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Z MD1 locomotor and exercise block > fungi and opportunistic infections > Flashcards

fungi and opportunistic infections Flashcards

1
Q

are fungi eurkaryotic or prokaryotic

A

eukaryotic

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2
Q

what are the 3 classifications of fungi

A

unicellular (yeasts)
filamentous (moulds)
dimorphic

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3
Q

explain the features of unicellular fungi

A
  • facultative anaerobes
  • reproduce asexually by budding
  • produce colonies on agar
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4
Q

explain the features of filamentous fungi

A
  • aerobes
  • reproduce by conidia (asexual spores)
  • produce mycelia on agar
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5
Q

explain the features of dimorphic fungi

A

they can switch between unicellular and filamentous forms

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6
Q

what is a hypha

A

a long, multicellular condidium (asexual spores)

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7
Q

which type of fungi is more virulent to humans and why

A

dimorphic fungi - because they can grow as filamentous organisms in the environment and then change to growing as unicellular within us

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8
Q

where do dermatophytes live on humans

A

within keratin layers (hair, skin)

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9
Q

give an example of a dermatophyte

A

tinea corporis = ring worm (not actually a worm!)

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10
Q

what are the 3 types of candidiasis infection

A
  • mucocutaneous
  • chronic mucocutaneous
  • systemic (causes septicaemia)
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11
Q

what are 2 diseases caused by cryptococcosis

A

pulmonary infection

meningitis

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12
Q

what is important to remember about crytococcocal meningitis

A

it is an AIDS defining illness

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13
Q

what are the two agents that cause cryptococcosis

A

C. neoformans

C. gattii

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14
Q

what are the 3 types of aspergillosis infection

A
  • saprophytic (fungus ball)
  • allergic
  • systemic
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15
Q

how do you diagnose fungal infections

A 
microscopy
culture 
antigen detection
PCR
mass spectrometry
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16
Q

what are the systemic anti-fungal chemotherapy drugs

A

polyenes (amphotericin B)
triazoles (fluconazole)
echinocandins
5-fluorocytosine

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17
Q

what are the topical anti-fungal treatments

A

polyenes

imidazoles

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18
Q

what are the targets of anti-fungal medications

A

ergosterol in cytoplasmic membrane

nucleic acids

19
Q

which anti-fungal drugs affect the cytoplasmic membrane and how

A

polyenes affect the integrity

allylamines, trizoles and morpholines affect the synthesis

20
Q

what is the bad thing about using anti-fungals that target the cytoplsamic membrnae of fungi

A

they also bind to our cholesterol in our membrane

21
Q

which antifungal drug affects the nucleic acids of fungi

A

5-flurocytosine = converted to 5-flurouracil - affects DNA and RNA synthesis

22
Q

empiric treatment of candida spp

A

fuconazole (trizaole 1st gen)

23
Q

empiric treatment of cryptococcus

A

amphotericin B (polyene) + 5-flurocytosine

24
Q

empiric treatment of aspergillus

A

voriconazole (triazole 2nd gen)

25
Q

empiric treatment of dimorphic fungi

A

amphotericin B (polyene)

26
Q

which opportunistic bacteria are associated with nosocomial epidemics

A
  • staph aureus
  • Klebsiella pneumoniae
  • enterococcus spp
  • pseudomonas aeruginosa
  • enterobacter spp
  • serratia spp
27
Q

what are the local alterations of a patient that allow infection by opportunistic pathogens

A
  • anatomical defect
  • surgical and other wounds
  • burns
  • catherterisation
  • foreign bodiesin general
28
Q

what are the systemic alterations of a patient that allow infection by opportunistic pathogens

A
  • extremes og age
  • leucopenia
  • malignancy
  • malnutrition
  • diabetes
  • liver disease
  • certain infections (HIV, measles)
  • treatment with antimicrobials
  • primary immunodeficiency
29
Q

what are the types of infection that a patient can get with an opportunistic infection

A
  • wound infection
  • UTI
  • intra-abdominal infection
  • pneumonia
  • septicaemia
  • meningitis
30
Q

what are the features of pseudomonas

A
  • gram negative rod
  • motile
  • aerobes or facultative anaerobes
  • non-fermenting, non-sporing
  • catalase and oxidase positive
  • low nutritional requirements
31
Q

pseudomonas is divided into different species according to…

A

biochemical tests

32
Q

how is pseudomonas aeruginosa subtyped

A

serotyping, biotyping

33
Q

which 4 bacteria usually colonise the respiratory tract of patients with CF

A

psuedomonas aueroginosa
burkholderia cepacia
stenotrophomonas maltophilia
burkholderia pseudomallei

34
Q

which systemic infections is pseudomonas aeruginosa now mostly associated with

A

penumonia, UTI and sepsis

35
Q

which superficial infections is pseudomonas aeruginosa associated with

A

skin - wound infection, otitis externa, folliculitis
eye - keratitis, corneal ulcer
(places where innate immunity is reduced)

36
Q

how does pseudomonas aeruginosa adhere to skin

A

via flagella, pili and LPS

- LPS and flagellin bind to TLRs -> affect cytokine production

37
Q

why is pseudomonas aeruginosa associated with patients with CF

A

because it binds to the CFTR and it is not inhibited by high salt concentrations

38
Q

what features of pseudomonas aeruginosa help it to adhere and invade other than flagella and LPS

A
  • once adherent, it tends to produce a biofilm

- it has a capsule - assists adherence and biofilm formation, and makes it resistant to immune system

39
Q

what are the properties of pseudomonas aeruginosa within the biofilm it makes

A
  • non motile
  • more adherent
  • more capsule materia
  • less invasive
  • slow growth
  • increased R to AB
  • shorter LPS
40
Q

what causes the change in properties of pseudomonas aeruginosa when it is in a biofilm

A

activation of genes that are regulated by quorum sensing

41
Q

what things help pseudomonas aeruginosa spread through the tissues

A

flagella
exoenzymes
exotoxins
LPS-CFTR mediated nvasion

42
Q

which exoenzymes does pseudomonas aeruginosa have and what do they do

A

proteases, haemolysins, phospholipases, elastase –> act on pulmonary tissue and surfactant

43
Q

what exotoxins does pseudomonas aeruginosa have and what do they do

A

exotoxin A, exoenzymes S and U –> inhibit phagocytosis

44
Q

ways to manage pseudomonas aeruginosa in the environment

A
  • reduce risk of susceptible patients
  • be on alert for infection and treat early
  • practice high levels of hand hygiene
  • use contact lenses and solutions appropriately
  • lifelong monitoring and Tx of CF patients

Z MD1 locomotor and exercise block (13 decks)

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