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OP - Yield > 6: fungal and protozoal > Flashcards

6: fungal and protozoal Flashcards

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1
Q

chronic multifocal candidiasis sites

A

median rhomboid glossitis + other

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2
Q

angular cheilitis causes %

A

20% candida
20% staph
60% both

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3
Q

perioral candidiasis prereq and name

A

moist skin

cheilocandidiasis

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4
Q

mucocutaneous candidiasis genetics

A

AIRE mutation

auto AB against endocrine glands

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5
Q

AIRE mutation

A

mucocutaneous candidiasis

auto AB against endocrine glands

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6
Q

auto AB against endocrine glands

A

AIRE mutation

mucocutaneous candidiasis

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7
Q

APECED signs and risks

A

autoimmune polyendocrinopathy candidiasis ectodermal dystrophy sybdrome
increased risk of oral and esophageal carcinoma

hypothyroidism, hypoparathyroidism, hypoadrenocortism (addisons) and diabetes

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8
Q

most common systemic fungal infx in US

A

histoplasmosi

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9
Q

rich moist soil fungi

A

histoplasmosis and blastomycosis (rivery valleys – Ohio, Missisippi)

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10
Q

desert soil fungus

A

coccidioidomycosis

SW US, mexico

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11
Q

painful erythematous nodules on leg

A

erythe,a nodosum

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12
Q

valley fever

A

coccidiodidomycosis + erythema nodosum

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13
Q

pigeon poop fungus

A

cryptococcosis

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14
Q

pigeon poop meningitis

A

crytpo

headache, fever, vomiting

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15
Q

mucormycosis aka and cause

most important form

A

aka zygomycosis or phycomycosis
zaused by zygomycetes (mucor, absidia)
rhinocerebral form most important

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16
Q

pts at risk for mucor

A

uncontrolled diabetes _ DKA (increased Fe levels)

+ pts with thalassemia using deferoxamine (increases iron levels)

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17
Q

mucor micro

A

non septate brancing hyphae

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18
Q

most common aspergillus

A

90% A fumigatus

but also A flavus

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19
Q

forms of aspergillosis

A

non invasive (allergic fungal sinusitis or fungus ball) or invasive

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20
Q

risk for disseminated aspergillosis

A

leukemia or corticosteroids

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21
Q

aspergillus micro

A

septate brancing hyphae, smaller than mucor

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22
Q

toxoplasma gondii host

A

cat – oocysts in feces

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23
Q

congenital toxoplasmosis

A

blindness, mental retardation, delayed psychomotor development

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24
Q

most common oral fungal infx (how common?)

A

candidiasis

carried by 30-50% of ppl

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25
form of candida
dimorphic: | innocuous yeast and invasive hyphae
26
classic forms of candida (4)
pseudomembranous, erythematous, chronic hyperplastic, and mucocutaneous
27
most common form of candidiasis
acute atrophic, often 2/2 abx
28
central papillary atrophy on tongue
median rhomboid glossitis
29
white plaque that does not wipe off but is fungal
chronic hyperplastic cnaididasis
30
candida tx
nystatin, clotrimazole (topical), ketoconazole, fluconazole (systemic)
31
candida stain
PAS 0 carbohydrates, KOH, Grocott-Gomori methenamine silver
32
histoplasmosis lives in
droppings from chickens, pigeons, birds, bats
33
forms of histoplasmosis
acute (most common) chronic (similar to TB: upper lobe changes, calcifictiona) disseminated *oral lesions ~ ulcer ~ SCC
34
histoplasmosis stain
PAS or Grocott-Gomori
35
blastomycosis aka
chicago dz
36
chicago dz aka
blastomycosis
37
blasto habitat
similar to histo -- humid moist soil (Ohio, Missisippi) but extends north
38
forms of blastomycosis
acute 0 ~pneumonia | chronic (mimics TB)
39
blastomycosis on skin
facial nodules that enlarge and become verrucous or ulcerated oral similar to SCC
40
blastomycosis stain
PAS or Grocott-Gomori
41
oral paracoccidioidomycosis
mulberry ulcerations
42
paracoccidiodiomycosis stain, look
PAS, Grocott | Mickey mouse ears or mariner's wheel
43
mariner's wheel
paracoccidiodiomycosis
44
mickey mouse ears
paracoccidiodiomycosis
45
desert soil fungus
coccidioidomycosis immitis (SW US and Mexico)
46
forms of coccidioidomycosis
acute, chronic progressive pulmonary (mimics TB) and disseminated
47
coccidioidomycosis on skin
EM-like skin eruption or erythema nodosum (subQT painful erythe,atous nodules)
48
coccidioidomycosis + erythema nodosum
valley fever
49
disseminated coccidioidomycosis
``` skin lesions (papules, abscess, verrucous plaques, granulomatous nodules) central face, esp nasolabial fold ``` oral lesions rare
50
coccidioidomycosis histo
large 20-60nm round spherules with numerous endospores
51
large sphersules with endospores
coccidioidomycosis
52
coccidioidomycosis stain
PAS, Grocott
53
cryptococcus full name
cryptococcus neoformans
54
special stain for crypto
mucous capsule is mucopolysaccharide (mucicarmine) positive
55
most common locations for crypto
meninges and skin
56
crypto meningitis presentation
headache, fever, vomiting
57
skin crypto
erythematous papules/pustules that may ulcerate and discharge material rich in organisms
58
oral crypto
rare -- similar to SCC
59
zygomycetes (x2)
mucor, absidia
60
oral mucormycosis
black and necrotic palate ulceration -- extension from sinus involvement
61
mucor histo
non-septate branding hyphae at 90 degrees | extensive tissue destruction (predilection for vessels --> infarction and necrosis)
62
non-spetate brandinh hyphae at 90 degrees
mucor
63
mucor mortality
60% rate
64
invasive aspergillus when
AIDS, CT, organ transplant, uncontrolled diabetes
65
antroliths
aspergilloma when undergoes dystrophic calcification
66
oral aspergillosis
gingival ulcerations and swelling with surrounding gray/violaceous hue
67
feature of eos in aspergillus fungal ball
charcot-leyden -- eosinophilic hexagonal pyramidal crystals
68
aspergillus fungal ball
GMS and fontana-masson
69
tx for aspergillus (x3)
aspergilloma - debridement fungal ball - debridement + corticoids invasive - voriconazole
70
aspergillus histo
fruiting bodies, septate branching hyphae at 40 acute angle
71
rhinosporidiosis cause
rhinosporidium seeberi
72
rhinosporidiosis geography
90% in India and Sri Lanka
73
rhinosporidium histo
100-300um cysts or sporangia with numerous endospores | immature - small, mature - large
74
toxo symptoms
like mono in immunocompetent host
75
toxo histo
triad of follicular hyperplasia, clusters of eputhelioid histiocytes, plasmacytoid B cells
76
toxoplasmosis diagnosis
serum Ab titers
77
cysticercosis cause
Taenia solium
78
taenia solium cause
cysticercosis
79
how acquire cysticercosis
undercooked pork
80
cneruocysticercosis most common symptom
epilepsy
81
cysticercosis histo
cystic cavity with larvae scolex at cephalic region and caudal to it, with duct like invagination invagination lined by eosinophilic membrane caudal -- ovoid basophilic calcified corpuscles
82
mucocutaneous candidiasis eponym
whitaker syndrome
83
whitaker syndrome
mucocutaneous candidiasis
84
mucocutaneous candidiasis inheritance and genetics
most sporadic but AR if familial | Due to IL-17 and IL-22 / Autoimmune regulator gene (AIRE) mutation on chromosome # 21
85
syndromic consequences of AIRE mutation
```  Endocrine-candidiasis syndrome ; Autoimmune polyendocrinopathy-candidiasis- ectodermal dystrophy ( APECED ) / Autoimmune polyendocrinopathy syndrome type 1 ```  Iron def Anemia  mucocutaneous candidiasis
86
endocrine and other problems in APECED
```  Hypothyroidism  Hypoparathyroidism  Hypoadrenocorticism (Addison disease)  DM  10% have esophageal cancer ```
87
external presentation of APECED
 Erythematous candida on tongue  Nail dystrophy  Corneal keratopathy
88
 Erythematous candida on tongue  Nail dystrophy  Corneal keratopathy
APECED
89
APECED mutation where
21q22.3
90
21q22.3 mutation
APECED
91
smallest relevant fungus
histoplasma capsulatum
92
largest relevant fungus
coccidiodes posadasii/immitis
93
refractory cell wal fungus
balstomyces dermatitidis
94
non septate hyphae fungus
mucormycotina (absidia, mucor, rhizomucor, rhizopus)
95
endocrine consequence of disseminated histoplasmosis
addison disease if affects adrenal
96
psudoepitheliomatous hyperplasia which fungus
blastomyces
97
acute blastomycosis clinical course
 Resembles PNEUMONIA |  High fever, night sweats, chest pain, malaise, productive cough
98
chronic blastomycosis clinical coure
 More common than acute  Mimic TB but NO CALCIFICTAIONS  Low grade fever, night sweats, chest pain, malaise
99
ppl at risk for chronic histoplasmosis
older, immunosuppressed, | emphysematous white men
100
lungs affected in which histoplasmoses
acute and cronic | disseminated starts affecting extrapulmonary sites
101
2-10% of disseminated histoplasmosis in which population
HIV
102
paracoccidiomycosis aka and population predilection
(South American blastomycosis) | Men >Women 15:1
103
paracoccidiomycosis organ damage
Addison Disease
104
which fungus can result in addison disease
paracoccidiomycosis
105
paracoccidiomycosis histo
Mickey mouse ears = Mariner’s wheel= daughter buds
106
Mickey mouse ears
paracoccidiomycosis
107
Mariner’s wheel
paracoccidiomycosis
108
4)Coccidioidomycosis aka
(San Joaquin Valley Fever
109
(San Joaquin Valley Fever aka
Coccidioidomycosis
110
Valley Fever what is
Coccidioidomycosis Fever: Occasionally Allergic response is triggered causing erythema nodosum on skin of legs that occur in conjugation with cocci
111
Allergic response is triggered causing erythema nodosum on | skin of legs that occur in conjugation with cocci
Valley Fever
112
Coccidioidomycosis geography
Alkaline , semiarid, desert soil / southwestern States and Mexico
113
chronic Coccidioidomycosis
Mimics TB, persistent cough, hemoptysis, chest pain, low grade fever, weight loss.
114
disseminated Coccidioidomycosis which population
extra pulmonary = skin (most common) and LN, Filipinos, blacks, native Americans
115
cryptococcosis animal spirit
pigeons
116
crypto classic
Meningitis/ headache/ vomiting/skin/bone
117
mucormycosis ions
Fe! DKA (ketoacidosis due to prevention of binding of Iron to transferrin = HIGH iron) and deferoxamine for thalassemia
118
thalassemia patients at risj for (infx)
mucormycosis
119
histo of noninvasive aspergillus
allergic fungal sinusitis which have tide lines | or fungal ball
120
disseminated aspergillusw ho's at rosk
leukemia or high steroids
121
primary reservoir for leishmania
dogs and other mammals sandfly vector
122
most common leishmaniasis
cutaneous -- mexicana
123
kala azar
visceral leishmania donovani old world braziliensis new world black discoloration, pancytopenia, hepatosplenomegaly, weight loss
124
leishmania stains
giemsa, brown hopp

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