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Nelson - Exam 3 (IDS) > Fungal infections > Flashcards

Fungal infections Flashcards

1
Q

Tissue phase of Candida

A

Pseudomycelium

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2
Q

Candida species that accounts for most human infections

A

Albicans

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3
Q

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

A

Albicans

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4
Q

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

A

Amphotericin B

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5
Q

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

A

Fluconazole

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6
Q

3rd MCC of bloodstream infection in premature infants

A

Candida species

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7
Q

Significant risk factors for neonatal invasive candidiasis

A

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

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8
Q

T/F CNS involvement is common in neonatal candidiasis

A

T, meningoencephalitis

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9
Q

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

A

Invasive candidiasis, G- sepsis, G+ sepsis

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10
Q

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

A

Topical antifungal therapy

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11
Q

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

A

Systemic therapy

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12
Q

Systemic antifungal therapy should be administered for how long in neonates

A

21 days from last positive Candida culture

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13
Q

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

A

Ampho B deoxycholate

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14
Q

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

A

F, affects ~2-5% of normal newborns

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15
Q

MC isolated species in cases of oral thrush

A

C. albicans

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16
Q

MC prescribed antifungal agent for oral thrush

A

Nystatin

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17
Q

Treatment for recalcitrant or recurrent oral thrush

A

Single dose fluco

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18
Q

MC infection caused by Candida among infants

A

Diaper dermatitis

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19
Q

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

A

> 3 days

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20
Q

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

A

F, Trichophyton and Epidermophyton

21
Q

Candida paronychia often respond to treatment consisting of

A

Keeping hands dry and using topical antifungal agent

22
Q

More than 80% of cases of vulvovaginitis are caused by

A

Candida albicans

23
Q

Candida vulvovaginits is common among what age group

A

Pubertal and postpubertal females

24
Q

Candida vulvovaginitis treatment

A

Vaginal creams or troches of nystatin, clotrimazole, or miconazole

25
Q

MCC of invasive candidiasis among immunocompromised pediatric patients

A

Albicans

26
Q

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

A

Albicans

27
Q

MC Candida infections in HIV-infected children

A

Oral thrush and diaper dermatitis

28
Q

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

A

Atrophic candidiasis

29
Q

Candida in HIV-infected children: Oral symmetric white plaques

A

Chronic hyperplastic candidiasis

30
Q

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

A

Angular cheilitis

31
Q

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

A

Chemo-induced neutropenia

32
Q

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

A

BM transplant recipients

33
Q

Decreases incidence of candidemia in BM transplant recipients

A

Fluconazole prophylaxis

34
Q

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

A

T

35
Q

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

A

T-lymphocyte responsiveness to Candida

36
Q

Conditions associated with chronic mucocutaneous candidiasis

A

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

37
Q

Predominant pathogenic fungal infection among persons infected with HIV

A

C. neoformans var. neoformans

38
Q

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

A

Cryptococcosis

39
Q

In most cases, C. neoformans is acquired by

A

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

40
Q

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

A

Cell-mediated immunity

41
Q

MC form of cryptococcosis

A

Pneumonia

42
Q

MC predisposing factor for disseminated cryptococcosis

A

Advanced HIV infection

43
Q

MC clinical manifestation of disseminated cryptococcal infection

A

Subacute or chronic meningitis

44
Q

Most useful diagnostic test for C. neoformans

A

Latex agglutination test that detects cryptococcal antigen in serum and CSF

45
Q

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

A

T

46
Q

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

A

T, fluco or itraconazole

47
Q

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

A

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

48
Q

Where are C. neoformans seen in nature

A

Bird droppings

Nelson - Exam 3 (IDS) (21 decks)

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