct visualization in lung tissue
BAL
induced sputum

26
Q

describe how aspergillus grows in the lungs

A

it makes fungal balls that are called aspergillomas…they reside in the cavities of the lungs

27
Q

how do you visualize aspergillus for diagnosis?

A

direct observation in tissue

28
Q

how do you visualize mucor and rhizopus for diagnosis?

A

direct observation in tissue

29
Q

describe how histoplasma capsulatum looks by shape in a patient and where they reside?

A

oval cells inside tissue macrophages

30
Q

when do you treat histoplasma and with what?

A

itraconazole and amphotericin B only when symptoms are really bad

31
Q

describe what happens when histoplasma is grown in lab and what is the shape of it?

A

taken from patient as yeast and allowed to grow in lab it will become a mold…the mold looks like a ships wheel

32
Q

describe the shape of blastomyces

A

thick walled yeast with broad based budding

33
Q

what is tricky about pneumonia with blastomyces?

A

it originally appears to be bacterial but does not respond to any antibiotics

34
Q

what is treatment for blastomyces?

A

amphotericin B and itraconazole

35
Q

where is coccidioides immitis most common?

A

in the SW USA

36
Q

describe the shape of coccidioides

A

circular with endospored when in tissue, but in environment it is barrel shaped

37
Q

what does coccidioides form in the lung (2)

A

cavity or nodules

38
Q

which of the dimorphic organisms is associated with desert bumps or erythema nodosum?

A

coccidioides

39
Q

what is the treatment for coccidioides?

A

amphotericin B or fluconzole

40
Q

what is nocardia asteroides?

A

this is a branching bacteria that can cause pneumonia

41
Q

how do you describe Nocardia asteroides?

A

beaded filaments that are weakly acid fast

42
Q

how to treat nocardia asteroides?

A

SMX/TMP

43
Q

what is actinomyces israelii?

A

a branching bacteria that can cause pneumonia

44
Q

what symptom do people with actinomyces israelii normally have?

A

oral/facial abscesses

45
Q

how to treat actinomyces israelli?

A

penicillin

46
Q

what is the shape of actinomyces israelii and is it acid fast?

A

filamentous…not acid fast, unlike nocardia

47
Q

what two aspects of fungi are usually targeted with antigen detection tests?

A

mannoproteins and beta glucans

48
Q

what three bugs have good fungal antigen detection tests?

A

cryptococcus
aspergillus
histoplasma

Respiratory Week 1 (18 decks)

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