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26 Cards in this Set
- Front
- Back
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In which of the following diseases are fungi most likely to enter the bloodstream and cause a systemic infection?
A. thrush B. Histoplasmosis C. Aspergillus lung infection D. All of the above are highly invasive infections |
B. thrush is a surface infection of the tongue and mouth. Aspergillus infections usually are limited to the mouth or lung. H. capsulatum, by contrast, can cause systemic infection.
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Which of the following is most likely to be found in soil?
A. Histoplasma capsulatum B. candida albicans C. Aspergillus spp. D. A and C above |
A and C. Histoplasma capsulatum and Aspergillus spp.
C. albicans is found in the resident microbiota of the mouth, skin, vagina and colon. |
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Yeast forms are NOT seen in people infected with:
A. Candida albicans B. Histoplasma capsulatum C. Aspergillus spp. D. None of the above. All are dimorphic fungi. |
C. aspergillus spp. only have a mycelial form and hyphae are the forms seen in the lungs.
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The symptoms of histoplasmosis are most similar to those of which of the following bacterial infections?
A. C. pneumoniae pneumonia B. S. pneumoniae pneumonia C. P. aeruginosa lung infections in cystic fibrosis patients D. Tuberculosis |
D. Tuberculosis
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Which of the following is/are found most commonly within a defined geographical region of the US?
A. C. albicans B. H. capsulatum C. Aspergillus spp. D. P. jirovecii |
B. C. albicans is ubiquitous because it is part of the resident microbiota. P. jiroveci is commonly found in the airways of people in all parts of the country. Aspergillus is widely disseminated in soil. H. capsulatum is most likely to be encountered in a delimited geographical location, the Ohio Valley and Mississippi Valley, although it can be found in other parts of the US and in many part of the world.
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P. jirovecii causes damage to the lung by...
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1. producing substances that kill pneumocytes
2. eliciting a eosinophilic response that causes a foamy exudate. |
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Which of the following is most commonly found in the human upper respiratory tract?
P. jirovecii H. capsulatum Aspergillus spp. None of the above |
P. jirovecii
The other two are commonly found in soil. Some consider P. jirovecii to be part of the resident microbiota of humans. |
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A common feature of histoplasmosis and P. jirovecii pneumonia is that
A. infections can occur in otherwise healthy adults B. granulomatous lesions are commonly produced. C. elderly people are most likely to develop symptomatic infections. D. None of the above |
B. granulomatous lesions are commonly produced.
- commonly seen as a symptomatic disease in people with underlying conditions such as smoking and emphysema or other lung damage. - older people are more likely to be symptomatic - P. jirovecii is rarely seen except in immunocompromised pts such as AIDS. - both organisms can produce granulomatous lesions |
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The skin test for histoplasmosis is not very useful because...
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because so many people in an endemic area test positive.
inapparent infections are quite common, so most people in an endemic area will be positive. Even outside an endemic area, people with positive skin tests are probably positive because of an earlier inapparent infection than because of a current infection. |
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Amphoterecin B has to be used to treat histoplasmosis in AIDS patients, whereas azoles can be used for other histoplasmosis cases, because...
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Because the azoles are fungistatic and require action of the immune system to help eliminate the infection.
Amphotericin B is relatively toxic drug but is needed to kill the fungi. It is not effective against P. jirovecii pneumonia. |
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When are fungal infections most likely to take over the body?
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In immunocompromised situations.
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What causes tissue damage in fungal infections?
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The host's own immune system.
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What does thrush - candida albicans physically look like?
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white patches in different areas of the mouth
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What type of pts are infected with C. albicans?
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newborns and immunocompromised children, AIDS patients
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Does a C. albicans infection become systemic?
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NO.
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Where are Histoplasma infections common?
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The Midwest.
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What is the disease progression of Histoplasma similar to?
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Tuberculosis
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Where does Histoplasma set up shop?
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In macrophages, where the fungal cells multiply and then become granulomous.
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Where are Coccidoides infections common?
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California and Southwest aka Valley Fever
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How does Coccidoides set up shop?
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Same as Histoplasma. Infect macrophages and forms granulomas.
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Where is Blastomyces spread?
What is its physical characteristic? |
US, Central and South America
Although it is a budding yeast in lung tissue, it is interestingly characterized by SKIN LESIONS that last 20 years. |
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What mild infection is more serious in immunocompromised, and has both a trophozoite and a cyst form?
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P. jirovecii
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What are the physical characteristics of P. jerovecii?
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Desquamation of alveolar lining, elicits a eosinophilic response, honey comb appearance, foamy exudate, and RARELY forms granulomas.
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Other than the lung, where does Aspergillus invade?
What yeast form does Aspergillus stay in? |
Orally
Mycelial. Grows and forms extensive Mycelial Mats in the lung. |
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How are Histoplasmosis and P. jerovecii both differentially diagnosed?
How do you treat Histoplasmosis? How do you treat P. jerovecii? |
appearance in bronchial washings.
Treath with Azole, unless immunocompromised, in which case use Amphoterecin B P. jerovecii, treat with sulfa/trimethoprim. If patient is AIDS, used Pentamidine. |
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Discussion question: what do Candida albicans and Aspergillus have in common? How do they differ?
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Both have the same symptoms, except Aspergillus hangs out in a spore form, while Albicans in a yeast form. Albicans is also a natural part of the gut flora, and therefore opportunistic. Aspergillus on the other hand, hangs out outside the body in the spore form as part of mold.
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