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[3Y1S] Myco Viro > [Lec] MU6: Opportunistic Mycoses > Flashcards

[Lec] MU6: Opportunistic Mycoses Flashcards

1
Q

Infections in patients with immune deficiencies who would otherwise not be infected

A

Opportunistic Mycoses

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2
Q

Infections seen in those people with impaired host defenses

A

Opportunistic Mycoses

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3
Q

Odd One Out:
Impaired Host Defenses
a. AIDS
b. Alteration of normal flora
c. Diabetes mellitus
d. Immunosuppressive therapy
e. Presence of indigenous microbiota
f. Malignancy

A

e. Presence of indigenous microbiota
(normal flora)

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4
Q

Type of Opportunistic Mycoses:
part of a normal human flora

A

Endogenous

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5
Q

Type of Opportunistic Mycoses:
fungus does not normally live in/on human body

A

Exogenous

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6
Q

Endogenous species

A

Candida albicans and other spp.
Pneumocystis jirovecii

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7
Q

Exogenous species

A

Cryptococcus neoformans
Aspergillus spp.
Zygomycetes

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8
Q

Candidiasis / Moniliasis:
causative agent

A

Candida albicans and other Candida spp.

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9
Q

What disease:
caused by Candida albicans and other Candida spp.

A

Candidiasis / Moniliasis

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10
Q

What species:
Oval, budding yeast that produces pseudohyphae

A

Candida albicans

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11
Q

What species:
causes the most frequent opportunistic fungal infections

A

Candida albicans

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12
Q

What species:
Harmless inhabitants of the skin and mucous membranes (RT, GIT, female genital tract)

A

Candida albicans

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13
Q

T/F:
Compromised immune system keeps Candida on body surfaces

A

F; normal immune system

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14
Q

Odd One Out:
Risk Factors for Candidiasis/Moniliasis
a. Neutropenia
b. Diabetes mellitus
c. AIDS
d. SCID
e. Antineoplastic therapy

A

e. Antineoplastic therapy;
RF for Pneumocystis

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15
Q

Odd One Out:
Risk Factors for Candidiasis/Moniliasis
a. Myeloperoxidase defects
b. Broad-spectrum antibiotics
c. Corticosteroid therapy
d. Indwelling catheters
e. Major surgery

A

c. Corticosteroid therapy
RF for Pneumocystis, Cryptococcosis/Torulosis, & Aspergillosis

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16
Q

Odd One Out:
Risk Factors for Candidiasis/Moniliasis
a. Organ transplantation
b. Hematological malignancy
c. Neonates
d. Severity of any illness
e. Intravenous drug addicts

A

b. Hematological malignancy;
RF for Cryptococcosis/Torulosis & Aspergillosis

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17
Q

What disease:
Although it is endogenous in most cases, cross infections are described, especially in intensive care unit patients

A

Candidiasis/Moniliasis

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18
Q

What disease:
Oral thrush, Oezophagitis, Vulvovaginal infection, Onychomycosis

A

Candidiasis/Moniliasis
(Cutaneous and Mucosal Candidiasis)

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19
Q

Cutaneous candidiasis:
seen in what types of patients?

A

skin trauma, burn patients

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20
Q

Mucocutaneous candidiasis
seen in what types of patients?

A

SCID patients

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21
Q

Choose 3: Invasive Candidiasis
a. Systemic
b. Disseminated
c. Cutaneous
d. Hematogenous

A

a. Systemic
b. Disseminated
d. Hematogenous

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22
Q

Invasive Candidiasis:
Usually begins with __________

A

candidemia

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23
Q

Candidemia:
* Only about ____% of cases can be proven
* Mortality is ____%

A

50% proven
30-40% mortality

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24
Q

T/F:
In invasive candidiasis, invasive infection stops in compromised phagocytic system.

A

F;
normal phagocytic system

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25
Q

T/F:
In normal phagocytic system of invasive candidiasis, infection spreads to many organs and causes focal infection in these organs.

A

F;
In compromised phagocytic system

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26
Q

Choose 4:
Defense mechanism against Candidiasis/Moniliasis
a. Skin and mucous membranes integrity
b. Presence of normal bacterial flora
c. Phagocytosis
d. Immune suppression
e. T-cells (CD4)

A

a. Skin and mucous membranes integrity
b. Presence of normal bacterial flora
c. Phagocytosis
e. T-cells (CD4)

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27
Q

T/F:
Defense mechanisms against Candidiasis/Moniliasis include killing, mostly in macrophagses, less in polymorphonuclear cells.

A

F;
killing mostly in polymorphonuclear cells, less in macrophages

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28
Q

Candidiasis/Moniliasis:
Specimen for lab diagnosis

A

CESS:
CSF
Exudates
Sputum
Swabs or Scrappings from lesions

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29
Q

What species:
Microscopic morphology: Gram (+) oval, budding yeast/ elongated budding cells in chain (pseudohyphae)

A

Candida spp

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30
Q

Candida spp:
appearance in SDA

A

soft, cream-colored colonies with a yeasty odor, surface growth consists of oval budding cells

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31
Q

Candidiasis/Moniliasis:
Ferments _______ and _______ producing acid and gas for lab diagnosis

A

glucose
maltose

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32
Q

Candidiasis/Moniliasis:
Serological test

A

Precipitation tests

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33
Q

Candidiasis/Moniliasis:
Treatment

A

FANC:
Fluconazole
Amphotericin B
Nystatin
Caspofungin

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34
Q

Candidiasis/Moniliasis:
Treatment for neutropenic patients

A

Amphotericin B

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35
Q

Candidiasis/Moniliasis:
Treatment for nonneutropenic patients

A

Fluconazole

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36
Q

Candidiasis/Moniliasis:
Treatment that suppresses intestinal and vaginal candidiasis

A

Nystatin

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37
Q

Pneumocystis Pneumonia:
causative agent

A

Pneumocystis jirovecii

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38
Q

What disease:
caused by Pneumocystis jirovecii

A

Pneumocystis Pneumonia

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39
Q

What species:
was formerly carinii and was previously classified as a protozoa but now considered a fungus based on nucleic acid and biochemical analysis

A

Pneumocystis jirovecii

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40
Q

What species:
Present in lungs of many mammals, including humans in persistent but harmless infection

A

Pneumocystis jirovecii

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41
Q

Odd One Out:
Risk Factors for Pneumocystis Pneumonia
a. Myeloperoxidase defects
b. AIDS
c. Transplantation
d. Corticosteroid
e. Antineoplastic therapy

A

a. Myeloperoxidase defects
RF for Candidiasis/Moniliasis

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42
Q

Pneumocystis:
Clinical manifestation

A

Interstitial pneumonitis (in compromised patients)

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43
Q

Pneumocystis:
Defense Mechanism

A

T-cell mediated

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44
Q

Pneumocystis Pneumonia:
Treatment

A

Co-trimoxazole
Pentamidine

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45
Q

Cryptococcosis/Torulosis:
causative agent

A

Cryptococcus neoformans

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46
Q

What disease:
caused by Cryptococcus neoformans

A

Cryptococcosis/Torulosis

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47
Q

What species:
Causes an acute or chronic infection that involves the brain

A

Cryptococcus neoformans

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48
Q

What species:
Occurs worldwide in soil and in bird droppings

A

Cryptococcus neoformans

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49
Q

What species:
Prominent feature is thick polysaccharide capsule, which causes evasion from phagocytosis

A

Cryptococcus neoformans

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50
Q

Odd One Out:
Risk Factors for Cryptococcosis/Torulosis
a. T-cell deficiency (AIDS patients)
b. Bone marrow transplantation
c. Corticosteroid therapy
d. Organ transplantation
e. Hematological malignancy

A

b. Bone marrow transplantation
RF for Aspergillosis

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51
Q

T/F:
Cryptococcosis/Torulosis is transmitted from human to human.

A

F

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52
Q

What disease:
A slowly developing chronic meningitis that resembles a brain tumor

A

Cryptococcosis/Torulosis

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53
Q

What disease:
Brain abscess

A

Cryptococcosis/Torulosis

54
Q

What disease:
Degenerative CNS disease

A

Cryptococcosis/Torulosis

55
Q

Cryptococcosis/Torulosis:
Infection is via ___________

A

respiratory tract

56
Q

What disease:
Symptoms associated with nonspecific pulmonary signs and symptoms

A

Cryptococcosis/Torulosis

57
Q

What disease:
May disseminate in other organs like the brain

A

Cryptococcosis/Torulosis
(most common is cryptococcal meningitis)

58
Q

Cryptococcosis/Torulosis:
most common manifestation when it disseminates in other organs like the brain

A

Cryptococcal Meningitis

59
Q

Cryptococcosis/Torulosis:
Defense mechanism
________ responsible for defense

A

T-cells

60
Q

Cryptococcosis/Torulosis:
Cryptococcus reaches humans by?

A

inhalation of aerosolized yeast cells

61
Q

Cryptococcosis/Torulosis:
Specimen for lab diagnosis

A

SUCE:
Sputum
Urine
CSF
Exudate

62
Q

What species:
Microscopic morphology:
round or ovoid, often budding with thick capsule

A

Cryptococcus neoformans

63
Q

Cryptococcus neoformans:
appearance in SDA

A

cream, shiny, mucoid colonies

64
Q

Cryptococcosis/Torulosis:
serological tests

A

CoPy-CAT LAT:
Cryptococcal polysaccharide capsular antigen test
Latex agglutination test

65
Q

Cryptococcosis/Torulosis:
Treatment

A

Combination of chemotherapy of:
Amphotericin B
Flucytosine

66
Q

Cryptococcosis/Torulosis:
Recurrence Prevention

A

Fluconazole

67
Q

Aspergillosis:
causative agent

A

Aspergillus spp.

68
Q

What disease:
caused by Aspergillus spp.

A

Aspergillosis

69
Q

What species:
worldwide occurring saprophytes, living in soil and on plants

A

Aspergilli

70
Q

What species:
have small conidia that form aerosols

A

Aspergilli

71
Q

Odd One Out:
Risk Factors for Aspergillosis
a. Hematological malignancy
b. Bone marrow transplantation
c. Indwelling catheters
d. Corticosteroid therapy

A

c. Indwelling catheters
RF for Candidiasis/Moniliasis

72
Q

Aspergillosis:
defense mechanism

A

Phagocytosis

73
Q

Aspergillosis:
specimen for lab diagnosis

A

Tissue Biopsy

74
Q

Aspergillus spp:
microscopic morphology using what stain

A

hyphal fragments (methenamine silver)

75
Q

Aspergillus spp:
apperance in SDA

A

gray to green colonies

76
Q

Aspergillus spp:
treatment

A

FASI:
Flucytosine
Amphotericin B
Surgery
Itraconazole

77
Q

T/F:
Prevention of Aspergillosis includes avoiding exposure to conidia (new buildings).

A

T

78
Q

Zygomycosis:
Causative agents

A

Rhizopus
Mucor
Absidia
Rhizomucor

79
Q

Zygomycosis:
Also called as?

A

Mucormycosis
Phycomycosis

80
Q

What disease:
caused by zygomycetes, principally by the species of Rhizopus, Mucor, Rhizomucor, Absidia

A

Zygomycosis/ Mucormycosis/ Phycomycosis

81
Q

What species:
These fungi are ubiquitous thermotolerant saprophyte; spores are present in air and dust

A

Zygomycetes
(Rhizopus, Mucor, Rhizomucor, Absidia)

82
Q

What Class:
an obsolete polyphyletic taxon that form coenocytic hyphae and reproduce asexually by producing sporangiophores within which develops sporangiospores

A

Class Phycomycetes

83
Q

T/F:
Class Phycomycetes form coenocytic hyphae and reproduce sexually by producing sporangiophores within which develops sporangiospores.

A

F;
reproduce asexually

84
Q

Rhizopus:
Mycelium is differentiated
into 3 types of hyphae, which are?

A
  1. Stolon
  2. Rhizoid
  3. Sporangiophores
85
Q

What species:
Mycelium is differentiated
into 3 types of hyphae, which are:
1. Stolon
2. Rhizoid
3. Sporangiophores

A

Rhizopus

86
Q

What species:
Mycelium has only one type of hyphae → Sporangiophores

A

Mucor

87
Q

What species:
Rhizoids are present

A

Rhizopus

88
Q

What species:
Food materials are absorbed
mainly by rhizoids.

A

Rhizopus

89
Q

What species:
Sporangiophores occurs in tufts from the stolons opposite the rhizoids.

A

Rhizopus

90
Q

What species:
Spores easily disseminated by the wind.

A

Rhizopus

91
Q

What species:
Rhizoids are absent.

A

Mucor

92
Q

What species:
Sporangiophores usually occur singly from any point on the mycelium

A

Mucor

93
Q

What species:
Food is absorbed by the
entire mycelial surface

A

Mucor

94
Q

What species:
Spores remain adhered to
the columella thus not easily
disseminated

A

Mucor

94
Q

What species:
Difference from Mucor:
Mucor have no rhizoids

A

Absidia

95
Q

What species:
Difference from Rhizopus:
Rhizoids in between Sporangiophores

A

Absidia

96
Q

What species:
Difference from Mucor:
Have rhizoids and stolons;
grows at 50- 55°C

A

Rhizomucor

97
Q

What species:
Difference from Rhizopus:
Have branched sporangiophores

A

Rhizomucor

98
Q

What species:
Difference from Absidia:
Have globose sporangia and sporangiophores are not swollen where they merge with the columellae

A

Rhizomucor

99
Q

Odd One Out:
Zygomycosis Risk Factors
a. Acidosis
b. Severity of any illness
c. Leukemias
d. Leukemias

A

b. Severity of any illness
RF for Candidiasis / Moniliasis

100
Q

Odd One Out:
Zygomycosis Risk Factors
a. Corticosteroid treatment
b. Severe burns
c. Immunodeficiencies
d. Antineoplastic therapy

A

d. Antineoplastic therapy
RF for Pneumocystic Pneumonia

101
Q

What disease:
Clinical manifestations include Rhinocerebral Mucormycosis.

A

Zygomycosis/ Mucormycosis/ Phycomycosis

102
Q

What disease:
Clinical manifestations include Thoracic Mucormycosis.

A

Zygomycosis/ Mucormycosis/ Phycomycosis

103
Q

What disease:
Clinical manifestations include other sites of invasion

A

Zygomycosis/ Mucormycosis/ Phycomycosis

104
Q

What clinical manifestation (Zygomycosis):
Results from germination of the sporangiospores in the nasal passages and invasion of the hyphae into the blood vessels, causing thrombosis, infarction and necrosis

A

Rhinocerebral Mucormycosis

105
Q

What clinical manifestation (Zygomycosis):
The disease can progress rapidly with invasion of the sinuses, eyes, cranial bones and brain

A

Rhinocerebral Mucormycosis

106
Q

What clinical manifestation (Zygomycosis):
Blood vessels and nerves are damaged, and patients develop edema of the involved facial area, a bloody nasal exudate, and orbital cellulitis

A

Rhinocerebral Mucormycosis

107
Q

What clinical manifestation (Zygomycosis):
It is almost invariably associated with acute diabetes mellitus or with debilitating diseases such as leukemia or lymphoma.

A

Rhinocerebral Mucormycosis

108
Q

What clinical manifestation (Zygomycosis):
This follows inhalation of the sporangiospores with invasion
of the lung parenchyma and vasculature

A

Thoracic Mucormycosis

109
Q

What clinical manifestation (Zygomycosis):
In both locations, ischemic necrosis causes massive tissue
destruction

A

Thoracic Mucormycosis

110
Q

T/F:
Other sites of invasion of aspergillosis include primary cutaneous infections such as skin infections following burns or surgery have also been reported.

A

F;
Zygomycosis

111
Q

T/F:
Subcutaneous zygomycosis cases are also reported.

A

T

112
Q

Zygomycosis:
Specimen for lab diagnosis

A

Nasal discharge
Sputum
Biopsy

113
Q

Zygomycetes:
microscopic morphology using what stain

A

Using KOH:
Broad and aseptate
Branched mycelium (sometimes distorted hyphae)
stained by Methenamine silver stain

114
Q

Zygomycetes:
appearance in SDA

A

abundant and cottony

115
Q

Zygomycosis:
Treatment

A

Amphotericin B

116
Q

Penicilliosis / Talaromycosis:
causative agent

A

Talaromyces marneffei
(formerly Penicillium)

117
Q

What disease:
caused by Talaromyces marneffei (formerly Penicillium)

A

Penicilliosis / Talaromycosis

118
Q

What species:
There are more than 150 Penicillium species; when it was still classified as Penicillium it was the only most medically important species

A

Talaromyces marneffei
(formerly Penicillium)

119
Q

What species:
Thermally dimorphic fungi

A

Talaromyces marneffei
(formerly Penicillium)

120
Q

What species:
saprophytes, present in the environment and grow on various substrates such as bread, jam, fruit and cheese

A

Talaromyces marneffei
(formerly Penicillium)

121
Q

What species:
has been reported to be an important
opportunistic pathogen in the HIV
infected

A

Talaromyces marneffei
(formerly Penicillium)

122
Q

What species:
It causes disseminated infection with
multiple organ involvement.

A

Talaromyces marneffei
(formerly Penicillium)

123
Q

Odd One Out:
Risk Factors for Penicilliosis / Talaromycosis
a. Adult-onset immunodeficiency syndrome
b. Diabetic Ketoacidosis
c. Cancer
d. HIV/AIDS
e. Organ transplant

A

b. Diabetic Ketoacidosis
RF for Zygomycosis

123
Q

What species:
Common in Southeast Asia

A

Talaromyces marneffei
(formerly Penicillium)

124
Q

What disease:
Bamboo rats can also get ___________.

A

Talaromycosis

125
Q

T/F:
In Penicilliosis / Talaromycosis, infection can be spread from Bamboo rats to people and from person to person.

A

F;
No evidence of spread from Bamboo rats to people
No person to person spread

126
Q

Penicilliosis / Talaromycosis:
specimen for lab diagnosis

A

Bone Marrow
Blood
Lung Fluids
Lymph
Nodes
Skin

127
Q

Talaromyces marneffei:
microscopic morphology

A

yeast are small, oval, 2-4 µm in diameter

128
Q

Talaromyces marneffei:
appearance in SDA

A

yellow green colonies with characteristic soluble red pigment

129
Q

Talaromyces marneffei:
molecular technique

A

PCR

130
Q

Penicilliosis / Talaromycosis:
treatment

A

Amphotericin B
Oral Itraconazole

[3Y1S] Myco Viro (5 decks)

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