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HDID Block 2 > L60 > Flashcards

L60 Flashcards

1
Q

Which 3 fungi should you be thinking about for opportunistic mycoses due to altered T cell fxn?

A
  1. MUCOCUT candidasis
  2. Cryptococcosis
  3. Pneumocystosis
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2
Q

What are the 3 AIDs defining illnesses?

A

Cryptococcosis
Pneumocystosis
Esophageal candidasis

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3
Q

What 3 fungi should you be thinking about for opportunistic mycoses due to altered phagocytic activity?

A

INVASIVE candidiasis
Aspergillosis
Zygomycosis

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4
Q

Why must you be immune compromised to get a candida infection?

A

B/c part of normal flora otherwise!

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5
Q

What are some examples of mucocutaneous candidasis infections? (Aka these are how you should be thinking of these infections presenting in the ED)

A 
Oral thrush 
Esophageal 
Epiglottis 
Onychomycosis 
Vulvovaginal
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6
Q

Who are some patients that would develop mucocutaneous candidasis?

A

Those w/ defective T cells:

  • Corticoidsteroids (inhaler)
  • AIDs
  • Women on birth control
  • Diabetes
  • Babies
  • Antibiotics
  • Elderly
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7
Q

What are some examples of systemic/deep candida infections?

A

Candidemia
Endocarditis
Heptosplenic

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8
Q

Which patients are at risk for systemic candida infections?

A 
Leukemia/lymphoma (neutropenic)
\+ Catheter to ICU pt
Trauma, burns
Transplant pts
EYES!
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9
Q

What will you see on scraping sample for candida infections?

A

All 3!
Hyphae
Pseudohyphae
Budding cells

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10
Q

What inherited condition would present with skin candida infections?

A

APECED - recessive

  • Polyendocrinopathy
  • Candidosis
  • Ectodermal dystrophy
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11
Q

Treat mucocutaneous candidiasis

A

Topical clotrimazole

Severe: PO fluconazole

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12
Q

Treat systemic candidiasis

A

Echinocandins - big guns!!

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13
Q

Candida VFs

A

Surface receptors = adhesion
Enzymes
Host mimcry
Dimorphism - opposite of usual!

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14
Q

What toxin does aspergillus produce? Why is this so concerning?

A

Aflatoxin

Liver toxic/carcogenic!

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15
Q

Where in the environment would you find aspergillus/its toxin?

A

Peanut or grain plants

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16
Q

Talk through the pathogenesis of aspergillosis invasion and infection in the LUNG

A

Inhale conidia
Impaired immune host - alveolar macrophages don’t kill the inhaled fungus
Germinate
Hyphae invade lung parenchyma
Angioinvasion b/c defective neutrophils
- Infarction
May or may not spread throughout vasculature

17
Q

Shape and classification of aspergillus

A 
Angular
Dichotomous (Y)
Branching
Septate
W/ hyphae
18
Q

What is the difference between the pathogenesis for aspergillus infection in neurtopenic vs immune suppressed patients?

A

Neutropenia:

  • Coag necrosis
  • Dissemination (nothing to fight it leaving site of infection)

Immune suppression

  • Inflam necrosis
  • Local invasion
19
Q

What are the 2 lung lesions you might see with aspergillus infection?

A

Halo sign

Crescent sign

20
Q

Treat aspergillosis

A

Voriconazole

HDID Block 2 (39 decks)

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