Mycology 2

Front 1

T/F: candida are normal flora of ppl? Candida are uncommon nosocomial infections?

Back 1

T, F

Front 2

clinical manifiestations of candida?

Back 2

skin, nails, mucosal surfaces of mouth, vag, esophagus, bronchs; disseminated disease including heart and brain (very dangerous), associated with AIDs.

Front 3

diseases caused by candida?

Back 3

oropharyngeal infection, esophagitis, vulvovaginal infection, skin and nail infection, chronic mucocutaneous, UTI, pneumonia, endocarditis, pericarditis, CNS infection, ocular infection, bone and joint, abdominal infection, hematogenous infection

Front 4

what species of candida can cause infection? what are the risk factors associated with candidiasis?

Back 4

many species. surgery, valve disease, prosthetic valves, IV drugs, venous catheters, immunosuppression, ventricula shunts, tramau, intraarticular injections,diabetes, diabetic foot, pancreatitis, organ transplants, prolonged antibiotic use, ICU support, hemodialysis, age extremes, stem cell transplants, parenteral nutrition, denture wearers, chemotherapy, HIV, cancer, steroids, oral contraceptives, peripheral vascular disease, urinary catheter

Front 5

possible pathogenic mechanisms of candidia?

Back 5

bud-hyphae transmission, adherence, cell surface hydrophobicity, cell wall mannans, proteases and phosphipases, phenotypic switching

Front 6

diagnosis of candidia?

Back 6

yeast, pseudohyphae, septate hyphae in tissues. Culture positive specimens from normally sterile tissues, gram stain, need a lot of yeasts bc remember it is normal flora

Front 7

how can you speciate candida species?

Back 7

germ tube array plates and different species grow different color colonies

Front 8

treatment of candida?

Back 8

depends on severity and location: topical agents for cutaneous
systemic: amp B alone or in combo with 5 fluorocytosine. azole derivatives (oral availability)

Front 9

describe the growth and morphology of aspergillus and give two important species.

Back 9

grows as mold with characteristic conidiophores. A fumigatus and A. flavus

Front 10

clinical manifestations of aspergillosis?

Back 10

allergic bronchopulminary disease, fungal colonization of pulmonary cavities, invasive disease involving many organs, often rapidly fatal

Front 11

pathogenesis of aspergillosis?

Back 11

cells secrete elestase, proteases, and catalse that may play a role in pathogenesis, gliotoxin inhibits phagocytosis and T cell activation, conidia bind to fibrinogen and laminin to set up resistance, neutrophils are important in clearing the infection

Front 12

diagnosis of aspergillosis?

Back 12

culture that produces septate hyphae that branch at regular intervals - good stain is methenamine silver

Front 13

treatment of aspergillosis?

Back 13

invasive disease requires aggressive therapy with amp B, or azoles (voriconazole is choice) can do capsofungin (chitin wall inhibitor as last resort)

Front 14

three agents that cause zygomycosis?

Back 14

rhizobium, absidia, mucro

Front 15

morphology of the zygomycosis orgs?

Back 15

coenocytic hyphae that are fragile and ribbon like with 90 degree branching that produces asuxually via sporangia. spores are infectious

Front 16

epi and mortality rate of zygomycosis?

Back 16

ubiquitous in the environment, fairly rare, but 70 to 100% fatal when infected

Front 17

clinical manifestations of zygomycosis?

Back 17

rhinocerebral: initiates in the paranasal sinuses that can invade into the brain in diabetics, can go to GI, lung, SQ, burn pts colonize and then becomes invasive esp in blood vessels

Front 18

diagnosis of zygomycosis.

Back 18

micro exam reveals hyphal filaments, silver stain, culture not reliable, will see vascular invasion and tissue necrosis

Front 19

treatment of zygomyosis?

Back 19

aggressive invasive treatment that is usually not very effective... AMP B and posacinazole (only azole that works)

Front 20

describe the classification and morphology of Pneumocystis carinii.

Back 20

classified with fungi but could be a parasite. trophic form is a uninucleated sporocyst or a mature spore case containing eight spherical spores

Front 21

clinical manifestations of pneumocystis carinii?

Back 21

AIDs pts and pneumonia: interstital pneumonitis with plasma cell infiltrates, death as a result of asphyxiation. subclinical infection in healthy ppl is frequent

Front 22

diagnosis of pneumocystis carinii?

Back 22

morphological ID of org in tissue stained with gomori methamine silver or giemsa

Front 23

treatment for pneumocystis carinii?

Back 23

TMP-SMX or pentamidine isethionate (note orgs can become resistant to treatment)

Front 24

opportunistic fungi?

Back 24

candida, aspergillus, mucormycosis AKA zygomycosis eg Rhizopus,

Front 25

infectious particle of candida?

Back 25

yeast and pseudohyphae

Front 26

tissue form of candida?

Back 26

yeast and paeudohyphae.

Front 27

2 common clinical presentations of candida?

Back 27

oral thrush and disseminated disease

Front 28

distinguishing morphology of candida?

Back 28

pseudohyphae have pinched off branch points

Front 29

T/F: zit like skin lesions, endopthalmitis, and abscesses of liver and spleen are seen in candidiasis?

Back 29

T

Front 30

negative aspects of AMP B? FCZ?

Back 30

nephrotoxic. hepatotoxic and interacts with many other drugs via P450

Front 31

infectious particle of aspergillus? tissue form?

Back 31

conidia (spores). narrow septate hyphae with acute angle branching (dichotomous)

Front 32

specefic risk factors for aspergillus?

Back 32

abnormal mucociliary clearance, macrophage phagocytosis defects (as well as neutropenics and CGD - oxidase mechanisms do not work)

Front 33

what are the main risk factors for mucormycosis/zygomycosis?

Back 33

neutropenics and poorly controlled diabetics

Front 34

infectious particles of cryptoccus.

Back 34

probably dessicated yeast

Front 35

tissue form of cryptocccus?

Back 35

encapsulated narrow based budding yeast

Front 36

clinical manifestations of cryptococcus?

Back 36

pulmonary crypto, chronic meningitis

Front 37

what immunocompromised group is NOT at risk for getting cryptococcus infections?

Back 37

neutropenics

Front 38

diagnosis of cryptococcus?

Back 38

india ink smear of CSF, serum crypto antigen, culture CSF, blood, urine, sputum.

Front 39

treatment for crypto?

Back 39

AMP B, FCZ

Front 40

properties of histoplasma?

Back 40

infectious particle is microconidia, tissue form is tiny intracellular budding yeast in mononuclear phags. can be pulmonary or disseminated... usually in AIDs with fever and destructive GI lesion. Dx smear, culture, urine, histo antigen, hist complement fixation test. complement fixation. Tx: itraconazole, for dissemenated do lipid formulations of amph B

Front 41

describe Blastomyces.

Back 41

infectious particle is conidia, tissue form is broad based budding, pulmonary or disseminated, smear and stain Dx, Tx: itraconazole, AMP B

Front 42

describe coccidioides?

Back 42

barrel shapped arthroconidia are infectious, tissue form are spherules and tiny endospores, presentation are pulmonary disease, meningitis, disseminated disease, skin infections, Tx is FCZ, ampho B