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fungal infections Flashcards

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1
Q

risk factors for fungal disease

A

dampness
poor circulation
post menopause
suppressed immune system
nail and skin injury
Abx use
low vitamin D
DM

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2
Q

dry and scaly

A

tinea

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3
Q

moist and beefy

A

candida

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4
Q

superficial fungal infection of the skin caused by dermatophytes trichophyton

A

tinea infections

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5
Q
  • pt notices a balding patch
    -dry crusting scalp
    -dry,flaking well defined around plaque like lesion
A

tinea capitis

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6
Q

tinea capitis treatment

A

oral terbinafine (kids per 4)
griseofulvin (kids over 2)

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7
Q

-inflamed dry patches/plaques within the beard
-may itch
-may have yellow crusting
-tender

A

tinea barbae

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8
Q

tinea barbae treatment

A

oral terbinafine, griseofulvin,flucanoazole

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9
Q

-often from infected pet
-itchy
-annular lesion with advancing scaly border and central clearing

A

tinea corporis

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10
Q

tinea corporis prevention

A

-treat infected pets
-use foot powder
-keep feet dry
-wear clean socks

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11
Q

tinea corporis treatment

A

topical terbinafine

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12
Q

-itching of skin of genitals, inner thighs and buttock
-intertriginous areas
-burning sensation
-annular shaped erythematous lesions with raised scaly borders and a clear center

A

tinea cruris (jock itch)

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13
Q

tinea cruris (jock itch) prevention

A

miconazole nitrate drying powder for excessive perspiration or protection of skin folds

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14
Q

tinea cruris (jock itch) treatment

A

topical terbinafine

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15
Q

-most often presents with asymptomatic scaling
-may progress to fissuring or maceration in toe web spaces
-itching, burning
-scaling palms and soles

A

tinea pedis (athletes foot)

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16
Q

tinea pedis treatment (macerated stage)

A
  1. aluminum acetate (domeboro) solution soak
  2. PLUS topical cream (azoles or ciclopirox)
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17
Q

-thickened yellow brittle deformed nail
-possible loss of nail or partial nail

A

onychomycosis

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18
Q

tinea pedis treatment (dry and scaly stage)

A

any broad spectrum antifungal cream

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19
Q

how to confirm onychomycosis

A

clipping

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20
Q

onychomycosis treatment (toenail)

A

Terbinafine

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21
Q

-velvety,tan,pink,or white macule that do not tan with sun exposure
-fine scales that are not visible but are seen by scraping the lesion
-young adults/teenagers
-central upper trunk
-spaghetti and meatballs seen under microscope (KOH)

A

tinea versicolor

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22
Q

tinea versicolor treatment

A

oral fluconazole 300mg 14 days apart

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23
Q

-typically a noninvasive yeast that can be found in stool,urine,mouth,genitalia,skin
-normal part of GI and GU microbiota

A

candidiasis

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24
Q

risk factors for candidiasis

Study These Flashcards
A

-Abx
-IV/inhaled/oral steroids
-DM
-burns
-IV/Foley catheter

25
-itching, burning/sore throat -dysphagia/odynophagia -possible pain at sides of lips -thick,white plaques on the tongue or oropharyngeal mucosa -beefy red appearance
candidiasis oropharyngeal
26
hallmark of candidiasis
white plaques that bleed easily and can be scraped away with a tongue depressor (it is friable)
27
candidiasis oropharyngeal treatment
fluconazole ketoconazole nystatin mouth rinse
28
-cracked lips -red swollen corners of the mouth -white patches*
candidiases cheilitis
29
how to diagnose candidiases cheilitis
clinical
30
-common -white discharge, itching, irritation, dysuria, dyspareunia -risk factors: Abx, intercourse, pregnancy, oral contraceptives, DM
vulvovaginal candidiasis
30
candidiases cheilitis treatment
nystatin, ketoconazole, clotrimazole
31
how to diagnose vulvovaginal candidiasis
swab of vaginal sidewall and discharge
32
vulvovaginal candidiasis treatment
single dose fluconazole
33
-itching around the glans penis -red,swollen foreskin/glans penis -possible white discharge around the glans penis
balanitis
34
balanitis treatment
topical nystatin ointment
35
-skin condition caused by maceration of skin due to heat, moisture, and friction -irritating agents -in skin folds -exposure to urine,feces,sweat -pruritic -stinging burning -beefy red rash -WATCH for secondary bacterial infection
intertrigo
36
intertrigo treatment
-good hygiene -keep dry -drying powders -topical antifungal (imidazole or clotrimazole with hydrocortisone)
37
-usually in patients with indwelling catheter -fever,chills -dysuria,urgency,hesitancy -flank or abdominal pain
candidal cystitis: funguria
38
how to diagnose candidal cystitis
urine analysis: should contain yeasts or pseudohyphae
39
candidal cystitis treament
usually resolves with discontinuance of Abx or removal of bladder catheter
40
persistant symptomatic funguria treatment
PO fluconazole
40
-immunosuppressed pts -substernal odynophagia -gastroesophageal reflux -pts may have thrush, but not always
esophageal candidiasis
41
how to diagnose esophageal candidiasis
by endoscopy with biopsy and culture
42
esophageal candidiasis treatment
If patients can swallow: fluconazole severe illness/inability to swallow: IV fluconazole
42
-inhaled fungi found in soil from bat and bird droppings -most prevalent endemic mycosis in north america -ohio and Mississippi River valley -eastern Canada,mexico,central America,south America,africa,southeast asia -soil, humidity, and acidity
histoplasmosis
43
hallmark of histoplasmosis
activities that stir up dirt: plowing soil, spelunking (cave exploring), excavation,demolition of old homes, cleaning chicken coops, bats
44
histoplasmosis labs
combination of first morning urine and serum polysaccharide antigen assays has 83% sensitivity for diagnosis of acute pulmonary histoplasmosis
45
histoplasmosis treatment
mild/moderate: itraconazole severe: IV amphotericin B
46
-rare disease thought to be a result of an abnormal immunologic response to antigens released by histoplasma capsulatum
fibrosing mediastinitis
47
- most common cause of fungal meningitis -frequently found in soil and bird feces -inhaled -pulmonary symptoms -can be simple nodules or widespread infiltrates and respiratory failure
cryptococcosis
48
how to diagnose cryptococcosis
-culture of respiratory secretions or pleural fluid -lumbar puncture for suspected CSF involvement -chest xray and CT show a solitary pulmonary nodule
49
-coccidioides immitis or C. posadasii -fungus that inhabits arid soil of the southwestern US (California, Arizona)*** -an opportunistic organism in immunosuppressed patients Primary: -fever,chills,HA,body aches -erythema nodosum
coccidiodomycosis (valley fever)
50
hallmark of coccidiodomycosis (valley fever)
soil of southwestern US (California,arizona)
51
coccidiomycosis labs
CBC- leukocytosis and eosinophilia ELISA- IgM antibodies CSF- lymphocytosis, reduced glucose, complement fixing antibodies
52
coccidioidomycosis treatment
symptomatic for limited disease with progression--> itraconazole or fluconazole
53
-inhaled and most commonly infects the pulmonary tissue -usually occurs in immunocompetent individuals who work outside** -outdoor activities -abrupt onset fever, chills,body aches -pleuritic chest pain -cough: productive or nonproductive
blastomycosis
54
blastomycosis labs
-CBC: leukocytosis, anemia -grows readily in culture -organism found in expectorated sputum or tissue biopsy -lobar consolidation*
54
blastomycosis treatment
mild/moderate: itraconazole sever: IV amphotericin B

infectious disease (13 decks)

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