Fungi and Protists Flashcards

1
Q

histoplasmosis – primary locations, cell of infection

A

Mississippi and Ohio River valleys. found in caves, spread by bird and bat feces
Macrophage filled with Histoplasma (smaller
than RBC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

histoplasmosis – primary disease, lung findings

A

causes pneumonia, presence of caseating granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

blastomycosis – primary locations, primary disease and disease signs, defining feature on pathology

A

States east of Mississippi River, around the Great Lakes and Central America.

Causes inflammatory lung disease
and can disseminate to skin and bone. Forms
granulomatous nodules.

broad-based budding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

coccidiomycosis - primary locations, exacerbating factor for transmission. size of fungi

A

Southwestern United States, California. Case rate increase aftper earthquakes
(spores in dust thrown into air increasing inhaled
spherules in lung).

Spherule (much larger than RBC) filled with
endospores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

coccidiomycosis – primary disease, disseminated disease. other disease manifestations, skin, joints?

A

Causes pneumonia and meningitis. disseminated disease in skin and bone.

“(San Joaquin) Valley fever”
“Desert bumps” = erythema nodosum
“Desert rheumatism” = arthralgias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

paracoccidiomycosis - primary locations, key feature on pathology, size of yeast

A

primarily found in Latin America, captains wheel found in budding yeast, much larger than a red blood cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

common features of systemic mycosis: disease, form at temperature (plus the exception), treatment of choice

A

all can cause pneumonia especially in immunocompromised individuals

Most are molds at 20°C, beome yeast at 37°C, coccidiomycosis is the exception as it is a spherule at body temperature.

Treatment: fluconazole or itraconazole for local infection;
amphotericin B for systemic infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

relationship between tuberculosis and systemic mycosis, difference?

A

both can present as Caseating granulomatous disease, except systemic mycosis does not have person-to-person transfer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

tinea - causative agents of infection x 3, key feature on pathology

A

Dermatophytes -
include Microsporum, Trichophyton, and Epidermophyton.

Branching septate hyphae visible on
KOH preparation with blue fungal stain A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

tinea capitis - location of disease, associated symptoms x3

A

Occurs on head, scalp. Associated with lymphadenopathy, alopecia, scaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

tinea corporis – location of disease, findings on the skin, infection source

A

Characterized by erythematous scaling rings (“ringworm”) and central
clearing.

Can be acquired from contact with an infected cat or dog.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

tinea cruris – location of disease, difference between tinea corporis

A

Occurs in inguinal area

Often does not show the central clearing seen in tinea corporis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

tinea Pedis – location of disease, disease types X3

A

Interdigital ; most common
Moccasin distribution.
Vesicular type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

tinea unguium - location of infection

A

Onychomycosis; occurs on nails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

tinea vesicolor - causative agent of disease, primary cell target, time and year of infection.

A

Caused by Malassezia spp. (Pityrosporum spp.), a yeast-like fungus (not a dermatophyte despite
being called tinea).

Degradation of lipids produces acids that damage melanocytes. hypopigmented and/or pink patches.

Can occur any time of year but common in summer (hot, humid weather)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

tinea vesicolor - appearance on pathology, treatment

A

“Spaghetti and meatballs” appearance on microscopy

Treatment: topical and/or oral antifungal medications, selenium sulfide.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Candida albicans – primary signs of infection, primary demographic of infection,

A

mouth, leading to oral thrush and esophageal thrush, the vagina, leading to vulvovaginitis, the bloodstream, which can lead to endocarditis,

if disseminated can go anywhere

focuses on the immunocompromised, (chemo, HIV-AIDS, steroids), and IV drug users.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Candida albicans – treatment, vaginal versus oral versus disseminated

A

topical azole for vaginal;

nystatin,fluconazole, or caspofungin for oral/esophageal

fluconazole, caspofungin, or amphotericin B for systemic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Aspergillus fumigatus - people likely to be infected

A

Immunocompromised and those with chronic

granulomatous disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Allergic bronchopulmonary aspergillosis - disease associations X2, may cause…

A

associated with asthma and cystic fibrosis; may cause bronchiectasis and eosinophilia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

TB and aspergillosis - relationship

A

Aspergillomas in lung cavities, especially after

TB infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

aspergillosis and liver disease. What is the mediating factor.

A

Some species of Aspergillus produce aflatoxins,
which are associated with hepatocellular
carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Aspergillus – appearance on pathology

A

Septate hyphae that branch
at 45° angle (left). Conidiophore with radiating chains of
spores (right)

Think “A” for Acute Angles in Aspergillus. Not
dimorphic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cryptococcus neoformans – disease X2. Signs on pathology, fungal culture

A

Cryptococcal meningitis and cryptococcosis (which can lead to pneumonia)

Heavily encapsulated yeast. Not dimorphic, 5-10 μm yeasts with wide capsular halos and unequal budding in India ink stain. Stains with India ink and mucicarmine

Culture on Sabouraud agar.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Cryptococcus neoformans – disease vector x2 and transmission
Found in soil, pigeon droppings. Acquired through inhalation with hematogenous dissemination to meninges.
26
Mucor and Rhizopus fungi. - Population of infection, pathophysiology
Disease mostly in ketoacidotic diabetic and/or neutropenic patients (e.g., leukemia). Fungi proliferate in blood vessel walls, penetrate cribriform plate, and enter brain.
27
Mucor and Rhizopus fungi. - disease in face and brain. physical signs of disease, skin face and nerves
Rhinocerebral, frontal lobe abscess; cavernous sinus thrombosis. Headache, facial pain, black necrotic eschar on face; may have cranial nerve involvement.
28
Mucor and Rhizopus fungi. - signs of pathology, treatment.
Irregular, broad, nonseptate hyphae branching at wide angles surgical debridement, amphotericin B.
29
Pneumocystis jirovecii - typical disease, fungi or protist? primary route of infection
atypical pneumonia typically called pneumocystis pneumonia. considered a Fungi Inhaled. Most infections are asymptomatic.
30
Pneumocystis jirovecii - population of infection, signs on CT or x-ray, diagnosed with what test? signs on pathology.
Immunosuppression (e.g., AIDS) predisposes to disease. Diffuse, bilateral ground-glass opacities on CXR/CT A . Diagnosed by lung biopsy or lavage. Disc-shaped yeast forms on methenamine silver stain of lung tissue
31
Sporothrix schenckii –, monomorphic or dimorphic? primarily found on…? method of transmission
Dimorphic, cigar-shaped budding yeast that lives on vegetation spores are traumatically introduced into the skin, typically by a thorn (“rose gardener’s”disease)
32
Sporothrix schenckii – disease produced, what if the person is immunocompromised? treatment of disease
local pustule or ulcer with nodules along draining lymphatics (ascending lymphangitis) Disseminated disease possible in immunocompromised host. treatment: itraconazole or potassium iodide.
33
giardia – type of diarrhea produced, infected population. primary means of transmission, diagnosis on pathology.
bloating, flatulence, foul-smelling, fatty diarrhea (often seen in campers/hikers). transmitted through Cysts in water Trophozoites or cysts in stool.
34
Giardia – treatment
metronidazole
35
Entamoeba histolytica - clinical symptoms, G.I. and abdominal, signs on pathology, diagnosis? stool and blood
bloody diarrhea (dysentery), liver abscess (“anchovy paste” exudate), RUQ pain. histology shows flask-shaped ulcer, Serology and/or trophozoites (with RBCs in the cytoplasm) or cysts (with up to 4 nuclei) in stool
36
Entamoeba histolytica - treatment, for symptomatic and asymptomatic individuals
Metronidazole; iodoquinol for asymptomatic cyst | passers
37
Cryptosporidium - disease, normal versus immunocompromised.
Severe diarrhea in AIDS. Mild disease (watery diarrhea) in | immunocompetent hosts.
38
Cryptosporidium – transmission, diagnosis, with what stain?
Oocysts in water, Oocysts on acid-fast stain
39
Cryptosporidium treatment and prevention?
filtering city water supplies; nitazoxanide in immunocompetent hosts.
40
Toxoplasma gondii - Congenital toxoplasmosis equals? (eyes and brain) reactivation infection in AIDS leads to what finding on MRI?
chorioretinitis, hydrocephalus, and intracranial calcifications brain abscess seen as ring-enhancing lesions on CT/MRI
41
Toxoplasma gondii - most common mode of transmission, other modes, risk the pregnant women diagnosis? treatment?
Cysts in meat (most common); cysts in cat feces, Cysts cross the placental barrier and lead to congenital toxoplasmosis. Serology, biopsy (tachyzoite) Sulfadiazine + pyrimethamine
42
Naegleria fowleri - disease? transmission. diagnosis?
Rapidly fatal meningoencephalitis Swimming in freshwater lakes (think Nalgene bottle filled with fresh water containing Naegleria); enters via cribriform plate diagnosis by Amoebas in spinal fluid
43
Naegleria fowleri - best treatment available?
Amphotericin B has been effective for a few survivors
44
Trypanosoma brucei - disease, vascular and neurological name of the two different species
African sleeping sickness— enlarged lymph nodes, recurring fever (due to antigenic variation), somnolence, coma Trypanosoma brucei rhodesiense, Trypanosoma brucei gambiense
45
Trypanosoma Brucei – primary disease vector, diagnosis, treatment X2
the tsetse fly diagnosis by blood smear treatment: Suramin for bloodborne disease or melarsoprol for CNS penetration (“it sure is nice to go to sleep”; melatonin helps with sleep)
46
Plasmodium P. vivax/ovale P. falciparum P. malariae all lead to what disease? disease presentation? primary vector of disease?
malaria, which presents with Plasmodium. headaches, fever, shaking chills, prostration, and splenomegaly Anopheles mosquito is the primary vector of disease
47
P. vivax/ovale - nature of fever, timeframe, involvement of the liver? P. falciparum— nature of fever, timeframe, involvement of other organs P. malariae - fever cycle
48-hr cycle (tertian; includes fever on first day and third day, thus fevers are actually 48 hr apart); dormant form (hypnozoite) in liver severe; irregular fever patterns; parasitized RBCs occlude capillaries in brain (cerebral malaria), kidneys, lungs. P. malariae—72-hr cycle (quartan)
48
Plasmodium species – findings on blood smear, finding with Plasmodium vivax/ovale?
Blood smear: trophozoite ring form within RBC, schizont containing merozoites red granules (Schüffner stippling) throughout RBC cytoplasm seen with P. vivax/ovale
49
treatment for Plasmodium? mechanism, what if resistant to primary treatment? would you use in life-threatening infections? special considerations for Plasmodium vivax/ovale?
Chloroquine (for sensitive species), which blocks Plasmodium heme polymerase if resistant, use mefloquine or atovaquone/ proguanil If life-threatening, use intravenous quinidine or artesunate (test for G6PD deficiency) For P. vivax/ovale, add primaquine for hypnozoite (test for G6PD deficiency)
50
Babesia - disease, relationship to malaria, primary disease vector, diagnosis?
Babesiosis—fever and hemolytic anemia, with similar disease presentation and histological findings as malaria. the Ixodes tick is the primary disease factor much like Lyme disease, can often co-infect. ring forms on blood smear, presence of the Maltese cross sign, diagnosis by PCR
51
Babesia - treatment
atovaquone plus azithromycin.
52
Trypanosoma cruzi - disease, G.I. and cardiac? primary location of disease. Initial signs of disease?
Chagas disease—dilated cardiomyopathy with apical atrophy, megacolon, megaesophagus. primarily in South America Unilateral periorbital swelling (Romaña sign) characteristic of acute stage
53
Trypanosoma cruzi - primary disease vector, signs on blood smear, treatment
the primary disease vector is the Reduviid bug (“kissing bug”) feces, deposited in a painless bite (much like a kiss). a blood smear, presence of the protozoa Benznidazole or nifurtimox is treatment.
54
Leishmania donovani - disease presentation, blood cells?
presents with spiking fevers, hepatosplenomegaly, pancytopenia. the sand fly is the primary disease vector histology, blood smear shows Macrophages containing amastigotes
55
Leishmania donovani - treatment
Amphotericin B, sodium stibogluconate
56
Trichomonas vaginalis - presentation, Only mode of transmission? diagnosis? anatomical signs? treatment and prophylaxis
Vaginitis—foul-smelling, greenish discharge; itching and burning; different presentation than with bacterial vaginosis sexual contact is the only mode of ttransmission as it cannot form cyst and replicate outside of the body. diagnosis made by trophozoites on wet mount, presence of strawberry cervix treatment with metronidazole for both the woman and her sexual partner.
57
Enterobius vermicularis - disease, means of transmission, diagnosis? treatment?
Intestinal infection causing anal pruritus, transmission is fecal oral Treat with the bedazoles. eggs on the tape test.
58
Ascaris lumbricoides - disease, means of transmission, diagnosis? treatment?
Intestinal infection with possible obstruction at ileocecal valve, some lung involvement Fecal-oral; eggs visible in feces under microscope Bendazoles?
59
Strongyloides stercoralis - disease and latency, means of transmission, diagnosis?
Intestinal infection causing vomiting, diarrhea, epigastric pain, may reactivate years later in lead to superinfection of bacteria pneumonia, secondary to decreased immunity. May present like a peptic ulcer. Worms penetrate skin while in sand and soil. treat with ivermectin and Albendazole
60
Ancylostoma duodenale, Necator americanus - transmission, disease, treatment
Larvae penetrate skin Intestinal infection causing anemia by sucking blood from intestinal walls Bendazoles or pyrantel pamoate.
61
Trichinella spiralis - transmission, disease (eye, bloodstream, and constitutional), treatment?
Fecal-oral; undercooked meat (esp. pork) Intestinal infection; larvae enter bloodstream and encyst in striated muscle cells leading to inflammation of muscle. Bendazoles
62
Onchocerca volvulus (River blindness) - transmission, Disease, allergy? treatment?
female black fly Hyperpigmented skin and river blindness (black flies, black skin nodules, “black sight”); allergic reaction to microfilaria possible iver mectin
63
Loa loa - transmission, disease (skin and eye), treatment
Deer fly, horse fly, mango fly are the disease vectors, Swelling in skin, worm in conjunctiva treatment is with Diethylcarbamazine
64
Wuchereria bancrofti - transmission, disease (timeframe), treatment,
transmission is through female mosquitoes Elephantiasis—worms block lymphatic vessels , takes 9 mo–1 yr after bite to become symptomatic treatment is Diethylcarbamazine
65
Toxocara canis - disease, transmission, treatment?
Visceral larva migrans, blindness in small children, transmission is fecal oral Treatment is Bendazoles
66
Taenia solium - transmission, disease (eggs versus larva), treatment (eggs versus larvae)
Ingestion of larvae encysted in undercooked pork if larvae are ingested, leads to Intestinal infection, that can be treated with praziquantel ingestion of the eggs can lead to Cysticercosis, neurocysticercosis, which can be treated with, praziquantel plus albendazole for the neurocysticercosis
67
Diphyllobothrium latum - transmission, disease, treatment
Ingestion of larvae from raw freshwater fish causes a vitamin B12 deficiency that eventually leads to megaloblastic anemia, Praziquantel is the treatment
68
Echinococcus granulosus - transmission, disease, treatment (avoidance of allergic reaction).
Ingestion of eggs from dog feces. Sheep are an intermediate host Hydatid cysts in liver ,causing anaphylaxis if antigens released (hydatid cyst injected with ethanol or hypertonic saline to kill daughter cysts before removal) Albendazole
69
schistosomiasis – transmission
Snails are host; cercariae penetrate skin of humans, you are the exit up his feces
70
schistosomiasis mansoni, japonicum, and haematobium disease characteristics.
Liver and spleen enlargement (S. mansoni, egg with lateral spine, S.japonicum, ), fibrosis, and inflammation (pipe stem necrosis) Chronic infection with S. haematobium (egg with terminal spine ) can lead to squamous cell carcinoma of the bladder (painless hematuria) and pulmonary hypertension Praziquantel
71
Clonorchis sinensis transmission, disease and complications, treatment
Undercooked fish biliary tract inflammation leading to pigmented gallstones can eventually lead to chlangiocarcinoma.