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STEP1 2015 > Mycology > Flashcards

Mycology Flashcards

1
Q

yeast

A

candida albicans
cryptococcus neoformans
pneumocystis jirovecii (PCP)

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2
Q

candidal esophagitis

A 
AIDs, leukemia, lymphoma
sx:
painful swallowing
substernal chest pain
feeling of obstruction when swallowing

DDx: CMV, herpes esophagitis

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3
Q

oral thrush

A

neonates
steroids
diabetes AIDS
DDx: oral hairy leukoplakia

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4
Q

candidal vulvovaginitis

A 
diabetic patients, women with recent antibiotic use
sx: 
severe itching
edema
vaginal discharge
acidic pH
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5
Q

candida albicans diaper rash

A

jagged edges, satellite lesions

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6
Q

candical intertrigo

A

erythematous central lesions with satellite lesions

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7
Q

candida bloodstream infections

A

central lines
drug users
cancer patients
transplant patients

leading to endophthalmitis, endocarditis

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8
Q

chronic mucocutaneous candidiiasis

A

mucous membranes, hair, nails

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9
Q

candida albicans diagnosis

A

blood culture

germ tubes- small projections on side of cell, usually within 90 minutes

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10
Q

treatment for candida albicans

A

superficial infections: nystatin, clotrimazole, fluconazole

systemic infections:
fluconazole, amphotericin B, echinocandin

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11
Q

cryptococcal meningitis

A

AIDS

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12
Q

cryptococcus- wide or narrow? where is it found? what can you use to culture it? what can you use to stain it?
is there a serological test?
what does it look like on imaging?

A

heavily encapsulated yeast, reproduces by narrow- based budding
soil and pigeon droppings
can be cultured on most bacterial and fungal media
often cultured on Sabouraud’s agar

stain with India ink

serological test for cryptococcal antigen is more sensitive than India ink

latex agglutination test to detect polysaccharide capsular antigen

“soap bubble” lesion on imaging

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13
Q

How to treat cryptococcus

A

amphotericin B + flucytosine

followed by fluconazole

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14
Q

PCP PNA
what stain?
what does it look like on imaging?

A

atypical
diffuse interstitial PNA that developed into potentially fatal PNA in immunocompromised patients

Dx: silver stain
imaging- ground glass appearance of interstitial infiltrates

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15
Q

PCP PNA treatment

A

TMP-SMX (begin with IV, transition to oral)

sulfa allergy: pentamidine, clindamycin + primaquine

ppx when CD4

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16
Q

Molds

A

Aspergillus fumigatus
mucor
rhizopus

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17
Q

Aspergillus fumigatus

A

allergic bronchopulmonary aspergillosis

fungus ball (aspergilloma)
invasive aspergillosis
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18
Q

where is aspergillus found

A

ubiquitous

soil, air, water, food

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19
Q

what does it look like?

A

narrow septate hyphae that branch at acute angles (45 degrees)

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20
Q

aspergillus treatment

A

voriconazole

lipid formulation of amphotericin B

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21
Q

Mucor and Rhizopus

where are they found? who gets infected? what do they look like?

A

cause mucormycosis
ubiquitous
invasive disease in severely immunocompromised, trauma patients, diabetics

broad, irregularly shaped, nonseptate hyphae branching at right angles

22
Q

patients with DM, DKA, leukemia, neutropenia, with mucormycosis

A

rhinocerebral mucormycosis
facial pain
HA

Mucor grows into vessel walls, leading to large necrotic lesions (look like eschar)

CN deficits, blindness
Dx: biopsy

Tx: surgical debridement, amphotericin B

23
Q

Dermatophytes

A

Trichophyton
Microsporum (dog or cat reservoir)
Epidermophyton
Malassezia furfur

24
Q

What infections are commonly caused by dermatophytes?

how do we diagnose?

A 
tinea pedis (feet)
tinea cruris (groin)
tinea capitis (head)
tinea unguium (nails) aka onychomycosis

on the body it is called ringworm

diagnosis: fungal hyphae or spores on skin or hair samples

culture

25
Q

how to treat fungal skin infection

A

topical terbinafine or azole

extensive skin infection or scalp/hair infection
PO terbinafine or azole

26
Q

tinea unguium (nails) aka onychomycosis

A

trichophyton rubrum

thickened, discolored nails
PO therapy recommended
terbinafine
itraconazole
fluconazole 
treat for a year (fingernails clear faster than toenails)
27
Q

Malassezia furfur

A

hypopigmented patches.

nonpruritic

KOH prep: spaghetti and meatballs

topical azole, selenium sulfide

28
Q

causes diaper rash

A

candida albicans

29
Q

opportunistic mold with septate hyphae that branch at a 45 degree angle

A

aspergillus

30
Q

opportunistic mold with irregular nonseptate hyphae that branch at wide angles (>90)

A

mucor, rhizopus

31
Q

causes thrush in immunocompromised patients and vulvovaginitis in months

A

candida albicans

32
Q

known for causing pneumonia in AIDS patients

A

PCP

33
Q

yeast known for causing meningitis in AIDS patients

A

cryptococcus meningitis

34
Q

dimorphic fungi

A

mold form at 20 degrees C
yeast form at 37 degrees C

cold mold, heat yeast

35
Q

systemic mycoses versus tb

A

both cause granulomas, however molds form non-caseating granulomas unlike TB

36
Q

what kind of agar for dimorphic fungi?

A

Sabourad agar

37
Q

Histoplasma capsulatum

A

Mississippi and Ohio river valleys in bird and bat guano

on histology, you will see macrophage filled with histoplasma (smaller than RBC)

histo hides within macrophages

38
Q

Blastomyces dermatitidis

A

states bordering Mississippi and Ohio river basins up to Canada

Central America

enters via pulmonary route
causes pulmonary infection
disseminates to the rest of the body

skin, bone, granulomatous nodules

39
Q

coccidiodes immitis

A

Southwestern US.
“San Joaquin Valley Fever”
disease incidence may increase after sandstorms or earthquakes

Mycelial (soil) and spherule
forms arthroconidia (barrel shape)
can become airborne and deposit themselves in the human lung

The arthroconidia form spherules within the lung, which divide until the spherule becomes so packed with daughter cells that it bursts

infections are often asymptomatic or mild

severe PNA or disseminated disease

  • CNS (meningitis)
  • skin findings
  • bones
  • joints
40
Q

Paracoccidiodes brasiliensis

A

latin america is the only known endemic area
enters through respiratory route
disseminated progressive disease
-severe PNA
-granulomatous changes in mucous membranes and skin

Captain’s wheel appearance

41
Q

Sporothrix Schenckii

A 
dimorphic fungus
soil and vegetation
often introduced by a thorn
sphagnum moss
nodules appear along the draining lymphatics (painless)

no systemic sx
Tx: itraconazole
potassium iodide

42
Q

found in SW US including west Texas and California

A

coccidioides immitis

43
Q

found in Mississippi and Ohio River basins

A

histoplasma capsulatum

44
Q

causes San Joaquin Valley fever

A

coccidioides immitis

45
Q

found in rural Latin America

A

paracoccidioides brasiliensis

46
Q

associated with plant thorns and cutaneous injury

A

Sporothrix schecnkii

47
Q

found in states east of the Mississippi River

A

blastomyces dermatitidis

48
Q

found in bird and bat droppings

A

histoplasma capsulatum

49
Q

mold form contains barrel- shaped arthroconidia

A

coccidioides immitis

50
Q

associated with dust storms

A

coccidioides immitis

51
Q

broad- based budding of yeast

A

blastomyces dermatitidis

52
Q

multiple budding of yeast form

A

paracoccidioides brasiliensis (captain’s wheel)

STEP1 2015 (30 decks)

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