Opportunistic Fungal infections

Question 1

Fungal organisms responsible for Opportunistic infections

Answer 1

Cryptococcus
Candida
Aspergillus
Mucor (Zygomycetes)
Pneumocystis

Question 2

Cryptococcus is classified on based of Morphology

Answer 2

True yeast - Budding

Question 3

Pathogenic organism known to cause Cryptococcus

Answer 3

Cryptococcus Neoformans

Question 4

Serotypes of Cryptococcus

Answer 4

A,D, AD - C. Neoformans
B,C - C. Gatti

Question 5

Geographical distribution of C. Neoformans and C. Gatti

Answer 5

C Neoformans - all over world
C Gatti - Tropical and subtropical

Question 6

Isolation of Cryptococcus Neoformans is done on

Answer 6

Soil with pigeon dropping

Question 7

Isolation of C. Gatti is done on

Answer 7

Soil around Eucalyptus trees

Question 8

C. Neoformans and C. Gatti known to effect what type of immunity

Answer 8

C Neoformans - Immunocompromised
C Gatti - Both immunocompromised and immunocompetent pt.

Question 9

Which Cryptococcus needs prolonged treatment

Answer 9

C Gatti

Question 10

How C Neoformans enters human body

Answer 10

Soil with Pigeon dropping - inhalation - Lungs - Blood - cause Meningitis - causes Cryptococcal Meningitis

Question 11

Stain used for diagnosis of Cryptococcal Meningitis

Answer 11

CSF - Negative stain (India ink, Nigrosin)

Question 12

Biopsy sample in case of Cryptococcal Meningitis is stained with

Answer 12

Mucicarmine - Rose pink

Question 13

Culture media used for diagnosis of Cryptococcal infection

Answer 13

SDA - Mucoid colony
Niger seed agar/Bird seed agar/Caffeic seed agar

Question 14

Finding of Cryptococcal infection on Niger seed agar/Bird seed agar or Caffeic seed agar

Answer 14

Melanin (brown ) due to Phenol oxidase/laccase

Question 15

Confirmatory test for Cryptococcal Meningitis

Answer 15

LAT (Latex agglutination test)

Question 16

Treatment of Cryptococcal Meningitis

Answer 16

Liposomal Amphotericin B with Flucytosine - DOC

Question 17

Candida is classified in which group according to morphology

Answer 17

Yeast like - Both bud and Pseudohyphae

Question 18

Candida Includes which organisms and Most common

Answer 18

Candida albicans - M/C
Candida dupliniensis
Candida galbrata
Candida auris
Candida krussei
Candida kefyr

Question 19

Which candida species doesn’t have pseudohyphae

Answer 19

Candida glabrata

Question 20

Which candida species are resistant to Azoles

Answer 20

Candida auris
Candida krussei

Question 21

Which candida species are used as control in susceptibility tests

Answer 21

Candida kefyr

Question 22

Sites at which Candida is normally present

Answer 22

Normal Flora - GIT, Genital tract
Mucosa
Skin
Nails
Internal organs

Question 23

Mucosal clinical features of Candida infection

Answer 23

Oral thrush - Curdy white discharge
Esophagitis
Vulvovaginitis
Balanitis
Ocular Candidiasis

Question 24

Other clinical manifestations of Candida

Answer 24

Paronychia
Onychomycosis
Diaper rash
UTI
Endocarditis
Meningitis
Pulmonary involvement

Question 25

Pap smear finding in case of Candida infection

Answer 25

Shish kebab effect

Question 26

Predisposing factors for Candida infection

Answer 26

Decreased immunity Infancy - Diaper rash Old age DM Steroids Pregnancy Immunocompromised states/Immunodeficiency diseases Immunosuppressant drugs Neutropenia pt.

Question 27

Culture used for diagnosis of Candida

Answer 27

SDA Corn meal agar Chrom agar

Question 28

Finding of Candida on SDA agar

Answer 28

Creamy pasty yeasty colonies

Question 29

Finding of Candida on Corn meal agar

Answer 29

Chlamydospores (double wall configuration)

Question 30

Specific phenomenon or test done in case of Candida infection

Answer 30

Reynolds braude phenomenon or Germ tube test

Question 31

Germ tube test is positive for which infections

Answer 31

C. Albicans and C. Dubiliensis

Question 32

Chlamydospores can be seen in which Candida species

Answer 32

Both Candida albicans and Dubiliensis

Question 33

Which candida can grow above 45°C and in hypertonic saline

Answer 33

Candida albicans

Question 34

Treatment of Oral thrush and vulvovaginal candidiasis in case of Candida

Answer 34

Topical Nystatin

Question 35

Treatment of Severe Candidiasis

Answer 35

Fluconazole/Nystatin

Question 36

Treatment of Deep Candidiasis

Answer 36

Liposomal Amphotericin B Azoles

Question 37

Aspergillus is known to cause which conditions

Answer 37

ABPA (Allergic Bronchopulmonary Aspergillosis) Aspergilloma - grows in prexisting cavity Invasive Aspergillosis - disseminated Superficial - Otomycosis

Question 38

ABPA (Allergic Bronchopulmonary Aspergillosis) is Combination of which HS Reactions

Answer 38

Combination of Type 1 and 3 HS reaction Due to repeated/heavy exposure to spore

Question 39

Type of hyphae and type of branching seen in Aspergillus

Answer 39

Septate hyphae Shows acute angle Dichotomous branching

Question 40

Aspergillus includes which Organisms

Answer 40

A. Fumigatus A. Flavus A. Niger A. Terreus

Question 41

Colonies and LPCB Stain finding in case of A. Fumigatus

Answer 41

Smoky green colonies - LPCB Stain - Conidia along upper part

Question 42

Colonies and LPCB stain finding in case of A. Flavus

Answer 42

Yellow green colonies - LPCB Stain - Conidia all around

Question 43

Culture and LPCB Finding in case of A. Niger

Answer 43

Black colonies - LPCB stain - Blackish/Brown color

Question 44

Culture finding in case of A. Terreus

Answer 44

Beige/Cinnamon color

Question 45

Toxin found in Aspergillus Fumigatus

Answer 45

Aflatoxin - Groundnut/Peanut contaminant

Question 46

Aflatoxin can cause mutation at

Answer 46

Codon 249 of p53 gene and can lead to Hepatocellular carcinoma

Question 47

Type of Hyphae in case of Zygomycetes/Glomerulomycetes

Answer 47

Aseptate hyphae

Question 48

Organisms involved in Zygomycetes/Glomerulocytes

Answer 48

RAM Rhizopus - fungus with root (just below) A - Absidia/Leicthemia - root in between organism M - doesn't have root

Question 49

Rhizopus Oryzae is known to cause

Answer 49

Rhino-oculo-cerebral disease

Question 50

Triad seen in case of Rhizopus infection

Answer 50

Nasal discharge Proptosis Delirium 2nd M/C - Lung

Question 51

Treatment of Rhizopus infection

Answer 51

Surgical resection Amphotericin B Alternative - Posaconazole

Question 52

Which fungus is known as Black fungus

Answer 52

Mucor - clinically black lesion

Question 53

Hyphae and branching seen on tissue biopsy in case of Mucor infection

Answer 53

Obtuse/perpendicular branching Aseptate hyphae

Question 54

Mucor Finding on SDA Agar

Answer 54

Cotton wool growth or Salt and pepper appearance

Question 55

Mucor AKA and shape

Answer 55

AKA Lid lifters Shape - broader and ribbon like

Question 56

Beta D glucan

Answer 56

Polysaccharide cell wall component of many Fungi Not seen in Mucor, Blastomyces and Cryptococcus

Question 57

Galactomannan

Answer 57

Major polysaccharide constituent of Aspergillus cell walls Mucor -ve and +ve in rest all

Question 58

Which fungus doesn't have Ergosterol in it's cell membrane

Answer 58

Pneumocystis carinii

Question 59

Clinical features and Microscopic finding in Pneumocystis carinii

Answer 59

Pneumonia - Dry cough Bronchoalveolar lavage - on M/E : Plasma cells ++

Question 60

Stain used and Finding for Pneumocystis carinii

Answer 60

Gomori Methanamine stain - Crushed Ping pong ball appearance/Helmet appearance/Cup and saucer appearance

Question 61

Is pneumocystis carinii cultivable

Answer 61

No

Question 62

Treatment of Pneumocystis carinii

Answer 62

Cotrimoxazole Pentamidine - in sever cases

Question 63

Pneumocystis carinii Mnemonic

Answer 63

PCP - Pneumocystis carinni pneumonia PCP - Plasma cell Pneumonia PCP - Ping Pong Crushed ball PCP - Pneumocystis, Cotrimoxazole, Pentamidine