Fungal infections (Mycology & Antifungals) Flashcards

1
Q

What are features of fungi?

A
  • Eukaryotic
  • Chitinous cell wall
  • Heterotrophic
    • Can’t synthesise their own carbon molecules from inorganic sources
  • Move by means of growth or through the generation of spores (conidia), which are carried through air or water
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2
Q

What is yeast?

A
  • Yeasts are small single celled organisms that divide by budding
    • Account for <1% of fungal species but include several highly medically relevant ones
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3
Q

What is mould?

A

Moulds form multicellular hyphae and spores

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4
Q

What is dimorphic fungi?

A

Some fungi exist as both yeasts and moulds switching between the two when conditions suit (usually based on temperature)

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5
Q

Why do only a few hundred species of fungi cause human infection?

A
  • Inability to grow at 37 degrees
  • Innate and adaptive immune response of body
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6
Q

Why is it different to treat bacteria rather than fungi?

A
  • Fungi have some components similar to humans
  • Generally much more different for fungi than bacteria because they are eukaryotic
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7
Q

What is the main target of antifungals?

A

Plasma membrane

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8
Q

What is the main component of plasma membrane in fungi?

A

Ergosterol

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9
Q

What’s the difference between human plasma walls and fungi plasma walls?

A

Human plasma walls have cholesterol and fungi plasma walls have ergosterol

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10
Q

What is similar between mammalians and fungi?

A

DNA/RNA synthesis, protein synthesis

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11
Q

What components of fungi cell wall aren’t present in humans?

A

Mannoproteins
B1,3 glucan
B1,6 glucan
Chitin

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12
Q

What 3 classes of drugs target the plasma membrane?

A
  • Polyenes - can form pores in fungal cell membrane → leakage of cations and disrupt membrane proteins
  • Azoles
  • Allylamines
    • Both inhibit ergosterol synthetic pathway
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13
Q

What is the aim of antimicrobial drug therapy?

A

to achieve inhibitory levels of agent at the site of infection without host cell toxicity
Relies upon identifying molecules with selective toxicity for organism targets

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14
Q

What features should an antimicrobial drug have?

A
  • Target does not exist in humans
  • Target is significantly different to human analogue
  • Drug is concentrated in organism cell with respect to humans
  • Increased permeability to compound
  • Modification of compound in organism or human cellular environment
  • Human cells are ‘rescued’ from toxicity by alternative metabolic pathways
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15
Q

Can a fungal infection be life threatening in a healthy host?

A

Yes but rare

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16
Q

What is a common and recurrent disease caused by fungal infection?

A

Mucosal candidiasis

17
Q

What are risk factors for Mucosal candidiasis?

A

immunosuppression, diabetes antibacterial therapy and mucosal disruption

18
Q

What would you treat Mucosal candidiasis with?

A

topical or oral azoles

19
Q

How are dermatophytes spread?

A

Human-human or animal-human transmission

20
Q

What temperature are dimorphic fungi mould?

A

Mould at ambient temperature (25-30C)

21
Q

What temperature are dimorphic fungi yeast?

A

Convert to yeast form at 37C

22
Q

What is a true pathogen?

A

infect healthy hosts

23
Q

What is the containment level or dimorphic fungi?

A

Containment level 3 (especially in mould form)

24
Q

What can cause infection from dimorphic fungi?

A

Infection via inhalation of conidia from soil or implantation

25
Q

What are examples of dimorphic fungi?

A

Coccidioides, Invasive candidiasis, cryptococcus

26
Q

What infection could a cannula cause?

A

Invasive candidiasis

27
Q

What is an infective differential diagnosis of sub-acute/ chronic meningitis?

A
  • Tuberculosis
  • Cryptococcus
  • Dimorphic fungi – Histoplasma, Coccidioides, Blastomyces
  • Lyme
  • Brucella
  • Syphilis
28
Q

What is a non-infective differential diagnosis of sub-acute/ chronic meningitis?

A
  • Sarcoidosis
  • Behçets’s
  • SLE
  • Malignant
  • Drug induced
29
Q

Who is severe disease caused in by a small number of fungi?

A

Immunocompromised