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3 PID Unit > Mycosis II > Flashcards

Mycosis II Flashcards

1
Q

What is the most common fungus found in bone marrow transplant patients?

A

Aspergillus (mold)

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2
Q

What is the most common fungus found in solid organ transplants?

A

Candida (Yeast)

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3
Q

T/F Candida is a human commensal organism?

A

TRUE

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4
Q

what is considered the leading cause of opportunistic fungal infections?

A

Candida

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5
Q

what 3 general areas are usually attacked by candida?

A

1) skin and nails
2) mucosa (vagina, esophagus)
3) blood

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6
Q

What is thrush?

A

A common HIV disease that is a mucosal candida infection mainly affecting the esophagus.

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7
Q

what is candidiasis?

A

blood stream infection of candida

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8
Q

T/F candida is the 3rd most common cause of central line associated infections?

A

TRUE

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9
Q

How does candida usually get into the blood stream?

A

usually catheter related.

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10
Q

what is hepatosplenic candidaisis?

A

microabscesses in liver/spleen from candida that is unique to cancer patients with prolonged neutopenia.

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11
Q

what are the 6 major risk factors for candida infection?

A

immunocompromized with:

1) antibiotic use
2) catheter
3) abdominal surgery
4) TPN
5) In the hospital
6) Neutopenia

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12
Q

what are the two most common types of candida?

A

1) candida albicans

2) candida glabrata

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13
Q

What is this describing? budding yeast that can form pseudohyphae and rarely may form true septate hyphae?

A

All candida species

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14
Q

what is chromogenic media? why is it used?

A

It is media that turns different colors depending on the type of candida grown. Great for identification.

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15
Q

why is early diagnosis of candida difficult?

A

1) lack of inflammatory response
2) Diagnostic procedures are risky
3) lack of sensitive assays

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16
Q

How do you treat skin and mucosal candida disease?

A

topical medications such as “-azoles”

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17
Q

How do you treat invasive candida disease?

A

Oral therapy such as “-azoles”, and amphotericin B.

Also, pull any indwelling catheters.

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18
Q

what is considered to be the most common cause of invasive mold infection?

A

Aspergillus

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19
Q

Over 95% of human disease caused by a mold is caused by which 3 organisms?

A

1) A. fumigatus
2) A. flavus
3) A. niger

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20
Q

T/F Aspergillus routinely colonize healthy individuals?

A

False, but candida does

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21
Q

what is allergic aspergillosis?

A

Airway colonization of aspergillus with allergic reaction. Associated with bronchospasm and scarring.

22
Q

what is Aspergilloma in pre-existing cavity?

A

Secondary colonization of the lung with a fungus ball. Frequently associated with hemoptysis

23
Q

what is semi-invasive aspergillosis?

A

Chronic cavitary, chronic fibrosing, chronic invasive

24
Q

what is invasive aspergillosis?

A

Life threatening and rapid spreading mold that is angioinvasive causing infaction.
Risk factors: neutropenia, immunosuppression, transplant

25
Q

What do you see with an MRI when looking at the lungs of someone with allergic bronchopulmonary aspergillosis?

A

thickening of the airways (bronchiectasis) and pleura

26
Q

where does invasive aspergillosis usually begin?

A

in the lungs

27
Q

T/F Mortality associated with Aspergillosis in increasing as we advance in modern medicine?

A

False. The mortality rate is slowly declining.

28
Q

Which type of organism has septate hyphae that branch at 45 degrees?

A

Aspergillis

29
Q

How do you diagnose aspergillis?

A

1) 45 degree branching hyphae that are septated

2) Antigen detection (Galactomannan in the blood)

30
Q

Which 3 underlying diseases make you have the highest risk of invasive aspergillosis?

A

1) Bone marrow transplant
2) Neutropenia
3) Hemotologic cancer

31
Q

what is Galactomann?

A

a polysaccaride cell wall component of aspergillus. It serves as an antigen for monitoring hematologic malignancy in patients. (NOTE: it is not helpful with patients receiving antifungal therapy or certain antibiotics because it gives a false negative)

32
Q

How do you treat allergic bronchopulmonary aspergillosus?

A

corticosteroids

33
Q

How do you treat an aspergilloma?

A

combined surgical and medical therapy

34
Q

how do you treat semi-invasive and invasive aspergillosus?

A

1) Voriconazole is first line therapy

2) Amphoteracin B would follow

35
Q

Which group of organisms are characteristically classified by broad hyphae without septate?

A

Zygomycosis

36
Q

Rhizopus, Mucor, and Rhizomucor all belong to which group?

A

Zygomycosis

37
Q

What diseases does zygomycosis usually cause?

A

1) Rhinocerebral DZ
2) pulmonary DZ
3) Disseminated DZ in immunocompromized

38
Q

What are the 3 main risk factors for zygomycosis infections?

A

1) Diabetes with hyperglycemia
2) acidosis
3) Hematologic malignancies

39
Q

what is the treatment for zygomycosis?

A

Amphoteracin B and surgical debridment

40
Q

T/F If you have a coinfection of zygomycosis and aspergillus and you knock out aspergillus with treatment, zygomycosis infection will increase?

A

TRUE

41
Q

When tying to identify zygomycosis, you should mince rather than crush of ground the hyphae. Why?

A

This is to minimize the damage done to the hyphae. Recall identification of zygomycosis is by identifying broad non-septate hyphae.

42
Q

T/F you can detect zygomycosis by D-glucan or galactomannan assays?

A

False. Both of these will not help detect zygomycosis

43
Q

what type of fungus is known as lid lifters?

A

zygomycosis grows so quickly that if you leave it, it will overgrow its container.

44
Q

T/F Pneumocytis jeroveci = P. carinii?

A

TRUE

45
Q

In which patients do you generally see P. Jeroveci?

A

AIDS patients with <200 CD4 level

46
Q

why has the incidence of P. Jeroveci decreased in AIDS patients over the last decade?

A

Introduction of the HAART therapy

47
Q

What has a ground glass infiltrate appearance on CXR?

A

Interstitial pneumonia from Pneumocystis Jeroveci

48
Q

what is the most common clinical syndrome for pneumocystis?

A

interstitial pneumonia

49
Q

What is the best way to diagnose pneumocystosis?

A

It is almost entirely through microscopic examination of sputum of bronchial samples.

50
Q

what is the best treatment for Pneumocystosis (jeroveci)?

A

1 bactram (Trimethoprim-sulfamethoxazole)

51
Q

T/F Patient receiving treatment for pneumocystosis using bactram get worse before they get better?

A

True. This is because with treatment a large antigen load is released from the lysing organisms.

3 PID Unit (11 decks)

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