Fungal infections

Question 1

Tissue phase of Candida

Answer 1

Pseudomycelium

Question 2

Candida species that accounts for most human infections

Answer 2

Albicans

Question 3

Candida species that forms a germ tube when incubated with rabbit or human serum for 1-2 hours

Answer 3

Albicans

Question 4

Tx for Candida that is inactive against approx 20% of C. lusitaniae

Answer 4

Amphotericin B

Question 5

Tx for Candida that is useful for many infections but is inactive against ALL strains of C. krusei and 5-25% of C. glabrata

Answer 5

Fluconazole

Question 6

3rd MCC of bloodstream infection in premature infants

Answer 6

Candida species

Question 7

Significant risk factors for neonatal invasive candidiasis

Answer 7

Prematuriy, LBW, broad-spectrum antibiotics, abdominal surgery, presence of central venous catheter

Question 8

T/F CNS involvement is common in neonatal candidiasis

Answer 8

T, meningoencephalitis

Question 9

Thrombocytopenia is sensitive but not specific; it occurs in 80% of preterm infants with ___, 75% with ___, and nearly 50% with ___

Answer 9

Invasive candidiasis, G- sepsis, G+ sepsis

Question 10

In the absence of systemic manifestations, ___ is the treatment of choice for congenital cutaneous candidiasis in FULL-TERM infants

Answer 10

Topical antifungal therapy

Question 11

In the absence of systemic manifestations, ___ is the treatment of choice for congenital cutaneous candidiasis in PRETERM infants

Answer 11

Systemic therapy

Question 12

Systemic antifungal therapy should be administered for how long in neonates

Answer 12

21 days from last positive Candida culture

Question 13

Mainstay of therapy for systemic candidiasis and is active against both yeast and mycelial forms

Answer 13

Ampho B deoxycholate

Question 14

T/F Oral thrush/candidiasis is a clue for investigation of immunocompromised condition in newborns

Answer 14

F, affects ~2-5% of normal newborns

Question 15

MC isolated species in cases of oral thrush

Answer 15

C. albicans

Question 16

MC prescribed antifungal agent for oral thrush

Answer 16

Nystatin

Question 17

Treatment for recalcitrant or recurrent oral thrush

Answer 17

Single dose fluco

Question 18

MC infection caused by Candida among infants

Answer 18

Diaper dermatitis

Question 19

Presumptively treat any diaper rash present for ___ with topical antifungal therapy such as nystatin, clotrimazole, or miconazole

Answer 19

> 3 days

Question 20

T/F Candida spp are the most common cause of paronychia and onychomyosis

Answer 20

F, Trichophyton and Epidermophyton

Question 21

Candida paronychia often respond to treatment consisting of

Answer 21

Keeping hands dry and using topical antifungal agent

Question 22

More than 80% of cases of vulvovaginitis are caused by

Answer 22

Candida albicans

Question 23

Candida vulvovaginits is common among what age group

Answer 23

Pubertal and postpubertal females

Question 24

Candida vulvovaginitis treatment

Answer 24

Vaginal creams or troches of nystatin, clotrimazole, or miconazole

Question 25

MCC of invasive candidiasis among immunocompromised pediatric patients

Answer 25

Albicans

Question 26

Candida spp associated with higher rates of mortality and end-organ involvement

Answer 26

Albicans

Question 27

MC Candida infections in HIV-infected children

Answer 27

Oral thrush and diaper dermatitis

Question 28

Candida in HIV-infected children: Fiery erythema of the mucosa or loss of papillae of the tongue

Answer 28

Atrophic candidiasis

Question 29

Candida in HIV-infected children: Oral symmetric white plaques

Answer 29

Chronic hyperplastic candidiasis

Question 30

Candida in HIV-infected children: Erythema and fissuring of the angles of the mouth

Answer 30

Angular cheilitis

Question 31

Fungal infections especially Candida and Aspergillus are a significant problem in oncology patients with what hematologic abnormality

Answer 31

Chemo-induced neutropenia

Question 32

Population of cancer patients with a much higher risk of fungal infections because of dramatically prolonged duration of neutropenia

Answer 32

BM transplant recipients

Question 33

Decreases incidence of candidemia in BM transplant recipients

Answer 33

Fluconazole prophylaxis

Question 34

T/F Solid organ transplant patients are at increased risk for superficial and invasive Candida infections

Answer 34

T

Question 35

Chronic mucocutaneous candidiasis is a group of heterogeneous immune disorders with a primary defect of ___

Answer 35

T-lymphocyte responsiveness to Candida

Question 36

Conditions associated with chronic mucocutaneous candidiasis

Answer 36

Hypoparathyroidism, hyperimmunoglobulin E syndrome (Job syndrome), autoimmune disorders, HIV, inhaled corticosteroid use

Question 37

Predominant pathogenic fungal infection among persons infected with HIV

Answer 37

C. neoformans var. neoformans

Question 38

3rd MC invasive fungal infection after candidiasis and aspergillosis in organ transplant patients

Answer 38

Cryptococcosis

Question 39

In most cases, C. neoformans is acquired by

Answer 39

Inhalation of fungal spores, <5-10um, which are engulfed by alveolar macrophages

Question 40

Most important host defense for producing granulomatous inflammation and thus containing cryptococcal infection

Answer 40

Cell-mediated immunity

Question 41

MC form of cryptococcosis

Answer 41

Pneumonia

Question 42

MC predisposing factor for disseminated cryptococcosis

Answer 42

Advanced HIV infection

Question 43

MC clinical manifestation of disseminated cryptococcal infection

Answer 43

Subacute or chronic meningitis

Question 44

Most useful diagnostic test for C. neoformans

Answer 44

Latex agglutination test that detects cryptococcal antigen in serum and CSF

Question 45

T/F Immunocompetent patient with asymptomatic or mild cryptococcosis may be closely observed without therapy

Answer 45

T

Question 46

T/F Immunocompetent patient with asymptomatic or mild cryptococcosis may be treated with oral antifungals

Answer 46

T, fluco or itraconazole

Question 47

Staged approach for patients with cryptococcemia or severe symptoms and immunocompromised hosts

Answer 47

1) Induction chemotherapy with Amphotericin B + Flucytosine 2) Consolidation therapy with oral Fluconazole or Itraconazole 3) Lifelong maintenance therapy for children who remain immunocompromised

Question 48

Where are C. neoformans seen in nature

Answer 48

Bird droppings