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Path Y > Microbiology - Fungal infections > Flashcards

Microbiology - Fungal infections Flashcards

1
Q

What is the main conponent of fungal cell walls?

A

Chitin

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2
Q

What is the main component of fungal cell membranes?

A

Ergosterol

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3
Q

What is the reproductive method of yeats?

A

Budding

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4
Q

Recall 3 examples of yeasts that are clinically important

A

Candida
Cryptococcus
Histoplasma (dimorphic)

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5
Q

What are moulds?

A

Multicellular hyphae

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6
Q

Give 3 examples of moulds that are clinically important

A

Dermatophytes
Aspergillus
mucormycetes.

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7
Q

what drug to treat Candida albicans

A

fluconazole

amphetricin B for invasive disease

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8
Q

2 principles of candidiasis management

A

serology for B-D-glucan

antifungals

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9
Q

Recall the different types of cryptococcus, and which of these infect immunodeficient vs immunocompetent hosts

A

Serotypes A and D = cryptococcus neoformans (immunodeficient hosts)

Serotypes B and C = cryptococcus gatti (immunocompetent hosts)

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10
Q

Which type of cryptococcus can cause meningitis?

A

Cryptococcus gatti

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11
Q

What ink can be used to stain for cryptococcus?

A

India Ink (all black apart form distinct capsule around yeast)

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12
Q

How should cryptococcus infection be managed?

A
  1. Induction: 2/52 of amphotericin B + flucytosine

2. Consolidation: 8/52 of high dose oral fluconazole

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13
Q

Which type of aspergillus disease is an allergic disease?

A

ABPA - Allergic bronchopulmonary aspergillosis

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14
Q

How does aspergillus appear under the microscope?

A

Fluffy colonies

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15
Q

What parts of the body can be infected by aspergillus?

A

Pre-formed cavities (eg. by TB) - so treated pulmonary TB may be in the history

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16
Q

What is a galactomannan assay used for?

A

Aspergillosis diagnosis

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17
Q

Why is pneumocystis jirovecii an unusual fungus?

A

No ergosterol

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18
Q

What is the typical history for PCP pneumonia?

A

Desaturating on exertion

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19
Q

What are the clinical features of mucormycoses?

A

Orbital/facial cellulitis with discharge of black pus from nose/ palate

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20
Q

How are mucormycoses managed?

A

LONG duration of ambisone (amphotericin B)

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21
Q

Recall 2 examples of a dermatophyte

A

tinea

ringworm

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22
Q

Where does tinea cruris infect?

A

Groin

23
Q

How is tinea diagnosed?

A

Often clinically, but can be confirmed via skin scrapings for MC&S

24
Q

Recall 4 classes of antifungal

A

Azoles - membrane
Polyenes - membrane
Echinocandins -inhibit glucan synthase (cell wall)
Pyrimidine analogues - dna synthesis

25
Q

Recall the side effect profile of each class of antifungal

A

Azoles - abnormal LFTs
PolyeNes - Nephrotoxicity
Echinocandins - relatively innocuous
Pyrimidine analogues - blood disorders

26
Q

What is the mechanism of action of azoles?

A

Inhibit ergosterol synthesis

27
Q

What is the mechanism of action of polyenes?

A

Bind sterols in membranes to create leakage of electrolytes

28
Q

Give 2 examples of polyene medications

A

Amphotericin B

Nystatin

29
Q

Which 2 types of fungus are echinocandins particularly useful for?

A

Candida

Aspergillus

30
Q

What class of antifungal is flucytosine? mechanism?

A

Pyrimidine analogue - INHIBITS dna SYNTHESIS

31
Q

what stain for candida

A

periodic acid schiff (PAS)

32
Q

most common candida

A

Candida albicans

33
Q

what’s the germ tube test? what so you see for what organism

A

Germ tube test is a screening test for the presumptive identification of Candida albicans
only albicans has pseudohyphae

34
Q

what can candida cause in the eyes & in mouth

A

candida endophthlamitis

angular chelitis

35
Q

what agar to detect candida

A

sabouraud agar

can also detect w beta-d glutan assay

36
Q

what is the management of candidiasis

A

eco and fundoscopy
if albicans - fluconazole
if not - echinocandin

37
Q

Cryptococcus gatti grows in which plant

A

eucalyptus

38
Q

what crypotocccus is common in those w AIDS

A

neoformans

2nd most common cause of death in AIDS

39
Q

cryptococcal meningitis can cause what in the brain

A

hydrocephalus

in LP CSF isn’t mixed w CSF in brain

40
Q

what stain to diagnose aspergillosis

A

Grocott methenamine silver (GMS)

41
Q

treatment of aspergillosis

A

amphoetrcin B

not fluconazole for moulds as poor activity

42
Q

what causes pityriasis versicolour

A

looks like vitiligo

caused by malassezia fur

43
Q

mucormycosis happens in which 2 patients

A

imunocompromised

poorly controlle diabetics

44
Q

cellulitis of orbit and black pus = what disease

A

mucormycosis

45
Q

severe brain consequence of mucormycosis

A

rhinocerebral mucormycosis

murco. is caused by rhizopum and rhizomucor spp

46
Q

management of mucormycosis

A

ENT referral as surgical emergency

high dose amphotericin B

47
Q

tines pedis, tinea cruris, tinea capatis and onchomycosis (fungal nail) are all caused by?

A

trichophyton rubrum

many other too but this is common to all

48
Q

which anti fungal works for virtually all fungi

A

amphotericin B

49
Q

what fungi are resistant to echinocandins

A

Cryptococcus

50
Q

give an example of an echinocandin

A

micafungin

51
Q

mechanism of polyenes

A

bind ergosterol in cell membrane, creating channels

52
Q

mechanism of azoles

A

inhibit enzyme in cell membrane (lanosterol 14 a demythelyase)

53
Q

mechanism of echinocandins

A

inhibit beta d glucan synthase

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