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Respiratory Exam 2 > Micro Funcal and Parasitic Infections > Flashcards

Micro Funcal and Parasitic Infections Flashcards

1
Q

True Molds

A

Aspergillus (ubiquitous- burn pts)

Mucor

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2
Q

True Yeasts

A 
Cryptococcus neoformans (AIDS assoc-meningitis)
Candida albicans
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3
Q

Dimorphic Fungi

mold in the cold
yeast in the beast (pathogenic form)

A

Blastomyces
Coccidioides (super common- can go to brain)
Histoplasma
“can have both shapes”

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4
Q

inhaled from soil

Yeast: spherule

A

Coccidioides immitis

SW U.S., San Joaquin Valley “Valley fever”

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5
Q

Fever, cough, chest pain, weight loss (segmental or lobar pneumonia)- Typical Pneumonia
Progressive pulmonary disease (nodules can lead to cavitation)
PE: rales, pleural rubs, wheezing
Erythema nodosum*
Can disseminate (AIDS pts to the brain)

A

C. immitis

pac-man image
KOH prep of tissue
Sabouraud dextrose
Serology, CXR

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6
Q

Treatment C. immitis

A

Ketoconazole (or fluconazole alt.)

Amphotericin B for pregnancies

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7
Q

Decaying matter
Dimorphic fungus
yeast: broad based budding yeast

A

Blastomyces dermatitidis

mold: hyphae w/nondescript conidia

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8
Q

Acute onset, lobar infiltrates, higher fever cough
Skin (cover in derm) and bones
CNS in AIDS pts

A

Blastomyces dermatitidis

Microscopy (3Bs) followed by culture
serology available, not useful

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9
Q

Treatment of B. dermatitidis

A

very sick: Amphotericin B

Itraconazole used in immune competent adults

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10
Q

spelunking

Yeast: intracellular, infects WBC

A

Histoplasma capsulatum

inhale bat poo
Mold: hyphae w/ microconidia & tuberculate macroconidia

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11
Q

high intensity exposure:
acute: flu-like, cough, chest pain (CXR: patchy infiltrates)

Progressive: destruction and fibrosis of pulmonary tissue

A

Histoplasma capsulatum

Intracellular yeast in WBC(macrophages)
ELISA of plasma
Sabouraud dextrose agar

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12
Q

Treatment of H. capsulatum

A

severe: IV amphotericin B
mild: intraconazole

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13
Q

Sabouraud dextrose

A

grows fungi only

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14
Q

KOH prep of tissue

A

not bacteria not virus

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15
Q

Ohio, Mississippi River, Great Lakes

Ohio, Mississippi river basin, Missouri

A

Blastomyces Dermatidis

Histoplasma capsulatum

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16
Q

Fever, cough, chest pain, weight loss (segmental or lobar pneumonia)

A

Signs of Typical pneumonia

17
Q

Are spherules infective?

A

no they just push on lung tissue causing issues.

18
Q

-azoles

A

teratogenic

19
Q

Pilot’s wheel-multiple budding yeast

South America

A

Paracoccidioidomycosis

treat itraconazole

20
Q

How is aspergillosis transmitted?

A

inhaled: air soil, decaying matter

shower heads, water tanks, plants

21
Q

Three types of allergic Aspergillosis

A

IgE-mediated asthma: eosinophilia
Allergic Bronchopulmonary aspergillosis (ABPA)
Farmer’s lung- Type 3 hypersensitivity Rxn

22
Q

Hypersensitivity Pneumonitis

A

Farmer’s lung over and over again
they present with fever, chills, malaise, nausea, dry cough, chest tightness, dyspnea

you can shut down their immune response with long term steroids

23
Q

Aspergillosis non-invasive

A

fungal ball
granuloma can erode and leave an empty space where the fungal can grow
underlying disease of: cystic fibrosis, chronic bronchitis, TB

24
Q

Aspergillousis invasive

A

rapidly fatal; immunosuppressed host

clinically pt presents as: fever, pulmonary infiltrates, chest pain, hemoptysis

25
Q

Aspergillosis diagnosis

A

acute 45 degree angle
CRX: fungal ball
immuno assays for invasive aspergillosis

26
Q

Treating Aspergillosis

A

Allergic: cortisteroids
Aspergilloma: surgical resection
Invasive: voriconazole

27
Q

black pus

KOH prep reveals: 90 degrees hyphae

A

Mucor

28
Q

diabetics (ketoacidosis)

A

Mucor

29
Q

Mucor treatment

A

amphotericin B

30
Q

Pneumoncystis jiroveci review this dented helmets

A

Atypical pneumonia
Interstitial pneumonia
Infects immunocompromised pts
when they hit 200 cells you get bactrim treatment

31
Q

Parasites

A

Paragonimus westermani (lung fluke)
look for travel: Found in Asia, Africa, India, Latin America
person will cough up eggs
Adult fluke: Coffee bean shaped
rusty sputum: blood tinged dark with parasite eggs

32
Q

P westermani

A

treat with praziquantel
prevent by cooking foods
golden-brown, operculated eggs

Respiratory Exam 2 (6 decks)

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