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MICROM 460 > Mycology Lecture 6 > Flashcards

Mycology Lecture 6 Flashcards

1
Q

adaptive defenses are _______, take longer to ______, and include __ cell and ______ responses

A

specific, respond, T, antibody

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2
Q

innate defenses are _________, respond _____, and are responsible for fever, redness, pain, and pus

A

non-specific, quickly

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3
Q

neutrophils are part of the ____ immune system

A

innate

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4
Q

antibodies are part of the ____ immune system

A

adaptive

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5
Q

T cells are part of the ____ immune system

A

adaptive

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6
Q

neutropenia is linked to what infections? (3)

A
  • aspergillus
  • mucormycosis
  • candida
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7
Q

antibodies play an _____ role in fungal disease

A

unclear

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8
Q

T cells are important in _______, _____ _____ transplant, and ______

A

HIV/AIDS
solid organ
steroids

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9
Q

what are the main players involved with fighting fungal infections?

A

T cells

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10
Q

name a few non-immune factors that play a role in host defenses

A
  1. mechanical barriers (skin, mucosa)
  2. competition for nutrients from bacterial flora
  3. mucociliary clearance of respiratory tract
  4. iron overload
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11
Q

________ and _______ are significant in the first steps of host defense

A

neutrophils and macrophages

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12
Q

t or f: macrophages and neutrophils can be attracted by fungi or from signaling from other phagocytes that are already at the site of infection

A

true

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13
Q

phagocytes can destroy fungi via ______ or ___-______ mechanisms

A

oxidative, non-oxidative

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14
Q

t or f: to help with immunity formation, phagocytes are able to displayed ingested fungal part on their surface

A

true

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15
Q

what two features of cryptococcus allow it to evade the immune system?

A

capsule, melanin

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16
Q

which azoles can treat candida?

A

fluconazole (for non-resistant species like c. albicans and c. parapsilosis)

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17
Q

which azoles can treat aspergillus?

A

voriconazole (first line), isavuconazole, posaconazole

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18
Q

which azoles can treat mucormycosis?

A

azoles are used for second line of therapy (posaconazole, isavuconazole)

*first line therapy is ampho in high doses

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19
Q

name 4 major places that antifungals attack

A
  1. cell membrane function
  2. cell wall synthesis
  3. nucleic acid synthesis
  4. ergosterol synthesis
20
Q

why was liquid amphotericin B created?

A

it was created to reduce the side effects that came along with use of amphotericin B (loss of kidney function and electrolyte imbalance)

21
Q

liquid amphotericin B is a _____ option compared to the conventional amp B

A

safer

22
Q

azoles inhibit _______ synthesis by binding to _____. this leads to a lack of ergosterol in cell _____, and a buildup of the precursor.

A

ergosterol
ERG11
membranes

23
Q

primary resistance (intrinsic) is typically seen in ______ patients, where there is _______ of ______ species or subpopulations

A

immunocompromised
selection
resistant

24
Q

secondary resistance (acquired) is seen in ____ patients or ______ patients. Patients with ____ may have recurrent candidiasis and may be on long-term fluconazole therapy, where there may be a _______ or ______ of drug efflux pumps.

A 
AIDS
neutropenic
AIDS
mutation
upregulation
25
Q

what are CDRs and MDR?

A

transport proteins found in the fungal cell wall - they pump antifungal drugs out

26
Q

an example of secondary resistance w/ azoles is if Erg11 gets a ______ where it decreases binding to _____

A

mutation

azoles

27
Q

an example of secondary resistance w/ azoles is if there is an issue in the ________ biosynthetic pathway, which leads to buildup of precursors

A

ergosterol

28
Q

t or f: CDRs are usually _____ to all _____, whereas MDR is ______ for _______

A

generalized, azoles, specific, fluconazole

29
Q

_______ and tolnaftate also inhibit ergosterol synthesis, but specifically ______

A

terbinafine

ERG1

30
Q

5-FC is rarely used alone, because…..

A

it quickly develops resistance

31
Q

side effect of 5-FC?

A

bone marrow toxicity

32
Q

spectrum for 5-FC?

A

narrow

33
Q

when is 5-FC used?

A

it is used to treat crypto meningitis (used with ampho B), candida (normally never use), chromoblastomycosis (not for long term)

34
Q

name an example of a polyene and what it does?

A

amphotericin B

-it binds to ergosterol and destabilizes the membrane (punches pores in it)

35
Q

side effect of amphotericin B?

A

nephrotoxicity

36
Q

when 2g of ampho B is used, about __% of patients develop acute renal failure

A

50%

37
Q

t or f: while liquid ampho B does reduce nephrotoxicity, it does not protect against it

A

true - it just reduces toxicity

38
Q

what do echinocandins do?

A

they inhibit cell wall synthesis by inhibiting beta-1,3 D glucan synthase

39
Q

echinocandins lead to loss of ____, thus leading to ____ fragility

A

glucan, osmotic

40
Q

what is the spectrum for echinocandins?

A
  • candida species resistant to fluconazole
  • aspergillus species

**no coverage for cryptococcus neoformans

41
Q

downside of using echinocandins?

A

IV administration only

42
Q

downside of using voriconazole?

A

hallucinations, vivid dreams

43
Q

what is the yeast connection?

A

the belief that yeast in our body causes a variety of health issues

44
Q

what is the candida diet?

A

a low sugar / anti-inflammatory diet that encourages gut health and eliminates sugars that feed candida

45
Q

candida plan supplements can lead to ____ failure. also, supplements are not ___ regulated

A

liver

FDA

46
Q

what is yeast free?

A

supposedly a natural medicine used to clear fungal/yeast overgrowth, and c. albicans infections

MICROM 460 (20 decks)

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