Fungi And Drugs

Question 1

New class semisynthetic antifungal which inhibits b glucan synthesis in cell wall

Answer 1

Echinocandins—- anidulafungin
Caspofungin
Micafungin

Question 2

Treatment for cryptococcal meningitis

Answer 2

Ampho b with flucytosine

Question 3

Mechanism of action of flucytosine

Answer 3

Acts in nucleus

Gets converted by cytosine deaminase to 5 FU and inhibits DNA RNA synthesis

Question 4

Doc for suppression of cryptococcal meningitis in AIDS patient

Answer 4

Fluconazole

Question 5

Most important adverse reaction of azole esp ketoconazole

Answer 5

Cytochrome p450 inhibition

testosterone synthesis is inhibited causing gynaecomastia

Question 6

Doc for dermatomytosis

Fungal infection of skin finger and toe nails and hair

Answer 6

Terbinafine

Question 7

Antifungal that inhibits microtubule function

Answer 7

Greisofulvin

Question 8

Adv reaction of griesofulvin

Answer 8

Teratogenic
Carcinogenic
Disulfiram like reaction
Increase cytochrome p 450 and warfarin metabolism

Question 9

greisofulvin doesnt act on which fungi

Answer 9

Candida and other deep mycosis

Question 10

What makes griesofulvin usable in dermatophytosis

Answer 10

Gets concentrated in keratinocytes skin hair nails

Concentrated in cells infected with tinea

Question 11

Greisofulvin is fungistatic or cidal

Answer 11

Greisofulvvin is fungistatic
Prevents new keratinocytes from getting infected
Old cells still harbour infection till shed off

Question 12

Ulcer or granuloma with macrophages showing intracellular yeast

Answer 12

Histoplasma capsulatum
Histo hides in macrophages
And are smaller than rbcs

Question 13

Granulomatous nodules in lung skin bone

Biopsy shows broad based budding

Answer 13

Blastomycosis

Skin lesions can be verrucous and mimic scc

Question 14

Budding yeast with captain wheel type formation

Answer 14

Paracoccidiodo mycosis

Seen in latin america

Question 15

Skin or bone disease

Biopsy shows large spherule which is larger than rbc and contains numerous endospores

Answer 15

Coccidiodo mycosis

Seen in deserts of usa california

Question 16

Desert rheumatism

Desert bumps—- erythema nodosum

Answer 16

Coccidiodo mycosis

Spherule with endospores

Question 17

Inhalation of dust in earth quake and archeological excavation

Answer 17

Inhalation of spore laden dust
Coccidiodomycosis
Deserts california
Spherule which is much larger than rbc containing numerous endospores

Question 18

Name the cutaneous mycosis

Answer 18

Dermatophytosis is tinea capitis, corporis, cruris, pedis and unguium

Tenia versicolor also called pityriasis versicolor

Question 19

Cutaneous mycosis skin scrapings on koh mount would show

Answer 19

Filamentous septate hyphae

Not budding yeast

Question 20

Ring worm with central clearing and acquired from pets or farm animals

Answer 20

Tinea corporis

Question 21

Causative organism for pityriasis versicolor

Answer 21

Malessezia spp - pityrosporum species

It is a yeast like fungus

Question 22

Why hypopigmentation occurs in pityriasis versicolor

Answer 22

Malessezia spp infection
Lipid breakdown produces acid
Acid inhibits tyrosinase
Melanin synthesis inhibited

Question 23

Microscopic appearence of pityriasis versicolor

Answer 23

Spagetti and meatball appearence

Caused by malessezia

Question 24

Treatment of pityriasis versicolor

Answer 24

Selenium sulfide

Other topical or old antifungals

Question 25

Fungal infection in iv drug users

Answer 25

Candida endocarditis

Question 26

Pseudohyphae with budding yeast at 20 degree | And germ tubes at 37 degress

Answer 26

Candida albicans

Question 27

Fungus with septate hyphae that has acute angle 45.branching Aka dichotomous branching V shaped branching

Answer 27

Aspergillus fumigatus

Question 28

Treatment of aspergillus

Answer 28

Voriconazole | 2nd line echinocandins

Question 29

Highly encapsulated yeast from soil or pigeon droppings

Answer 29

Cryptococcus neoformans

Question 30

Gelatinous pseudocysts in brain | Fungal infection?

Answer 30

Cryptococcus neoformans

Question 31

Lat test for crytococcus neoformans detects what??

Answer 31

Capsular polysaccharide antigen

Question 32

Stains for cryptococcus neoformans

Answer 32

India ink—- clear halo suggests thick capsulated crypto Mucicarmine stain—- shows thick red capsule due to its polysaccharide content

Question 33

Uses of mucicarmine stain

Answer 33

To see cryptococcus neoformans capsule stains red | To detect mucin

Question 34

Diabetic patients Necrotic face Orbital fungal infection Causative organism and morphology

Answer 34

Mucor and rhizopus Non septate and hence broad With irregular outline Broad wide angled branching

Question 35

Disc shaped yeast on methanamine silver stain or fluroroscent antibody stain of lung tissue In aids patient

Answer 35

Pneumocystis jerovecci | Is a yeast like fungus

Question 36

Drugs in pcp pneumonia

Answer 36

``` Trimethoprim sulfimethoxazole Pentamidine Dapsone for prophylaxis Atovaquone Prophylaxis is started when cells fall below 200 ```

Question 37

Rose gardners fungal disease

Answer 37

Sporothrix schenkii

Question 38

Rose garderners fungal disease morphology

Answer 38

Dimorphic CIGAR shaped budding yeast With branching hyphae With rosettes of conidia

Question 39

Fungal ascending lymphangitis from pustule ulcer at the site of thorn prick

Answer 39

Sporothrix schenkii

Question 40

Treatment of sporothrix schenkii

Answer 40

Itroconazole when systemic | Potassium iodide when cutaneous or lymphatic