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Fungal infections Flashcards

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1
Q
A
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2
Q

What are the differences between yeasts and moulds?

A

Yeasts are single-celled and reproduce by budding, while moulds are multicellular, grow by branching and extension of hyphae.

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3
Q

List at least 2 examples of yeasts.

A
  • Candida spp.*
  • Cryptococcus spp.*
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4
Q

List at least 2 examples of moulds.

A
  • Aspergillus spp.*
  • Dermatophytes*
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5
Q

What are the possible clinical presentations of Candida infections?

A
  • Oral candidiasis*
  • Vulvovaginitis*
  • Cutaneous candidiasis*
  • Candidaemia*
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6
Q

What are the general risk factors for fungal disease?

A

Immunosuppression, malignancies, prolonged antibiotic use, diabetes, and indwelling devices.

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7
Q

What are the three targets of antifungals?

A
  • Cell membrane*
  • Cell wall*
  • Nucleic acids*
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8
Q

What is the commonest cause of fungal infections in humans?

A

Candida spp.

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9
Q

What is the clinical manifestation of oral candidiasis?

A

Painful mouth and white patches on the tongue.

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10
Q

What type of diagnostic tests are used for fungal infections?

A
  • Clinical diagnosis*
  • Fungal microscopy and culture*
  • Skin scrapings*
  • Blood cultures*
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11
Q

What is the treatment for oral thrush?

A

Nystatin

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12
Q

What is the treatment for vulvovaginitis caused by Candida?

A

Clotrimazole or fluconazole.

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13
Q

What organism causes cryptococcosis?

A

Cryptococcus neoformans and Cryptococcus gattii.

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14
Q

Which animal is Cryptococcus associated with?

A
  • Bats*
  • Pigeons*
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15
Q

What is the risk factor for cryptococcosis?

A

Impaired T-cell immunity, especially in HIV patients.

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16
Q

What is the management for cryptococcal meningitis?

A
  • Induction: Amphotericin B + flucytosine*
  • Consolidation: High dose fluconazole*
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17
Q

What is the typical stain used for cryptococcal diagnosis?

A

India ink.

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18
Q

What type of disease does Aspergillus cause?

A

A spectrum of disease from allergic reactions to invasive infections.

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19
Q

What are the risk factors for Pneumocystis jiroveci pneumonia?

A
  • Immunodeficiency*
  • Immunosuppressive drugs*
  • Severe protein malnutrition*
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20
Q

What is the treatment for Pneumocystis pneumonia?

A

High dose cotrimoxazole.

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21
Q

What are the clinical features of mucormycosis?

A
  • Rhinocerebral infections*
  • Cellulitis of the orbit and face*
  • Pulmonary disease*
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22
Q

What is the primary antifungal treatment for mucormycosis?

Study These Flashcards
A

Ambisome or Posaconazole.

23
Q

What is tinea pedis commonly caused by?

Study These Flashcards
A

Trichophyton rubrum.

24
Q

What is the diagnosis for dermatophyte infections?

Study These Flashcards
A
  • Skin scrapings*
  • Nail specimens*
  • Plucked hairs*
25
Match the antifungal class to its associated side effect: Azoles.
Abnormal LFTs.
26
Match the antifungal class to its associated side effect: Polyenes.
Nephrotoxicity.
27
Match the antifungal class to its associated side effect: Echinocandins.
Blood disorders.
28
Match the antifungal class to its associated side effect: Pyrimidine analogues.
Relatively innocuous.
29
True or False: Fungi have cholesterol in their cell membranes.
False.
30
What is the primary component of fungal cell membranes?
Ergosterol.
31
What are Echinocandins?
Cyclic lipopeptide antibiotics that interfere with fungal cell wall synthesis by inhibition of ß-(1,3) D-glucan synthase
32
What is the primary target for antifungal therapy related to the cell membrane?
Ergosterol
33
What are the major classes of antifungal agents?
* Azoles * Polyenes * Echinocandins * Pyrimidine analogues
34
What is the main side effect associated with Echinocandins?
Relatively innocuous
35
What side effect is most often associated with Azoles?
Abnormal LFTs
36
What is a common side effect of Polyenes?
Nephrotoxicity
37
Fill in the blank: Fungi use principally _______ instead of cholesterol.
ergosterol
38
What is the action of Azole antifungals?
Inhibit the production of ergosterol by binding to lanosterol 14α-demethylase
39
What is a notable characteristic of Polyene antibiotics?
They bind sterols in the fungal cell membrane
40
Which antifungal is known to have a classic formulation with serious toxic side effects?
Amphotericin B deoxycholate (Fungizone™)
41
What is the mechanism of nephrotoxicity associated with Amphotericin B?
* Renovascular mechanisms * Tubular mechanisms
42
What are the less toxic preparations of Amphotericin B?
* Liposomal amphotericin B * Amphotericin B colloidal dispersion * Amphotericin B lipid complex
43
What is the restricted spectrum of activity for Flucytosine?
Candida and cryptococcosis
44
What are common clinical presentations of Candida infections?
* Oral thrush * Cutaneous intertrigo * Oesophagitis * Vulvovaginitis * Candidiasis * Endocarditis * Urinary tract infections
45
What are the general risk factors for fungal disease?
* Immunodeficiency * Immunosuppressive medications * Inhaled steroids * Malignancy * Burns * Complicated postoperative conditions * Long lines * Diabetes
46
What diagnostic tests are used for diagnosing fungal infections?
* MC&S * Biopsy for histology * Serology (BDG/GM/Abs/Ag, CRAG) * PCR * Imaging
47
What are the three targets of antifungals?
* Cell membrane * DNA/RNA synthesis * Cell wall
48
True or False: Echinocandins have activity against Cryptococcus neoformans.
False
49
What distinguishes yeasts from moulds?
* Yeasts: single celled, reproduce by budding (e.g., Candida, Cryptococcus) * Moulds: multicellular hyphae, grow by branching and extension (e.g., Aspergillus, dermatophytes)
50
What is the effect of Azoles on steroidneogenesis?
Impairment
51
What are the common clinical presentations of Cryptococcus infections?
* Pulmonary symptoms (SOB, cough, CXR changes) * CNS symptoms (chronic/subacute meningitis, raised pressures)
52
What types of diseases can Aspergillus cause?
* Mycotoxicosis * Allergy * Sequelae (e.g., ABPA, colonization of cavities, systemic/fatal disease)
53
What is the mechanism of action for Pyrimidine analogues?
Interfere with DNA/RNA synthesis
54
What can enhance nephrotoxicity in patients treated with Amphotericin B?
Volume depletion or concomitant nephrotoxic agents

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