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BDI > Fungi > Flashcards

Fungi Flashcards

1
Q

Mycology

A

Study of fungi

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2
Q

Fungi Kingdom

A

Eumycota

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3
Q

Fungi are _ organisms

A

Eukaryotic

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4
Q

Cell membranes are composed of

A

ergosterol

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5
Q

Cell walls are composed of

A

Glucans, chitin

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6
Q

Fungus metabolism

A

Heterotrophic

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7
Q

Bacteria characteristics

A

Prokaryotes
Cell membrane- proteins, phospholipids
Cell wall- peptidoglycan, LPS
Metabolism- heterotrophic

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8
Q

Human characteristics

A

Eukaryotes
Cell membrane- cholesterol
Cell wall not present
Metabolism- heterotrophic

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9
Q

Plant characteristics

A

Eukaryotes
Cell membrane- sterols
Cell wall- cellulose
Metabolism- autotrophic

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10
Q

2 types of fungi

A

Yeast
Mold (fleshy fungi-mushroom, filamentous molds)

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11
Q

Dimorphic

A

Can be yeast or mold depending on environmental conditions

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12
Q

Yeast morphology

A

Unicellular
Non-filamentous (budding, pseudohyphae)

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13
Q

Budding yeast with pseudohyphae are

A

Candida species (gram +)

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14
Q

Molds morphology

A

Multi-cellular
Filamentous (hyphae, can be septate or non-septate)
Interwoven hyphae form mycelium
Reproductive structures (basidium-fruiting bodies, conidia-spores)

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15
Q

Stain for fungi

A

Lactophenol cotton blue stain

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16
Q

Dimorphic fungus morphological

A

Mold (room temperature in the environment)
Infectious through inhalation of spores
Yeast (body temperature, diagnostic form)
Not infectious

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17
Q

Systemic disease caused by Dimorphics

A

Blastomycosis- Blastomyces dermatitidis
Coccidioidomycosis-Coccidioides immitis
Histoplasmosis- Histoplasma capsulatum
Tararomyces- Talaromyces (Penicillium) marneffei

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18
Q

Laboratory diagnosis involves

A

Direct detection
Culture isolation
Identification
Molecular
Serological

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19
Q

Direct detection from Specimen

A

Gram stain
KOH preparation
Wet mount
Wood’s lamp
India ink stain
Histopathology

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20
Q

Gram staining

A

Yeast- stain gram +
Molds stain poorly

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21
Q

KOH preparation

A

Keratinized tissues (skin, hair, nails)
Look for Dermatophytes (skin infections)
Cutaneous yeast

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22
Q

Wood’s lamp

A

Hair
Dermatophytosis (ringworm)

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23
Q

Wet mount

A

Oral or vaginal secretions
Budding yeast
Thrush

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24
Q

India ink

A

Cerebral spinal fluid
Encapsulated yeast
Cryptococcosis (Cryptococcosis neoformans)- encapsulated yeast

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25
Q

Histopathological

A

Gomori’s methenamin silver (GMS) stain
Mold hyphae
Detect: Aspergillosis (mold infection) , Mucormycosis/Zygomycosis, Invasive Candidiasis

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26
Q

Sabouround dextrose agar

A

Low pH, nutritionally deficient
2+ days for yeast
7+ days for mold
can take 4+ weeks

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27
Q

Blastoconidium

A

Produced by yeast cells
“Budding”
Seen in all yeast species

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28
Q

Biochemical testing

A

Candida albicans (Germ test tube, 2-3 hr incubation, lateral hyphae extension=positive result)
Other yeast ID methods: biochemical tests, MALDI-TOF MS

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29
Q

Mold identification

A

Macroscopic characteristics (culture growth)
Microscopic (hyphae structures, reproductive structures)

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30
Q

MALDI-TOF fungal ID

A

Identify unique species protein in yeast

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31
Q

Detection of fungal antibodies

A

In serum
Not reliable
Not useful in immunocompromised

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32
Q

Detection of fungal antigens

A

Latex agglutination (cryptococcal antigen in CSF)
Serum glactomannan (aspergillosis)

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33
Q

Culture confirmation

A

Nucleic acid probes (Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis/posadasii)
Sequence analysis comparison
Positive blood culture bottle
Bio fire BCID2 panel

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34
Q

True fungal pathogens infect

A

Normal immune system

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35
Q

Opportunistic fungus affects

A

Immunocompromised

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36
Q

Fungus pathogenesis

A

Colonize host
Find suitable environment
Avoid host defense
Multiply

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37
Q

Fungal virulence factors

A

Thermotolerance
Adhesion (cell surface receptors, biofilm formation)
Growth (use host nutrients)
Immune evasion (capsule, intracellular survival in phagocytes)

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38
Q

How do fungi damage host tissues

A

Extracellular enzymes (keratinases, phospholipids, urease)
Toxic metabolites (toxins)
Immune overreaction (cytokine storm)

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39
Q

Mycetismus

A

Poisoning by ingestion of mushroom

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40
Q

Mycotocicosis

A

Intoxication by eating food contaminates with mycotoxin (aflatoxin poisoning, psilocybin intoxication)

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41
Q

Fungal hypersensitivity disease

A

Inhalation of fungal elements induces immunological response (contact dermatitis, Hypersensitivity pneumonitis, farmers lung, allergic bronchopulmonary)

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42
Q

Mycoses

A

Infection caused by fungus

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43
Q

Candida auris

A

Concerns of multi drug resistance

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44
Q

Fungal infections

A

Slower growing than bacteria
Endogenous or exogenous
Often infect immunocompromised patients
Classification based on appearance and reproductive mechanism

45
Q

Fungal cells are _

A

Eukaryotic

46
Q

Antifungal medications target

A

Fungal cell wall and membrane (chitin and beta 1,3 glucan-target for diagnostic testing and medications, ergosteral- another drug target)

47
Q

Yeast

A

Round or oval
Budding reproduction

48
Q

Filimentous fungi

A

Molds
Tubular appearance (hyphae)
Brow through branching and extension

49
Q

Dimporphic

A

Yeast in humans
Mold in labs

50
Q

Yeast

A

Round smooth colonies
Stain gram +

51
Q

Risk factors for Candida infection (part of endogenous human flora)

A

Neutropenia
Antibiotics
Uncrotrolled diabetes
HIV

52
Q

Mucosal Candidiasis

A

Orthopharyngeal: thrush, pseudomembrane
Esophageal: difficulty swallowing
Cutaneous: skin fold or moist areas
Vaginitis: burning, itching, cottage-cheese live discharge

53
Q

Candidiasis localized organ infection

A

UTI: caused by cantamination from skin
Peritonitis (intraabdominal infection): after abdominal surgery or bowel perforation
CNS infection: following intracranial surgery (such as shunt placement)

54
Q

Candidemia

A

candida in the blood

55
Q

Hepatospenia Candidiasis

A

liver/spleen

56
Q

Osteoarticular candidiasis

A

bone/joint infection

57
Q

Endophthalmitis candida

A

inta-ocular infection

58
Q

Endocarditis Candida

A

heart valve

59
Q

Most common species causing Candida infection

A

Candida albincans (treated with fluconazole)

60
Q

Diagnosis of Candida

A

mucocutaneous: based on physical exam
organ or systemic: cultures, Germ tube (used in C albicans cultures postive for yeast), Assay for 1,3 beta D glucan (detected in fungal cell wall)

61
Q

Diagnosis of Cutaneous, Orthopharyneal

A

clinical appearance, wet mount
treat with topical agents (nystatin, clotrimazole or for sever infection azoles, echinocandin)

62
Q

Diagnosis for esophagitis candidiasis

A

dysphafia or adynophagia
diagnosis with endoscopy
treat with azoles or echinocandin

63
Q

Urinary tract Candidiasis

A

assiciated with urinary instrumentation
Remove catheter, may also use azole or amphotericin B

64
Q

Disseminated Candidiasis/Candidemia

A

blood cultures
1,3 beta D glucan assay

65
Q

Endophthalmitis candidiasis diagnosis

A

dialated retinal exam

66
Q

Endocarditis candidiasis diagnosis

A

blood culture and echocardiogram

67
Q

Cryptococcus infection

A

most common fungus causing meningitis
inhaled yeast from environment
C. neoformans: bird droppings
C. gatti: trees (eucalyptus) in west coast

68
Q

Risk factors for Cryptococcus infection

A

HIV/AIDs

69
Q

Cryptococcus pathogenesis

A

yeast cells surrounded by thick polysaccharide *capsule (allows growth, prevents phagocytosis, supress immune response, interference with antigen presentation, adherance)
Melanin (produced and deposited in cell wall- integrity, protection from phagocytosis/oxidation/temperature extremes)

70
Q

Cryptococcus spectrum of disease

A

Respiratory tract (asymtomatic to pneumonia)
CNS (meningitis, cryptococcoma)
Disseminated (fungemia)

71
Q

Diagnosis of Cryptococcus

A

Pneumonia: look for nodule, Serum cryptococcal antigen detects polysaccharide capsule
CNS: CSF cryptococcal antigen, India ink stain
Disseminated: serum cryptococcal antigen, need LP to evaluate for CNS involvement

72
Q

Pneumocytosis jjirovecci

A

protozoa
oppertunistic infection in immunocomprimised
HIV with CD4<200
prolonged steroid use
aquired through inhalation
likely aquired during childhood and reactivated during immunisupression

73
Q

Pneumocystis jirovecci causes

A

diffuse bilateral pneumoia
starts with dry couch/difficulty breathing/hypoxia
causes chronic lung damage with cytic changes

74
Q

Pneumocystitis diagnosis and treatment

A

Cannot be cultured
identified using GMS stain
elevated 1,3 beta-D-glucan
Treatment: high dose Bactrim
reverse immunocompromising state

75
Q

Malassezia furfur clinical syndromes

A

Cutaneous infection: Pityriasis (tinea) versicolor
hypo (patients with dark skin) or hyperpigmented (patients with light skin) scalded macules interfering with melanin production

76
Q

Malassezia furfur diagnosis

A

Skin scraping with KOH prep (spaghetti and meatballs yeast)
Skin lesions fluorescence with wood lamp
Culture requires lipids to grow (add olive oil to culture)

77
Q

Malassezia furfur treatment

A

Cutaneous: topical agents
Systemic (Fungiemia): catheter removal, systemic treatment

78
Q

Dermatophytes

A

Cause human disease (ringworm)
Keratinolytic (break down skin, hair, nails)

79
Q

Tinea capitis

A

Infection on head and face

80
Q

Tinea barbae

A

Beard and facial hair

81
Q

Tinea corporis

A

Body

82
Q

Tinea pedis

A

Foot

83
Q

Tinea cruris

A

Groin

84
Q

Tinea unguium

A

Toenails, fingernails

85
Q

Dermatophytes diagnosis and treatment

A

Clinical appearance
Wood lamp flouresence
Skin/nail scraping with KOH
Culture on Sabouraud agar
Treatment: topical agents

86
Q

Dimorphic

A

Histoplasma
Blastomyces
Coccidiodes
Sporothrix
Present in soil (inhalation or direct inoculation)
Primary pathogen in immunocompetent

87
Q

Histoplasmosis capsulatum

A

Found in chicken and bat droppings
Conidiophores inhaled and transform to yeast cells
Yeast cells are ingested by macrophages leading to an increase in PH residing efficacy of lysosomal enzymes
Proliferate and destroy macrophages

88
Q

Histoplasmosis diagnosis and treatment

A

Culture on Sabouraud agar
Narrow based budding yeast
Cytology with yeast forms via GMS Giemsa or PAS stains
Detection of Histoplasma antigen

89
Q

Blastomycosis pathogenesis

A

Grows as hyphal form in environment
Canidia released and transform into yeast within respiratory tract

90
Q

Blastomyces pathogenesis

A

Resist phagocytosis by modifying cell wall composition (shed WI-which activates immune response)
Proliferation in tissues and invasion into blood stream

91
Q

Blastomycosis

A

Pneumonia
Cutaneous (disseminated infection or direct inoculation)
Bone
CNS

92
Q

Blastomycosis diagnosis

A

culture on sabouraud agar
Look for broad based budding yeast
Blastomyces antigen detection

93
Q

Blastomycosis treatment

A

Mild cases do not require treatment

94
Q

Coccidioidomycosis

A

Live in desert soil
produce ammonia to create alkaline environment
Hyphae fragment into conidia, inhaled

95
Q

Coccidioidomycosis pathogenesis

A

Develop into spherules which produce endospores
Less susceptibile to phagocytosis due to urease production
Can enter bloodstream

96
Q

Coccidioidomycosis disease spectrum

A

Valley fever
May reactive during immunosuppression
Pneumonia
Meningitis
Cutaneous

97
Q

Coccidioidomycosis diagnosis and treatment

A

Culture is insensitive
Coccidioides antigen
Cytology with yeast forms
Serology: EIA
Immunocompetent people don’t usually require treatment
Fluconazole for moderate infection

98
Q

Saporothrix schenckii

A

Soil and decaying plant matter
Direct inoculation into skin
Associated with rose gardeners
Causes chronic nodular ulcerative lesions and spreads via lymphatics

99
Q

Sporotrichosis diagnosis and treatment

A

Culture
Cytology (cigar shaped yeast)
Treatment with potassium iodine

100
Q

Filamentous Fungi

A

Aspergillus species

101
Q

Pathophysiology of Mold infection

A

Conidia inhaled and invade respiratory
Attach to epithelium
Conidia swell and germinate in alveoli
Hyphae spread through lung parenchyma and blood vessels causing hemorrhage and necrosis

102
Q

Aspergillus species

A

Inhaled from environment (decomposing plants, soil, moist environments)
Profound neutropenia and prolonged steroid use is a risk factor

103
Q

Aspergillis disease

A

Allergic bronchopulmonary aspergillosis
Pneumonia
Invasive sinusitis
Cerebral aspergillosis

104
Q

Aspergillis diagnosis and treatment

A

Imaging test
Galactomannan (Aspergillis antigen) in serum
1,3 beta D glucan
PCR
Histopathology- septate, acute angle branching
Treatment- Voriconazole

105
Q

Mucormycosis

A

*Rhizopus, *Mucormycosis, Lichtheimia, Cunninghamella, Absidia, *Rhizomucor
Inhaled from environment
Risks profound neutropenia, diabetics, steroid use

106
Q

Mucormycosis Diseases

A

Rhino-orbital cerebral disease (fungal sinusitis)
Pulmonary
Cutaneous necrotizing fasciitis and necrotic lesions
GI (premature neonates)

107
Q

Mucormycosis Disease and Treatment

A

High mortality
Clinical presentation
Glactomannan and 1,3 Beta-D-glucan= negative
Culture and histopathology (pauci-septate, ribbon-like, right angle branching)
Treatment: surgical debridement, reversing immunocompromising conditions

108
Q

What mold has septate hyphae

A

Aspergillus

BDI (18 decks)

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