Fungi

Question 1

endemic mycoses

Answer 1

blastomycoses, histoplasmosis, coccidioidomycosis, sporotrichosis, paracoccidioidomycosis

Question 2

opportunistic yeasts

Answer 2

candida, cryptococcus

Question 3

opportunistic molds

Answer 3

aspergilus, mucormycosis

Question 4

dimorphic mycoses

Answer 4

yeast in the heat, mold in the cold

all are endemic mycoses

Question 5

superficial mycoses

Answer 5

Tinea ____

Question 6

General treatment for endemic mycoses

Answer 6

itraconazole (for mild to moderate infections)
amphotericin B (for severe infections)
6-12 month treatment

Question 7

Blastomycosis morphology

Answer 7

multinucleate broad based budding yeasts

systemic pyogranulomatous infection

Question 8

Blastomycosis geographic distribution

Answer 8

southeastern and south central US, great lakes region

Question 9

Blastomycosis clinical aspects

Answer 9

most infections are symptomatic, chronic pneumonia, can disseminate to skin, mimics malignancy

Question 10

Diagnosis of endemic mycoses

Answer 10

smears with KOH, GMS or PAS stains
culture (Sabouraud dextrose agar)- grows as a mold in the culture
urine antigen detection

Question 11

Histoplasmosis morphology

Answer 11

yeasts with narrow-based budding, often within macrophages

intracellular yeasts within PMNs

Question 12

Histoplasmosis geographic location

Answer 12

Ohio and Mississippi river valleys

Question 13

Histoplasmosis transmission

Answer 13

bird or bat poop in caves (spelunkers are at increased risk)

Question 14

Histoplasmosis clinical aspects

Answer 14

majority of infections are asymptomatic, pneumonia, mucosal ulcers

Question 15

Transmission of endemic mycoses

Answer 15

all acquired primarily via inhalation

Question 16

Coccidioidomycosis morphology

Answer 16

forms spherules with endospores in host

Question 17

Coccidioidomycosis geographic location

Answer 17

southwestern US

Question 18

Coccidioidomycosis clinincal aspects

Answer 18

most are asymptomatic; pneumonia, skin infection, bone infection, joint infection, erythema nodosum

Question 19

Coccidioidomycosis treatment

Answer 19

use fluconazole in addition for CNS infection

Question 20

Sporotrichosis transmission

Answer 20

more commonly caused by inoculation than inhalation
zoonotic transmission
common in landscapers, christmas tree farmers, rose gardeners

Question 21

Paracoccidioidomycosis morphology

Answer 21

“pilot wheels” or “Mickey mouse heads”

Question 22

Paracoccidioidomycosis geographic location

Answer 22

central and south america

Question 23

Paracoccidioidomycosis treatment

Answer 23

can also use TSX (antibacterial) in addition to itraconazole or amphotericin B

Question 24

Candida morphology

Answer 24

normal human flora of GI and skin

endogenous fungi

Question 25

Candida clinical features

Answer 25

cutaneous infections, mucosal infections, invasive infections, fungemia

Question 26

Candida diagnosis

Answer 26

biopsies of tissue reveals yeast and/or pseudohyphae, blood culture

Question 27

Candida treatment

Answer 27

echinocandin

Question 28

Cryptococcus morphology

Answer 28

exogenous fungi | narrow based budding yeast with capsule

Question 29

Cryptococcus clinical aspects

Answer 29

meningitis, pulmonary disease, cutaneous manifestations

Question 30

Cryptococcus diagnosis

Answer 30

smear (with KOH, India Ink, GMS or PAS) culture antigen detection

Question 31

Cryptococcus treatment

Answer 31

Amphotericin B WITH flucytosine | **HAVE A SYNERGISTIC EFFECT TOGETHER

Question 32

Aspergilus morphology

Answer 32

septated hyphae with acute angle branching

Question 33

Aspergilus clinical aspects

Answer 33

angioinvasion (invade and occlude arteries), affects mostly immunocompromised patients, pneumonia, CNS infection, cutaneous involvement is RARE

Question 34

Aspergilus diagnosis

Answer 34

tissue histology plus culture (histology on its own isnt enough)

Question 35

Aspergilus treatment

Answer 35

voriconazole

Question 36

Mucormycosis morphology

Answer 36

broad, non-septate, right angle branching hyphae

Question 37

Mucormycosis clinical aspects

Answer 37

pneumonia, CNS infection, rhinosinusitis

Question 38

Mucormycosis diagnosis

Answer 38

biopsy and culture

Question 39

Mucormycosis treatment

Answer 39

lipid formulation of amphotericin B

Question 40

Pneumocystosis transmission

Answer 40

usually acquired via inhalation of cysts at a young age which are latent for a while

Question 41

Pneumocystosis clinical aspects

Answer 41

diffuse interstitial pneumonia, clear lung exam, but infiltrates seen on x-ray

Question 42

Pneumocystosis diagnosis

Answer 42

GMS or IMF staining on respiratory secretions, or PCR | cultrue not possile

Question 43

Pneumocystosis treatment

Answer 43

trimethoprim-sulfa (TSX), prophylaxis for high risk patients