Fungus

Question 1

does vaginitis (vulvovaginal candidiasis) increase in AIDS pts?

Answer 1

no; predisposing factor but not higher than normal pop

Question 2

Dermatophytosis

Answer 2

produce keratinase (degrade keratin for nrg)
mycetoma: subcutaneous tissue infection - rete mucosa
PAS (periodic acid-shiff) stain to visualize the fungus
“id” allergic reaction by Type2/3 immune complex
type 1 IgE hypersensitivity
T-cell immunity: protective
diagnosis: hyphae visible on KOH -> culture on DTM (based on acid pH)

Question 3

Resistance to Azoles (candida) - inherent (not plasmid-mediated)

Answer 3

1. overexpression of ERG11 (enzyme that makes ergosterol)
2. overexpression of membrane efflux pumps
3. point mutation of ERG11 (azole target)
4. cross-resistance among azoles

Question 4

azole inhibits erg11 enzyme (CYP450) enzymes and shouldn’t be given with which drug that’s also metabolized by CYP450?

Answer 4

statin