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MICROPARA > M6 PART 2 > Flashcards

M6 PART 2 Flashcards

1
Q

FUNGI

targets immunocompromsed & immunosupressed

A

OPPORTUNISTIC MYCOSES

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2
Q

OPPORTUNISTIC MYCOSES

part of normal microbiota

A

endogenous

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3
Q

OPPORTUNISTIC MYCOSES

from external sources

A

exogenous

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4
Q

immune system is working

A

immunocompetent

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5
Q

OPPORTUNISTIC MYCOSES

  • dimorphic - can exist as mold or yeast
  • Causative agents – Candida parapsilosis, Candida glabrata, Candida tropicalis, Candida guilliermondii, and Candida dubliniensis
  • They form a pseudohyphae
  • Members of the normal flora of the skin, mucous membrane, and gastrointestinal tract
  • Endogenous
A

CANDIDIASIS

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6
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS

main causative agent

A

C. albicans

endogenous

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7
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS

they form a ____

A

pseudohyphae

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8
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS

Members of the ____ of the skin, mucous membrane, and gastrointestinal tract

A

normal flora

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9
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | CLINICAL FINDINGS

Cutaneous and Mucosal Candidiasus:
characterized by patchy to confluent, whitish pseudomembraneous lesion that can occur on the tongue, lips, gums, or palate

A

ORAL THRUSH

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10
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | CLINICAL FINDINGS

RISK FACTORS

A

Corticosteroids or antibiotics
Diabetes
Cellular immunodeficiency

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11
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | CLINICAL FINDINGS

  • characterized by irritation, pruritus, and discharge in the vaginal mucosa
  • the acidity of vagina is disturbed
A

VULVOVAGINITIS

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12
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | CLINICAL FINDINGS

occurs in moist, warm parts of the body
o Diaper rash in newborns
o Repeated prolonged immersion in water
o Onychomycosis – thickening and loss of nail

A

CUTANEOUS CANDIDIASIS

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13
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | CLINICAL FINDINGS

CUTANEOUS CANDIDIASIS:
thickening and loss of nail

A

ONYCHOMYCOSIS

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14
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | CLINICAL FINDINGS

  • Most often associated with chronic administration of corticosteroids or immunosuppressive agents; with hematologic diseases; or with chronic granulomatous disease
  • Candidal endocarditis associated with prosthetic heart valves
A

SYSTEMIC CANDIDIASIS

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15
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | CLINICAL FINDINGS

  • It is rare but distinctive clinical manifestation characterized by the formation of granulomatous candidal lesions on any or all cutaneous and/or mucosal surfaces.
  • Crusty lesions
A

CHRONIC MUCOCUTANEOUS CANDIDIASIS (CMC)

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16
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | TREATMENT

Thrush and other mucocutanenous forms of candidiasis

A

topical nystatin
oral ketoconazole
fluconazole

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17
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | TREATMENT

systemic candidiasis

A

amphotericin B

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18
Q

OPPORTUNISTIC MYCOSES | CANDIDIASIS | TREATMENT

Chronic mucocutaneous candidiasis

A

oral ketoconazole & other azoles

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19
Q

OPPORTUNISTIC MYCOSES

  • Causative agent – Cryptococcus neoformans and C. gattii
  • Possess a large polysaccharide capsules
  • May be visualize using India ink
  • Forms a narrow based body
A

CRYPTOCOCCOSIS

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20
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS

Causative agent

A

C. neoformans

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21
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS

possess a ____

A

large polysaccharide capsules

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22
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS

may be visualized using ____

A

indiana ink

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23
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS

forms a ____ body

A

narrow based

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24
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS | CLINICAL FINDINGS

transmission

A

from bird droppings (pigeon)

bird itself is not infected, only humans will be infected

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25
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS | CLINICAL FINDINGS

  • usually in immunocompromised
  • major clinical manifestation which can resemble:
    o Brain tumor
    o Brain abscess
    o Degenerative CNS disease
    o Any mycobacterial or fungal meningitis
A

chronic meningitis

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26
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS | CLINICAL FINDINGS

diseases

A

primary pulmonary ifection
chronic meningitis

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27
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS | TREATMENT

menigitis

A

Amphotericin B + flucocytosine

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28
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS | TREATMENT

non-AIDS px

A

amphotericin B

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29
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS | TREATMENT

HIV/AIDS patient treated with highly____ may develop immune reconstitution inflammatory syndrome (IRIS), which greatly exacerbates the illness

used to manage HIV

A

ANTI-RETROVIRAL THERAPY (ART)

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30
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS | TREATMENT

HIV/AIDS patient treated with highly active anti-retroviral therapy (ART) may develop ____, which greatly exacerbates the illness

A

IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS)

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31
Q

OPPORTUNISTIC MYCOSES | CRYPTOCOCCOSIS | TREATMENT

what to do to prevent IRIS

A

treat infection first before giving ART

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32
Q

OPPORTUNISTIC MYCOSES

  • Causative agents – A. fumigatus (most common human pathogen), Aspergillus flavus (produces aflatoxin causing mycotoxicosis), Aspergillus niger, Aspergillus terreus, and Aspergillus lentulus
  • Acquired through inhalation of conidia
  • Exists only as mold; not dimorphic
  • Forms a v-shaped branches
A

ASPERGILLOSIS

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33
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS

CAUSATIVE AGENTS:
most common human pathogen

A

A. fumigatus

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34
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS

CAUSTIVE AGENTS:
produces aflatoxin causing mycotoxicosis

A

A. flavus

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35
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS

acquired through inhalation of ____

A

conidia

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36
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS

spores produced by the microorganism

A

conidia

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37
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS

exists as ____

A

only as mold, NOT dimorphic

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38
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS

forms a ____ branches

A

v-shaped

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39
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS | CLINICAL FINDINGS

  • Hypersensitivity reaction because of the presence of aspergillosis in the bronchi of the lungs
  • Produce asthmatic symptoms and there is allergy because of IgE antibodies
A

Allergic Bronchopulmonary Aspergillosis (ABPA)

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40
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS | CLINICAL FINDINGS

  • Happens because of the ability of the organism to grow in the cavities within the lungs
  • Forms an asperula known as fungus ball
  • Some patients may be asymptomatic from aspergilloma but others develop cough, dsypnea, weight loss, fatigue, haemoptysis
  • Rarely invasive
  • Extrapulmonary colonization – nasal sinuses, ear canal, cornea canals, nails
A

ASPERGILOMA AND EXTRAPULMONARY COLONIZATION

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41
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS | CLINICAL FINDINGS

Aspergiloma and Extrapulmonary Colonization forms an ____ known as fungus ball

A

asperula

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42
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS | CLINICAL FINDINGS

  • Hyphae invade the lumens and walls of blood vessels causing thrombosis, infarction, and necrosis
  • From the lungs, the disease may spread to the GI tract, kidney, liver, brain, or other organs, producing abscesses and necrotic lesions.
A

INVASIVE ASPERGILLOSIS

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43
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS | CLINICAL FINDINGS

INVASIVE ASPERGILLOSIS:
____ invade the lumens & walls of the blood vessels

A

HYPHAE

44
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS | TREATMENT

aspergilloma

A

itraconazole
amphotericin B

45
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS | TREATMENT

invasive aspergillosis

A

amphotericin B
voriconazole

46
Q

drug that is always used for systemic infections

A

amphotericin B

47
Q

OPPORTUNISTIC MYCOSES | ASPERGILLOSIS | TREATMENT

allergic forms of aspergillosis

A

corticosteroids
disodium comoglycate

48
Q

OPPORTUNISTIC MYCOSES | MUCORMYCOSIS

most prevalent causative agent

A

RHIZOPUS ORYZAE

49
Q

OPPORTUNISTIC MYCOSES | MUCORMYCOSIS

____ of the cases of Mucormycosis are caused by Rhizopus oryzae

A

60%

50
Q

OPPORTUNISTIC MYCOSES | MUCORMYCOSIS

RISK FACTORS

A

diabteic ketoacidosis
dialysis w/ deferoxamine

51
Q

OPPORTUNISTIC MYCOSES | MUCORMYCOSIS

siderophore; sequester iron from the patient and then supplying iron to the fungi

A

deferoxamine

52
Q

OPPORTUNISTIC MYCOSES | MUCORMYCOSIS | CLINICAL FINDINGS

  • major clinical form
  • Spores germinate within the sinuses and forms an abundant of hyphae invading the blood vessels that supply the brain causing thrombosis
A

RHINOCEREBRAL MUCORMYCOSIS

53
Q

OPPORTUNISTIC MYCOSES | MUCORMYCOSIS | CLINICAL FINDINGS

  • Happens following the inhalation of organism
  • Sporangospores invades the lungs but necrosis may be observed resulting to the destruction of the tissue
  • Patients can survive but there is a possibility of long-term effect like facial paralysis, lose their eye
A

THORACIC MUCORMYCOSIS

54
Q

OPPORTUNISTIC MYCOSES | MUCORMYCOSIS | TREATMENT

DOC

A

amphotericin B

surgical debridement also

55
Q

OPPORTUNISTIC MYCOSES

  • Morphologically distinct forms – thin-walled trophozites and thick-walled cysts
  • Pneumocytis pneumonia – fever, nonproductive cough and dyspnea, chest x-rayshows a “ground-glass” pattern
  • Before, it was the major cause of death among AIDS patients; seen when CD4 positive T cells count drops below 400 microliters
  • Lacks ergosterol; resistant to many antifungal agents
A

PNEUMOCYSTIS PNEUMONIA

56
Q

OPPORTUNISTIC MYCOSES | PNEUMOCYSTIS PNEUMONIA

MORPHOLOGICALLY DISTINCT FORMS:
thin-walled ____

A

trophozites

57
Q

OPPORTUNISTIC MYCOSES | PNEUMOCYSTIS PNEUMONIA

MORPHOLOGICALLY DISTINCT FORMS:
thick-walled ____

A

CYSTS

58
Q

OPPORTUNISTIC MYCOSES | PNEUMOCYSTIS PNEUMONIA

causative agent

A

Pneumocytis jirovecii

59
Q

OPPORTUNISTIC MYCOSES | PNEUMOCYSTIS PNEUMONIA

it is formerly classified as a ____

A

protozoa

60
Q

OPPORTUNISTIC MYCOSES | PNEUMOCYSTIS PNEUMONIA

what makes it unique

A

it lacks ergosterol, hence resistant to many antifungal agents

61
Q

OPPORTUNISTIC MYCOSES | PNEUMOCYSTIS PNEUMONIA | CLINICAL FINDINGS

fever, nonproductive cough and dyspnea, chest x-ray shows a “ground-glass” pattern

A

PNEUMOCYTIS PNEUMONIA

62
Q

OPPORTUNISTIC MYCOSES | PNEUMOCYSTIS PNEUMONIA | CLINICAL FINDINGS

before it was known to be the major cause of death among ____

A

AIDS patients

63
Q

OPPORTUNISTIC MYCOSES | PNEUMOCYSTIS PNEUMONIA | TREATMENT

DOC

A

trimethoprim-sulfamethoxazole
pentamidin isethionate

64
Q

OPPORTUNISTIC MYCOSES

  • Causative agent – Talaromyces marneffei
  • Clinical manifestations – fungemia, skin lesions, and systemic involvement of multiple organs
    o Fungemia – when fungi reaches the blood
  • 70% of patients, with or without AIDS, develop cutaneous or subcutaneous papules, pustules, or rashes
A

PENICILLOSIS

65
Q

OPPORTUNISTIC MYCOSES | PENICILLOSIS

causative agent

A

Talaromyces marneffei

66
Q

OPPORTUNISTIC MYCOSES | PENICILLOSIS | CLINICAL FINDINGS

when fungi reaches the blood

A

FUNGEMIA

67
Q

OPPORTUNISTIC MYCOSES | PENICILLOSIS | CLINICAL FINDINGS

____% of patients, with or without AIDS, develop
cutaneous or subcutaneous papules, pustules, or rashes

A

70%

68
Q

OPPORTUNISTIC MYCOSES | PENICILLOSIS | TREATMENT

DOC

A

amphotericin B followed by itraconazole

69
Q
A
70
Q

ANTI-FUNGAL CHEMOTHERAPY

  • Polyene antibiotic
  • Indication – major systemic mycoses
  • Side effects – nephrotoxic, azotemia almost always occur
    o Not ideal to patients with kidney damage
    o Azotemia – high levels of nitrogen in the blood
  • Toxicity is greatly diminished with the lipid formulations
A

AMPHOTERICIN B

71
Q

ANTI-FUNGAL CHEMOTHERAPY | AMPHOTERICIN B

____ antibiotic

A

polyene

72
Q

ANTI-FUNGAL CHEMOTHERAPY | AMPHOTERICIN B

indication

A

major systemic mycoses

73
Q

ANTI-FUNGAL CHEMOTHERAPY | AMPHOTERICIN B

side effects

A

nephrotoxic
azotemia

74
Q

ANTI-FUNGAL CHEMOTHERAPY | AMPHOTERICIN B

  • almost always occur with amphotericin B therapy
  • high levels of nitrogen in the blood
A

azotemia

75
Q

ANTI-FUNGAL CHEMOTHERAPY | AMPHOTERICIN B

not ideal to patients with ____

A

kidney damage

76
Q

ANTI-FUNGAL CHEMOTHERAPY | AMPHOTERICIN B

Toxicity is greatly diminished with the ____

A

lipid formulations

77
Q

ANTI-FUNGAL CHEMOTHERAPY | AMPHOTERICIN B

targets what

A

ergosterol

78
Q

ANTI-FUNGAL CHEMOTHERAPY

  • Indication – with amphotericin B for treatment of cryptococcosis and candidiasis
  • Side effect – prolonged administration results in bone marrow suppression, hair loss and abnormal liver function
  • Development of resistance if the drug is used alone
A

FLUCYTOSINE

79
Q

ANTI-FUNGAL CHEMOTHERAPY | FLUCYTOSINE

indication

A

combined w amphotericin B for treatment of cryptococcosis & candidiasis

80
Q

ANTI-FUNGAL CHEMOTHERAPY | FLUCYTOSINE

side effects

A

bone marrow suppression
hair loss
abnormal liver function

81
Q

ANTI-FUNGAL CHEMOTHERAPY | FLUCYTOSINE

will develop ____ if used alone

A

resistance

82
Q

ANTI-FUNGAL CHEMOTHERAPY | FLUCYTOSINE

side effects are caused by

A

5FU

a drug used in cancer

83
Q

ANTI-FUNGAL CHEMOTHERAPY | AZOLES

have a signature ____ structure

A

five-membered ring structure

84
Q

ANTI-FUNGAL CHEMOTHERAPY | AZOLES

has 2 nitrogen that are non-adjacent

A

IMIDAZOLE

85
Q

ANTI-FUNGAL CHEMOTHERAPY | AZOLES

has 3 nitrogen

A

TRIAZOLES

86
Q

ANTI-FUNGAL CHEMOTHERAPY | AZOLES

given for fungal meningitis because it has good penetration in the CNS

A

FLUCONAZOLE

87
Q

ANTI-FUNGAL CHEMOTHERAPY | AZOLES

imidazole

A

ketoconazole

88
Q

/ANTI-FUNGAL CHEMOTHERAPY | AZOLES

fluconazole
voriconazole
itraconazole
posaconazole

A

TRIAZOLE

89
Q

ANTI-FUNGAL CHEMOTHERAPY | AZOLES

may inhibit the synthesis of testosterone and cortisol, which may result to:
▪ Gynecomastia
▪ Decreased libido
▪ Impotence
▪ Menstrual irregularity
▪ Occasionally adrenal insufficiency

not used systemically because it is toxic

A

KETOCONAZOLE

90
Q

ANTI-FUNGAL CHEMOTHERAPY

responsible for the metabolism of drugs

A

CYP450

91
Q

ANTI-FUNGAL CHEMOTHERAPY | AZOLES | DRUG INTERACTIONS

Isoniazid, phenytoin, or rifampin can ____ azole concentration

A

INCREASE

92
Q

ANTI-FUNGAL CHEMOTHERAPY | AZOLES | DRUG INTERACTIONS

____ can increase cyclosporine, phenytoin, oral hypoglycemics, anticoagulants, digoxin

A

ANTIFUNGAL AZOLE THERAPY

93
Q

ANTI-FUNGAL CHEMOTHERAPY | ECHINOCANDINS

The first licensed drug that has shown efficacy against aspergillosis and systemic candidiasis.

A

CASPOFUNGIN

94
Q

ANTI-FUNGAL CHEMOTHERAPY | ECHINOCANDINS

targets what

A

glucan

found in cell wall

95
Q

ANTI-FUNGAL CHEMOTHERAPY

  • caspofungin
  • targets glucan
A

ECHINOCANDINS

96
Q

ANTI-FUNGAL CHEMOTHERAPY

  • Orally administered antibiotic derived from a species of penicillum
  • Indication – dermatophyte infections of the skin, hair, and nails
  • Side effect – headache
  • Targets mitotic spindle (found in cell division)
A

GRISEOFULVIN

97
Q

ANTI-FUNGAL CHEMOTHERAPY | GRISEOFULVIN

derived from a species of ____

A

PENICILLUM

98
Q

ANTI-FUNGAL CHEMOTHERAPY | GRISEOFULVIN

indication

A

dermatophyte infections of the skin, hair, nails

99
Q

ANTI-FUNGAL CHEMOTHERAPY | GRISEOFULVIN

side effect

A

headache

100
Q

ANTI-FUNGAL CHEMOTHERAPY | GRISEOFULVIN

targets what

A

mitotic spindle

found in cell division

101
Q
A
102
Q

ANTI-FUNGAL CHEMOTHERAPY | GRISEOFULVIN

what increases its absorption

A

high fat diet

103
Q

ANTI-FUNGAL CHEMOTHERAPY

  • Indication – dermatophyte infections (nail infections)
  • Side effects – GI distress, HA, skin reactions, and loss of sense of taste
A

TERBINAFINE

104
Q

ANTI-FUNGAL CHEMOTHERAPY

  • Nystatin – polyene antibiotic
  • Clotrimazole and miconazole
A

TOPICAL ANTI-FUNGAL AGENTS

105
Q

ANTI-FUNGAL CHEMOTHERAPY | OTHER ANTI-FUNGAL AGENTS

  • natural antifungal
  • extracted from castor oil
  • given for Tinea infections such as athlete’s foot
A

UNDECYLENIC ACID

106
Q

ANTI-FUNGAL CHEMOTHERAPY | TOPICAL ANTI-FUNGAL AGENTS

  • vaginal suppository
  • polyene antibiotic
A

NYSTATIN

MICROPARA (37 decks)

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