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Microbiology > fungi > Flashcards

fungi Flashcards

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1
Q

give two situations in which fungal infections are common?

A

after abdominal surgery

in the immunocompromised

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2
Q

what are fungi?

A

eukaryotic
Chitinous cell wall
Heterotrophic
“Move” by means of growth or through spores, which are carried through air or water

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3
Q

name two types of fungi and which is a more common cause of infection?

A

mould and yeast and mould is much more common

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4
Q

what is the difference between yeast and mould?

A

yeast - single celled, divide by budding

mould - multicellular hyphae, form spores

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5
Q

what are diamorphic fungi?

A

they can be yeasts or moulds depending on the conditions

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6
Q

give examples of clinical diseases caused by fungal infection

A 
Nappy rash and Vulvovaginal candidiasis
Tinea pedis (athlete’s foot)
Onychomycosis (fungal nail infections)
Otitis externa
Fungal asthma
tinea capitis and fungal keratitis
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7
Q

name a special agar plate used for fungi

A

Sabouraud agar

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8
Q

what stain used in histology can be used to detect fungi?

A

silver stain

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9
Q

name infections that can be life threatening in immunocompromised people

A 
Candida line infections
Invasive aspergillosis
Pneumocystis
Cryptococcosis
Mucormycosis
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10
Q

why is so much money spent on antifungals?

A

diagnosis is poor so people may be give anti-fungals just in case
new drugs so are expensive

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11
Q

what is selective toxicity?

A

achieve inhibitory levels of agent at the site of infection without host cell toxicity

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12
Q

why is selective toxicity difficult for fungi?

A

as they are eukaryotic

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13
Q

which antifungal targets DNA/RNA synthesis, protein synthesis?

A

Flucytosine

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14
Q

which antifungal targets the cell wall?

A

Echinocandins

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15
Q

which antifungals target the ergosterol plasma membrane?

A

Amphotericin
Azoles
Terbinafine

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16
Q

how does amphotericin B bring about fungal death - fungicidal?

A

insets pore into the cell membrane and cases leakage of electrolytes and also displaces and affects activity of membrane bound proteins

17
Q

what are the side effects of polyenes?

A 
nephrotoxicity
hypokalaemia
hyperkalaemia
chills/rigors. hypotension 
anaphylaxis
18
Q

how do azoles and terbinafine work?

A

they inhibit the ergosterol pathway

19
Q

what are the advantages of terbinafine?

A

well absorbed and distributes extensively to poorly perfused tissues
works for candida and aspergillus

20
Q

what are the drawbacks of terbinafine?

A

metabolised by CYP450 enzymes so can result in drug interactions
extensive first pass metabolism

21
Q

is terbinafine fungistatic or fungicidal?

A

fungicidal

22
Q

are azoles fungistatic or fungicidal?

A

fungistatic

23
Q

what are the advantages of triazoles?

A

improve and broadened antifungal spectrum

24
Q

what are the adverse effects of azoles?

A

hepatitis
Alopecia - fluconazole
GI symptoms- Itra:
Nausea, abdominal pain, diarrhoea
Rare life threatening liver failure - itra
Voriconazole - visual disturbance in 30%
Photosensitivity in 1-2% voriconazole and skin malignancy

25
Q

list some drugs that interact with fluconazole

A

Warfarin, phenytoin, calcineurin inhibitors, anxiolytics

26
Q

list drugs that interact with itraconazole or voriconazole

A

Warfarin, phenytoin, calcineurin inhibitors, anxiolytics, steroids, statins, rifamycins,PIs

27
Q

list 3 ways in which azoles can become resistant

A

target site modification by mutation
increased expression of a gene
efflux pumps that pump out the azole

28
Q

what is the first line azole?

A

fluconazole

29
Q

which enzyme do echinocandins inhibit?

A

1,3 beta glucan synthase

30
Q

what are echinocandins good for?

A

reisitant candida and mould infections

31
Q

what method of administration are echinocandins given in?

A

IV, as poor oral bioavailability

32
Q

where are areas of poor penetration of Echinocandins?

A

CSF, eye and urine

33
Q

what are some side effects of Echinocandins

A

Rare type-1 hypersensitivity
Hepatotoxicity
Hypokalaemia

34
Q

what is the most common species of candida to infect a central line?

A

C. albicans

35
Q

what is the most common cause of fungal nails?

A

mould - Trichophyton rubrum

36
Q

what substance is released into the serum by the fungi during invasive infection that can be measured?

A

1,3 beta D glucan

37
Q

in which pts is Pneumocystis most common?

A

HIV, transplant, steroids

38
Q

what is the first line therapy for PCP (pneumocystis pneumonia)?

A

Co-trimoxazole

Microbiology (12 decks)

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