Jeef First Aid Micro Part 2-5

Front 1

305. Mycoplasma pneumoniae causes?

Back 1

a. Classic cause of atypical “walking” pneumonia.
1. Insidious onset
2. HA
3. Non-productive cough
4. Diffuse interstitial infiltrate.
5. X-ray looks worse than patient.

Front 2

306. Mycoplasma pneumoniae lab diagnosis?

Back 2

a. High titre of cold agglutinins (IgM)- which can agglutinate or lyse RBCs.
b. Grown on Eaton’s agar.

Front 3

307. Characteristics of Mycoplasma pneumoniae organism?

Back 3

a. No cell wall- Not seen on gram stain
b. Only bacterial membrane containing cholesterol.
c. More common in patients <30. Frequent outbreaks in military and prison settings.

Front 4

308. Systemic Mycoses?

Back 4

1. Histoplasmosis
2. Blastomycosis
3. Coccidiomycosis
4. Paracoccidiomycosis.
b. All can cause pneumonia and can disseminate.
c. All caused by dimorphic fungi: Cold-mold, heat-yeast.
i. Only exception is Coccidiomycosis- which is a spherule (not yeast) in tissue.

Front 5

309. Treatment of all the systemic mycoses?

Back 5

a. Fluconazole or ketoconazole for local infections.
b. Amphotericin B for systemic infection.

Front 6

310. Histoplasmosis is endemic to, cause, other details?

Back 6

a. Mississippi and Ohio river valleys.
b. Causes pneumonia
c. Histo Hides (within Macs)
d. Bird or bat droppings.

Front 7

311. Blastomycosis is endemic to, cause, other details?

Back 7

a. States east of Mississippi river and Central america.
b. Causes inflammatory lung disease and can disseminate to skin and bone.
c. Forms granulomatous nodules.
d. Blast Buds (Broadly).- Broad based budding- (about same size as RBC).

Front 8

312. Coccidiomycosis is endemic to, cause, other details?

Back 8

a. SW US, California.
b. Causes pneumoni and meningitis.
c. Can disseminate to bone and skin.
d. Case rate increases after earthquakes (spherules in dust are thrown up in the air.
e. Coccidio Crowds. San Joaquin Valley or desert (desert bumps) “valley fever”

Front 9

313. Paracoccidioidomycosis?

Back 9

a. Latin America
b. Budding yeast with “Captain’s wheel” appearance. Much larger than RBC
c. “Paracoccidio Parasails with the captain’s wheel all the way to Latin America.

Front 10

314. Size of each of the systemic mycoses?

Back 10

a. Histo- 3-5 um
b. Blastomycosis- 5-15 um.
c. Coccidioidomycosis- 20-60 um.
d. Paracoccidioidomycosis- 40-50 um.

Front 11

315. Cutaneous Mycoses types?

Back 11

1. Tinea Versicolour
2. Tinea pedis (foot), Tenia cruris (groin), Tinea capitis (head, scalp)
3. Tinea corporis (ringworm on body)

Front 12

316. Cause of Tinea Versicolour and pathophys?

Back 12

a. Malassezia furfur.
b. Degradation of lipids produces acids that damage melanocytes and cause hypopigmented and/or hyperpigmented patches.
c. Occurs in hot, humid weather.

Front 13

317. Tx of Tinea Versicolour (Malassezia furfur)?

Back 13

a. Topical miconazole, selenium sulfide (Selsum).

Front 14

318. Appearance of Tinea Versicolour (Malassezia furfur) on KOH preparation?

Back 14

a. Spaghetti and meatball appearance on KOH.

Front 15

319. Tinea (pedis, cruris, corporis, capitis)?

Back 15

a. Pruritic lesions w/central clearing resembling a ring.
b. Caused by dermatophytes (Microsporum, trichophyton, and Epidermophyton.

Front 16

320. Appearance of Tinea causing dermatophytes (Microsporum, trichophyton, and Epidermophyton on KOH prep?

Back 16

a. See Mold hyphae- NOT DIMORPHIC.

Front 17

321. Reservoir for Microsporum?

Back 17

a. Pets- can be treated w/topical azoles.

Front 18

322. Candida albicans features?

Back 18

a. Systemic or superficial.
b. Dimorphic:
c. yeast w/pseudohyphae in culture at 20C
d. Germ tube formation at 37C (diagnostic).

Front 19

323. Candida albicans causes?

Back 19

a. Oral and oesophageal thrush in immunocompromised pts.
b. Vulvovaginitis (diabetes, use of abx)
c. Endocarditis (IV drug users)
d. Disseminated candidiasis (any organ).
e. Chronic mucocutaneous candidiasis.

Front 20

324. Treatment of Candida albicans?!?

Back 20

a. Nystatin for superficial infections.
b. Amphotericin B for serious systemic infections!

Front 21

325. Aspergillus Fumigatus causes?

Back 21

a. Allergic bronchopulmonary aspergillosis.
b. Lung cavity aspergilloma “fungus ball”
c. Invasive aspergillosis, esp. in immunocompromised pts and those w/chronic granulomatous disease.

Front 22

326. Aspergillus Fumigatus features?

Back 22

a. MOLD with septate hyphae that branch ate acute angles (<45).
b. Think “A” for Acute Angles in Aspergillus.
c. Not dimorphic

Front 23

327. Cryptococcus neoformans Causes and diagnostic feature?

Back 23

a. Cryptococcal meningitis, cryptococcosis.
b. “Soap Bubble” lesions in brain.

Front 24

328. Cryptococcus neoformans features?

Back 24

a. Heavily Encapsulated YEAST.
b. Not Dimorphic
c. Found in soil, pigeon droppings.

Front 25

329. Culture and stain of Cryptococcus neoformans?

Back 25

a. Culture on Sabouraud’s agar.
b. Stain w/India ink.
c. Latex agglutination test detects polysaccharide capsular antigen and is more specific.

Front 26

330. Mucor and Rhizopus cause and who is susceptible?

Back 26

a. Mucormycosis.
b. Mostly in keto acidotic diabetics and leukemic patients.

Front 27

331. Mucor and Rhizopus pathophys?

Back 27

a. Fungi proliferate in blood vessel walls when there is excess ketone and glucose.
b. Then penetrate the cribriform plate and enter the brain.
c. Cause Rhinocerebral, frontal lobe abscesses.

Front 28

332. Mucor and Rhizopus- Mucormycosis symptoms?

Back 28

a. HA
b. Facial pain
c. Black necrotic eschar on face cranial nerve involvement.

Front 29

333. Mucor and Rhizopus features?

Back 29

a. MOLD w/irregular nonseptate branching at WIDE angles (>90).

Front 30

334. Pneumocystis jiroveci (formerly carinii) causes and diagnosis?

Back 30

a. Diffuse interstitial pneumonia.
b. Most infections are asymptomatic (immunosuppression predisposes to disease).
c. Diffuse bilateral CXR appearance.
d. Diagnosed by lung biopsy or lavage.