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8th > Chapter 162- Deep fungal infections > Flashcards

Chapter 162- Deep fungal infections Flashcards

1
Q

Sporadic diseases contracted in the tropics, subtropics caused by fungi that have been introduced directly into dermis or subcutaneous tissue

A

Subcutaneous mycoses

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2
Q

Etiology of Sporotrichosis (5)

A 
S. Schenkii
S. Brasiliensis
S. Globosa
S. Lurieie
S. Mexicana
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3
Q

One impt characteristic of sporotrichosis

A

Scarcity of organisms in tissue

Asteroid body

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4
Q

More common forms of sporotrichosis

A

Lymphangitic form

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5
Q

Patients with AIDS who develop sporotrichosis often who have multiple cutaneous lesions with prominent lymphatic involvement.
True or False

A

False, without

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6
Q

Molds should be confirmed to yeast phase on enriched media at 37 C

A

Brain heart infusion agar

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7
Q

Sporotrichosis may resolve spontaneously but persist for more than ___ years

A

3

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8
Q

Treatment for Sporotrichosis (2)

A

Itraconazole 200 mg daily
Terbinafine 250 mg daily
KI 4-6 ml TID for 3-4 weeks

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9
Q

Infection of chest wall is most characteristic of

A

Nocardia infection

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10
Q

Key to establishing diagnosis of mycetoma

A

Grains

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11
Q

Black grains are always caused by ___; Red grains are always caused by ___

A

Fungi

Actinomycetes

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12
Q

Matching type

  1. Pale white to yellow grains
  2. Yellow to brown grains
  3. Red to pink grains

A. Streptomyces brasiliensis
B. Actinomadura pelletieri
C. Actinomadura madurae
D. Nocardia brasiliensis

A

C D
A
B

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13
Q

Treatment for Eumycetoma

A

Itraconazole 200 mg
Ketoconazole 200mg
Voriconazole 200- 400 mg

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14
Q

Actinomycetoma is treated with

A

Dapsone + Streptomycin

TMP-SMX + Rifampin / streptomycin

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15
Q

Definitive treatment for mycetoma

A

Surgery

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16
Q

Used in recalcitrant Nocardia infections

A

Amikacin
Moxifloxacin
Imipenem

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17
Q

Chronic fungal infection caused by pigmented (dematiaceous) fungi implanted into dermis

A

Chromoblastomycosis

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18
Q

In chromobalstomycosis, they form thick walled single cells or cell clusters termed as ___ with paeudoepitheliomatous hyperplasia

A

Sclerotic or muriform bodies

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19
Q

Etiologic agent of chromoblastomycosis

A 
Philaophora verrucosa
Fonsacea pedrosoi
Fonsacea compactm
Cladophialophora carrionii
Wangiella dermatitidis
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20
Q

Treatment for chromoblastomycosis

A

Itraconazole 200 mg daily
Terbinafine 250mg daily
If extensive,
IV amphotericin B 1mkday

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21
Q

Etiology for phaeohyohomycosis

A

Exophiala jeanselmei

Wangiella dermatitidis

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22
Q

Appear in immunosuppressed patients as short, irregular pigmented hyphae

A

Phaeohyohomycosis

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23
Q

Cystic lesions casued by nonpigmented hyphae

A

Hyalohyphomycotic cysts

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24
Q

Etiologic agent by lobomycosis

A

Lacazia loboi

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25
Q

Treatment for lobomycosis

A

Surgical removal

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26
Q

SubQ mucormycosis characterized by woody cellulitis at limb girdle sites is caused by

A

Basidiobolus ranarum

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27
Q

Subq mucormycosis present in the inferior turbinates of nose with painless swelling of central part of the face with severe deformity is caused by

A

Conidiobolus coronatus

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28
Q

Treatment for subQ mucormycosis

A

Ketoconazole 400 mg daily
Itraconazole 100-200mg daily
KI 4-6 drops TID

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29
Q

Development of polyps affecting mucous membranes esp nasal mucosa

A

Rhinosporidiosis

30
Q

Rhinosporidiosis is characterized by development of polyps studded with white flecks called

A

Sporangia

31
Q

2 main varietis of endemic mycoses

A

Opportunistic mycoses

Endemic respiratory mycoses

32
Q

Erythema nodosum may be caused by

A

Endemic mycoses

33
Q

Sexual state of Histoplasma capsulatum

A

Ajellomyces capsulatus

34
Q

Matching type

  1. Biologic therapy
  2. DM
  3. Heart valve surgery
  4. Abdominal surgery

A. Candidiasis
B. Endemic mycosis
C. Mucormycosis

A

B
C
A
A

35
Q

Neutropenic patients are predisposed to (3)

A

Aspergillosis
Candidiasis (Oropharyngeal, Systemic)
Mucormycosis

36
Q

Patients with CD4 lymphopenia (3)

A

Candidiasis (oropharyngeal)
Cryptococcosis
Endemic respiratory mycoses

37
Q

This type of histoplasmosis is more common in HIV positive patients with widespread dissemination to liver, spleen, lymphoreticular system, and bone marrow

A

Acute progressive disseminated histoplasmosis

38
Q

The most common presentation of chronic progressive disseminated histoplasmosis are (3)

A

Oral or pharyngeal ulceration
Hepatosplenomegaly
Adrenal insufficiency

39
Q

T. Marneffei is differentiated from Histoplasma by its

A

Septum formation

40
Q

Intradermal histoplasmin skin test is not useful as disseminated histoplasmosis is often negative.
True or False

A

True

41
Q

Rising complement fixation antibodies in histoplasmosis indicates

A

Dissemination

42
Q

Precipitins by immunodiffusion are valuable due to presence of (2) antibodies

A

H- active infection

M- recent infection

43
Q

MC involved sites of African Histoplasmosis

A

Skin, bone&raquo_space; lymph nodes

44
Q

African Histoplasmosis is caused by

A

Histoplasma capsulatum var. duboisii

45
Q

Disseminated or localized histoplasmosis is treated with

A

Itraconazole 200-400mg daily

46
Q

Blastomyces is a chronic mycosis caused by the dimorphic pathogen of

A

Blastomyces dermatitidis

47
Q

Chief site of involvement of blastomycosis are

A

Lungs

48
Q

Common presenting feature of disseminated blastomycosis

A

Skin manifestations

Hyperkeratotic, symmetric, affects face and extremities

49
Q

Exposed to a cave, and presented with cough, chest pain, fever with accompanying joint pains and rash - toxic erythema, EN, or EM

A

Acute Pulmonary Histoplasmosis

50
Q

Precipitating antibodies are present in the sera of infected patients, and a characteritic precipitin line

A

E band

51
Q

Aside from Itraconazole, treatment for blastomycosis

A

Voriconazole for 6 months

52
Q

Characteristic of coccidioidomycosis is a large spore containing structures in infected tissue in coccidioidomycosis

A

Spherules

53
Q

Matching type

  1. Nodule or indurated ulcer
  2. Chancre
  3. Indurated nodule
  4. Acneiform pustules
  5. Echthyma Gangrenosum
  6. Target like lesions
A. Blastomycosis
B. Coccidiodomycosis
C. Histoplasmosis
D. Aspergillosis
E. Cryptococcosis
F. Fusarium
A 
C
A
B
E
D
54
Q

Most common clinical type of coccidiodomycosis

A

Primary pulmonary form

55
Q

Precipitins develop in approximately 90% within ___ in coccidiodomycosis

A

2-6 weeks

56
Q

Characteristic of more severe infections and increases to a maximum in 6 months

A

Complement fixing antibodies

57
Q

Types of coccidioidomycosis with better prognosis

A

Skin and joint

58
Q

Dimorphic fungus with respiratory tract infection with tendency to disseminate to mucous membranes and lymph nodes

A

Para coccidioidomycosis

59
Q

Para coccidioidomycosis mainly affects males due to presence of ___ on the fungus wherein ___ suppresses concersion of mycelium to yeast

A

Cytoplasmic estrogen receptor

Estradiol

60
Q

Numbers of round yeasts with a characteristic form of multiple budding

A

Para coccidioidomycosis

61
Q

(2) antibodies are highly specific for this infection in immunoblotting

A

Pb27

87kDa

62
Q

Natural infections are known to occur in ___

A

Cannonys bamboo rats

63
Q

T. Marneffei is a green or grayish mold that produces typical ___

A

Conidiophores

64
Q

The most common clinical manifestation of cryptococcosis

A

Meningoencephalitis

65
Q

Cryptococcosis are observed by direct microscopy of ___

A

India ink

Nigrosin

66
Q

The most frequently used drug regimen in the nonAIDS patients

A

IV Amphotericin B + Flucytosine

67
Q

In systemic candidiasis, skin lesions can occur in (2)

A

Neutropenic patients

IV drug users

68
Q

Cause disease in patients with poorly controlled DM, neutropenia, or renal disease

A

Mucormycosis

69
Q

Mucormycosis in close apposition of skin with contaminated dressings is caused by

A

Rhizopus rhizopodiformis

70
Q

Mucormycosis in wooden tongue depressors

A

Rhizopus microsporus

71
Q

Aspergillosis can be detected by using

A

Galactomannan assays

8th (28 decks)

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