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Step 1 2019 First Aid Flashcards > Micro FA Mycology/Parasitology p151 -161 > Flashcards

Micro FA Mycology/Parasitology p151 -161 Flashcards

1
Q

Systemic mycosis from
Mississippi and Ohio River Valleys

A
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2
Q

Mycoses from Eastern and Central US, Great Lakes

A

Usually NC/SC - gen E of Mississippi River

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3
Q

Systemic mycoses from Southwestern US, California

A
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4
Q

Systemic mycosis from Latin America

A
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5
Q

Sx of Histoplasmosis

A

Palatal/tongue ulcers, splenomegaly, pancytopenia

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6
Q

Patho signs of Histoplasmosis

A

Macrophage filled with Histoplasma (smaller than RBC

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7
Q

Where is histoplasma found?

A

bird (starlings) or bat droppings

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8
Q

Dx of Histoplasmosis

A

Diagnosis via urine/ serum antigen

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9
Q

Patho features of blastomycosis

A

Broad-based budding of Blastomyces (same size as RBC)

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10
Q

skin lesions of blastomycosis look like what neoplasm?

A

looks like SCC

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11
Q

Sx of blastomycosis

A

Inflammatory lung disease, can disseminate to skin/ bone

granulomatous nodules

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12
Q

Patho features of Coccidiodomycosis

A

Spherule (much larger than RBC) filled with endospores of Coccidioides

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13
Q

Sx of Coccidioidomycosis

A

Disseminates to skin/ bone Erythema nodosum (desert bumps) or multiforme Arthralgias (desert rheumatism) Can cause meningitis

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14
Q

Patho features of Paracoccidioidomycosis

A

Budding yeast of Paracoccidioides with “captain’s wheel” formation (much larger than RBC

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15
Q

3 dermatophytes - which infects what

A

Trichophyton - 3 skin, hair, and nails

Epidermophyton - skin and nails

(phyton - “fightin” tooth & nail)

Microsporum - skin and hair

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16
Q

Tinea corporis - acquired from?

A

contact with infected pets or farm animals

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17
Q

causative agent of tinea versicolor

A

Malassezia furfur

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18
Q

What leads to the different pigmentation pattern of tinea versacolor

A

Degradation of lipids produces acids that inhibit tyrosinase (involved in melanin synthesis) –> hypopigmentation
hyperpigmentation and/or pink patches can also occur due to inflammatory response.

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19
Q

Which mycoses is described morphologically as round yeast clusters with short curved hyphae?

A

Malassezia (“spaghetti & meatballs”)

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20
Q

Dx with Wood’s lamp or KOH skin scraping

A

Tinea

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21
Q

form pseudohyphae and budding yeasts at 20oC, germ tubes at 37oC

A

Candida albicans

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22
Q

Candida is NF of where?

A

mucous mem

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23
Q

septate hyphae that branch at 45o

A

Aspergillus

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24
Q

non dimorphic heavily encapsulated yeast

A

Cryptococcus

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25
Q

What does Candida cause in the immunocomromised?

A

oral and esophageal thrush

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26
Q

Candida vulvovaginitis is seen in what patient pop?

A

Diabetes pt (Fungi love sugar)

pt on inc antibiotic use

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27
Q

IV drug users can get what manifestation of candida?

A

endocarditis

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28
Q

Chronic mucocutaneous candidiasis seen in what pts?

A

Anyone with a Th1 defect

DB

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29
Q

Can form a ball like structure in pre-existing lung cavities, like after a TB infection

A

Aspergillus - aspergilloma (fungus ball)

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30
Q

Some species of Aspergillus produce _______ (associated with what neoplasm).

A

Some species of Aspergillus produce Aflatoxins (associated with hepatocellular carcinoma).

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31
Q

Tx of Aspergillus

A

voriconazole or echinocandins (2nd-line).

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32
Q

Patients with asthma or cystic fibrosis will have what response to Aspergillus

A

Allergic bronchopulmonary aspergillosis (ABPA)—hypersensitivity response to Aspergillus growing in lung mucus. Associated with asthma and cystic fibrosis; may cause bronchiectasis and eosinophilia.

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33
Q

Most sensitive/specific test for Cryptococcus

A

Latex agglutination test detects polysaccharide capsular antigen and is more sensitive and specific.

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34
Q

found in soil, pigeon droppings

A

Cryptococcus

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35
Q

What does Cryptococcus cause?

A

Acquired through inhalation with hematogenous dissemination to meninges.

therefore, leads to Cyptococcal pneumonia (cryptococcosis) and meningitis, encephalitis

36
Q

At what CD count do you treat Candida, Histoplasma, Pneumocystis, Cryptococcus and Aspergillus

A

<500/mm3

  • Candida albican oral thrush

<200/mm3

  • Histoplasma
  • Pneumocystis

<100/mm3

  • Candida esophagitis
  • Aspergillus
  • Cryptococcus meningitis
37
Q

irregular ribbon like broad non septate hyphae that branch at wide angles

A

Mucor/Rhizopus/Absidia

38
Q

Mucormycosis seen in which pt pop?

A

Diabetes (ketoacidotic)

neutropenic pt (leukemia)

39
Q

Pathogenesis of Mucor, Sx/

A

Inhalation of spores –> fungi proliferate in blood vessel walls, penetrate cribriform plate, and enter brain.

Rhinocerebral, frontal lobe abscess; cavernous sinus thrombosis.

Headache, facial pain, black necrotic eschar on face; may have cranial nerve involvement.

40
Q

diffuse interstitial pneumonia caused by fungi in immune compromised pt?

A

Pneumocystis

41
Q

disc shaped yeast seen on methenamine silver stain of lung tissue

A

Pneumocystis - honey comb like - dark colonies on a green background

42
Q

Dx of Pneumocystis - why?

A

Diagnosed by bronchoalveolar lavage or lung biopsy

Pneumocystis - attaches to and kills type I pneumocytes –> leads to prolifer’n of type II –> alveoli fill with a dense exudate, can’t cough it up. Have to go in for it

43
Q

Tx of Pneumocystis

A

TMP-SMX

44
Q

Dimorphic, cigar-shaped budding yeast that grows in branching hyphae with rosettes of conidia

A

Sporothrix Schenckii

45
Q

Typical presentation of Sporothrix

A

When spores are traumatically introduced into the skin, typically by a thorn (“rose gardener’s disease”), causes local pustule or ulcer with nodules along draining lymphatics (ascending lymphangitis

46
Q

Immunocompromised pt with Sporothrix - presentation, common pt pop?

A

Disseminated disease possible in immunocompromised host. – pulm sprotrichosis

Seen in homeless, alcoholic pt inhaling infection form

47
Q

Tx of sporthrix

A

itraconazole, KI (cutaneous)

48
Q

bloating flatulence foul smelling diarrhea + camping/hiking

A

Giardia

49
Q

bloody diarrhea + travel to tropics/mexico

A

Entamoeba histolytica

50
Q

flask shaped ulcers on colon biopsy

A

entamoeba histolytica

51
Q

What causes chronic watery diarrhea in an AIDS pt ? When do we Prophylactically tx?

A

Cryptosporidium

<50 (<100 CD4 count)

52
Q

multiple ring enhancing lesions in CNS

A

brain abscesses of Toxoplasma - but look for AIDS

Also Glioblastoma

53
Q

Congential Toxoplasmosis

A

chorioretinitis (neonatal blindness)

hydrocephalus
intracranial calcifications

54
Q

Tx of Toxoplasma - what CD # do we prophylax?

A

Sulfadiazine, pyrimethamine
CD# <100

55
Q

Primary sources of Toxoplasma

A
  1. undercooked pork
  2. Cat feces
56
Q

In immunocompetent pt, how does Toxoplasma look?

A

Like mono - but heterophile Ab test (-)

57
Q

Diving in warm water - what organism?

A

Naegleria fowleri

58
Q

How does Naegleria lead to meningoencephalitis?

A

Crawling up the cribriform plate

59
Q

why is there a recurring fever with Trypansoma?

A

antigenic variation

Covered in variant surface glycoproteins

Ab fight it —> fever –> new VSG

60
Q

Transmission of Trypansoma from ?

A

Tsetse fly

61
Q

Sx of Typansoma

A

African sleeping sickness

enlarged l.n., recurring fever, large red chancre at bite site –> somnolence –> coma

62
Q

Diff b/w P. vivax/ovale and P malariae fever cycle

A

Vivax and ovale - 48 hr fever cycle

malariae - 72 hr fever cycle

63
Q

What is p. falciparum fever cycle? why is it diff?

A

No regular fever spikes - Fever spikes due to RBC lysis, but unlike vivax/ovale/malariae the lysis of RBC is not synchonized, but occur individually - keeps the fever up

64
Q

dormant form of p vivax/ovale - lives where?

How do we treat this form?

A

Liver - hypnozoite

Add Primaquine for radical cure

65
Q

P falciparum infects what? leads to?

A

parasite infected RBC will occlude capillaries in brain, kidneys, lung —> tissue hypoxia, lactic acidosis, hypoglycemia

66
Q

Transmission of Plasmodium

A

Anopheles mosquito

67
Q

Vector for Babesia? Also transmits which other organisms?

A

Ixodes tick

same as Borrelia burgdorferi (Lyme) & Anaplasma

(Ehrlichia is Lone star tick Amblyomma)

68
Q

Sx of Babesia

A

fever and hemolytic anemia

69
Q

What can predispose one to more severe form of Babesia?

A

asplenia (thru op or practically)

70
Q

Which people have natural immunity vs Plasmodium?

A

HbS heterozygote protected from p falciparum

Duffy blood group neg - from p. vivax

Thalassemia/Ab Normal Hgb - from plasmodium

71
Q

unilateral periorbital swelling

A

Chagas disease - T cruzi

72
Q

What cell type does T cruzi infect –> what are the consequences?

A

cardiac musc and smooth m. –> dilated cardiomyopathy, megacolon, mega esophagus

73
Q

Vector for T Cruzi?

A

Reduviid bug (kissing bug)

Triatomine insect

74
Q

vector of Leishmania?

A

sandfly

75
Q

foul smelling, greenish discharge from vagina

A

Trichomonas vaginalis

76
Q

Which nematodes do you get from ingesting them?

A

Enterobius
Ascaris
Toxocara
Trichinella
Trichuris

77
Q

Which nematodes come thru the skin?

A

Strongyloides, Ancyclostoma, Necator

78
Q

Nematode transmitted thru bite

A

Loa Loa, Onchocerca volvulus
Wulchereria bancrofti

79
Q

Causes anal pruritus

A

Enterobius vermicularis

pin worm

80
Q

May cause obstruction at ileocecal valve, biliary obstruction, intestinal perforation, migrates from nose/mouth

A

Ascaris lumbricoides (giant roundworm)

81
Q

young child, can see larvae in sputum

A

Ascaris lumbricoides

82
Q

causes microcytic hypochromic anemia

A

Ancylostoma , Necator

AN iron sucker

83
Q

From wild game

A

Trichinella spiralis

84
Q

fever, vomiting, nausea, periorbital edema, myalgia, splinter hemorrhages, eosinophils

A

Trichinella spiralis

85
Q

loose stools, anemia, rectal prolapse in children

A

Trichuris trichiura (whipworm)

TrichuRIS - Rectum is Slipped

Step 1 2019 First Aid Flashcards (63 decks)

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