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MOD 1 EXAM 3 > Fungus > Flashcards

Fungus Flashcards

1
Q

Systemic Mycososes

and location

A
  1. Hisplasma capsuluta: Midwestern US ( Ohio/Missippi River Valley)
  2. Blastomycosis dermatitis (Southern and Eastern US/ Great Lakes and Ohio River Valley)
  3. Coccoides immititans (Southwestern US: AZ, NM, Mexico, Cali; San Joaquin Valley) DUST
  4. Paracoccidioesmucoses => brazilan blastomyosis (SA and brazil)
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2
Q

All systemic mycoses are dimorphic. However, which is weird

A

Coccoides imitations
Cold: mold (25-30)

Heat (35-37): spherule of endospores. When the spherule ruptures, it releases the endospore to go throughout our body

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3
Q

What skin conditions do we see in coccidioes and histoplasma

A

erythema nodosum; but these are more common in cocciodies

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4
Q

Coccoides imititans can affext what in immunocompromised

A

skin
bone
lungs
meninges (HA and stiff neck)

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5
Q

dx Coccoides imititans

A
  1. KOH stain/culture

2. Seriology: IgM AB titers

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6
Q

what does the yeast form of Paracoccidioidomycosis look like?

how is it transmitted?

A

central vacoule with multiple buds that radiate out (captains wheel)

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7
Q

 Paracoccidioidomycosis how is it transmitted?

A

respiratory droplets => inhaled =: LYMPHADENOPATHY (cervica => axillary and inguinal; moves down). As the disease progresses, it affects the lungs and URT, forming MUCOSAL LESIONS (ulcers in the URT and mouth)

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8
Q

________ and ______ lymphadenopathy are the most important defining clinical features of the Paracoccidioidomycosis.

A

mucocutaneous lesions and

cervical lymphadenoopathy

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9
Q

Which cutaneous fungus is dimorphic (only one)

A

Sprothrix schenkii = Sporotrichosis (Rose Gardners Dz)

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10
Q

All systemic mycoses can form what?

A

granulosum, like TB

pneunmonia

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11
Q

Which fungus is most often confused for TB?

A

Histoplasma

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12
Q

which fungus a clinical presentation in heathly that is similar to acute pneo: coughing, arthralgia, fever?

A

Coccidious imitatans

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13
Q

Who is more suceptible to infections in catalase + organisms?

A

People with chronic granumatous diseases

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14
Q

What two fungi are CATALASE +?

What does this imply?

A
  1. Candida albicans
  2. Asperigullis Fumigatus

This implies that people with chronic granulomatous disease are more susceptible

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15
Q

Aspergillus ______, produces AFLATOXINS, which does what?

A

Aspergillus FLAVUS => alflatoxins => can cause hepatocellular carcinoma

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16
Q

Morphology can be used to distinguish Aspergillus vs. Mucor

How?

A

Aspergillus have

acute branching hyphae (<45 degrees) with SEPTATIONS.

17
Q

How is asperigillus transmitted?

A

Forms conidiophores with fruiting bodies. They sit at the top and are released into air => inhaled in humans.

18
Q

3 main infections caused by aspergillus?

A
  1. Allergic Bronchopulmonary Aspergillosis (ABPA)
  2. Aspergillomas (fungus balls)
  3. Angioinvasive Aspergillosis
19
Q

What is Allergic Bronchopulmonary Aspergillosis (ABPA)

Who is more susceptible?

Blood tests wil lshow what?

A

Type 1 hypersensitivity reaction that causes [wheezing, fever and migratory pneumo]. Assx with: asthma pts and CF;

increased IgE

20
Q

Aspergillomas (fungus balls): who is more susceptible?

A

TB patients (those with pre-existing cavitary lesions) or Klebsiella.

21
Q

Who affects immunocompromised pts wiht aspergellis?

Which immunocompromised pts are more suscpetible

A

Angioinvasive Aspergillosis

Those with neutropenia d/t leukemia or lymphoma.

22
Q

Angioinvasive Aspergillosis invades BV and disseminates quiclkly. Thus, on imaging you can see the acute branched, septic hyphae in vessels.

What does it cause and what organs does it affect?

A
  1. Hemoptysis (bloody cough)
  2. Fever

Heart (endocarditis)
kidneys (renal failure
Black ring enhancing lesions in the brain.
Paranasal necrosis (necrosis around the nose)

23
Q

LEss serious infections of Aconazole can be treated how?

A
  1. VORICONAZOLE

2. MUST be surgically debreded

24
Q

How is cryptococcus neoformans, a oportunistic infection, different from other fungi?

A
  1. Heavily encpsulated with repeating polysaccharide antigens on the capsule; which is its main VF and makes it anti-phagocytic
  2. Urease +
  3. MOST COMMON CAUSE OF FUNGAL MENINGITIS
25
Q

How do we get cryptococcus neoformans?

Who is most commonly affected?

A

In soil in pigeon poop => enters body via inhalation and settles in lungs => disseminates throughout the body (CSF)

HIV pts, cancer pts

26
Q

Sx of cyrtococcus neoformans

A
  1. Cough/resp problems
  2. Fever
  3. Fungal meningitis, with soap bubble lesions in grey matter seen on images, which can cause DEATH
27
Q

What culture is used for all FUNGI, but rarely used bc it takes so long?

A

Sabouraud’s agar

28
Q

Dx of cryptococcus neoformans,

A
  1. Culture with Sabouraud’s agar (slow)
  2. Bronchopulmonary washings of lung tissue, stained with red (mucicarmine) or silver (methananime) stain
  3. Dx meningitis: Lumbar puncture and CSF stained with iindia ink: darkens background will organism is transparent (negative staining technique); yeast will as wide clear zone with capsular halos
  4. Latex agglutination test is more sensitive. It detects the repeating capsular polysaccharide antigens => causes agglutination.
  5. Soap bubble lesions
29
Q

Tx of cryptococcus neoformans,

A
  1. Amphotericin B + Flucytosine

2. Fluconazole

30
Q

what is the most COMMON CAUSE OF FUNGAL MENINGITIS?

A

CRYPTOCOCCUS NEOFORMAS

31
Q

Pt comes in with a CD4 count below 200 and a diffuse, interstitial pneumonia and a NON-productive cough.

What does this patient have?

What will a CXR show?

A
  1. Pneumocystis jiroveci causes pneuocystis pneumonia, a opportunistic fungus that is most common in AIDS patients (CD4 count below 200).

Diffuse, interstitial pneumonia with a ground glass appearance.

32
Q

In the fungus Pneumocystis jiroveci,, who can get it.

A

Both normal AND immunocom people, but only immunocomp will show sx.

33
Q

Pneumocystis pneuomonia, is a ______-definining illness

A

AIDS

34
Q

How do we DX Pneumocystis jiroveci?

A
  1. BAL (bronchoalveolar lavage, which rinses lungs

2. Tissue sample=> stain with Methamine silver: will appear disk/ oval)

35
Q

What is BACITRACIN

A

A sulfa-drug prophalyxis for anyone with CD4 <200 AND to TX pneumocystis jrivocci

36
Q

IF someone has a sulfa allergy, how do we treat PCP (pneumocystis pneumo)

A

Pentamadine

37
Q

What is the MOST prevalent AIDS-defining illness

A

Pneumocystis jiroveci pneumonia (PCP Ping Pong)

MOD 1 EXAM 3 (7 decks)

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