Fungi and Parasites

Question 1

what fungi is NOT dimorphic

Answer 1

coccidioidomycosis

is a spherule not yeast in tissue

Question 2

general rule for Tx of fungi

Answer 2

fluconazole or itraconazole for local infections

amphotericin B for systemic

Question 3

Histoplasmosis

Answer 3

Miss/Ohio river valleys
Histo Hides in macrophages
bird/bat droppings

Question 4

blastomycosis

Answer 4

east of Miss river and central america
granulomatous nodules
broad base budding

Question 5

coccidioidomycosis

Answer 5

SW US
increased rates after earthquake
spherule

Question 6

paracoccidioidomycosis

Answer 6

latin america

budding yeast w/captains wheel formation

Question 7

dermatophytes

Answer 7

cutaneous infections
microporum
trichophyton
epidermophyton
branching spetate hyphae on KOH prep

Question 8

tinea versicolor

Answer 8

malassezia
yeast like
spaghetti and meatballs

Question 9

aspergillus fumigatus

Answer 9

in lung cavities post TB
produce aflatoxins -> hepatocellular carinoma
45 degree angles

Question 10

crytococcus

Answer 10

encapsulated
soil, pigeon droppings
latex agglutination
‘soap bubble’ lesions in brain

Question 11

rhizopus

Answer 11

mucor
usually in ketoacidosis or neutropenic
black eschar on face
irregular, broad,k nonseptated, brr at wide angles

Question 12

when do you start prophylaxis for Pneumocystis jirovecii

Answer 12

CD4

Question 13

how does sporothrix schenckii spread?

Answer 13

lymph

Question 14

giardia

Answer 14

cysts in water

trophozoites or cysts in stool

Question 15

entamoeba histolytica

Answer 15

amebiasis- bloody diarrhea, liver abscess, flask shaped ulcer
cysts in water
trophozoites in RBCs, cysts (up to 4 nuclei) in stool

Question 16

cryptosporidum

Answer 16

severe diarrhea in AIDS
mild disease in normal
oocytes in water
oocytes acid-fast stain

Question 17

Toxoplasma gondii

Answer 17

triad: chorioretinitis, hydrocephalus, intracranial calcifications
cysts in meat
oocytes in cats feces

Question 18

Naegleria fowleri

Answer 18

rapidly fatal meingoencephalitis
swimming in freshwater lakes
(fresh water in nalgene bottle)
amoebas in spinal fluid

Question 19

trypanosoma brucei

Answer 19

african sleeping sickness
enlarged lymph nodes, recurring fever, somnolence, coma
tsetse fly (painful bite)
Tx: suramin, melarsoprol

Question 20

plasmodium vivax/ovale

Answer 20

48hr cycle

dormant hypnozoite in liver

Question 21

P. falciparum

Answer 21

severe, irregular fever patterns

cerebral malaria

Question 22

P. malariae

Answer 22

72hr cycle

Question 23

Dx of malaria

Answer 23

trophozoite ring w/in RBC

red granules, schuffner stipping

Question 24

babesia

Answer 24

babesiosis
fever, hemolytic anemia
NE US
asplenic increased rick 
often co-infection w/Lyme 
Maltese cross on blood smear

Question 25

trypanosoma cruzi

Answer 25

``` chagas disease dilated cardiomyopathy megacolon/esophagus south america U/L periorbital swelling (Romana sign) in acute stage Reducid (kissing) bug ```

Question 26

leishmania donovani

Answer 26

visceral leishmaniasis spiking fevers, hepatosplenomegaly, pancytopenia sandfly amastigotes in macros

Question 27

Trichomonas vaginalis

Answer 27

strawberry cervix

Question 28

enterobisu vericularis

Answer 28

fecal-oral aka pin worms Tx: bendazoles

Question 29

ascaris lumbricoides

Answer 29

F-O eggs visible in feces under microscope intestinal infection Tx: bendazoles

Question 30

stronyloides

Answer 30

larvae in soil penetrate skin intestinal infection Ivermectin or bendazoles

Question 31

ancylosoma duodenale and nector americanus

Answer 31

hookworms larvae penetrate skin intestinal infection bendazoles or pyrantal pamoate

Question 32

trichinella spiralis

Answer 32

F-O, undercooked pork intestinal infection trichinosis-fever, vomiting, periorbital edema, myalgia bendazoles

Question 33

onchocerca volvulus

Answer 33

female blackfly bite hyperpigmented skin and river blindess ivermetin

Question 34

loa loa

Answer 34

deer fly, horse, fly, mango fly swelling in skin, worm in conjunctiva diethylcarbamazine

Question 35

Wuchereria bancrofti

Answer 35

female mosquito elphantiasis (takes 9mo-1yr) diethylcarbamazine

Question 36

toxocara canis

Answer 36

F-O visceral larva migrans bendazoles

Question 37

which nematodes are ingested?

Answer 37

``` EATT Enterobius Ascaris Toxocara Trichinella ```

Question 38

Which nematodes enter cutaneously

Answer 38

SANd Strongyloides Ancylostoma Necator

Question 39

Which nematodes enter via a bite?

Answer 39

LOW Loa loa Onchocerca volvulus Wuchereria bancrofti

Question 40

taenia solium encysted in undercooked pork

Answer 40

tapeworm GI infection Tx praziquantel

Question 41

tanenia solium eggs

Answer 41

tapeworm cysticercosis, neurocysticercosis Tx praziquantel, albendazole for neuro

Question 42

Diphyllobothrium latum

Answer 42

tapeworm ingestion of larvae from raw freshwater fish Vit B12 deficiency -> megaloblastic anemia Tx praziquantel

Question 43

Echinococcus granulosus

Answer 43

``` tapeworm ingestion of eggs from dog feces sheep intermediate host hydatid cysts in liver (must inject w/ethanol before removal) Tx albendazole ```

Question 44

schistosoma haematobium

Answer 44

``` fluke snails host, cercariae penetrate skin of humans hepatosplenomegaly SCC of bladder and pulmonary HTN Tx praziwuantel ```

Question 45

Clonorchis sinenssi

Answer 45

undercooked fish biiary tract inflammation -> pigmented gallstones assocaited w/cholangiocarcinoma Tx praziquantel

Question 46

biliary tract disease, cholangiocarcinoma

Answer 46

clonorchis sinensis (trematode)

Question 47

brain cysts seizures

Answer 47

tanenia solium (tapeworm)

Question 48

hematuria, SCC bladder

Answer 48

Schistosoma haematobium

Question 49

liver (hydatid) cysts

Answer 49

Echinococcus ganulosus (tapeworm)

Question 50

microcytic anemia

Answer 50

Ancylostoma, Necator

Question 51

Myalgia, periorbital edema

Answer 51

Trichinella spiralis

Question 52

perianal pruritus

Answer 52

enterobius

Question 53

portal HTN

Answer 53

Schistosoma

Question 54

Vit B deficiency

Answer 54

diphyllobothrium latum