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Unit 4: D & D > Introduction to Fungal Pathogens > Flashcards

Introduction to Fungal Pathogens Flashcards

1
Q

Fungi may reproduce by ____ and/or ____ means, and the nature reproduction is used in classification.

A

sexual; asexual

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2
Q

Like plants, fungi have _____, a feature which separates them from animals. They contain chitin (a material also found in the exoskeleton of insects) and also cellulose (a material found in plant matter).

A

rigid cell walls

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3
Q

Fungi also have a cell membrane inside of the cell wall which contains _____.

A

ergosterol

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4
Q

Fungal species may be subclassified as ____, _____, _____, or _____.

A

saprobes, symbionts, commensals, or parasites

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5
Q

_____ live upon dead and decaying organic matter.

A

Saprobes

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6
Q

_____ live upon another organism to the mutual advantage of both.

A

Symbionts

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7
Q

Like plants, fungi have rigid cell walls, a feature which separates them from animals. They contain ____ (a material also found in the exoskeleton of insects) and also _____ (a material found in plant matter).

A

chitin; cellulose

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8
Q

_____ live upon another organism with no detriment to the host.

A

Commensals

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9
Q

Colonies of yeast are usually ____ or ____ in appearance.

A

moist; mucoid

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10
Q

Fungi also have a ____ inside of the cell wall which contains ergosterol.

A

cell membrane

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11
Q

What is a sapbrobe?

A

fungi that lives upon dead and decaying organic matter

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12
Q

_____ live upon another organism with clear detriment to the host.

A

Parasites

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13
Q

Fungi occur in two basic growth forms:

A
  1. yeast

2. molds

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14
Q

What is a symbiont?

A

fungi that lives upon another organism to the mutual advantage of both

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15
Q

YEAST - a _____ growth form where the fungus reproduces via budding to form _____, or by dividing in half through fission.

A

unicellular; blastoconidia

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16
Q

What are Commensals?

A

fungi that live upon another organism with no detriment to the host

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17
Q

Parasites are?

A

fungi that live upon another organism with clear detriment to the host

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18
Q

Medically relevant yeast includes ____ and ____.

A

Cryptococcus neoformans; Candida albicans

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19
Q

MOLDS - a _____ growth form where the fungus reproduces via formation of _____.

A

filamentous; spores or conidia

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20
Q

The filamentous elements in mold are called ____.

A

hyphae

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21
Q

A mass of hyphae is referred to collectively as ____.

A

mycelium

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22
Q

Medically relevant molds include ____ and _____.

A

common dermatophytes; Aspergillosis

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23
Q

Pseudohyphae are simply ____; they do not have _____.

A

elongated yeast linked together like sausages; cytoplasmic connections between the compartments

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24
Q

_____ is an organism that often forms pseudohyphae.

A

Common Candida albicans

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25
Q

Fungi that do not have a fixed morphology but may exist in a yeast or hyphal form are referred to as ____.

A

dimorphic

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26
Q

What triggers a dimorphic fungi to transition from one form to another?

A

an environmental change (atmosphere, temp, or food supply)

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27
Q

Name the medically-relevant thermally dimorphic organisms.

A 
S – some  Sporothrix schenckii
C – can  Coccidioides immitis
H – have  Histoplasmosa capsulatum
B – both  Blastomyces dermatitidis
P – phases  Paracoccidioides brasiliensis
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28
Q

_____ are a specialized from of hyphal elements that grow like roots from larger hyphae.

A

Rhizoids

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29
Q

____ are those that demonstrate complete cell walls that subdivide the hyphae into compartments.

A

Septate hyphae

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30
Q

_____ is an example of a septate hyphal fungus, as are the _____.

A

Aspergillus fumigatus; dermatophytes

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31
Q

What are conidia?

A

asexual spores borne off specialized aerial hyphae called conidophores

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32
Q

A conidium may be _____ or ____.

A

large and multinucleated; small and unicellular

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33
Q

What are the asexual spores called?

A

endospores

34
Q

What are chlamydospores?

A

thick walled, round spores that are highly resistant to adverse environmental conditions

35
Q

_____ form at the ends of hyphae, while ____ form along and within hyphae.

A

Terminal chlamydospores; intercalary chlamydospores

36
Q

What are arthrospores?

A

similar to chlamydospores but more numerous and elongated and likened to a barrel

37
Q

How does Coccidioides immitis cause disease?

A

by inhaling the spores

38
Q

What are spherules?

A

large, asexual spores that develop during the yeast phase of some organisms

39
Q

The yeast form of the dimorphic fungus _____ forms spherules in tissue that are filled with endospores.

A

Coccidioides immitis

40
Q

What are blastoconidia?

A

yeasts that bud asymmetrically

41
Q

What are thick-walled, round spores that

are highly resistant to adverse environmental conditions called?

A

chlamydospores

42
Q

These are large, asexual spores that develop during the yeast phase of some organisms.

A

spherules

43
Q

What are sclerotic/Medlar bodies?

A

thick-walled, environmentally protective forms of yeast

44
Q

What is a thallus?

A

a fungal colony growing on a culture dish

45
Q

What is the top side of the growing thallus called?

A

the obverse side

46
Q

What is the bottom side of the thallus called?

A

the converse side

47
Q

Define anthropophilic.

A

confined to humans and less inflammatory

48
Q

Define geophilic.

A

fungus found in soil

49
Q

Define zoophilic.

A

fungus found in animals

50
Q

Define dematiaceous.

A

fungus that produces its own pigment (usu melanin)

51
Q

Name 3 superficial fungal infections.

A
  1. tinea
  2. candida
  3. pityrosporum
52
Q

Name several deep/systemic fungal infections.

A 
Sporotrichosis
Cryptococcosis
Coccidioidomycosis
North American Blastomycosis
Histoplasmosis
Paracoccidiodomycosis
Lobomycosis
Mucormycosis
53
Q

What are dermatophytes?

A

fungi that utilize keratin as a substrate for growth (limits them to the hair, skin, and nails)

54
Q

What is candida?

A

non-dermatophyte yeast that prefers the glucose of interstitial fluids for growth

55
Q

What is pityrosporum?

A

non-dermatophyte yeast that prefers breakdown products of sebum for growth

56
Q

The ____ are characterized by their ability to cause systemic infection and usually begin infection in the lungs.

A

deep mycoses

57
Q

A patient with itching and scaling between the toes, who also frequents a local health club, and who’s condition has responded in the past to topical antifungal
creams likely has?

A

“Athlete’s foot” (tinea pedis)

58
Q

An AIDS patient with headache, mental confusion, and disseminated papules on the skin very likely has _____.

A

systemic cryptococcosis

59
Q

How are fungi examined by microscopy?

A
  1. take scraping of the epi
  2. add a drop of KOH or DMSO to clean the fungus of the human components
  3. maybe add chlorazol E black stain
  4. observe
60
Q

How is cryptococcosis viewed via microscopy?

A

CSF from a lumbar puncture is mixed with India ink, which stains everything EXCEPT cryptococcosis’ mucoid capsule

61
Q

What is the advantage of doing a fungal culture?

A

it allows for direct speciation of the infecting organism

62
Q

_____ is often used on fungal specimens taken from colonies grown via culture.

A

Lactophenol cotton blue stain

63
Q

_____ bind with ergosterol in the fungal cell membrane; they are considered to be fungicidal, leading directly to fungal cell death.

A

Polyenes

64
Q

____ binds to ergosterol, creating a pore in the fungal

membrane, which causes ions and other molecules to leak out of the cell.

A

Amphotericin B

65
Q

Name the polyenes.

A
  1. Amphotericin B

2. Nystatin

66
Q

_____ is another polyene used topically for Candida infections, although it is not absorbed when given by mouth and is too toxic for intravenous use.

A

Nystatin

67
Q

The imidazole and triazole antifungals inhibit the

enzyme, 14α-demethylase, the enzyme that converts lanosterol to ergosterol; these drugs are considered to be ____.

A

fungistatic

68
Q

The _____ inhibit the enzyme, 14α-demethylase, the enzyme that converts lanosterol to ergosterol; these drugs are considered to be fungistatic.

A

imidazole and triazole antifungals

69
Q

Oral imidazoles and triazoles also often interfere with _____, leading to potentially fatal drug interactions with certain medications.

A

cytochrome P450 enzymes

70
Q

Name an oral imidazole.

A

ketoconazole

71
Q

____ and _____ inhibit the enzyme squalene epoxidase, leading to accumulation of squalene within the fungal cell; this is toxic, making these agents fungicidal.

A

Allylamines; benzylamines

72
Q

The most common allylamine is _____.

A

terbinafine

73
Q

What is an issue with terbinafine?

A

it can unmask a lupus-like condition

74
Q

Which agents inhibit the synthesis of glucan in the cell walls of some fungi, probably via inhibition of the enzyme 1,3-β glucan synthase?

A

the Echinocandins

75
Q

In addition to fungicidal activity against _____, echinocandins are fungistatic against _____ but are not useful against many other forms of fungus.

A

Candida; Aspergillus

76
Q

_____ inhibits fungal cell mitosis by disrupting mitotic spindle formation, a critical step in cellular division.

A

Griseofulvin

77
Q

______ is a small molecule that is transported into fungal
cells by cytosine permease and is then converted in the
cytoplasm by cytosine deaminase to 5-fluorouracil (5-FU). 5-FU is a pyrimidine anti-metabolite that interrupts DNA synthesis.

A

Flucytosine

78
Q

_____ is thought to chelate polyvalent metal cations, such as Fe3+ and Al3+ leading to inhibition of many different fungal enzymes, including cytochromes.

A

Ciclopirox olamine

79
Q

A 64 year old man presents with an erythematous rash in the groin area

  • bright red erythema of the penis and scrotum
  • some satellite pustules
  • patient states due to his prostate condition his under- pants are often wet, and he wears occlusive absorbent undergarments.

Dx? Tx?

A

dx: Candidiasis
tx: Air drying, avoidance of prolonged wetness, blood sugar control, topical azoles, nystatin, or oral fluconazole

80
Q

A 51 year old man, otherwise healthy, presents with a pruritic macerated rash in the groin area. On inspection, you identify erythematous annular plaques of the thighs largely sparing the scrotum. The patient frequents an athletic club and states some of the other
members who he often associated with have had “jock itch.”

Dx? Tx?

A

dx: Tinea cruris (dermatophytosis)
tx: socks on before underpants, topical azoles or allylamines

81
Q

A 44 year old bone marrow transplant candidate develops fever, cough, dyspnea, chest pain and hemoptysis while neutropenic and before engraftment. Imaging reveals infiltrates in his lungs. Skin lesions develop with central necrosis. A skin biopsy contains hyphal elements with “acute angle branching” and vascular invasion.

Dx? Tx?

A

Dx: Aspergillosis

Tx: Voriconazole, posaconazole, amphotericin, or echinocandins, along with a reduction in the dose of immunosuppressives or reversing neutropenia with granulocyte colony-stimulating factors (G-CSF/GM-CSF)

Unit 4: D & D (22 decks)

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