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91 Cards in this Set
- Front
- Back
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What does dimorphic fungi mean?
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Capable of growing in mold or yeast form.
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What is thermal dimorphism?
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Mold grows at 25-30 degrees celcius. Yeast at 37 degrees celcisu
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How is systemic mycoses acquired?
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Inhalation
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Is there evidence of transmission of systemic mycoses among humans or animals?
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No.
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What five fungi cause true systemic mycoses?
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Cocci, histo, blasto, paracocci, penicillium marnefei
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Where is cocci found?
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Soil, dust
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What is the geographic distribution of Cocci?
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southwestern US, northern mexico, central and south america
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How is cocci characterized in tisssue?
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Spherules
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How does cocci reproduce?
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Endospores
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What are possible clinical findings of Primary Pulmonary Coccidiodomycosis?
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most asymptomatic, self limited pneumonia,pneumonia with immune complex formation
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What are the characteristics of Cocci self limited pneumonia?
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non-productive cough, fever, night sweats, anorexia
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What are the characteristics of San Joaquin Valley Fever?
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Rash, erythema nodosum, erythema multiforma, arthritis
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What percentage of those who are infected with Cocci will have chronic sequelae?
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5%
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What percentage of patients will get disseminated cocci?
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1%
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List the three locations cocci can disseminate to, in order from most likely to least likely.
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Skin, bone/joint, meninges
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List the 6 risk factors for Cocci dissemination
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Age extremes, male, filipino or AA, High CF Titer, Pregnancy, immunosuppressed
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In what three ways is Cocci diagnosed?
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Complement fixation test, Culture, Pathology
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What is the treatment for Cocci?
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Fluconazole, Itraconazole, Amphotericin B
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Where is Histo found?
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Moist surface soil and soil with droppings of birds and bats
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What is the geographic ditribution of Histo?
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Found worldwide, in US:MIssissippi and Ohio RIver Valleys (Midwest)
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How does Histo reproduce?
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arthroconidia
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List the three pathogenic mechanisms of Histo?
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Survives in unstimulated macrophages, disseminates within monocytes, CMIR causes granulomas
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What percentage of patients with Histo will be asymptomatic?
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90%
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What are the symptoms of primary acute histoplasmosis?
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fever, non-productive cough, headache, myalgias, arthralgias, residual calcified lesions
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Does histoplasmosis have inflammatory sequelae, if so what?
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Yes, arthritis and pericarditis
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What are the symptoms of Disseminated histo?
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fever, weight loss, fatigue, oropharyngeal ulcers; skin, hepatosplenomegaly, bone marrow involvement
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What are the symptoms of Progressive pulmonary histoplasmosis?
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lung desctruction, cavities, fibrosis
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What caues mediastinal fibrosis?
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Histoplasmosis
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How is histoplasmosis diagnosed?
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culture, pathology, serology
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What is the treatment for Histoplasmosis?
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Itraconazole or amphotericin B
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What fungi is found in decaying organic matter?
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Blasto
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What is the geographic distribution of Blasto?
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North America (ohio and mississippi river valleys, around great lakes, southesat, africa
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Which fungi shes immunodominant AG from cell surface and modifies cell wall composition
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blasto
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What are the clinical features of Acute Blastomycosis?
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fever, arthralgias, myalgias, headache, productive cough, pleuritic chest pain, erthema nodosa
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What are the features of chronic blasto?
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chronic pulmonary, cutaneous blastomycosis
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How do you diagnose Blasto?
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pathology, culture, urinary antigen, serologic tests not sued
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What is the treatment of Blasto?
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Amphotericin B, Itraconazle, Fluconazole, Surgery
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What is the ecology of paracocci?
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soil, wood
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Geographic distribution of Paracocci?
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south and central america
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Which fungi is characterized by a "pilot wheel"?
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Paracocci
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What are the pathogenic mech's of Paracocci?
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Survives in unstimulated macrophages, alpha-(1,3) gucan in cell wall acts as imunomodulator and virulence factor
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What are the characteristics of Paracococci subacute disseminated form?
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younger and immunocomprimised, lymphadenopathy, organomegaly, bone marrow involvement
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Is amphoterecin B curative of Paracoccy?
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No
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What is the ideal therapy for Paracoccy?
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Itraconazole or Sulfa drugs
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Ecology of Penicilliosis?
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Soil, bamboo rat
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Which fungal infection is located in Southeast asia?
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Penicilliosis
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Which fungal infection affects patients with AIDS living in or visiting SE Asia or southern china?
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Peniclliosis
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What are the clinical characteristics of Peniclliosis?
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progressive systemic febrile disease, infiltration and inflammation of RE system, almost any organ can e involved
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Which fungi can ELISA-based antibody to Mp 1P diagnose?
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penicilliosis
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Treatment of Penicilliosis?
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amphoterecin B for 2 weeks, followed by itraconazole
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Infections of the tonsils can also involve the BLANK.
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pharynx
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The three important causes of exudative tonsilitis are:
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strep infection, mono, diptheria
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What are three main complications of tonsilitis?
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spread of infection to the neck, peritonsilar abscess, spread of strep infection to heart and kidneys
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(T/F) Squamous cell carcinomas of the lip are predominantly on the upper lip.
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False
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Which virus causes parotid gland inflammation?
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paramyxomavirus (mumps)
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What is the main component in the pathology of salivary gland calculi?
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restriction of flow-stasis->chronic infection state
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75% of Salivary gland tumors are (benign/malignant)?
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benign
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What is the most common type of malignant salivary gland tumor?
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Mucoepidermoid
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What is the first line of therapy for hemangiomas?
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Steroids
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What is the main treatment for lymphangiomas?
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Surgery
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What congenital lesion is caused by immature laryngeal cartilage?
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Laryngomalacia
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What is the main cause of supraglottitis (acute epiglottitis)?
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H.Influenzae type b
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(T/F) Supraglottitis is a medical emergency.
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True
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What age group is affected by Laryngotracheal bronchitis (croup)?
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children age 3-5
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What disease starts with a typical URI, has a barking cough and is caused by a parainfluenza virus?
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laryngotracheal bronchitis (croup)
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What is the most common laryngeal tumor in children?
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laryngeal papilloma
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What disease is caused by HPV types 6&11?
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laryngal Papilloma
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Which type of laryngeal tumor is most likely to spread?
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Supraglottic
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Which two bacteria usually cause Otitis Externa?
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E.Coli and pseudomonas
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What is the main fungal cause of external otitis?
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Aspergillis
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What are the three main neoplasms of the ear canal?
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Squamous cell carcinoma, malignant melanoma and basal cell carcinoma
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What is the source of most cases of otitis media?
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eustachian tube dysfunction
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What are the two most common types of bacteria in Otitis Media?
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Strep pnuemonia, H. Influenzae
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What are examples of intracranial complications of AOM?
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epidural, subdural and brain abscesses
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What are examples of complications of chronic otitis media?
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perforations, ossicular erosion, tympanosclerosis, facial paralysis, cholesteatoma
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What is a cholesteatoma?
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Keratinized squamous cell growth in middle ear
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Where would one find a Glomus Tympanicum tumor?
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Middle Ear
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What is the mechanism of action of Albuterol?
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beta 2 agonist that phosphorylates myosin kinase, inactivating it, dilating airways
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What is a side effect of albuterol?
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skeletal muscle tremor
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Which beta 2 agonist lasts for over 12 hours?
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Salmeterol
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What is advair and does it relieve acute symptoms?
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Combination of salmeterol and fluticasone. No.
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What is the mechanism of action of ipatropium?
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Non-selective muscarinic blocker. Blocks vagus psp stimulation to lung. INhibits constriction
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Which drug inhibits mast cell degranulation?
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Cromolyn
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Does cromolyn work if it is given after antigen exposure?
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No.
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What does Zileuton do?
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blocks 5'lipoxygenase thus inhibiting leukotriene induced bronchoconstriction
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What do zafirlukast and montelukast do?
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block leukotriene receptors in the lung inhibiting bronchoconstriction
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Are glucocorticosteroids usefl in treating an acute attack?
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no
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How does beclomethasone work?
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inhibits prostaglandin and leukotriene synthesis
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Which drug forms complexes with circulating free IgE and prevents it from binding to mast cells and basophils?
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Omalizumab
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Which asthma drug would be used for a patient with allergic asthma with poorly controlled symptoms despite maximum therapy?
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Omalizumab
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How does theophylline work?
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inhibits the action of adenosine (a broncho-constrictor).
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