Micro Block 3

Front 1

Why does penicillin not work on Fungi?

Back 1

Because fungi consist of Chitin. Chitin is not a peptidoglycan and that is why penicillin doesn't work.

Front 2

What are the primary target of anti-fungal meds?

Back 2

Ergosterol and Zymosterol.

Front 3

What are Dimorphic Fungi?

Back 3

Dimorphic fungi form different structures at different temperatures. They may be molds (low temps) or yeasts (high temps).

Front 4

What is mycotoxicosis?

Back 4

literally means Toxic fungus. Occurs after eating amanita mushrooms. Two toxins produced by these fungi are amanitin and phallodin, both of which can cause liver damage.

Front 5

What are Alfatoxins?

Back 5

Alfatoxins produced by Aspergillus flavus can cause liver damage. Alfatoxin B1 induces a mutation in the P53 Tumor suppressor gene leading to overgrowth of hepatocytes (loss of control).

Front 6

Discuss Antifungal therapy.

Back 6

Antifungal therapy is normally controlled by either topical ointments or the azole drugs. If neither one of these works Amphotericin B (via IV) may be introduced but this is as a last resort because it is a very toxic drug.

Front 7

Cutaneous Mycoses (dermatophytes):
Lead to Dermatophytoses:
Name Three classifications:

Back 7

Epidermophyton, Trichophyton and Microsporum (know)

Front 8

Microsporum:

Tinea - Ringworm:

Back 8

only infect the superficial keratinized structures (skin, hair and nails.) Patient may show symptoms of Athlete's foot, jock itch and moist skin.

Front 9

Name 6 locations and appropriate names of Tinea Infection:

Back 9

Tinea Capitis (head)
Tinea Corporis (anywhere on the body except head and genitalia)
Tinea Lumbricata (thorax/lumbar region)
Tinea Cruris (genitalia)
Tinea Manuum (hands)
Tinea Pedis (feet)

Front 10

Name laboratory diagnosis tech for Tinea?

Back 10

Skin scrapings or nail placed in 10% KOH solution shows Hyphae (the hyphae identify fungus)
Cultures on Sabourads aga (id fungus)
KEY**** Utilizing a 'wood's lamp', Leasion seen under florescent/UV light from a woods lamp.+ for tinea!

Front 11

What is the Treatment for Tinea?

Back 11

Micronazole is preferred, if not topical ointments. If this does not work then Amphoterin B may be used as a last resort.

Front 12

Subcutaneous Mycoses
Sporothrix Schenckii:
"Rose Gardner's Disease"
is caused by?

Back 12

Normally this fungi is caused by some type of trauma. It is normally seen growing in soil and on vegetation.

Front 13

Treatment for Sporothrix Schenckii is done with what drug?

Back 13

Itraconazole

Front 14

What tinea does not show a "ring-worm" like appearance and affected area is NOT tan (dependent on the color of the skin).

Back 14

Tinea Versicolor

Front 15

CC: Patient from the South West, spherules in tissue, erythema nodosum or valley fever, arthrospores are present at the tip of the hyphae.

Back 15

Coccidioides Immitis

Front 16

What is treatment for Coccidioides immitis?

Back 16

Amphotericin B or Ketoconazole for lung disease.

Front 17

Memory tool for Histoplasmosis and Blastomyces and Coccidiodes?

Back 17

The cowboy "cocks" his gun in the OLD SW and "HITS" and "BLASTS" in the Mississippi river valley.

Front 18

CC: Patient from mississippi, histological specimen shows oval budding yeast inside macrophages, Patient works in Chicken house or bat infested cave, may cause pneumonia.

Back 18

Histoplasmosis, Hen House Hissing... or Hissing bat or chicken

Front 19

Treatment for Histoplasmosis?

Back 19

Oral Itraconazole for Pulmonary disease.
Amphotericin B for Disseminated disease.
Fluconazole for meningitis (penetrates spinal fluid)

Front 20

"Broad Based, Budding Yeast"

Back 20

Blastomyces

Front 21

CC: Infection occurs via the respiratory tract, labs show single broad based buds and hyphae with small pear shaped conidia.

Back 21

Blastomyces

Front 22

Treatment for Blastomyces

Back 22

Itraconazole (for resp issues)
Amphotericin B if necessary. Surgical excisioin may occur.

Front 23

A thick-walled yeast with multiple buds (pilots wheel).

Back 23

Paracoccidioides Brasiliensis

Front 24

CC: 10% KOH, shows hyphae under a Woods Lamp?

Back 24

TInea Capitus

Front 25

What are opportunisitic Mycoses?

Back 25

Fungi that induce a disease in immuno-compramised patients.

Front 26

CC: Oval yeast with single bud, causes oral thrush in HIV patients, vaginitis and chronic mucocutaneous candidiasis.

Back 26

Candida

Front 27

What age group does Chronic Mucocutaneous candidiasis affect?

Back 27

It affects children with T0cell defects.

Front 28

CC: Patient presents with Rash after given antibiotics, Yeast grown on Sabourad's agar.

Back 28

Candida

Front 29

What is the treatment for Candida?

Back 29

Ketoconazole for Chronic mucocutaneous candidiasis. For disseminated disease give Ampo B.

Front 30

What yeast has a polysaccharide capsule and causes meningitis?

Back 30

Cryptococcus neoformans

Front 31

CC: Patient presents with influenza like symptoms, oral sample taken and stained with India Ink, Labs show a wide unstained capsule and a dark inner capsule. History shows patient works with pigeons.

Back 31

cryptococcus neoformans

Front 32

Patient presents with infection of the eye, ear and lungs sample is taken and labs show "fungus Ball" appearance with Septate hyphae that branch at 45degree angle (V-Shape).

Back 32

Apergillus Fumigatus

Front 33

What is the treatment for Aspergillosis?

Back 33

Amphotericin B for invasive apergillosis. Steroid therapy is recommend for allergic bronchopulmonary Aspergillosis.

Front 34

Patient presents with labs that show nonseptated hyphae with right angle branching.

Back 34

Mucor and Rhizopus (R think right angle)

Front 35

CC: Ketoacidotic diabetic and lukemic patients are commonly infected by this species of mold. May cause meningitis and or encephalitis.

Back 35

Mucor and Rhizopus

Front 36

Treatment for Mucor and Rhizopus?

Back 36

Amphotericin B and Surgical removal of necrotic tissue.

Front 37

Parasites occur in two distinct forms, describe those forms.

Back 37

Single Cell called Protozoa and Multicellular metazoa called Helminths or worms.

Front 38

Metazoa are subdivided into?

Back 38

Platyhelminthes (flatworms)
Nemathelminthes (round worms, nematodes)

Front 39

Platyhelminthes (flatworms) are divided into two medically important classes:

Back 39

Cestoda (tapeworms)
"swimming in the a CES pool of tapeworms"
Trematoda (flukes)
"Its a fluke that you won a million dollars and you are tTREMbling with excitement"

Front 40

Single Cell Protoza within the intestinal tract, Name three:

Back 40

The ameba (entamoeba histolytica)
The flagellate (giardia Lamblia)
Sporozoan (cryptosporidium Parvum)

Front 41

Urogenital Protozoa

Back 41

Flagellate (Trichomonas Vaginalis)

Front 42

Intestinal Protozoa?

Back 42

Entamoeba Histolytica. Which can cause Diarreah and liver abscess

Front 43

What are the two forms of Entamoeba histolytica?

Back 43

Trophozoite: consists of one ingested RBC and one nucleus

Cysts:four nuclei with no internal fibers

Front 44

Entamoeba Histolytica
Life Cycle:
Transmission:
Pathogenesis:

Back 44

Life cycle:Humans ingest cysts then form trophozoites, trophozoites form cysts in the colon. Diagnosis with Cyst form.
Transmission: Fecal Oral cysts
Pathogenesis: "Teardrop uncer/Flask-shaped" invasive can spread to liver and lugs.

Front 45

What is the treatment for Entamoeba histolytica?

Back 45

Metronidazole plus iodoquinol.
"GET BAC on the Metro" (Giardia, Entamoeba, trichomonas, bacterial vaginitis, amoebic infection and C. Diff.)

Front 46

Giardia Lamblia
Shape/Life cycle?
Causes?

Back 46

Shape/Life cycle: Trophozoite: Pear shaped with two nuclei and for pairs of flagella.

Oval Cyst: Four Nuclei and several internal fibers.

Causes: most common after drinking water --> causes Diarrhea.

Front 47

Intestinal Protozoa?

Back 47

Entamoeba Histolytica. Which can cause Diarreah and liver abscess

Front 48

What are the two forms of Entamoeba histolytica?

Back 48

Trophozoite: consists of one ingested RBC and one nucleus

Cysts:four nuclei with no internal fibers

Front 49

Entamoeba Histolytica
Life Cycle:
Transmission:
Pathogenesis:

Back 49

Life cycle:Humans ingest cysts then form trophozoites, trophozoites form cysts in the colon. Diagnosis with Cyst form.
Transmission: Fecal Oral cysts
Pathogenesis: "Teardrop uncer/Flask-shaped" invasive can spread to liver and lugs.

Front 50

What is the treatment for Entamoeba histolytica?

Back 50

Metronidazole plus iodoquinol.
"GET BAC on the Metro" (Giardia, Entamoeba, trichomonas, bacterial vaginitis, amoebic infection and C. Diff.)

Front 51

Giardia Lamblia
Shape/Life cycle?
Causes?
Ingested/diagnosed?
Transmission:
Pathogenesis:
Treatment

Back 51

Shape/Life cycle: Trophozoite: Pear shaped with two nuclei and for pairs of flagella.

Oval Cyst: Four Nuclei and several internal fibers.

Causes: most common after drinking water --> causes Diarrhea.

Transmission: Fecal Oral

Pathogenesis: trophozoites attach to wall with no invasion, they interfere with absorption of fat and protein.

Laboratory Diagnosis: Trophozoites or cysts visible in stool, "string Test may be used"

Treatment: Quinacrine with Metronidazole

Front 52

Intestinal Protozoa?

Back 52

Entamoeba Histolytica. Which can cause Diarreah and liver abscess

Front 53

What are the two forms of Entamoeba histolytica?

Back 53

Trophozoite: consists of one ingested RBC and one nucleus

Cysts:four nuclei with no internal fibers

Front 54

Entamoeba Histolytica
Life Cycle:
Transmission:
Pathogenesis:

Back 54

Life cycle:Humans ingest cysts then form trophozoites, trophozoites form cysts in the colon. Diagnosis with Cyst form.
Transmission: Fecal Oral cysts
Pathogenesis: "Teardrop uncer/Flask-shaped" invasive can spread to liver and lugs.

Front 55

What is the treatment for Entamoeba histolytica?

Back 55

Metronidazole plus iodoquinol.
"GET BAC on the Metro" (Giardia, Entamoeba, trichomonas, bacterial vaginitis, amoebic infection and C. Diff.)

Front 56

Giardia Lamblia
Shape/Life cycle?
Causes?
Ingested/diagnosed?
Transmission:
Pathogenesis:
Treatment

Back 56

Shape/Life cycle: Trophozoite: Pear shaped with two nuclei and for pairs of flagella.

Oval Cyst: Four Nuclei and several internal fibers.

Causes: most common after drinking water --> causes Diarrhea.

Transmission: Fecal Oral

Pathogenesis: trophozoites attach to wall with no invasion, they interfere with absorption of fat and protein.

Laboratory Diagnosis: Trophozoites or cysts visible in stool, "string Test may be used"

Treatment: Quinacrine with Metronidazole

Ingested: Cyst form, can be diagnosed by cyst or tropozoite form.

Front 57

Cryptosporidum Parvum.
Transmission:
Labratory:

Back 57

Transmission: Fecal Oral transmission of Cysts

Laboratory Diagnosis: Oocysts visible in stool with Acid Fast Stain

Front 58

UroGenital Protozoa --: Trichomonas Vaginalis
Laboratory:
Clinical:
Treament:
Life Cycle:

Back 58

Lab: Pear Shaped with a central nuclei with four anterior/terminal flagella, Tropozoite visible in vaginal and prostate secretions.

Clinical: A watery Foul smelling, greenish vaginal discharge, acccompanied by itching and burning.

Treatment: Metronidazole for both partners

Life cycle: Tropozoites infects and Tropozoite diagnosis.

Front 59

Blood and tissue Protozoa:
Name Two Sporozoans:

Back 59

Plasmodium and Toxoplamsa

Front 60

Malaria is caused by four Plamodia, name them:

Back 60

Vivax, Ovale, malariae and Falciparum (most severe)

Front 61

Plasmodium (malaria):
Transmission:
Life Cycle:
Pathogenesis:
Labs:
Clinical:

Back 61

Transmission: Anopheles Mosquito

Life Cycle: the sporozoite is injected into the blood stream.

Labs: Blood smear shows "bananna shaped gametocytes" --> Falciform. If rings are seen within the cells it is indicative of malaria, the more rings the more severe the disease

Patho: Malaria--> destriction of RBC's.

Clinical: Hemorrhage and necrosis, particularly in the brain. Hemolysis and kidney damage, may also lead to "black water Fever" (dark color in patients urine)

Front 62

P. Falciform Infects what type of cells?

Back 62

FALCIFORM infects RBCs of all ages.

Front 63

P. Vivax infects what type of cells?

Back 63

Only reticulocytes

Front 64

P. Malariae infects what types of cells?

Back 64

Only mature red cells.

Front 65

Why is it that patients with Sickle Cell disease cannot get malaria?

Back 65

Because the patient's RBC's have insufficient amounts of ATPase for the parasite to survive. Also the Duffy Antigen is not present on the RBC. The duffy antigen binds to the Plasmodin species.

Front 66

Malaria/Plasmodium
Clinical:
Diagnosis:

Back 66

Clinical:Fever, chills, and Headache. May cause death if infected by P. Falciform. Other three are less likely to cause death.

Diagnosis:Thick and Thin Giemsa Stains-->
THick: Used to verify presence of organisms.
THin: used for Species identificaiton

Front 67

Treatment Malaria:

Back 67

Chloroquine for acute malaria
Mefloquin or Doxycycline
Neurological side effects may occur with Mefloquin (psychosis)
Hypersensitivity to sunlight may occur with Doxycycline

Front 68

What Species of Protozoa forms cysts in cat feces or meat (pork or lamb), also infects Macrophages?

Back 68

Toxoplama

Front 69

CC: CT scan shows presence of Cysts in the brain and patient presents of history of eating pork or having a cat.

Back 69

Toxoplama

Front 70

Tx For Toxoplama?

Back 70

Sulfonamide and Pyrimethamine for congenital or disseminated.

Front 71

"Kissing Bug", Ingested by Reduviid Bug and the fecal matter contaminate the wound of the bug bite.

Back 71

Trypansoma cruzi

Front 72

Clinical FIndings For Trypansoma:

Back 72

Trypomastigotes visible in blood, Facial edema (ramana's sign), Nodule near the bite (chagoma), MegaColon and enlarged heart.

Front 73

CC: Enlarged heart, Megacolon, Irregular HR, Rama's Sign (facial edema).

Back 73

T. Cruzi

Front 74

CC: Enlarged heart, Megacolon, Irregular HR, Rama's Sign (facial edema/eye).

Back 74

T. Cruzi

Front 75

Another name for Trypanosoma cruzi?

Back 75

Chaga's Disease or American Trypanosomiasis

Front 76

Trypanosoma African Trypanosomiasis is caused by and causes:

Back 76

Caused by bite by Tsetse fly and causes recurrent fever with Sleeping Sickness.

Front 77

African Trypanosomiasis,Clinical Findings:

Back 77

Enlargement of the glands of the posterior cervical region (winterbottoms sign), Trypanosomal chancre at the site of the fly bite and Wasting skin damage caused by intense itching.
"in the Winter, you do a lot of sleeping"

Front 78

What disease does Leishmania Donovani cause?

Back 78

Kala-Azar

Front 79

Leishmania Donovani Clinical Findings:

Back 79

Severe Muscle Wasting.
Thiskening, stiffening and darkening of the eyelashes and eyebrows, Enlarged spleen and liver (leshmania as EYE-Lashes)

Front 80

Treatment for Leishmania Donovani?

Back 80

Sodium Stibogluconate

Front 81

Name three types of Cestodes (tapeworms)?

Back 81

Diphyllobothrium Latum (Phyll the Fish) Fish Tape worm

Taenia Saginata (Sargent says "where's the beef") Beef tapeworm

Taenia Solium (Pig Sunning itself on the beach) Pork Tapeworm

Front 82

Leishmania Donovani Clinical Findings:

Back 82

Severe Muscle Wasting.
Thiskening, stiffening and darkening of the eyelashes and eyebrows, Enlarged spleen and liver (leshmania as EYE-Lashes)

Front 83

Treatment for Leishmania Donovani?

Back 83

Sodium Stibogluconate

Front 84

Name four types of Cestodes (tapeworms) that are medically important?

Back 84

Diphyllobothrium Latum (Phyll the Fish) Fish Tape worm

Taenia Saginata (Sargent says "where's the beef") Beef tapeworm

Taenia Solium (Pig Sunning itself on the beach) Pork Tapeworm

Echinococcus Granulosus -_> DOG tapeworm