Fungi

Front 1

virulence agents of fungi(5)

Back 1

proteolytic enzymes, polysaccharide immune modulators, Nucleases, Phospholipases, Hyphae

Front 2

host defences against fungi

Back 2

Neutrophils and macrophages, intact skin

Front 3

Polyenes (Name and action)

Back 3

Amphotericin B and Nystatin. Create holes in the capsule of fungi

Front 4

Azoles (Name and action)

Back 4

Fluconazole etc. Inhibits ergosterol synthesis

Front 5

Antimetabolite (Name and action)

Back 5

5-Flucytosine. DNA synthesis

Front 6

Echinocandin (Name and action)

Back 6

Caspofungin. Cell wall synthesis

Front 7

Allyamines (name and action)

Back 7

Terbinafine. Ergosterol synthesis

Front 8

xteristics of cryptocuccus (micro and virulence)

Back 8

yeast, 4-6 microns,polysaccharide capsue, melanin, grows at 37 celsius, mannitol, proteases

Front 9

clinical manifestation fo cryptococcus (4)

Back 9

meningoencephalitis, pneumonia, skin lesions, osteolytic bone lesions

Front 10

meningoencephalits of crypto

Back 10

early signs: increased ICP causes headache, nausea, gait abnormalities, delirum, confusion, visual changes. Fever and nuchal rigidity often absent. Advanced signs: coma and brainstem compression.

Front 11

Diagnosis of cryptococcus

Back 11

LP (stain with india ink, detect antigen, grow cultures), blood culture, microscopic appearance, melainin production.

Front 12

Cryptococcus gattii (5)

Back 12

serotype B and C, predominantly found in Australia, infects immune cometent pts, pts present with concommittant CNS and pulm disease, higher rate of granuloma formation, more difficult to treat

Front 13

Immune reconstitution inflammatory syndrome

Back 13

when pt is started on HAART, immune system is revived. Massive inflammatory precess against circulating antigens.

Front 14

treatment of IRIS

Back 14

give high dose of anti-fungals along with streoids (to downregulate immune system)

Front 15

Epidemiology of Histoplasma capsulatum

Back 15

prevalent in midwestern and soutern US (ohio and mississippi river valleys (indianapolis)). High infection rate, low incidence of clinical disease, an AIDS defining infection.

Front 16

Pathogenesis of Histo

Back 16

inhale microconidia into lungs --> transforms to yeast within hours --> taken up by macs -->disseminates rapidly. Inhibits pahagolysosomal fusion and therefore host cell hydrolytic enzymes are not functional

Front 17

acute manifestation of histo

Back 17

mild: flu-like illness. Moderate: cough, chestpain. Severe: fever, night sweats, weight-loss..

Front 18

CXR of histo

Back 18

multiple lesions, hilar LAN, slow resolution with calficiation. (single calcified or non calficied coin lesion).

Front 19

chronic pulm disease of histo

Back 19

opportunistic complication of underlying COPD --> cavitary histoplasmosis.

Front 20

diagnosis of histo (4)

Back 20

culture sputum or blood. Bone marrow (in disseminated disease). Serology. Skin testing.

Front 21

types of coccidiodes

Back 21

Immitis (Carlifonia's San Joaquin Valley region) and Posadasii (desert southwest of US, Mexico, and South America)

Front 22

Pathogenesis of Coccidoides

Back 22

Inhaled spores to distal alveoli --> swells in to spherules that develop endospores --> ruptures releasing large numbres of endospores, each developing into a spherule. Hematogenous dissemination of emdospsors to liver, spleen, bone, skin and CNS causing abscess formation and granulomas.

Front 23

Disease of Coccidiodes

Back 23

severe pneumonia (consolidation and caseatous necrosis, cavity formation (like TB)), Erythema nodosum (tender red nodules) = Valley fever, Meningitis (with biofilms)

Front 24

Diagnosis of Coccidiodes (3)

Back 24

Culture and smear. Coccidiodin skin test (+ after 1 -3 weeks of onset of disease). Complement fixation.

Front 25

Epidemiology of Blastomyces dermatitidis

Back 25

Endemic along Mississippi, Ohio, Wisconsin, and St. Lawrence River valleys and SE usa. Large thick wall. Broad based budding. No apparent increased incidence in pts with immunodeficiency

Front 26

Clinical manifestaion of Blastomycoses

Back 26

Progressive Pulm infection (cxr shows hilar adenopathy--> not diagnostic. Chronic disease mimicks TB). Disseminated (in patients with unresolving pulm disease --> skin ulceration, bone infection, CNS)

Front 27

Virulence factors of Blastomycoses

Back 27

WI-1 cell adhesin

Front 28

Diagnosis (3)

Back 28

Direct examination of tissue in search of broad based budding. Culture (4 weeks cos of slow growth). Serology

Front 29

Xteristics and Epi of Sporothrix

Back 29

plant saprophyte with worldwide distribution

Front 30

mode of infection of sporothrix

Back 30

following inoculaion of of fungus into subcutaneous tissue (by thron prick). Inhalation of hay.

Front 31

disease of sporothrix (2)

Back 31

lymphangitic sporotrichosis (small hard nodule at primary sites that discolors and ulcerates. Along lymphatics). Plaque sporotrichosis (nontender red maculopapular granuloma limited to the site of inoculation. Has not gone up the lymphatics)

Front 32

diagnosis of sporothrix (2)

Back 32

Culture of skin biopsy or pus. Apperance in tissue (asteriod body)

Front 33

Paracoccidiodes brasiliensis

Back 33

central and south america. Multiple budding conidia (captians wheel). Causes primarily cutaneous or mucocutaneous ulcers

Front 34

Microbiology of Candida

Back 34

grows as yeast. Replicates by budding. Hyphae formation

Front 35

virulence factors of candida (5)

Back 35

Adherence to epithelial and endothelial cells. Preoteinases. Phsopholipases. Phase variation. Biofilm formation.

Front 36

Clinical Manifestation of candida (6)

Back 36

superfical candidiaisis, Mucos Membrane infection. Chronic mucocutaneous Candidiasis. Disseminated Candidiasis. Neonatal Candidiasis. Unrinary Tract

Front 37

Superficial candidiasis

Back 37

intertrigo. Presents as a shrap demarcation, beefy red appearance

Front 38

chronic mucocutaneous candidiasis

Back 38

as a result of defects in innate or cell-mediated immunity. Granulomas. Bacterial superinfection and sepsis

Front 39

Disseminated candidiasis (2)

Back 39

endocarditis. Hepatospleic candidiasis (cheesy white nodules with hematogenous distribution)

Front 40

Diagnosis (2)

Back 40

scrapings of surface white patches + 10% KOH and microscopy. Tissue bio[sy with silver stain

Front 41

Treatment (3)

Back 41

restore barrier. Topical nystatin ,clotrimazole, miconazole. Antifula therapy for candidemia or disseminated candidiasis (fluconazole, echinocandin or amphotericin B)

Front 42

xteristics of aspergillus

Back 42

only grows as a mold (hyphal form non-pigmented), branches at 45 degrees. nosocomial epidemic.

Front 43

clinical manifestation of aspergillus (5)

Back 43

asthma, extrinsic allergic alveolitis (Farmer's lung), Allergic Bronchopulmonary Aspergillosis, Aspergilloma, Invasive aspergillosis

Front 44

Diagnosis of aspergiullus

Back 44

requires tissue for diagnosis --> hypae in tusseus plus grwoth in culture. Stain with silver of giemsa

Front 45

treatment of aspergillus

Back 45

anti-fungals.

Front 46

xteristics of host that are affected by zygomycoses

Back 46

neutropenia, DM/DKA, corticosteriods, transplant pts, broad spectrum Ab used, desoferoxamine therapy (organisms can scavenge iron from desferoxamine

Front 47

clincial mainfestation (2)

Back 47

rhinocerebal zygomycosis (facial pain, ptosis and erythema of the overlying eye lid, regrograde invasion and cavernous sinus thrombosis). Cutaneous zygomycosis (acute inflamatory response, subcutaneous nodule, may ulcerate)

Front 48

appearance of zygomycosis

Back 48

ribon-like. Non-septate hyphae. Right-angled (90 degree) branching.

Front 49

treatment and management of zygomycosis

Back 49

amphotericin B + surgical debridement.

Front 50

general characteristics of dermatophytes

Back 50

invade the stratum corneum. Superficial. Use keratin as food

Front 51

pathogeneis of dermatophytes

Back 51

infectious particle is arthrospore. Slowly progressive, painless, inflammatory lesions. Cell medtiated response

Front 52

presentation of tinea corporis (ringworm)

Back 52

well circumscribed, ring-like, single or multiple noduls under dry, red scaly skin with a serpiginous inflammatory border

Front 53

presentation of tinea pedis (athletes foot)

Back 53

itching, cracking of skin and laceration of lateral inderdigital spaces of the foot. Complicated by bacterial super infection, funal invasion of nails (onchomycosis)

Front 54

presentation of tinea capitis (scalp ringworm)

Back 54

loss of hair with scaling of skin. Hair will regrow if treated

Front 55

presentation of tinea cruris (jock itch)

Back 55

scaling and irritaiton of the gron. Well demarcated (unlike candidia)

Front 56

onychomycosis

Back 56

soires under the nails adjacent to dermatophytosis or candidiasis. Difficult to eradicate.

Front 57

presentation of malassezia furfur

Back 57

young person (pubertal), discoloration and depigmentation of skin

Front 58

diagnosis of tinea versicolor (m. furfur)

Back 58

clinically. Wood's lamp (yellowto yellow-green fluorescence)