Mycoses

Question 1

Histoplasmosis

Answer 1

Missippi and Ohio River valleys

Bird/bat droppings (Spelunking)

Histo Hides in Macrophages

Self limited, inhaled

Causes pneumonia, but ability for it to go systemic/disseminate

Smaller than RBC

Question 2

Missippi River Valley/ Ohio River Valley

Answer 2

Histoplasmosis

Question 3

Spelunking

Answer 3

Histoplasmosis

Question 4

Blastomycosis

Answer 4

East of Mississippi River and Central America

(pneumoniae) Inflammatory lung disease, disseminates to BONE and SKIN (like cocci)

Granulomatous nodules

Blast Buds Broadly. Same size as RBC

Question 5

Central US

Answer 5

Blastomycosis

Question 6

Within macrophages

Answer 6

Histoplasmosis (Histo Hides)

Question 7

Same size as RBC

Answer 7

Blastomycosis (Broad budding)

Question 8

Smaller than RBC

Answer 8

Histoplasmosis

Question 9

Larger than RBC

Answer 9

Coccidioidomycosis

Question 10

Coccidioidomycosis

Answer 10

SW US

Pneumonia, MENINGITIS

can disseminate to BONE and SKIN. Like blasto

Spherule > RBC

Desert bumps, erythema nodosum
Desert rheumatism, arthralgias

San Joaquin River Valley

Question 11

Bone and Skin

Answer 11

Blasto or Coccidio

Question 12

Spherule

Answer 12

Large w/ endospores (Coccidio)

Question 13

Erythema nodosum

Answer 13

Coccidio

Question 14

Paracoccidioidomycosis

Answer 14

Latin America

Budding year w/ Captains weal

Granuloma in skin or mucous

Question 15

Meningitis

Answer 15

Coccidio

Question 16

Malassezia furfur

Answer 16

Tinea Versicolor

Hypo or hyperpigmented patches.

Hot humid weather.

Degrades lipids and produces acid –> destroys melanocytes

Scalp = oral treatment

Question 17

Tinea pedis

Answer 17

Athletes foot

Question 18

Tinea Cruris

Answer 18

Groin fungal

Question 19

Tinea corporis

Answer 19

Ring worm on body

Question 20

Tinea capitis

Answer 20

Ring worm on scalp

Question 21

Tinea uniquium

Answer 21

Onychomycosis (usually trichophyton)

Question 22

Tinea

Answer 22

Pruritic lesion w/ central clearing

Trichophyton
Epidermophyton
Microsporum

Mold hyphae on KOH prep, not dimorpihic

Question 23

Trichophyton

Answer 23

Dermatophytes

Question 24

Epidermophyton

Answer 24

Dermatophytes

Question 25

Microsporum

Answer 25

Dermatophytes

Question 26

Malassezia furfur

Answer 26

Dermatophyte

Question 27

Esophageal/Oral thrush

Answer 27

Immunocompromized. Fluconazole/Caspofungin

Question 28

Vulvovaginitis

Answer 28

DM or Antibiotic threatment

Question 29

Diaper rash

Answer 29

Candida

Question 30

Endocarditic in IVDA

Answer 30

Candida

Question 31

Chronic mucocutaneous Candida

Answer 31

T cell deficiency

Question 32

Systemic Candida

Answer 32

Neutropenia

Question 33

Invassive aspergillosis

Answer 33

Immunocompromised or CGD

Question 34

Allergic Bronchopulmonary aspergillosis

Answer 34

Asthma and CF. Cause Brochiectasis and Eosinophilia

Question 35

Aspergilloma

Answer 35

Lung cavity, often after TB

Question 36

Alfatoxin

Answer 36

HCC from Aspergillus

Question 37

Acute Angles

Answer 37

Aspergillus

Question 38

Paseudohyphae

Answer 38

Candida

Question 39

Pigeon Droppings/soil

Answer 39

Crypto, COuld be histo too, or c. psitticae

Question 40

Soap Bubble Lesion in brain

Answer 40

Cypto

Question 41

India Ink

Answer 41

Cypto

Question 42

Cyptococcus

Answer 42

Meningitis in AIDS Encapsulated yeast. CSF or Serum for Dx. Latex agglutinin test - Specific

Question 43

Latex Agglutination

Answer 43

Crypto

Question 44

Ketoacidotic Diabetic and Leukemia

Answer 44

Mucor or Rhizopus

Question 45

Mucor/rhizopus

Answer 45

Proliferate in vessel walls when excess ketone and glucose. Enter brain + eye via cribiform Rhinocerebral frontal lobe abcess, Necrotic eschar

Question 46

PCP

Answer 46

Diffuse interstitial pneuonia Yeast, inhaled. Usually asymtpo Immunosuppression progresses to disease Diffuse bilat CXR Dx: Lung biopsy/lavage Disc shaped yeast on methenamine silver stain

Question 47

Yeast

Answer 47

Candida, Crypto, PCP

Question 48

Neutropenia

Answer 48

Apergillus or Candida

Question 49

Sporothrix

Answer 49

Dimorphic cigar shape yeast Gardner's disease (thorn) Traumatically induced. Local pustule/ulcer w/ nodules along draining lympahtics