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CLINICAL MED I- ID (part 2) > FUNGUS > Flashcards

FUNGUS Flashcards

1
Q

what are fungi

A

eukaryotic, non motile, rigid cell wall (chitin/polysacch), ergosterol cell membrane

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2
Q

fungi- yeasts describe and name (review)

A
  • round/oval/budding repro
  • candida
  • cryptococcus neoformas
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3
Q

fungi- molds describe and list (review)

A

tubular hyphae, aspergillus

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4
Q

dimorphic fungi- name

A

histoplasmosis (endemic fungi)

year OR mold form

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5
Q

chest CT scan used for what?

A

pneumocystis jirovecii pneumonia

(PCP)

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6
Q

PCP Pneumonia- what is it, common in who, high risk lab result??

A

fungi w protozoa characteristics

  • common in AIDS pts (before prophylaxis)
  • CD4>200 high risk
  • 10-20% population carries, eventually clears
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7
Q

PCP S+S

A
  • progressive dyspnea (short of breath)
  • non productive cough
  • fever
  • hypoxemia
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8
Q

PCP lab/image findings

A
  • hypoxemia (extertional/when walking with pulse ox)
  • elevated LDH
  • CXR (bilat symmetrical pattern)/CT chest (ground glass)
  • ground glass opacity on x-ray (inc opacity)
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9
Q

PCP diagnose/test

A
  • PCR sputum
  • bronchoscopy into lungs, squirts water and soaks up water to send for analysis (PCR)
  • serum B-D-glucan positive
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10
Q

PCP treatment

A

BACTRIM.—-TMP/SMX for 21 days

  • possibly steroids for hypoxemia
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11
Q

PCP prophylaxis

A

start when CD4<200 w HIV/immunocomp pt

BACTRIM IS FIRST LINE.

(less than 200=aids, need to be on antibio)

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12
Q

Candida- what are they, grow how

A

yeast, unicellular, grow well in CULTURE media

albicans and glabrata!

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13
Q

Candida found where

A

part of normal flora

can invade GI, female genital tract, skin

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14
Q

candida barriers

A
  • INTACT skin and mucosa
  • WBC
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15
Q

candida host risk factors

A
  • immunosuppression
  • DM
  • disruption of skin
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16
Q

candida exogenous risk factors

A
  • catheters (urinary, venous)
  • ABX use (kills normal flora)
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17
Q

candida auris- describe

A

HIGHLY RESISTANT to fluconazole (common treatment)

def consider when screening for candida infection

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18
Q

candida infections- THRUSH

  • describe
  • location
A

creamy, curd like patch on tongue/oral mucosa

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19
Q

thrush treatment

A

nystatin rinse

20
Q

candida esophagitis S+S

A
  • painful swallowing
  • heartburn
  • nausea
21
Q

candida esoph diagnose/test and treatment

A

endoscopy/visualization

fluconazole (oral)

22
Q

candida vaginitis

A

most common candida infection, candida overgrowth

23
Q

candida vag- treatment

A

topical fluconazole, or PO

24
Q

how do we diagnose all these candida?

A

physical exam

25
Q

urinary tract candidiasis
- associated with what

A

in urine, hard to treat

  • can be asymp or symp (cystitis)
  • assoc with ABX and CATHETER use
26
Q

candida bloodstream common in pt with?

A

LIFE THREATENING, high mortality

  • common in pt with LINES (pic line, cbc line)
  • seen in ICU, GI surgery
27
Q

Candida treatment overview

A

depends on location:

bloodstream- IV AZOLE

thrush- nystatin rinse, clotrimazole lozenge

mucosas- topical nystatin, PO fluconazole

esophagus- fluconazole

28
Q

when do you suspect fungi?

A

during NON RESOLVING pneumonia

(symptoms: nodules, fungal ball, effusion)

29
Q

endemic fungi 4 type

A

Histomycoces, blastomycoses, coccygiomycoses, cryptococcyges

30
Q

coccidioidomycosis

A
  • common in arizona and cali
  • self limited

usually not, but can be severe, meningitis syndrome

31
Q

coccidioidomycosis S+S

A

localized pulmonary infection

  • cough, chest pain, fever
  • pleural effusion
  • pulmonary disease
  • nodules (rare)
  • rash
32
Q

rare complication of coccidioidomycosis

A

extrapulmonary disease

33
Q

coccidioidomycosis diagnose/test

A

depends where it is/what tissue

lung- sputum culture

34
Q

treat coccidioidomycosis

A

fluconazole, itraconazole

severe disease- amphotericin, admitted for IV therapy

35
Q

histoplasmosis found where

A

soil contaminated, americas, islands caribbean

36
Q

histo S+S

A
  • pneumonia syndromes (early)

can cause meningitis

37
Q

histoplasmosis meds

A

fluconazole, itraconazole

or IV for severe

38
Q

blastomycosis is acute or chronic

A

acute, usually not recognized

39
Q

blastomycosis S+S

A
  • flu like illness
  • non healing lesion, can biopsy
  • if manifesting as extrapulmonary–> verrous or ulcerative lesions
40
Q

blastomyc usually manifested how

A

pulmonary
- flu like symptoms with abrupt onset

41
Q

blastomyc treatment

A

fluconazole

42
Q

cryptococcosis enters body how

A

inhale, pulmonary

meningitis- extrapulmonary

skin,blood- less common

43
Q

cryptococcosis treatment

A

prolonged course of IV therapy, amphoterecin With or without fluconazole

  • if pulmonary use flutconazole
44
Q

crypt treatment meningitis

A

IV therapy, amphotericin and flucytosine

45
Q

cryptococc treatment pulmonary disease

A

fluconazole

CLINICAL MED I- ID (part 2) (5 decks)

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