Mycology

Question 1

Dermatophytoses diagnosis

Answer 1

10% KOH: septate hyphae

Question 2

Culture medium for dermatophytoses

Answer 2

Sabouraud’s agar: hyphae and conifia

Question 3

Spaghetti and meatballs on 10% KOH

Answer 3

Tinea versicolor or an-an

Maladsezia furfur

Question 4

Treatment for M. furfur

Answer 4

Miconazole

Question 5

Rose gardener’s disease? Treatment?

Answer 5

Sporotrichosis
Sporothrix schenckii
Tx: itraconazole or potassium iodide

Question 6

Dimorphic fungus that exists as a MOLD in SOIL and SPHERULE in TISSUE found endemic un Southwestern US and Latin America

Answer 6

Coccidioides immitis

Question 7

Desert bumbs, influenza-like illness; arthrospores form spherules with endospores with granuloma formation in bones and CNS

Answer 7

Coccidioides immitis
Tx: amphotericin B or itraconazole
If with meningitis: fluconazole

Question 8

Dimorphic fungus endemic in Ohio and Mississippi River valleys with 2 types of asexual spores: 1) thick walls and fingerlike projections 2) smaller, thin, smooth-walled spores - infective stage

Answer 8

Histoplasma capsulatum

1) tuberculare macronidia
2) micronidia

Question 9

H. capsulatum grows in soil with

Answer 9

Bird droppings (starlings) or bat guano

Question 10

Mimickers of tuberculosis

Answer 10

Histoplasmosis - H. capsulatum
Paragonimus westermani (parasite)

Question 11

DOC for H. capsulatum

Answer 11

Amphotericin B or itraconazole

Meningitis: fluconazole

Question 12

Round yeast with broad-based bud transmitted by inhalation of conidia and the most common cause of fungal pneumonia

Answer 12

Blastomyces dermatitidis

Tx: iraconazole

Question 13

Thick yeast with multiple buds in wheel configuration (Mariner’s wheel) restricted to Central and South America

Answer 13

Paracoccidioides brasiliensis

Tx: itraconazole

Question 14

“Man-hater fungus” - only affects men because estrogen inhibits its growth

Answer 14

Paracoccidioides brasiliensis

Question 15

Lutz-splendore-de Ameida disease

Answer 15

Paracoccidioides brasiliensis

Question 16

Opportunistic mycoses (4) and protozoan (1)

Answer 16

Candida albicans
Cryptococcus neoformans
Aspergillus fumigatus
Rhizopus oryzae and Mucor spp
Pneumocystis jirovecii (protozoan)

Question 17

Tx for candida in the ff: 1) oropharyngeal and esophageal, 2) skin, 3) disseminated infections, 4) chemoprophylaxis

Answer 17

1) nystatin swish and swallow
2) clotrimoxazole
3) amphotericin B
4) fluconazole

Question 18

Oval yeast with narrow-based bud surrounded by a wide polysaccharide capsule seen in India inj preparation

Answer 18

Crytococcus neoformans
DOC: amphotericin B and fluconazole
Chemoprophylaxis: fluconazole

Question 19

Molds with a septate hyphae that form v-shaped branches (acute angles)

Answer 19

Aspergillus fumigatus

Tx: amphotericin B

Question 20

Saprophytic molds with nonseptate hyphae with walls and branches at right angles; assoc with rhino-orbital-cerebral infection with eschar formation

Answer 20

Mucormycosis

Seen in patients with diabetic ketoacidosis, burns, or leukemia

Question 21

Frothy exudate that blocks oxygen exchange leading to a V/Q mismatch –> respiratory distress syndrome; most common AIDS-defining illness

Answer 21

Pneumocystis jirovecii

DOC: TMP-SMX

Question 22

Diagnosis of P. jirovecii

Answer 22

Staining BAL washings: toluidine blue, methenamine silver stain

Question 23

Infection of this microorganism occurs when CD4

Answer 23

P. jirovecii

Question 24

P. jirovecii on CXR

Answer 24

Diffuse interstitial pneumonia with ground glass infiltrates bilaterally

Question 25

3 important dermatophytoses

Answer 25

Microsporum canis
Trichophyton tonsurans
Epidermophyton floccosum