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PCM Exam 3 > Respiratory Tract Infections 8 > Flashcards

Respiratory Tract Infections 8 Flashcards

1
Q

What are some clinical features seen with fungal causes of RTI’s?

A
  • mild fever
  • non productive cough
  • progress dyspnea
  • weight loss
  • rheumatologic syndromes: arthritis, erythema nodosum and erythema multiform
  • CXR: pulmonary nodules, hilar lymphadenopathy and patchy infiltrates
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2
Q

what primary fungal pathogen is associated with skin lesions?

A

blastomyces dermatidis

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3
Q

list the primary fungal pathogens that can cause pneumonia and other LRTI’s

A
  • histoplasma capsulatum
  • blastomyces dermatitis
  • coccidiodies immitis
  • paracoccidioides brasiliensis
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4
Q

microscopic presentation of coccidiodes immitis

A
  • spherules with spores inside
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5
Q

List the opportunistic fungal pathogens that can cause pneumonia and other LRTI’s

A
  • cryptococcus neoformans
  • aspergillus
  • pneumocystis jiroveci
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6
Q

which fungal pathogen is capable of growing inside macrophages? how?

A 
Histoplasma capsulatum (primary) 
↑'s phagolysosomal pH which interferes with enzyme activity and antigen processing
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7
Q

which primary fungal pathogens can be found in the Mississippi River Valley and Ohio River Valley?

A
  • H. capsulatum

- B. dermatidis

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8
Q

_________ fungi is found in soil that has a lot of bird and bat droppings

A

Histoplasma capsulatum (primary) because the soil is high in nitrogen content

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9
Q

_______ is a fungal pathogen that is endemic to the southwestern US and NW Mexico

A

coccidiodies immitis

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10
Q

neutropenia is a predisposing factor for infection by which opportunistic fungal pathogen?

A

aspergillus

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11
Q

the ______ of aspergillus is inhaled from _______

A

conidia;

decaying organic matter

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12
Q

_______ agar is used for fungal pathogens

A

Sabouraud’s agar

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13
Q

what CD4 cell count is an AIDS defining criteria?

A

CD4 Cell count < 200

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14
Q

assisted ventilation is a predisposing factor for infection by which opportunistic fungal pathogen?

A

aspergillus

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15
Q

Organ transplant is a predisposing factor for infection by which opportunistic fungal pathogen?

A

pneumocystis, C. neoformans

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16
Q

allergic form of aspergillosis is associated with _____

A

recurrent infections from pathogen with asthma or cystic fibrosis

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17
Q

Describe the appearance of the histoplasma capsulatum yeast in alveolar macrophages

A
  • non encapsulated, thick walled and budding yeasts
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18
Q

single broad base bud in a yeast is the microscopic presentation of what fungal pathogen?

A
  • Blastomyces dermatidis

BBB = B
Broad Based Budding yeast = Blastomyces

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19
Q

cryptococcus neoformans is an non/encapsulated yeast

A

encapsulated

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20
Q

opportunistic fungal pathogens are usually monomorphic/dimorphic

A

monomorphic

21
Q

what are the predisposing factors for infection by aspergillus?

A

chemotherapy, assisted ventilation and neutropenia

22
Q

patient with AIDS comes in complaining of headache, vomiting, and confusion. He has exposure to areas with a lot of bird droppings. What would you do identify the most likely causal pathogen?

A
  • pathogen: cryptococcus neoformans

- do an india ink stain of the CSF

23
Q

narrow based budding yeast is indicative of what fungal pathogen?

A

cryptococcus neoformans

broad based budding yeast: blastomyces dermatidis

24
Q

what is a requirement for infection by pneumocystis jirovecii?

A

CD4 < 200

25
Q

a patient comes to the clinic with weight loss, mild fever, progressive dyspnea and arthritis like symptoms. He likes to go hike in caves. Where in the body are you most likely to find the causal pathogen?

A

causal pathogen: H. capsulatum because he is not immunocompromised (if he was and was in soil with bird droppings, would be cryptococcus neoformans) ;

inhale the microconidia aerosols

non encapsulated thick walled and budding yeasts found in the alveolar macrophages

26
Q

coccidiodes immitis is associated with the inhalation of ______

A

only a few conidia

MOST VIRULENT of all human mycotic pathogens

27
Q

what is the main virulence factor of cryptococcus neoformans

A
  • capsule that can down regulate the immune response
28
Q

patient has a lung nodule and biopsy shows spherules that contains spores. No budding is seen. What pathogen has a similar microscopic presentation?

A
  • Coccidiodies immitis
29
Q

what are the major forms of aspergillosis

A
  • allergic: asthma, CF

- invasive: hyphae invade tissue and seen in transplant patients and will have neutropenia (immunocompromised patients)

30
Q

what is the mode of transmission of H. capsulatum

A
  • microconidia and hyphae are aerosolized and inhaled
31
Q

what is a virulence factor for Paracoccidiodies brasiliensis?

A

primary fungal pathogen;

has a α 1,3 glucan in the cell wall

32
Q

acute angle branching form septate hyphae with branching tree like pattern seen with ____

A

aspergillus

33
Q

hemoptysis is seen by pneumonia caused by what fungal pathogen?

A

invasive aspergillosis (opportunistic fungal pathogen)

34
Q

outbreaks of histoplasma capsulatum are associated with what areas?

A
  • areas where birds roost
  • caves
  • old/decaying buildings
  • areas where buildings are undergoing demolition
35
Q

histoplasmosis capsulatum is a primary/opportunistic fungal pathogen

A

primary

36
Q

what fungal pathogen lacks ergosterol in their cell wall?

A

pneumocystis jirovecii

37
Q

cyptococcus neoformans is a primary/opportunistic fungal pathogen

A

opportunistic

38
Q

HIV/AIDS is a predisposing factor for infection by which opportunistic fungal pathogen?

A

C. neoforman, pneumocystis

39
Q

when trying to diagnose blastomycosis, what is an additional clinical feature to look for?

A
  • skin lesions associated with pulmonary symptoms

has similar epidemiology to that of H. capsulatum

40
Q

what is the geographical distribution of H. capsulatum

A

Mississippi River Valley and Ohio River Valley

41
Q

____ form of aspergillosis is seen with immunocompromised patients

A

invasive; lung transplantation

high morality, hemoptysis

42
Q

chemotherapy is a predisposing factor for infection by which opportunistic fungal pathogen?

A

Aspergillus and pneumocystis

43
Q

cryptococcal _______ is a common manifestation of C. neoformans infection in AIDS patients

A

meningitis;

44
Q

what are two fungal pathogens that can grow in pidgeon dropping enriched soil?
how can you tell when one is the more likely cause

A
  • Histoplasma capsulatum
  • cryptococcus neoformans

H. capsulatum is a primary pathogen while cryptococcus neoformans is a opportunistic. If the patient is NOT immunocompromised, the most likely pathogen is H. capsulatum

45
Q

_______ stain is used to stain for cyrtocopcus neoformans in the lungs

A

mucicarmine stain; will see a thick staining because of the thick capsule

46
Q

primary/secondary pathogens are ALL dimorphic: _____ and _______

A

PRIMARY: exist as moulds in the environment and yeasts in the tissues

47
Q

_______ has cholesterol in their cell wall

A

pneumocystis jirovecii

48
Q

india ink stain is used to diagnose ________

A

cryptococcus neoformans in patients with cryptococcal meningitis by staining them found in the CSF

PCM Exam 3 (32 decks)

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