Opportunistic

Question 1

Aspirgillus spp. Clin

Answer 1

aspergillosis (atyp or typ), found in cavities left by other infectious agents.

Question 2

Aspirgillus spp. ABPA

Answer 2

Allergic bronchopulm aspergillosis - HSR to colonized bronchial tree. In asthmatics and CF leading to fever, pulm infiltrates, dry cough and hemoptysis

Question 3

Aspirgillus spp. Pulm aspergilloma

Answer 3

Asympt - radiograph abnorm in patient with pre-existing cavity lung disease due to necrotizing pneu. CXR = round soft masses. Hemoptysis

Question 4

Aspirgillus spp. Invasive Pulm Aspergillosis

Answer 4

Patients with neutropenia = typ pneu, common in transplant patients. Radiograph - nodules, cavity, infiltrates, focal infiltrates

Question 5

Aspirgillus spp. Char

Answer 5

monomorphic fungi

Question 6

Aspirgillus spp. Diag

Answer 6

KOH/Silver stain = septate branching hyphae in sputum. Culture = SDA

Question 7

Aspirgillus spp. Serology

Answer 7

Allergic = detect IgE in serum via RAST

Invasive - detect galactomanno Ag via Elisa

Question 8

Pneumocystis Jiroveci Clin

Answer 8

Pneumocystis Pneumonia (PCP) atyp, CXR = bilateral diffuse infiltrate, extrapulmonary lesions, Image = ground glass with patches

Question 9

Pneumocystis Jiroveci Path

Answer 9

Org binds and kills alveolar epi cells, induces inflamm response w/in alveoli. blocks gas exchange

Leak of serum to alveoli gives rise to foamy and honeycomb appearing exudate, very thick

Alv macros w/o CD4 cell cant control infections

Question 10

Pneumocystis Jiroveci Char

Answer 10

Round shaped cup organism, fungus lacks ergosterol

Question 11

Pneumocystis Jiroveci RF

Answer 11

Immunocomp

Question 12

Pneumocystis Jiroveci Diag

Answer 12

Microscopy of bronch secretions (BAL/biopsy), silver stain or IF to see cupped trophozoite and cyst stage

Question 13

Pneumocystis Jiroveci Tx

Answer 13

Antifungals (not amphoterican B - not effective)

Question 14

Ascaris Lumbricades Clin

Answer 14

Ascarasis (round worm) pneumomitis, GI cramps, nausea, fever, dry cough, wheeze. Pancreatitis, cholecystitis, appendicitis

Question 15

Ascaris Lumbricades Primary infection

Answer 15

GI infection leading to cramping, nausea, vomit

Question 16

Ascaris Lumbricades Tissue migratory phase

Answer 16

Larvae move through tissue to lungs, are coughed up and swallowed back. May also migrate to bile and liver

Question 17

Ascaris Lumbricades Ascaris Pneumonitis

Answer 17

Form of Loeffler’s syndrome (pulmonary infiltrates with eosinophils) leading to eosinophilia when larvae spread. Non prod cough, wheeze, rales with consolidation, sputum with larvae, wbc shoes increased eosinophils. CXR with infiltrates

Question 18

Ascaris Lumbricades Char

Answer 18

Helminthic parasite

Question 19

Ascaris Lumbricades Trans

Answer 19

Fecal oral

Question 20

Ascaris Lumbricades Diag

Answer 20

eggs in stool, larvae in sputum, wbc for eo’s

Question 21

Ascaris Lumbricades Image

Answer 21

Patchy infiltrate

Question 22

Ascaris Lumbricades Tx

Answer 22

Anti-helm (mebendazole)

Question 23

Strongyloides Stercoralis Clinical

Answer 23

Strongyloidosis (pneumonitis), fever, dry cough, wheeze, burning chest, larvae nigrans. No abd symptoms

Question 24

Strongyloides Stercoralis Char

Answer 24

Helminthic parasite

Question 25

Strongyloides Stercoralis Trans

Answer 25

Direct Skin penetration

Question 26

Strongyloides Stercoralis Diag

Answer 26

Eosinophilia, stool neg, larvae in sputum, gastric and duodenal biopsy.

Question 27

Strongyloides Stercoralis CXR

Answer 27

patchy infiltrates

Question 28

Strongyloides Stercoralis Tx

Answer 28

Anti-helm = Thiabindazole