Mycology

Question 1

What kind of fungi cause systemic mycoses

Answer 1

Dimorphic fungi

Question 2

What are dimorphic fungi

Answer 2

Cold = mold
Heat = yeast (except coccidio is a spherule in tissue)

Question 3

What is the treatment for local infection with systemic mycoses

Answer 3

Fluconazole or itraconazole

Question 4

What is the treatment for systemic infection with systemic mycoses

Answer 4

Amphotericin B

Question 5

Endemic location of histoplasmosis

Answer 5

MS and OH river valleys

Question 6

What does histoplasmosis cause

Answer 6

Pneumonia

Question 7

What mycosis is classically seen with bird or bat droppings

Answer 7

Histoplasmosis

Question 8

Mycosis from Caves

Answer 8

Histoplasmosis

Question 9

Monocyte filled with many small yeast, smaller than RBC

Answer 9

Histoplasmosis

Question 10

Endemic to East of MS River and Central America

Answer 10

Blastomycosis

Question 11

Blastomycosis presentation

Answer 11

Inflammatory lung disease - granulomatous nodules

Can disseminate to skin and bone

Question 12

Broad base budding, same size as RBC

Answer 12

Blastomycosis

Question 13

Spherule filled with endospores

Answer 13

Coccidiomycosis

Question 14

Coccidiomycosis presentation

Answer 14

Pneumonia and meningitis

Can disseminate to skin and bone

Question 15

How does coccidio spread

Answer 15

Forms spores in dust that can become airborne (for example after an earthquake rates increase), become spherules in the lungs, and spherules burst

Question 16

Endemic mycosis to Latin america

Answer 16

Paracoccidiomycosis

Question 17

Budding yeast with captains wheel formation, larger than RBC

Answer 17

Paracoccidiomycosis

Question 18

Clinical presentation of paracoccidiomycosis

Answer 18

Severe pneumonia
Granulomatous formations
Widely disseminates after entering through lung

Question 19

What causes tinea versicolor

Answer 19

Malassezia furfur

Question 20

Pathophysiology of tinea versicolor

Answer 20

Lipid degradation produces acids. Acids damage melanocytes and cause hypopigmented patches in hot humid weather

Question 21

Hypopigmented patches in hot humid weather

Answer 21

Tinea versicolor

Question 22

Treatment for tinea versicolor

Answer 22

Topical miconazole

Selenium sulfide

Question 23

What do tineae like pedis, crucris, ringworm look like in KOH prep

Answer 23

Mold hyphae

Not dimorphic

Question 24

Treatment for vaginal candida

Answer 24

Topical azole

Question 25

Treatment for oral/esophageal candida

Answer 25

Fluconazole or caspofungin

Question 26

Treatment for systemic candida infection

Answer 26

Amphotericin B, fluconazole, or caspofungin

Question 27

What is the differential diagnosis for esophageal thrush

Answer 27

CMV Candida Herpes

Question 28

How is systemic candida diagnosed

Answer 28

Blood culture - look for Germ tubes at 37 degrees

Question 29

Germ tubes at 37 degrees

Answer 29

Candida albicans

Question 30

What do candida look like at 20 degrees

Answer 30

Pseudohyphae and budding yeasts

Question 31

What does aspergillus look like under microscope

Answer 31

Septate hyphae that branch at acute angles

Question 32

What is allergic bronchopulmonary aspergillosis

Answer 32

Aspergillus infection associated with asthma and CF | Can cause bronchiectasis and eosinophilia

Question 33

Where is cryptococcus neoformans found

Answer 33

Soil and pigeon droppings

Question 34

How is cryptococcus acquired

Answer 34

Inhale capsules, spreads hematogenously to meninges

Question 35

Sabouraud agar

Answer 35

Cryptococcus culture

Question 36

Stains for cryptococcus

Answer 36

India ink and mucicarmine

Question 37

Latex agglutination test

Answer 37

Detects polysaccharide capsular antigen in cryptococcus | More specific than stains

Question 38

Treatment for cryptococcus

Answer 38

Amphotericin B + flucytosine | Then fluconazole

Question 39

What does Mucor look like under microscope

Answer 39

Irregular, broad, nonseptate hyphae branching at wide angles

Question 40

In whom does Mucor and Rhizopus cause disease

Answer 40

Ketoacidotic diabetics and neutropenic/leukemia patients

Question 41

Pathophysiology of Mucor and Rhizopus species

Answer 41

Fungi proliferate in blood vessel walls when there's excess ketones and glucose. They penetrate the cribiform plate and enter brain

Question 42

Symptoms of Mucor/Rhizopus infection

Answer 42

Black eschar on face Facial Pain Cranial nerve involvement

Question 43

Treatment of Mucor/Rhizopus infection

Answer 43

Surgical debridement | Amphotericin B

Question 44

Identify pneumocystis jirovecii

Answer 44

Disc shaped yeast | Forms on methenamine silver stain of lung tissue

Question 45

Treatment for pneumocystis jirovecii

Answer 45

TMP-SMX | Pentamidine

Question 46

Prophylaxis for pneumocystis jirovecii

Answer 46

TMP-SMX Dapsone ATovaquone

Question 47

What does sporothrix schenckii look like

Answer 47

Dimorphic cigar shaped budding yeast

Question 48

Rose gardener's disease

Answer 48

Sporothrix schenckii - sporotrichosis

Question 49

Pathophysiology of sporotrichosis

Answer 49

Introduced during trauma to skin. Causes a local ulcer with nodules along draining lymphatics

Question 50

Treatment for sporotrichosis

Answer 50

Itraconazole or potassium iodide

Question 51

What are the 4 dermatophyte molds

Answer 51

1. Trichophyton rubrum 2. Microsporum 3. Epidermophyton 4. Malassezia furfur