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107 Cards in this Set
- Front
- Back
Superficial mycoses are limited to these parts of the body
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non-living tissues such as skin and hair
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Cutaneous mycoses are found in these parts of the body
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skin, scalp, nails
invade and persist in living tissue |
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Subcutaneous mycoses are found in these parts of the body
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deeper infections that are mostly limited in scope to the skin, muscles, fascia
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Factors that limit SCS mycoses:
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1. innate resistance to fungal infections
-cellular, not humoral 2. fatty acid content 3. pH = fungi like acid 4. cellular turnover 5. normal bacterial flora 6. limited iron content |
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_______ immunity controls fungal infection
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Cellular
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Cellular immunity against Fungi:
-PRR domain proteins like __1__ -__2__ |
1. Card9
2. Toll-like receptors |
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How are Superficial mycoses diagnosed?
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Direct Observation and culture
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Do superficial mycoses elicit an immune response?
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NO
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Superficial mycoses includes things like...(3)
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Pitryiasis versicolor
White and Black Piedra Tinea Nigra |
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Pityriasis versicolor is caused by this yeast
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Malassezia furfur
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Properties of Malassezia furfur
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Often asymptomatic
Normal flora Colonizes kids soon after birth |
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Pityriasis Versicolor is in this part of the skin
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Strateum Corneum
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Malassezia furfur is _________
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lipophilic
-requires special medium |
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Malassezia furfur is often in the __1__ or areas rich in __2__
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1. Torso
2. Sebaceous glands |
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Pityriasis Versicolor:
-sometimes seen around __1__ -can cause infections around indwelling __2__ -infections can be __3__ -most often in __4__ or in __5__ |
1. puberty
2. catheter 3. widespread 4. tropics 5. summer |
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Pityriasis Versicolor:
-related to fungi that cause __1__ on grain crops |
Bunt or Smut
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Diagnosis of Pityriasis Versicolor
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'spaghetti and meatballs' appearance of the organism in KOH cleared specimen
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DOC's for Pityriasis Versicolor
*ineffective drug? |
Fluconazole or Itraconazole
*Terbinafine |
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Drug recommended for Pityriasis Versicolor in patients with catheter infections
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Amphotericin B
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Topical treatments that may be considered for Pityriasis Versicolor
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Selenium or dandruff shampoo
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Tinea Nigra etiologic agent
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Exophiala Werneckii
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Tinea Nigra most often occurs on this part of the body
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Palms or soles
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Tinea Nigra can be confused with these things
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Melanoma
Moles Benign pigmentation |
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Places where Tinea Nigra are usually seen
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South or Latin America
Africa |
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Tinea Nigra is limited to this part of the skin
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Strateum Corneum
*no inflammation* |
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Tinea Nigra appearance in KOH cleared tissue
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abundant dark branched septate hyphae from 1.5-5 micrometers in diameter
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Tinea Nigra grow on this agar
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Sabourauds glucose at 30'C
*they are mucoid colonies *become dark green to black with time |
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Tinea nigra treatment
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topical antifungal applied for 2-4 weeks
*can be surgically removed or systemic antifungals |
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Black Piedra etiologic agent
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Piedra Hortae
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Describe Black Piedra
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-superficial hair infection
-nodules on hair of head are SEXUAL fruiting bodies and contain Ascospores |
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Most frequently infected area of body with Black Piedra: __1__
Most cases are __2__ and may remain so for __3__ |
1. scalp hair
2. asymptomatic 3. years |
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Diagnosis of Black Piedra
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Direct Observation
Culture |
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Black Piedra treatment
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shaving or clipping hair
Topical or Oral Azoles Terbinafine |
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White Piedra etiological agent
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Trichosporon Beigelii
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Describe White Piedra infection
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Superficial hair infection
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Trichosporon is a normal member of the flora of these body sites
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Mouth
skin nails |
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A ______ bacterial infection can be present along with Trichosporon (White Piedra)
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Coryneform
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White piedra affects these animals in addition to humans
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Horses and monkeys
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Taxonomy of White Piedra
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Basidiomycete, related to Cryptococcus
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Clinical significance of White Piedra
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IC'ed hosts at risk to develop invasive infection
-lungs -kidneys -spleen |
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White Piedra are more often seen on these hairs
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Pubic or Axillary hairs
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Treatment of White Piedra
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Shaving or Clipping hair
Oral Itraconazole |
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One case of disseminated White Piedra infection was reported as having been treated with _________
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Capsofungin
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Cutaneous Mycoses infect ______ tissue and elicit ______
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Living tissue
immune response |
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Cutaneous mycoses are often called__________
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Dermatophytes
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3 prominent genera of Cutaneous Mycoses
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Epidermophyton
Trichophyton Microsporum |
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All cutaneous mycoses are ________
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Mitosporic Ascomycetes
*mitosporic = reproduce by mitosis, asexual |
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Cutaneous Mycoses includes these clinical infections
Severity of infection is related to ________ |
Athletes Foot
Onychomycosis Ringworm (=Tinea) Immune status of the host |
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Tinea corporis = 1
Tinea Capitis = 2 Tinea Cruris = 3 Tinea Barbae = 4 Tinea Pedis = 5 Tinea unguium = 6 |
1. body ringworm
2. scalp 3. jock itch 4. beard 5. athletes foot 6. onychomycosis/nails |
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Term for Dermatophyte fungi associated with humans
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Anthrophilic
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How is Tinea diagnosed?
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Visualization of fungi in specimen
Lesion characteristics |
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List the 3 Zoophilic Tinea
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-Microsporum canis
-Trichophyton mentagrophytes var Metnagrophytes -Trichophyton verrucosum |
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Explain the significance of the Woods lamp
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Fluorescence does indicate the presence of Fungi, but lack of fluorescence does not indicate absence of fungi
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Most common fungal complaint?
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Tinea Pedis (athletes foot)
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DOC's for Tinea Pedis
1. Simple cases 2. More effective approach 3. Moccasin infections |
1. topical Allylamines, Azoles
2. Terbinafine applied 2X daily 3. Oral Terbinifine or Itraconazole for widespread or prolonged infection |
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Tinea corporis occurs on this part of the skin
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relatively HAIR-LESS
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What distinguishes Tinea Corporis from a Superficial infection
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Tinea corporis causes an immune response
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Transmittance of Tinea Corporis
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by pets or from infected people (sharing shoulder pads)
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DOC's for Tinea Corporis
1. for few lesions 2. Widespread infection |
1. Topical
2. Oral -Terbinifine -Itraconazole -Fluconazole -Griseofulvin |
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Tinea cruris = ?
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Jock itch
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Dermatophytes that cause Tinea Cruris (4)
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1. Epidermophyton floccosum
2. Microsporum canis 3. Trichophyton mentagrophytes 4. Trichophyton rubrum |
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If the scrotum is involved in Tinea Cruris, this fungus is involved
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Candida
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Tinea Capitis involves these parts of the body
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scalp
hair |
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Tinea capitis is most common in these people
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pre-pubescent blacks
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Tinea capitis DOC's
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Oral
-Griseofulvin -Terbinafine -Itraconazole -Fluconazole *topical not effective b/c drug cannot penetrate into the follicle |
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This is not useful in diagnosing Tinea Capitis
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Wood lamp
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Tinea Barbae are caused by ___________
How do you tell the difference between fungal and bacterial infection? |
Zoophilic Dermatophytes = most common in Farm-workers
Plucking hairs is painless in Tinea Barbae, but painful in bacterial infection |
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Tinea Barbae treatment
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ORAL
-Itraconazole -Terbinafine *oral b/c infection is deep in follicle |
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Onychomycosis is sometimes called _______
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Tinea Unguium (a subset)
*T. Unguium is caused by Dermatophyte fungi *Onychomycosis can also be caused by yeast or other molds |
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Onychomycosis is more common in these people
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Men
Elderly Diabetics *seen in 2-3% of the pop. |
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Most common form of Onychomycosis and its agent
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Distal and Lateral Subungual Onychomycosis (DLSO)
Dermatophyte fungi -Trychophyton -Epidermophyton -Microsporum |
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DOC's for Onychomycosis
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Lamisil - oral 6-12 wks
Sporanox - oral, pulse dosing -1 week on, 3 off for 5 months Griseofulvin Loprox (tea tree oil) |
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Downfall of Lamisil (Terbinifine)
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some Hepatocytoxicity
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Downfall of Sporanox (Itraconazole)
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Hepatotoxicity
Congestive heart failure |
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Cutaneous mycoses can also include ___________
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mucocutaneous candidiasis
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Mucocutaneous Candidiasis is a _______ infection of men and women
-it is in the _____ of all mammals |
yeast
GI tract |
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Way to diagnose Mucutaneous Candidiasis of the vagina
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Candida in WET MOUNT of vaginal smear
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DOC's vaginal candidiasis
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Clotrimazole cream/tablets
Oral Fluconazole |
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Orophayngeal Candidiasis is more common in these people
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Nursing babies
AIDS |
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DOC's for AIDS Oropharyngeal Candidiasis
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Lozenges of Clotrimazole or Nystatin
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How are Subcutaneous Mycoses infections usually obtained?
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following trauma
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Subcutaneous Mycoses infections characteristics
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-can be life threatening (difficult to treat)
-grow thru tissue and cause surface lesions -usually follow trauma -course of infection often many years -considered rare and exotic in USA -infect otherwise healthy people |
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How are Sporotrichosis infections often acquired?
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puncture wound (rose thorn)
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Sporotrichosis is associated with __1__, and outbreaks among __2__ workers
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1. sphagnum moss
2. nursery |
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Sporotrichosis follows the _____ that drain the site of inoculation
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Lymphatic glands
-lymph nodes are usually not involved |
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Sporotrichnosis:
-lesions sometimes mimic __1__ -sometimes called "__2__" |
1. Blastomycosis
2. rose gardener's thumb |
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How is Sporotrichosis diagnosed?
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-pattern of infection
-culture from tissue at 30'C, dimorphism is demonstrated by switching culture to 37'C |
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Treatment of Sporotrichosis (3)
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-ORAL SATURATED POTASSIUM IODIDE
-Itraconazole for subcutaneous disease -AmphotericinB for disseminated |
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Describe Chromoblastomycosis lesions
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chronic warty/verrucous nodules of epithelial tissue overgrowth caused by abnormal # and arrangement of cells
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What initiates Chromoblastomycosis lesions?
How much do they grow per year? |
trauma
~2 mm/year = very slow growing |
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How is diagnosis of Chromoblastomycosis made?
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Examination of Clnical Material
-Sclerotic cells or "Medlar bodies" are characteristic |
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Chromoblastomycosis are caused by a variety of __1__ fungi that are found in these places: __2__
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1. dematiaceous = dark hyphae
2. soil, decaying vegetation, rotting wood, forest carpets |
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Common fungi causing Chromoblastomycosis
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Cladosporium carrionii
Fonsecaea Phialophora verrucosa Exophiala |
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Chromoblastomycosis is common in this general area of the world
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tropics
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Chromoblastomycosis treatment
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Surgery
Cautery with topical antifungals |
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Phaeohyphomycosis lesion
-initiated most commonly by __1__ -can infect these parts of the body:__2__ |
Nodule or cyst
1. wound 2. sinus, brain, bone |
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Diagnostic feature of Phaeohyphomycosis
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Melanized cell walls
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Phaeohyphomycosis commonly causing fungi
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Exophiala jeanselmei Phialophora richardsiae
Bipolaris spicifera Wangiella dermatitidis |
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Treatment of Phaeohyphomcosis
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Surgical excision and chemotherapy
-Amphotericin B and 5-Fluorocytosine or Itraconazole |
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2/3's of Mycetoma lesions are on this part of the body
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feet
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Mycetomas are characterized by this lesion
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Indolent, deforming swollen lesions that contain numerous draining sinus tracts
*may take years to develop |
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How are Mycetomas diagnosed?
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observation of 'grains' of fungal tissue in specimen
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Mycetomas are caused by these fungi
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Pseudallescheria boydii
Madurella mycetomatis Madurella grisea Exophiala jeanselmei Acremonium falciforme Fusarium Scedosporium *Pseudo Madur Exo Acre Fus Sced |
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Organisms that cause Mycetomas are all common ______ fungi
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soil
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Treatment for Mycetomas
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Surgical debridement
Long-term chemotherapy AMPUTATION |
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3 most common fungi causing Onychomycosis
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Trichophyton rubrum
Trichophyton Mentagrophytes Epidermophyton Floccosum |
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Causative agent of Superficial White Onychomycosis
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Trichophyton Mentagrophytes
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