Fungal infections

Question 1

What are fungi?

Answer 1

Eukaryotic organisms with a true nuclei

Question 2

What are the two types of fungi?

Answer 2

Yeasts and moulds

Question 3

What are yeasts?

Answer 3

unicellular, round or oval cells which reproduce by budding or fission

Question 4

What are moulds?

Answer 4

multi-cellular also called filamentous fungi, produce hyphae

Question 5

What are dermatophytes?

Answer 5

Moulds

Question 6

What are dermatophytes associated with?

Answer 6

infections of skin, nail and hair

Question 7

What common symptoms do dermatophytes cause?

Answer 7

itching, burning, pain and irritation

Question 8

What is tinea corporis?

Answer 8

Ringworm of the skin

Question 9

What is tinea cruris?

Answer 9

Ringworm of the groin

Question 10

What is tinea capitis?

Answer 10

Ringworm of the scalp

Question 11

What is first line treatment for tinea corporis and cruris?

Answer 11

Topical imidazole:
clotrimazole or miconazole
Terbinafine is an alternative

Question 12

What oral therapy can be used for ringworm if needed?

Answer 12

Terbinafine 250mg OD
Itraconazole 100mg OD
Griseofulvin rarely given

Question 13

What is the treatment for Tinea Capitis?

Answer 13

Ketoconazole, selenium sulphide shampoos or terbinafine cream twice weekly for 2 weeks.
Oral:
Griseofulvin 1g OD
Terbinafine 250mg OD for up to 4 weeks

Question 14

What is Griseofulvin active against?

Answer 14

Microsporidium

Question 15

What is Terbinafine effective against?

Answer 15

Trichophyton tonsurans

Question 16

What is Griseofulvin only active against?

Answer 16

Dermatophytes

Question 17

Does Giseofulvin persist in keratinous tissue after end of therapy?

Answer 17

No

Question 18

What is griseofulvin contraindicated in?

Answer 18

Patients with severe liver disease & SLE

Question 19

Can griseofulvin be used if breastfeeding?

Answer 19

No

Question 20

How long should women avoid pregnancy for after taking griseofulvin?

Answer 20

one month

Question 21

How long should men not father a child for after taking griseofulvin?

Answer 21

6 months

Question 22

What are the main side effects of griseofulvin?

Answer 22

GI & headache, cognitive

Question 23

What does griseofulvin interact with?

Answer 23

oral contraceptives
coumarins
possibly cyclosporin

Question 24

What should griseofulvin be taken with or after?

Answer 24

Fatty food

Question 25

What is Tinea pedis?

Answer 25

Athlete's foot

Question 26

What species can cause athletes foot?

Answer 26

Trichophyton rubrum Trichophyton mentagrophytes Epidermophyton floccosum

Question 27

What is first line treatment for athlete's foot?

Answer 27

Imidazole cream 2-4 week | Terbinafine cream 1 week

Question 28

What is the oral treatment for athlete's foot?

Answer 28

Terbinafine 250mg OD 2-6 weeks Itraconazole 100mg OD for 30 days or 200mg BD for 7 days Griseofulvin 500mg OD in divided doses for 4-8 weeks

Question 29

Does terbinafine concentrate in keratinous tissue?

Answer 29

Yes

Question 30

What should terbinafine be avoided in?

Answer 30

Pregnancy Liver disease Renal impairment

Question 31

What are the side effects of terbinafine?

Answer 31

GI disturbances Hepatotoxicity Serious skin reations

Question 32

What interacts with terbinafine?

Answer 32

Rifampicin | OCP

Question 33

What species comonly cause onchomycosis?

Answer 33

Trichophyton rubrum Epidermophyton floccosum Trichophyton mentagrophytes Candida

Question 34

What is 1st line treatment for onchmycosis?

Answer 34

Terbinafine 250mg OD for 6 weeks to 3 months for finger nails (3-6 months for toe) Itraconazole 200mg BD for 7 days subsequent courses at 21 day intervals. 2 pulses for giners, 3 pulses for toes

Question 35

What is the topical treatment for onchomycosis?

Answer 35

Amorolfine once or twice weekly. 6 months nails, 9-12 months toe nails

Question 36

What is pityriasis versicolor?

Answer 36

Colonisation of the stratum corneum by Malassezia

Question 37

Where is pityriasis versicolor usually found?

Answer 37

patches on the trunk, neck and shoulders

Question 38

What is the topical treatment for pityriasis versicolor?

Answer 38

Ketoconazole shampoo Selenium sulphide shampoo Clotrimazole, econazole, ketoconazole or miconazole creams

Question 39

What is the systemic treatment for pityriasis versicolor?

Answer 39

Itraconazole 200mg OD 7 days | Fluconazole 50mg OD for 2 to 4 weeks

Question 40

What is the topical treatment of Oropharyngeal candidia ?

Answer 40

Miconazole oral gel 7 days | Nystatin suspension 7 days

Question 41

What is the oral treatment for Oropharyngeal candidia ?

Answer 41

Fluconazole 50mg OD for 7-14 days

Question 42

What are the risk factors for cutaneous candidiasis?

Answer 42

Systemic antibiotics, HIV, skin conditions, skin maceration

Question 43

How does cutaneous candidiasis present?

Answer 43

Prutitus and irritation, burning and pain

Question 44

What is the oral treatment for cutaneous candidiasis?

Answer 44

Fluconazole 50mg OD 2-4 weeks