Week 228 - Fungal Disease

Question 1

Week 228

Which condition is this?

Answer 1

This is athletes foot.

Question 2

Week 228

What is this?

Answer 2

Ringworm of the toenail

Question 3

Week 228

What is this?

Answer 3

Tinea cruris

Question 4

Week 228

What is this?

Answer 4

Tinea corporis

Question 5

Week 228

What is this?

Answer 5

Oral candida

Question 6

Week 228

What is this?

Answer 6

Oesophageal candida

Question 7

Week 228

What is this?

Answer 7

Mucus plug in right lung. FUNGUS BRO. FUNGUS.

Question 8

Week 228

What is this?

Answer 8

Madura foot

Question 9

Week 228

What is this?

Answer 9

Madura foot

Question 10

Week 228

What is this?

Answer 10

Madura foot

Question 11

Week 228

This patient recently had a liver transplant. What can you see?

Answer 11

This is aspergilliosis

Question 12

Week 228

What is this?

Answer 12

Bilateral “ground glass” infiltrates. Fungal.

Question 13

Week 228

What is this?

Answer 13

Aspergilliosis

Question 14

Week 228

What is this?

Answer 14

Aspergillioma

Question 15

Week 228

A patient with asthma or cystuc fibrosis is more likely to develop which kind of fungal infection?

Answer 15

Allergic bronchopulmonary Aspergilliosis (ABPA)

Question 16

Week 228

What type of fungal condition is more likely in patients with pre-existing cavitating lung diseases?

Answer 16

Mycetoma

Question 17

Week 228

LArge doses of inhaled organic material will induce which condition?

Answer 17

Hypersensitivity pneumonitis. Antigens can be fungi, avian proteins, and other organic dusts.

Question 18

Week 228

Which type of hypersensitivity reaction is caused by T lymphocytes driving macrophages to cause tissue damage?

Answer 18

Type 4

Question 19

Week 228

Which things will lead you to suspecting hypersensitivity pneumonitis?

Answer 19

• REstrictive defects
• Serum antibodies
• High lymphocyte count in bronchiolar lavage
• Occupation/hobbies
• pets
• Fine crackles at end of expiration

Question 20

Week 228

Asthma is due to Type ___ hypersensitivity. In ABPA Type ___ and Type ___ hypersensitivity reactions take place.

Answer 20

1

3

4

Question 21

Week 228

How is Allergic bronchopulmonary aspergilliosis diagnosed?

Answer 21

• Raised IGE and eosinophilia
• Hyphae in sputum
• Positive skin test to Aspergillius
• Broncho-alveolar lavage
• Bronchiectasis over time

Question 22

Week 228

How do Azoles affect fungi?

Answer 22

These inhibit cell membrane formation. There are two classes, Imidazoles and Triazoles.

Question 23

Week 228

What is clotrimazole used for?

Answer 23

This is an anti fungal medication. It is used topically in the treatment of candida (thrush) and Tinea infections (but not in hair/nail infections).

Question 24

Week 228

What is Fluconazole and what is it used for?

Answer 24

• Used topically or orally
• Used against Cryptococcus, dermatophytes, candida
• NOT EFFECTIVE IN ASPERGILLUS
• Lipophilic - penetrates CSF

Question 25

Week 228

What is Voriconazole and what is it used for?

Answer 25

• This is given either ORAL or IV (it’s a big boy!)
• Standard for blood borne Aspergilius and candida
• Penetrates CSF but metabplised before excretion as very lipophilic

Question 26

Week 228

Which drug is the standard treatment for blood borne aspergilliosis and candida?

Answer 26

Voriconazole

Question 27

Week 228

Which antifungal drug is used (IV and oral) for treatment of aspergillus, candida and cryptococcus, as well as topically for nail infections?

Answer 27

Itraconazole

Question 28

Week 228

Which anti fungal drug Inhibits B-glucan synthase, and is onl effective against aspergillus and candida?

Answer 28

Caspofungin

Question 29

Week 228

Which anti fungal drug is used IV or Inrathecally (clue), and is used as a broad spectrum against systemic Aspergillus, Candida, and cryptococcus. IT also has a bunch of side effects!

There is a version that has less side effects - what’s this called?

Answer 29

Amphotericin

Amphotericin B has less side effects.

Question 30

Week 228

Which anti-fungal drug is used topically for the treatment of oral thrush and nappy rash?

Answer 30

Nystatin

Question 31

Week 228

What is Terbinafine used for?

Answer 31

This is topical or oral, used for tyhe treatment of fungal infections in the hair or the nails (dermatophytes). Useful against tinea.

Question 32

Week 228

What is Flucytosine used for?

Answer 32

This is an anti fungal drug, used for systemic candida/cryptococcus, used in conjunction with amphotericin (to prevent resistance).

Question 33

Week 228

What is the best treatment for vaginal thrush?

Answer 33

Either clotrimazole or FLuconazole (topically)

Question 34

Week 228

What is the best treatment for a suspected systemic fungal infection in an immunocompromised patient?

Answer 34

Amphotericin

Caspofungin

Question 35

Week 228

What is the best treatment for oral thrush (fungal)?

Answer 35

Nystatin (topical)

Could use oral Fluconazole, but has systemic effects.

Question 36

Week 228

What could you use to treat a fingal nail infection?

Answer 36

Itraconazole (oral) or topical

Terbinafine (oral)

Amorolfine (topical)

Question 37

Week 228

What could you use to treat cryptococcal meningitis?

Answer 37

Amphotericin and Flucytosine (both IV)

Question 38

Week 228

What could you use to treat Pneumocystis pneumonia?

Answer 38

Co-Trimoxazole (this is an antibiotic)

Question 39

Week 228

What could you use to treat tinea (fungal) infections?

Answer 39

Limited cutaneous: Clotrimazole

Widespread: Itraconazole of Terbinafine (both oral)

Question 40

Week 228

What could you use to treat Pityriasis Versicans (Tinea versicolor)?

Answer 40

Miconazole (topically), or Kitoconazole (topically)

Question 41

Week 228

What can you use to treat Seborrhoeic Dermatitis?

Answer 41

Miconazole or Ketoconazole (both topical)