Antifungals

Question 1

What is the etiology of superficial mycoses candidiasis?

Answer 1

Common normal flora that can become an opportunistic pathogen

Question 2

What fungals can cause candidiasis?

Answer 2

Albicans
Glabrata
Krusei
Parapsilosis

Question 3

What are some risks for candidiasis?

Answer 3

Chronic disease(CKD, HIV, DM)
Medications(corticosteriods, immunosuppressants, broad abx)
Vascular access(IV drugs, intravascular catheters)
Other(Recent surgery, prolonged neutropenia, organ transplant)

Question 4

Who usually gets oral candidiasis?

Answer 4

Infants
Elderly
DM pts
Immune deficient
After use of abx/sterioids

Question 5

What are symptoms of oral candidiasis?

Answer 5

Early: asymptomatic
Later: abnormal/diminished taste, pain with eating/swallowing

Question 6

What shows on a PE for oral candidiasis?

Answer 6

Beefy red, edematous mucosa of oral cavity
White plagues in the mouth(removable)

Question 7

How do you diagnose oral candidiasis?

Answer 7

Clinically
KOH prep(budding yeasts, pseudohyphae)
Culture

Question 8

How do you treat oral candidiasis?

Answer 8

Nystatin
Clotrimazole
Miconazole
Fluconazole(PO, rest are topical)
Gentian violet

Question 9

Who usually gets esophageal candidiasis?

Answer 9

HIV+
Immunosuppressed

Question 10

What are symptoms of esophageal candidiasis?

Answer 10

Odynophagia(painful swallowing)
Nausea
Reflux
Oral thrush(PE finding)

Question 11

How do you diagnose esophageal candidiasis?

Answer 11

Endoscopy

Question 12

How do you treat esophageal candidiasis?

Answer 12

Fluconazole(PO, IV)
Itraconzaole(PO)
Voriconazole, posaconazole, echinocandin(if resistant to fluconazole)

Question 13

Who usually gets vulvovaginal candidiasis?

Answer 13

75% of women once in their lifetime
HIV
Pregnancy
Abx use
Uncontrolled DM

Question 14

What are the symptoms of vulvovaginal candidiasis?

Answer 14

Itching, burning, pain around genital area
“cottage cheese” discharge

Question 15

What are the PE findings of vulvovaginal candidiasis?

Answer 15

Erythematous, edematous mucosa
Erythema, edema, excoriations of external genitialia
“cottage cheese” discharge(removable)

Question 16

How would you diagnose vulvovaginal candidiasis?

Answer 16

Clinically
KOH prep
Culture

Same as CE

Question 17

How do you treat VC?

Answer 17

Miconazole, clotrimazole, terconazole (topical)
Fluconazole, Ibrexafungerp (PO)
Azoles, probiotics (prophylactic)
Gentian violet, boric acid

Question 18

Who usually gets candidiasis intertrigo?

Answer 18

Warm, moist environments(skin folds)
Obese
Tight clothes
Sweating
Incontinence
DM
Immosupression meds

Question 19

What are some symptoms of CI?

Answer 19

Could be symptomatic
Itching or burning

Question 20

What shows up on a PE for CI?

Answer 20

Plagues on skin folds
Papules and pustules

Question 21

How do you diagnose CI?

Answer 21

Same as CV and CE

Question 22

How do you treat CI?

Answer 22

Weight loss, control DM, different clothes
Talc, nystatin powder
Topical azaleas or nystatin
Fluconazole(PO)

Question 23

How do you treat CI?

Answer 23

Weight loss, control DM, different clothes
Talc, nystatin powder
Topical azaleas or nystatin
Fluconazole(PO)

Question 24

What are all the dermatophytes(tines) and location?

Answer 24

Capitis: scalp
Corpis: body(ring worm)
Cruris: groin(jock itch)
Pedis: food(athletes foot)
Unguium: nail(onychomycosis)
Versicolor: body(not a true tinea)

Question 25

What does dermatophytes feed off of?

Answer 25

Keratin
Infect skin, nails, and hair

Question 26

What shows up on a KOH prep for dermatophytes?

Answer 26

Segmented hyphae

Question 27

Who usually gets T capitis?

Answer 27

Children
Spread via child-to-child contact

Question 28

How is T capitis presented?