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BMS 622 Final Exam > Systemic Mysoces > Flashcards

Systemic Mysoces Flashcards

1
Q

What are the two forms of Histoplasma capsulatum at different temperatures?

A

Mold at 25°C, yeast at 37°C

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2
Q

Where is Histoplasma capsulatum endemic?

A

Ohio and Mississippi River valleys, eastern USA

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3
Q

How is Histoplasma infection typically acquired?

A

Inhalation of spores

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4
Q

What activities increase the risk of Histoplasma infection?

A

Spelunking, working near chicken coops

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5
Q

What symptom range does histoplasmosis present?

A

Mild flu-like symptoms to severe respiratory distress

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6
Q

Name the organs affected in disseminated histoplasmosis.

A

Skin, bones, liver, spleen, kidney, CNS

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7
Q

Who is at higher risk of severe Histoplasma disease?

A

Immunocompromised individuals

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8
Q

What is the first-line treatment for severe histoplasmosis?

A

Itraconazole or Amphotericin B

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9
Q

What diagnostic methods are used for histoplasmosis?

A

Microscopy, culture, serology

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10
Q

How is Histoplasma capsulatum transmitted?

A

Inhalation of bat or bird droppings

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11
Q

What areas are associated with Histoplasma capsulatum exposure?

A

Mississippi and Ohio River valleys

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12
Q

What lung finding can histoplasmosis mimic?

A

Calcified lung granulomas like tuberculosis

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13
Q

Name three systemic symptoms of histoplasmosis.

A

Erythema nodosum, tongue ulcers, splenomegaly

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14
Q

What severe manifestation occurs in immunocompromised patients with histoplasmosis?

A

Disseminated disease with severe hepatosplenomegaly

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15
Q

What microscopic finding is diagnostic for histoplasmosis?

A

Macrophages filled with small intracellular ovoid bodies smaller than RBCs

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16
Q

Which rapid diagnostic tests are used for histoplasmosis?

A

Serum or urine antigen tests

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17
Q

What treatments are used for mild and severe histoplasmosis?

A

Fluconazole or itraconazole for mild, amphotericin B for systemic cases

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18
Q

What is the first-line treatment for systemic histoplasmosis?

A

Amphotericin B

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19
Q

What is the hallmark feature of histoplasmosis in immunocompromised patients?

A

Hepatosplenomegaly

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20
Q

What is the temperature-dependent morphology of Blastomyces dermatitidis?

A

Mold at 25°C, yeast at 37°C

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21
Q

Where is Blastomyces endemic?

A

Eastern and Central U.S., Great Lakes, Ohio River Valley

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22
Q

How is Blastomyces transmitted?

A

Inhalation of spores from soil

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23
Q

Which animals are commonly infected by Blastomyces?

A

Dogs

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24
Q

What is a key feature of chronic skin involvement in blastomycosis?

A

Ulcerative or nodular lesions

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25
Q

Which organ systems can Blastomyces disseminate to?

A

Skin, bones, liver, CNS

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26
Q

What is the preferred treatment for severe blastomycosis?

A

Amphotericin B

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27
Q

How is blastomycosis diagnosed?

A

Culture, staining, serology, PCR

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28
Q

What is the primary route of transmission for Blastomyces?

A

Inhalation of spores from soil

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29
Q

Name regions endemic to Blastomyces.

A

Eastern and Central U.S., Great Lakes, Ohio River Valley

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30
Q

What initial infection type is caused by Blastomyces?

A

Lung infection with patchy alveolar infiltrates

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31
Q

What is a characteristic skin manifestation of disseminated blastomycosis?

A

Lesions mimicking squamous cell carcinoma

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32
Q

Which bone disease can Blastomyces cause?

A

Osteomyelitis

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33
Q

What is the distinguishing microscopic feature of Blastomyces?

A

Broad-based budding yeast similar in size to RBCs

34
Q

What diagnostic antigen test is used for blastomycosis?

A

Urine antigen testing

35
Q

What treatments are used for localized and systemic blastomycosis?

A

Itraconazole for localized, amphotericin B for systemic cases

36
Q

What is the main imaging finding for pulmonary blastomycosis?

A

Patchy alveolar infiltrates

37
Q

Which treatment is recommended for mild to moderate blastomycosis?

A

Itraconazole

38
Q

What are the two species of Coccidioides?

A

C. immitis and C. posadasii

39
Q

What is the infection route of Coccidioides?

A

Inhalation of spores, often after dust storms or earthquakes

40
Q

Where is Coccidioides endemic?

A

Southwestern U.S., including San Joaquin Valley

41
Q

What is another name for coccidioidomycosis?

A

Valley Fever

42
Q

Name three common symptoms of Valley Fever.

A

Pneumonia, fever, joint pain

43
Q

What is a common skin symptom of coccidioidomycosis?

A

Erythema nodosum

44
Q

In which patients does coccidioidomycosis disseminate?

A

Immunocompromised individuals

45
Q

Name the hallmark microscopic feature of Coccidioides in tissues.

A

Spherules much larger than RBCs

46
Q

What diagnostic methods confirm coccidioidomycosis?

A

KOH prep, culture, serology

47
Q

What treatments are used for localized and disseminated coccidioidomycosis?

A

Azoles for localized, amphotericin B for disseminated cases

48
Q

What environmental events increase the risk of coccidioidomycosis?

A

Dust storms or earthquakes

49
Q

What nickname is given to coccidioidomycosis?

A

Valley Fever

50
Q

How is Paracoccidioides transmitted?

A

Inhalation of spores

51
Q

Which regions are endemic to Paracoccidioides?

A

South America, especially Brazil

52
Q

What lymphadenopathy is characteristic of paracoccidioidomycosis?

A

Cervical, axillary, or inguinal nodes

53
Q

Name two major symptoms of paracoccidioidomycosis.

A

Lung granulomas, mucosal ulcers with hemorrhagic borders

54
Q

What microscopic feature identifies Paracoccidioides?

A

Yeast cells with multiple buds resembling a ‘captain’s wheel’

55
Q

How does the size of Paracoccidioides yeast compare to RBCs?

A

Much larger than RBCs

56
Q

What treatments are used for mild and severe paracoccidioidomycosis?

A

Itraconazole for mild, amphotericin B for severe cases

57
Q

What appearance does Paracoccidioides yeast exhibit microscopically?

A

‘Captain’s wheel’

58
Q

What lymphadenopathy regions are associated with paracoccidioidomycosis?

A

Cervical, axillary, inguinal

59
Q

What environmental factor increases the risk of Histoplasma transmission?

A

Bird and bat droppings in soil

60
Q

What is a key differential feature of blastomycosis skin lesions?

A

Mimics squamous cell carcinoma

61
Q

What diagnostic method is used to detect Paracoccidioides yeast?

A

Observation of ‘captain’s wheel’ in microscopy

62
Q

How does itraconazole work against systemic fungal infections?

A

Inhibits fungal ergosterol synthesis

63
Q

What is the mechanism of action for amphotericin B?

A

Binds to ergosterol, creating pores in fungal membranes

64
Q

How do azole antifungals, like fluconazole, exert their effect?

A

Inhibit lanosterol 14-alpha-demethylase, blocking ergosterol production

65
Q

What advantage does itraconazole have over amphotericin B?

A

Oral availability and lower toxicity

66
Q

What differentiates histoplasmosis granulomas from tuberculosis granulomas?

A

Histoplasmosis granulomas contain macrophages filled with intracellular fungi

67
Q

How can blastomycosis be distinguished from histoplasmosis?

A

Broad-based budding yeast in blastomycosis vs. intracellular fungi in histoplasmosis

68
Q

What distinguishes Coccidioides from Histoplasma under microscopy?

A

Coccidioides forms spherules much larger than red blood cells

69
Q

Which fungal infection is associated with lesions resembling squamous cell carcinoma?

A

Blastomycosis

70
Q

How do Coccidioides and Blastomyces compare in geographic distribution?

A

Coccidioides is endemic to the southwestern U.S., Blastomyces to the eastern U.S.

71
Q

In which region is Histoplasma most prevalent?

A

Mississippi and Ohio River valleys

72
Q

Where is Coccidioides endemic?

A

Southwestern U.S., including the San Joaquin Valley

73
Q

Which regions have the highest prevalence of Blastomyces?

A

Eastern and Central U.S., Great Lakes region

74
Q

Where is Paracoccidioides brasiliensis primarily found?

A

South America, especially Brazil

75
Q

What environmental factor contributes to Coccidioides prevalence in the southwestern U.S.?

A

Dust storms and earthquakes stirring soil spores

76
Q

How can occupational workers minimize exposure to Histoplasma?

A

Use masks in areas with bird or bat droppings

77
Q

What precaution can hikers take to avoid Coccidioides infection?

A

Avoid areas with high dust exposure during storms

78
Q

How can farmers reduce the risk of Blastomyces exposure?

A

Wear protective gear when working with soil in endemic areas

79
Q

What general strategy helps prevent fungal infections in immunocompromised individuals?

A

Avoid activities that expose them to high spore environments, such as caves or construction sites

80
Q

Why is controlling dust important in endemic regions for fungal infections?

A

Reduces inhalation of airborne fungal spores

BMS 622 Final Exam (2 decks)

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