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microbiology > fungi > Flashcards

fungi Flashcards

1
Q

What are the anti-fungal agents that act on the cell wall? What is their mechanism of action?

A

echinocandins - inhibit glucan synthesis

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2
Q

What are the anti-fungal agents that act on the cell membrane?

A

direct damage to cell membrane through pore formation - polyenes (amphotercin B, nystatin)
inhibitors of ergosterol synthesis - azoles

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3
Q

what are the anti-fungal agents that act in the nucleus?

A

flucytosine - inhibits nucleic acid synthesis

griseofluvin - inhibits microtubules/mitosis

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4
Q

What are the topical antifungals?

A

nystatin, clotrimazole, miconazole

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5
Q

What anti-fungal agent should you use for fungal nail infections (onychomycosis)?

A

terbinafine

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6
Q

what are the names of the azole drugs?

A

ketoconazole, fluconazole, itraconazole, voriconazole, posaconazole

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7
Q

What are the drugs in the echinocandin family?

A

caspofungin

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8
Q

What are the toxicities related to caspofungin? Amphotericin B?

A

Caspofungin - infusion related flushing, fever, rash. GI upset. IV site irritation
Amphotericin B - infusion related flushing, fever, rash. Nephrotoxicity with wasting of K+ and Mg2+

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9
Q

What are the toxicites related to the azole drugs?

A

All azoles - elevated LFTs and drug interactions because they interact with cytochrome P450 enzymes
fluconazole - N/V, rash
itraconazole - taste disturbances, osmotic diarrhea, CHF, N/V
voriconazole - visual disturbances
posaconazole - elevated LFTs

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10
Q

what are the toxicities related to flucytosine?

A

bone marrow toxicity, elevated LFTs

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11
Q

What are the opportunistic fungi?

A

candida, cryptococcus neoformans, aspergillus, pneumocystis jiroveci, zygomycetes

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12
Q

What are the systemic, endemic dimorphic fungi?

A

histoplasma capsulatum, blastomycetes dermatitidis, coccidiodes immitis, paracoccidoides brasilensis, penicillium marneffei

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13
Q

what are the superficial dermatophytes? subcutaneous mycoses?

A

trichophyton, malessezia

sporothrix, madurella

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14
Q

What are the 3 main clinical manifestations of candida albicans?

A

cutaneous - diaper rash, skin infections in intertriginous areas, nail plate
mucosal - oral thrush, esopgagitis, vulvovaginal
systemic/disseminated

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15
Q

What are the main clinical manifestations of cryptococcus neoformans?

A

asymptomatic, meningitis, pneumonia, skin lesions [cryptic MAPS]

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16
Q

How do you diagnose cryptococcus neoformans?

A

capsular antigen test, latex agglutination test, India ink stain, culture and stain with PAS and silver stain

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17
Q

How do you treat cryptococcal meningitis? Pulmonary cryptococcus?

A

meningitis - amphotericin B +/- flucytosine, maintenance with fluconazole
pulmonary cryptococcus - fluconazole

18
Q

How does crytococcus avoid the immune system/virulence factors?

A

capsule, phenotypic switching of capsular antigens, melanin (antioxidant, inhibits antibody-mediated phagocytosis)

19
Q

What are the four clinical manifestations of aspergillus?

A

aspergilloma - fungal ball in preformed cavities in the lung (TB, emphysema, COPD)
allergic bronchopulmonary aspergillosis - asthma or CF
disseminated aspergillosis
cutaneous aspergillosis

20
Q

which species of fungus produces aflatoxin? What disease is consumption of aflatoxin associated with?

A

aspergillus flavus

liver damage and hepatocellular carcinoma

21
Q

what is the treatment for aspergillus?

A

voriconazole, amphotericin B

22
Q

which fungus is associated with a fruiting head on lactophenol blue stain?

A

aspergillus

23
Q

what fungus is associated with wide, nonseptate, right-angle hyphae? with thin, septate, acute-angle hyphae?

A

right angle - zygomycetes

acute angle - aspergillus

24
Q

What are the two clinical manifestations of pneumocystis jiroveci?

A

pneumonia - “ground glass” appearance on CXR

pneumothorax

25
Q

what is the drug of choice for treatment of pneumocystis?

A

TMP-SMX (bactrim)

used for prophylaxis too

26
Q

What are the clinical manifestations of zygomycetes?

A

black, necrotic cutaneous lesions

27
Q

What are the risk factors for zygomycetes?

A

diabetic ketoacidosis, desferoxamine therapy, neutropenia, bone marrow transplant [diabetic dog named Zygo nawing a bone]

28
Q

How do you treat a zygomycetes infection?

A

aggressive surgical debridement
amphotericin B
posaconazole has activity

29
Q

what is the only fungus with a capsule?

A

cryptococcus

NOT histoplasma capsulatum

30
Q

what fungi is found in pigeon droppings? bat and bird droppings?

A

cryptococcus

histoplasma

31
Q

Which dimorphic fungi has a mold and spherule form, instead of a normal mold and yeast form?

A

coccidioides

32
Q

Which fungi is characterized by the mariner’s wheel upon visualization by microscopy?

A

paracoccidioides

33
Q

Which fungi is very common in AIDS patients in northern Thailand?

A

penicillium marneffei

34
Q

What organ do the systemic endemic dimorphic fungi usually manifest in?

A

The lungs. Usually cause some sort of pulmonary disease

35
Q

Which fungi has broad based budding?

A

blastomycetes dermatiditis

36
Q

What diseases does trichophyton cause?

A

athlete’s foot, jock itch, onychomycosis, ringworm

37
Q

what diseases does malassezia fur fur cause?

A

pytiriasis versicolor - hyper- or hypopigmented patches on the skin usually acquired on the beach

38
Q

What are the clinical manifestations of sporothrix schenckii? How is it commonly acquired?

A

Subcutaneous nodules that spread along the lymphatic tracts of the arm. Often acquired from the prick of a rose thorn.

39
Q

What are the clinical manifestations of a Madurella infection? How would you treat this kind of infection?

A

slow progressing ulcerative lesions on the foot (found in soil) with black fungal granules in discharge. Treat with surgical debridement or amputation - doesn’t respond well to anti fungal therapy

40
Q

What are the organisms that can cause a fungal pneumonia?

A

aspergillus, cryptococcus, blastomycetes, histoplasma, coccidioides, paracoccidioides, pneumocystis jiroveci

microbiology (8 decks)

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