Section 26- Fungal Infections

Question 1

KOH preparation in Candida

Answer 1

Pseudohyphae and yeast forms

Question 2

Topical treatment for cutaneous candidiasis

Answer 2

Nystatin
Azole
Imidazole cream or powder

Question 3

May be effective in recurrent cutaneous candidiasis

Eradicates bowel colonization

Answer 3

Nystatin suspension or tablet

Question 4

AIDS defining classification of mucosal candidiasis

Answer 4

Esophageal and Tracheobronchial

Question 5

Portal of entry of Candida in disseminated disease

Answer 5

GI tract

Question 6

Treatment for oropharyngeal candidiasis

Answer 6

Topical- nystatin or cotrimazole

Systemic- fluconazole and echinocandins (caspofungin, micafungin)

Question 7

Genital candidiasis treatment

Answer 7

Azole creams or suppository

Question 8

Onset of chronic mucocutaneous candidiasis

Answer 8

Infancy or early childhood

Question 9

Common cause of nosocomial infections

Risk factors: neutropenia, venous access catheters

Small disseminated erythematous cutaneous papules

Answer 9

Disseminated candidiasis

Question 10

Treatment for disseminated candidiasis

Answer 10

Echinocandins
Fluconazole
Amphotericin B

Question 11

Lipophilic yeast that normally resides in keratin of skin and hair follicles

Answer 11

Malassezia furfur

M. globosa

Question 12

Well demarcated patches with fine scale

Hypo/hyperpigmented

Most common in trunk

Predisposing factors: sweating and oily skin

Answer 12

Tinea versicolor

Question 13

Malassezia furfur result on KOH preparation

Answer 13

Spaghetti and meatballs

Round yeast and elongated pseudohyphae

Question 14

Woods lamp fluorescence in pityriasis versicolor

Answer 14

Blue green

Question 15

Topical treatment for pityriasis versicolor

Answer 15

Selenium sulfide 2.5% lotion or shampoo
Ketoconazole shampoo
Azole creams
Terbinafine 1% solution

Question 16

Systemic therapry for pityriasis versicolor

Answer 16

Fluconazole 300mg once a week x 3 weekd

Itroconazole 400ng single dose

Question 17

What differentiates malassezia folliculitis from acne vulgaris?

Answer 17

Absence of comedones

Question 18

Asymptomatic superficial fungal colonization of the hair shaft

Answer 18

Piedra

Question 19

White to beige nodules on hair shaft

Soft, easily removed

Answer 19

White piedra

Question 20

Darkly pigmented, firmly attached nodules on hair shaft

Weakens hair shaft with hair breakage

Affects scalp hair

Answer 20

Black piedra

Question 21

Treatment for trichosporon infections

Answer 21

Topical or systemic azoles

Amphotericin B

Question 22

Superficial fungal colonization of the stratum corneum

Answer 22

Tinea nigra

Question 23

Fungus associated with tinea nigra

Answer 23

Hortaea werneckii

Question 24

More common in tropical climates
Direct inoculation onto skin from contact with decaying vegetation, wood or soil

Brown to black macules with well defined borders that resemble silver nitrate stains

Answer 24

Tinea nigra

Question 25

Treatment for tinea nigra

Answer 25

Topical azole | Alochol gel sanitizer

Question 26

Most common cause of epidermal dermatophytosis and onychomycosis in industrialized nations

Answer 26

Trichophyton rubrum

Question 27

KOH preparation: | Multiple septated tubelike structures (hyphae or mycelia)

Answer 27

Dermatophytes

Question 28

Woods lamp fluorescence for Microsporum spp

Answer 28

Blue green

Question 29

Most common dermatophytic infection

Answer 29

Epidermal dermatophytoses

Question 30

Most effective oral antidermatophyte antifugal

Answer 30

Terbinafine 250mg tablet | -allylamine

Question 31

This systemic antifungal used in dermatophytoses needs acidic gastric pH for dissolution of capsule

Answer 31

Itraconazole

Question 32

Most common site of tinea pedis

Answer 32

Between 4th and 5th toes

Question 33

Condition that may coexist with interdigital tinea pedis

Answer 33

Erythrasma

Question 34

Topical agents for epidermal dermatophytoses

Answer 34

Imidazoles (clotrimazole, miconazole, ketoconazole) Allylamines (terbinafine) Naphthiaonates (tolnaftate) Substituted pyridine ( ciclopirox olamine)

Question 35

Treatment for tinea manuum | Or dermatophytoses of hands feet and nails

Answer 35

Oral agents: Terbinafine 250mg OD X 14 days Itraconazole 200mg OD x 7 days Fluconazole 150-200mg OD for 2-4 weeks

Question 36

Epidermal dermatophytosis that occurs after topical application of a glucocorticoid preparation to a site colonized or infected by dermatophyte

Answer 36

Tinea incognito

Question 37

Type of dermatophytic folliculitis where mycelia and arthroconidia are seen on the surface of the hair follicle

Answer 37

Ectothrix type (extrapilary)

Question 38

Type of dermatophytic folliculitis where mycelia and arthroconidia are seen within the hair shaft

Answer 38

Endothrix type (intrapilary)

Question 39

Variant of endothrix resembling seborrheic dermatitis

Answer 39

Black dot tinea capitis

Question 40

Variant of endothrix with arthroconidia and airspaces within hair shaft

Answer 40

Favus

Question 41

``` Boggy purulent inflamed nodules and plaques Usually painful Drains pus from multiple openings Hairs do not break off but fall out Heals with scarring alopecia ```

Answer 41

Kerion

Question 42

Latin for honeycomb Perifollicular erythema and matting of hair Later thick yellow crusts (scutula) composed of skin debris and hyphae Fetid odor

Answer 42

Favus

Question 43

Dermatophytic folliculitis with foreign body granuloma in response to keratin in dermis and immune reaction to dermatophyte Occurs with immunosuppression Distribution: any hair bearing area

Answer 43

Majocchi granuloma

Question 44

Treatment for Sporotrichosis

Answer 44

Itraconazole

Question 45

Caused by Madurella species Swelling, development of sinus tracts and fistula Unilateral on leg foot and hand Cauliflower like tumors

Answer 45

Eumycetoma

Question 46

Most common invasive mycosis in HIV disease Primary pulmonary infection Papules or nodules with surrounding erythema, may exude mucinous fluid Molluscum contagosum like, acneiform

Answer 46

Cryptococcosis

Question 47

Primary prophylaxis for cryptococcosis in HIV patients

Answer 47

Fluconazole

Question 48

Therapy for cryptococcal meningitis

Answer 48

Amphotericin B