3Distinguishing Features

Question 1

tinea versicolor (pityriasis)

Answer 1

Malasseziea furur
superficial fungus
Nonpruritic maculae on trunk/proximal
“bubbles and sticks”

Question 2

tinea nigra

Answer 2

Hortae werneckii
superficial fungus
brown maculae on palms/soles
“cooked wheat”

Question 3

black piedra

Answer 3

Pedraia hortae
superficial fungus
hard, black nodules on hair

Question 4

white piedra

Answer 4

Trichosporon
superficial fungus
soft, white nodules on hair

Question 5

tinea pedis (athlete’s foot)

Answer 5

Trichophyton rubrum

anthropophilic dermatophyte; cutaneous fungus

Question 6

tinea ______; ringworm

skin fungal infections - geophilic

Answer 6

Microsporum gypseum

geophilic dermatophyte; cutaneous fungus

Question 7

tinea ______; ringworm

skin fungal infections - zoophilic

Answer 7

Microsporum canis (cat/dog)
Microsporum nanum (pigs)
Trichophyton verrucosum (horse/pigs)
zoophilic dermatophyte; cutaneous fungus

Question 8

favus tinea capitis

Answer 8

Trichophyton schoenleinii
cutaneous fungus
very bad scalp infection

Question 9

sporotrichosis

Answer 9

Sprothrix schenkii
subcutaneous fungus
lymphocutaneous lesions
gardeners
"cigar shaped" and "rosettes"

Question 10

chromoblastomycosis

Answer 10

Fonsecaea, Phalophora, Cladophialophora
subcutaneous fungus
sclerotic body, cauliflower lesions
“fission lines”

Question 11

phaeohyphomycosis

Answer 11

Lots; Cladophialophora bantiana
subcutaneous fungus
cysts; brain lesions (rare)

Question 12

(Eu)mycetoma

Answer 12

Lots of fungi and actinomycetes
subcutaneous fungus
abscesses with granules (colonies); Madura foot

Question 13

coccidioidomycosis

Answer 13

Coccidiodes immitis and C. posadasii
dimorphic systemic fungus
pulmonary; lung lesions
“spherules with endospores”

Question 14

histoplasmosis

Answer 14

Hisoplasma capsulatum capsulatum
dimorpic systemic fungus
pulmonary; cavitary fibrosing mediastinitis

Question 15

African histoplasmosis

Answer 15

Histoplasma capsulatum duboisii
dimorphic systemic fungus
skin/bone infections; giant cells

Question 16

blastomycosis

Answer 16

Blastomyces dermatitidis
dimorphic systemic fungus
pulmonary; cutaneous; dissem in immunocomp.
“broad-based budding blasto”

Question 17

paracoccidioidomycosis

“South American blasto”

Answer 17

Paracoccidioides brasiliensis
dimorphic systemic fungus
lung, disseminated, mucocutaneous lesions
“pilot’s wheel”

Question 18

penicilliosis marneffi

Answer 18

Penicillium marnefei
dimorphic systemic fungus
skin lesions, lymphadenopathy
HIV+ in SE Asia

Question 19

cryptococcosis

Answer 19

Cryptococcus neoformans grubbi, C. neoformans neoformans, C. gattii
yeast systemic fungus
pulmonary, meningitis, dissem.
“capsule halo”

Question 20

candidiasis

hepatosplenic candidiasis

Answer 20

Candida albicans, C. glabrata, C. parapsilosis, C. tropicalis, C, krusei
opportunistic fungus
thrush, mucosal infections
biofilms on catheters & central lines; bone marrow transplants
“pseudohyphae”

Question 21

aspergillosis
allergic aspergillosis
aspergilloma "fungus ball"
semi-invasive
invasive

Answer 21

Aspergillus fumigatus, A. flabus, A. niger
opportunistic fungus
pulmonary; dissem.; solid organ transplants
“45 degree branching”

Question 22

zygomycosis

Answer 22

Rhizopus, Mucor, Rhizomucor
opportunistic fungus
rhinocerebral; pulmonary
“ribbon-like”

Question 23

pneumocystosis

Answer 23

Pneumocystis jiroveci (P. carinii)
opportunistic fungus
ground glass pneumonia, dissem.
AIDs patients

Question 24

Enterobius vermicularis

Answer 24

Intestinal round worm - nematode; pinworms
Pointed ends
Eggs eaten/breathed, hatch in small intestine, larvae to large intestine, mature/mate
Butt scratching (type I)

Question 25

Ascaris lumbricoides

Answer 25

Intestinal round worm - nematode earthworm-like, elliptical eggs Eggs eaten, hatch in small intestine, larvae invade lymphatics and portal blood, break capillaries in lungs, coughed and swallowed, mature in small intestine, lay eggs which mature in soil pneumonia (Loeffler's syndrome; Type I), obstruction

Question 26

Trichuris trichiura

Answer 26

Intestinal round worm - nematode; whipworm whip-like, bipolar eggs Eggs eaten, hatch in small intestine, larvae damage and move to large, mature and damage, lay eggs which mature in soil bleeding (anemia), diarrhea, rectal prolapse, secondary bacterial infections

Question 27

Ancylostoma deudenale | Necator americanus

Answer 27

Intestinal round worm - nematode; hookworms hook-like Larvae in soil penetrate skin as Dew Itch; lungs (Loeffler's syndrome), coughed and swallowed, mature in small intestine, lay eggs pneumonitis, hepatosplenomegaly, suck blood (anemia), diarrhea

Question 28

Strongyloides stercoralis

Answer 28

Intestinal round worm - nematode Larvae in soil penetrate skin; lungs (Loeffler's syndrome), coughed and swallowed, mature in small intestine, lay eggs which can mature in people and re-infect (red snake-like skin infection) pneumonitis, malabsorption

Question 29

larva migrans

Answer 29

Tissue round worm - nematode Toxocara canis: eggs from dogs; allergic and granulomas Ancylostoma brazilense: hookworms of cats/dogs; enter humans but cannot develop; Migrate unders skin until they die; Type I and IV

Question 30

Trichinosis

Answer 30

Trichinella spiralis Tissue round worm - nematode Animals ingest encysted larvae, adults in large intestine, mate and release larvae, penetrate tissues, encyst in striated muscle; humans eat undercooked meat with encysted larvae muscle weakness, granulomas, Type I

Question 31

Wucheria bancrofti | Brugia malayi

Answer 31

Filaria - tissue nematode Mosquito transmits larvae, mature and release microfilaria in blood, reinfect mosquitos elephantiasis (lymphatic obstruction), filarial fever; Type IV

Question 32

Loa loa

Answer 32

Filaria - tissue nematode; eye worm Deer fly transmits larvae, mature and release microfilaria in blood, reinfect deer fly Calabar swellings (Type I), eye infections

Question 33

Onchocera volvulus

Answer 33

Filaria - tissue nematode Black fly/buffalo gnat transmits larvae, mature and release microfilaria in blood, reinfect vector River blindness, nodules

Question 34

Dracunculus medinensis

Answer 34

Filaria - tissue nematode; guinea worm Drink water with infected Cyclops, subQ adults, release larvae through ulcer with water contact Ulcer with Type I, tetanus if worm dies in tissue

Question 35

Cestodes

Answer 35

Tissue nematode; tapeworm Taenia solium (pork) Taenia saginata (beef) Echinococcus (dogs) Tissue cysts eaten, intestinal adults attach and release proglottids weight loss, cysticercosis (encysted larvae), hydatid cysts (large, CNS)

Question 36

Schistosomes

Answer 36

Trematodes (blood flukes) Schistosoma mansoni - lateral spines on eggs; intestinal Schistosoma japonicum - small lateral spines; intestinal Schistosoma haematobium - terminal spine; urinary Miracidia (larvae) infect snails, develop into circariae (tails), invade human skin, lose tails to become metacercariea/schistosomula, acquire human coat in lungs (Type I), migrate to liver (Type III), migrate to intestine/urinary, release eggs and cause granulomas (Type IV)

Question 37

Schistomosiasis

Answer 37

Acute - Katayama fever; malaise, fever, abd. pain, CNS effects (Type III) Chronic - granulomas in liver, portal hypertension, intestinal bleeding (anemia) or blood in urine Swimmer's Itch - larvae can't develop, cause rash and hives until they die (Type I)

Question 38

Scabies

Answer 38

Sarcoptes scabiei (mite) Sexually transmitted and then transferred Rashes (Type I)

Question 39

Lice

Answer 39

Mite

Question 40

Toxoplasmosis

Answer 40

Toxoplasma gondii Protozoa - apica complexa (nonmotile) Eat oocysts, develop bradyzoites and tachyzoites (cross placenta) Immunocomp. get CNS, lymphadenitis, pneumonitis, myocarditis 1st trimester is severe, 3rd trimester less so - abortion, stillbirth, CNS abnormalities

Question 41

Cryptosporidium parvum

Answer 41

Protozoa - apica complexa (nonmotile) Eat, attach to intestinal epithelial cells Diarrhea (intractable in AIDS)

Question 42

Isospora belli

Answer 42

Protozoa - apica complexa (nonmotile) Enters epithelial cells Diarrhea

Question 43

Giardia lamblia

Answer 43

Protozoa - mastigophora (flagellated) Drink cysts, unencyst in stomach, attaches to epithelium in upper small intestine Steatorrhea, cramps, weight loss

Question 44

Trichomonas vaginalis

Answer 44

Protozoa - mastigophora (flagellated) STD trophozoite; male carriers Vaginal discharge, dysuria

Question 45

Leishmania

Answer 45

Protozoa - mastigophora (flagellated) Polar flagella Sandfly bite, promastigote phagocytized by macrophage, turns into amastigote, multiply and infect, reinfect sandfly cutaneous = L. tropica, L. braziliensis; ulcerating papules, permanent scars visceral = L donovani; 2x daily fevers, hepatosplenomegaly, pancytopenia mucosal = L. braziliensis; mucocutaneous lesions

Question 46

African sleeping sickness | Trypanosomiasis

Answer 46

Trypanosoma brucei Protozoa - mastigophora (flagellated) Tse tse fly bite Primary lesion, weekly fevers, lymphadenopathy, decreased consciousness

Question 47

Chaga's disease | Trypanosomiasis

Answer 47

Trypanosoma cruzi Protozoa - mastigophora (flagellated) Assassin bugs Chagoma lesion, conjunctivitis, megaesophagus, megacolon

Question 48

Malaria | Plasmodium

Answer 48

Protozoa - apica complexa (nonmotile) Anopheles/culex mosquito gives sporozites, divide in liver cells, asexual reprod. leads to merozoites, infect RBCs, create gametocytes, reinfect mosquitos, sexual reprod. leads to sporozoites Plasmodium falciparum = most severe, malignant tertian, infects all RBCsanemia, encephalitis, DIC, shock, death Plasmodium vivax and ovale = benign tertian, infects reticulocytes, recurrent malaria Plasmodium malariae = benign quartan, infects old RBCs

Question 49

Amebic dysentery

Answer 49

Entamoeba histolytica Protozoa - sarcodina (pseudopodia) Eat cysts, invades large intestine Intestinal ulcers, bleeding, diarrhea