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MYCOLOGY AND PARASITOLOGY Flashcards

1
Q

How do you diagnose A) Toxo B) Naelgeria and C) Trypanosoma brucei?

A

A) serology and biopsy B) amoebas in CSF C) blood smear or CSF sample for later disease

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1
Q

How do you treat Tanea solium intestinal infection? Neurocystericosis?

A

Intestinal = Praziquantel; Neurocysterocosis = Praziquantel + Mebendazole

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2
Q

Which systemic mycosis often forms granulomatous nodules in the skin?

A

Blastomyces dermatidis

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2
Q

What kind of parasite is Onchocerca volvulus?

A

nematode

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3
Q

What is melarsoprol used to treat?

A

Trypanosoma brucei in the CSF

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3
Q

What kind of parasite is Echinococcus granulosus?

A

Cestode (tapeworm)

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3
Q

What is the Tx for Loa loa?

A

Diethylcarbamazine

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3
Q

Which worms (2) cause microcytic anemia? Which worm (1) causes macrocytic anemia?

A

Microcytic = Necator americanus and Ancyclostoma duodenale; Macrocytic: Diphyllobothrium latum

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3
Q

How do you treat Paragonismus westermani? How does it present?

A

Praziquantel; lung inflammation with hemoptysis

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4
Q

Which systemic mycosis is common in the San Joaquin Valley?

A

Coccidiodes immitis

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5
Q

What should you think if a newborn has hydrocephalus, intracranial calcifications, and chorioretinitis?

A

Congenital toxoplasmosis

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5
Q

What is the Tx for Leishmania donovani?

A

Sodium stibogluconate

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5
Q

How is the Tx of trichomonas different from that of bacterial vaginosis?

A

Trichomonas vaginalis and BV (gardnerella overgrowth) are both Tx’d with metronidazole, but T. vaginalis is an STD so requires Tx of the partner as well

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6
Q

Which protozoal infection is an STD?

A

Trichomonas vaginalis

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7
Q

What route does Cryptococcus use to get to the meninges?

A

hematogenous from lungs

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7
Q

What is the reservoir for Trichomonas vaginalis?

A

Humans because cannot form cysts

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7
Q

How do you become infected with Strongyloides stercoralis?

A

Larvae penetrate the skin

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7
Q

How do you treat Schistosoma haematobium?

A

Praziquantel

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8
Q

Name 5 nematode infections of tissues (not intestines)

A

Loa loa, Onchocerca volvulus, Dracunculus medinensis, Wucheria bancrofti, and Toxocara canis

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8
Q

What protozoal infection is sodium stibogluconate used to tx?

A

Leishmania donovani

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9
Q

What should you test for before beginning intravenous quinidine for malaria?

A

G6PD deficiency

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10
Q

How does Naegleria fowleri infect the brain, what Tx has proven effective for a few survivors?

A

via the cribriform plate; amphotericin B

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10
Q

Which nematodes can cause microcytic anemia (2)?

A

The hookworms: they suck blood from intestine = Ancyclostoma duodenale and Necator americanus

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11
Q

What do microsporum, trichophyton, and epidermophyton cause?

A

These are dermatophytes and cause any of the tineas

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11
Q

KOH prep of rose gardeners disease would have what shape?

A

Cigar shaped dimorph (Sporothrix schenckii)

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11
Q

What kind of parasite is Loa loa?

A

nematode

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11
Q

What is the feared complication of Schistosoma haematobium?

A

Bladder cancer (hangs out in the venous plexus)

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13
Q

What is the most specific test for Cryptococcus neoformans?

A

Latex agglutination test

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14
Q

What will you see on KOH prep of a dermatophyte infection?

A

mold hyphae

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15
Q

What is the DOC for candidal vulvovaginitis (2)?

A

Topical Azole (inhibit ergosterol synthesis)

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16
Q

What is the treatment for systemic candidiasis (3)?

A

Amphotericin B (pores in membrane by binding ergosterol), Fluconazole (inhibit ergosterol synthesis), Caspofungin (inhibit cell wall by binding D glucan)

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17
Q

What is nitazoxinide used to treat?

A

Cryptosporidium in AIDS patients

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18
Q

How do you treat Schistosoma mansoni?

A

Praziquantel

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19
Q

Which fungus causes frontal lobe abscesses? What acid base status would be likely in this patient and why?

A

Mucor; infects ppl with DKA = metabolic acidosis with compensatory respiratory alkalosis

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21
Q

What is the Tx for Entamoeba histolytica?

A

Metronidazole

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21
Q

How do you get infected with Chlonorchis sinensis? Associated with what cancer? Tx?

A

Undercooked fish; Cholangiocarcinoma; Praziquantel

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22
Q

Which systemic mycosis is most likely found in Latin America?

A

Paracoccidiodes braziliense

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23
Q

Which fungus is associated with hepatocellular carcinoma?

A

Aflatoxins of Aspergillus can cause hepatocellular carcinoma

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23
Q

Regarding Aspergillus and Mucor/Rhizopus, which is septate and which is aseptate?

A

Septate = Aspergillus; Aseptate = Rhizopus

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25
Q

What fungus can cause endocarditis in an IV patient?

A

Candida albicans

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25
Q

What are the 3 major protozoa that cause CNS infections?

A

Toxoplasma gondii, Naegleria fowleri, Trypanosoma brucei (gambiense and rhodesiense)

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25
Q

What drug blocks heme polymerase in Plasmodium spp?

A

Chloroquine and for resistant strains, mefloquine

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27
Q

What is the Tx of Ascaris lumbricoides?

A

Bendazoles or pyrantel pamoate

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27
Q

What kind of parasite are Ancyclostoma duodenale and Necator americanus?

A

Hookworms but still nematodes

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29
Q

Why is pigmentation affected in Tinea versicolor?

A

The degradation of lipids by Malassezia furfur (it pefers areas with more sebaceous glands) yields acids that damage melanocytes leading to hypo or hyperpigmented patches

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29
Q

What are the 3 main dermatophytes?

A

Microsporum, Trichophyton, and Epidermophyton

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29
Q

What kind of parasite is Wucheria bancrofti?

A

nematode

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30
Q

What transmits T. cruzi?

A

Reduviid bug in SA

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30
Q

What transmits Leishmania donovani?

A

Sandfly

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31
Q

What 2 pt demographics are likely to get mucormycosis?

A

Diabetic Ketoacidotics and Leukemia

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32
Q

How are all flukes (schistosomes) treated?

A

Praziquantel (Paragonismus, Clonorchis, Schistosoma)

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34
Q

Why does African Sleeping Sickness have a recurring course?

A

Antigenic variation of the trophozoites

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35
Q

What would you see on a sputum sample of a person with Histoplasmosis pneumonia?

A

Macrophages filled with Histoplasma

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36
Q

What causes Visceral Larval Migrans? Explain.

A

Toxocara canis is a dog parasite so gets confused in human and stays in skin (from Keller: Ancyclostoma braziliense)

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37
Q

How do you get Diphyllobothrium latum? How do you treat it?

A

larvae from raw freshwater fish; praziquantel

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38
Q

How do you get Dracunculus medinensis? What is the Tx?

A

Drinking water (nearly eradicated by better sanitation); Surgical removal of worm (SLOWLY to prevent breaking), like wrapping it around a stick.

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39
Q

What are the 4 major GI protozoal infections?

A

Entamoeba histolytica, Giardia lamblia, Cryptosporidum parvum, Isospora spp.

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40
Q

What kind of parasite is Paragonismus westermani?

A

Trematode (fluke)

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41
Q

What is the vector for Babesia microti?

A

Ixodes tick

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42
Q

What are the protozoal hematologic infections?

A

Plasmodia (vivax, ovale, falciparum, malariae) and Babesia microti

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43
Q

What term for visceral leishmaniasis means “black fever”?

A

Kala-azar

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45
Q

Which systemic mycosis can disseminate to skin and bone?

A

Blastomyces dermatidis; sometimes Coccidiodes also (Blasto is the main one)

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46
Q

What is the Tx for ascending lymphangitis after a thorn prick?

A

Itraconazole or Potassium iodide (Sporothrix Schenkii)

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47
Q

What causes valley fever?

A

Coccidiodes immitis

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47
Q

What bug is associated with liver abscesses with an anchovy paste exudate?

A

Entamoeba histolytica

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49
Q

What dimorph is cigar shaped?

A

Sporothrix schenckii

50
Q

Which trematode causes pigmented gallstones?

A

Clonorchis sinensis

51
Q

What plasmodium spp. Causes quartan malaria?

A

Plasmodium malariae

52
Q

What is the Tx for Wucheria bancrofti?

A

Diethylcarbamazine

53
Q

What transmits malaria?

A

Anopheles mosquito

54
Q

Regarding the non-opportunistic systemic mycoses, what is usually the first sign of infection prior to dissemination?

A

They present as pneumonia

54
Q

What infection with Aspergillus fumigatus are asthma and cystic fibrosis patients likely to acquire?

A

Allergic Bronchopulmonary Aspergillosis

54
Q

Which dimorph can be treated with potassium iodide?

A

Sporothrix schenckii

55
Q

What kind of parasite is Ascaris lumbricoides?

56
Q

What is the Tx for elephantiasis?

A

Diethylcarbamazine

57
Q

Which fungal infections tend to mimic TB?

A

The systemic mycoses

58
Q

What kind of parasite is Enterobius vermicularis?

60
Q

Which dimorphic fungi is not actually a “yeast” in the beast?

A

Coccidiodes is actually a spherule NOT a yeast

62
Q

Which disease can be diagnosed with a blood smear with macrophages that contain amastigotes?

A

Leishmania donovani

63
Q

What is the Tx for entamoeba histolytica in an asymptomatic carrier?

A

iodoquinol

64
Q

What is the Tx of Babesia?

A

Atovaquone and azithromycin

65
Q

Which fungus penetrates the cribriform plate to enter the brain? Which protozoan?

A

Mucor; Naegleria fowleri

67
Q

What is the diagnostic histological feature of Paracoccidiodes?

A

Budding yeast with Captain’s Wheal formation?

68
Q

What is the Tx for Malassezia furfur (2)

A

Topical miconazole and selenium sulfide (aka Selsun Blue)

70
Q

Name 5 dimorphic fungi

A

Coccidiodes immitis, Paracoccidiodes braziliense, Blastomyces dermatidis, Histoplasma capsulatum, Sporothrix schenkii

71
Q

What plasmodium spp causes the most severe malaria?

A

Plasmodium falciparum

72
Q

Which 2 types of malaria have hypnozoites?

A

Vivax and ovale thus these can recur years later

73
Q

What fungus is identified with a latex agglutination test?

A

Cryptococcus neoformans

74
Q

Which protozoon is associated with flask-shaped ulcers in ruptured colon abscesses?

A

Entamoeba histolytica

75
Q

How do you treat Cryptosporidium parvum?

A

Nitazoxinide

76
Q

How do you treat PCP pneumonia? (3 but 1 really important) When does prophylaxis begin?

A

TMP-SMX (main), dapsone, and pentamidine; When CD4 less than 200

78
Q

What is the Tx for blood-borne Trypanosoma brucei? CSF?

A

Suramin, Melarsoprol

78
Q

What form is ingested to cause Taenia solium neurocystericosis? Tx?

A

Egg; Praziquantel and bendazoles

79
Q

Name 3 trematodes (flukes)

A

Schistosoma, Clonorchis sinensis, and Paragonismus westermani

81
Q

What is suramin used to treat?

A

Blood-borne trypanosoma brucei

82
Q

What kind of parasite is Chlorchis sinensis?

A

Trematode (fluke)

83
Q

What does the sandfly transmit?

A

Leishmania donovani

84
Q

What kind of parasite is Toxocara canis?

86
Q

What is a trophozoite ring on blood smear diagnostic for?

A

Plasmodium ring form but also Babesia; differentiate by Hx (mosquito vs. tick; U.S. vs. Africa)

87
Q

How do you get Echinococcus granulosus?

A

from ingestion of eggs from dog feces

89
Q

Name 3 tapeworms

A

Taenia solium, Diphyllobothrium latum, and Echinococcus granulosus

91
Q

What kind of parasite is Schistosoma?

A

Trematode (fluke)

93
Q

What do you use to stain for Pneumocystis jiroveci?

A

Methenamine silver

94
Q

What are 2 visceral protozoal infections?

A

Trypanosoma cruzi, Leishmania donovani

95
Q

What are the 2 Sx of Onchocerca volvulus?

A

Black skin nodules and African River Blindness

97
Q

What is the classical triad of congenital toxoplasmosis?

A

chorioretinitis, hydrocephalus, and intracranial calcifications

99
Q

What will you see on a blood smear of babesia that is pathognomonic for it?

A

Maltese cross; note: you can also see a ring form but this is also present in Plasmodium and is therefore not pathognomonic

101
Q

What is Nitazoxinide for? Nifurtimox?

A

Cryptosporidium in AIDS patients; Trypanosoma cruzi

102
Q

Which parasite can cause portal hypertension? Treatment?

A

Schistosoma mansoni; Praziquantel

103
Q

Why is mucor so common in diabetic ketoacidosis?

A

Proliferates in blood vessels where there are lots of ketones

105
Q

Which fungal infection is associated with an increase number of cases after earthquakes? Why?

A

Coccidiodes immitis, the earthquakes throw the spores up into the air

106
Q

Foul smelling green vaginal discharge?

A

Trichomonas vaginalis

106
Q

What bug is transmitted via undercooked crabmeat?

A

Paragonismus westermani

108
Q

How do you get Ancyclostoma duodenale or Necator americanus?

A

Larvae penetrate the skin

109
Q

Atovaquone and azithromycin is the combo given to Tx ________.

110
Q

Which intestinal infection is classically associated with IgA deficiency?

A

Giardia lamblia

112
Q

What should you test for before beginning primaquine for vivax and ovale malaria?

A

G6PD deficiency

113
Q

What kind of parasite is Taenia solium?

A

Cestode (tapeworm)

114
Q

By prophylaxing for PCP pneumonia with __________ what other opportunistic infection are you covering?

A

TMP-SMX when CD4

115
Q

What is the Tx for onchocerca volvulus?

A

Ivermectin

117
Q

Which systemic mycosis is capable of causing meningitis? How would you treat it at this stage?

A

Coccidiodes immitis; Amphotericin B is Tx of disseminated systemic mycoses (which this is). If it were localized to lungs it would be itraconazole or fluconazole

118
Q

Compare the transmission of Giardia, Entamoeba, and Cryptosporidium

A

ALL ARE FROM CYSTS IN WATER!

119
Q

What is the DOC for oral or esophageal candidiasis (2)?

A

Fluconazole (inhibit ergosterol synthesis) or Caspofungin (inhibit Cell wall by binding D-Glucan)

120
Q

What is the prophylactic Tx of toxoplasma? What is the treatment of active infection?

A

TMP-SMX (when CD4 under 100, but already covered by PCP); Pyrimethamine and sulfadiazine

121
Q

What agar do you grow Cryptococcus on? What 2 stains can be used to identify it?

A

Sabaurod’s agar? Mucicarmine and India ink

122
Q

Name 2 parasites treated with diethylcarbamazin

A

Loa loa and Wucheria bancrofti

123
Q

What is a risk factor for severe babesiosus?

124
Q

What form is ingested to cause Tanea solium intestinal infection? Treatment?

A

Cyst form; praziquantel

125
Q

What is the diagnostic histological feature of Coccidiodes?

127
Q

What causes desert bumps?

A

Coccidiodes (if disseminated to skin)

128
Q

What immunodeficiency are recurrent Aspergillus infections associated with and why?

A

Chronic Granulomatous disease (NADPH oxidase deficiency); Aspergillus is catalase positive

129
Q

What is the pathognomonic finding on KOH prep for tinea versicolor?

A

Malassezia furfur = Spaghetti and Meatballs

130
Q

Regarding Aspergillus and Mucor, which is acute angle branching and which is right angle branching?

A

Right angle = Mucor and Rhizopus; Acute angle branching = Aspergillus

131
Q

What is the Tx for visceral larval migrans?

A

Albendazole or mebendazole

132
Q

Which parasite is associated with cholangiocarcinoma?

A

Chlonorchis sinensis

134
Q

What kind of parasite is Diphyllobothrium latum?

A

Cestode (tapeworm)

136
Q

How do you get Enterobius vermicularis? What is the treatment?

A

Food contaminated with eggs, mebendazole (or pyrantel pamoate)

137
Q

Which 2 nematodes are hookworms?

A

Ancyclostoma duodenale, Necator americanus

138
Q

What are the 4 NON-OPPORTUNISTIC systemic mycoses? What is the Tx for local and disseminated disease?

A

Coccidiodes immitis, Paracoccidiodes braziliense, Blastomyces dermatidis, and Histoplasma capsulatum; Local = fluconazole or itraconazole; Systemic = amphotericin B

139
Q

What parasite is transmitted by the black fly?

A

Onchocerca volvulus

140
Q

What is the host for Schistosoma spp.?

A

Snails; cercariae penetrate skin in dirty water

141
Q

What is the triad of leishmaniaisis?

A

Spiking fevers, hepatosplenomegaly, and pancytopenia

142
Q

How do surgeons prevent anaphylaxis from cyst disruption when treating hydatid cyst disease? What organism?

A

Inject ethanol into cyst; Diphyllobothrium latum (fish tapeworm, cestode)

143
Q

What are the 3 chronic complications of T. cruzi how do you treat?

A

Megaesophagus, Megacolon, Cardiomyopathy–Tx symptomatically at that point NOT nifurtimox

144
Q

What bacterial infection can the systemic mycoses mimic?

A

Tuberuclosis due to the formation of granulomas

146
Q

What kind of parasite is Strongyloides stercoralis?

147
Q

How do you get Loa loa?

A

Deerfly, Mango fly, and Horsefly

148
Q

What systemic mycosis can cause meningitis? What opportunistic fungus?

A

Systemic = Coccidides immitis; Opportunistic = Cryptococcus neoformans

149
Q

What infection is a likely antecedent to an Aspergilloma?

A

TB; An Aspergilloma is a “fungal ball”, TB leaves cavities and Aspergillus gets in and forms a fungal ball

150
Q

What is the Tx for Toxocara canis?

A

Albendazole or mebendazole

151
Q

What does the Tsetse fly transmit?

A

Trypanosoma brucei (African Sleeping Sickness)

152
Q

How do you get Giardia? What is the Tx of nonpregnant vs. pregnant?

A

Cysts in water; metronidazole; paraMOMycin for pregnant moms

153
Q

What causes soap bubble lesions of the brain? Soap bubble lesions of bone?

A

Cryptococcus neoformans; Giant cell tumor of bone (osteoclastoma)

154
Q

What “vector” is Histoplasma associated with?

A

Bird and bat droppings (In Ohio and Mississippi river valleys)

155
Q

Which cutaneous mycosis is treated with topical miconazole and selenium sulfide?

A

Malassezia furfur = Spaghetti and Meatballs

156
Q

What are 5 major opportunistic fungi?

A

Cryptococcus neoformans, Aspergillus fumigatus, Candida albicans, Mucor and Rhizopus, and Pneumocystis jiroveci

157
Q

What is the Tx of Strongyloides stercoralis?

A

Ivermectin or albendazole

158
Q

What kind of parasite is Dracunculus medinensis?

159
Q

What is the treatment for B12 deficiency caused by the fish tapeworm?

A

Praziquantel

160
Q

Name 4 intestinal protozoal infections

A

Giardia lamblia, Isospora, Crytptosporidium parvum, and Entamoeba histolytica

161
Q

What Plasmodium spp. Cause tertian malaria?

A

Ovale and vivax

162
Q

What is the pathognomic histology of Blastomyces?

A

Broad Based Budding

163
Q

What is the Tx of ancyclostoma duodenale and Necator americanus?

A

Bendazoles or pyrantel pamoate

164
Q

What kind of parasite is Trichinella spiralis?

MICROBIOLOGY FOR BOARDS (6 decks)

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