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Flashcards in L60 Deck (20):
1

Which 3 fungi should you be thinking about for opportunistic mycoses due to altered T cell fxn?

1. MUCOCUT candidasis
2. Cryptococcosis
3. Pneumocystosis

2

What are the 3 AIDs defining illnesses?

Cryptococcosis
Pneumocystosis
Esophageal candidasis

3

What 3 fungi should you be thinking about for opportunistic mycoses due to altered phagocytic activity?

INVASIVE candidiasis
Aspergillosis
Zygomycosis

4

Why must you be immune compromised to get a candida infection?

B/c part of normal flora otherwise!

5

What are some examples of mucocutaneous candidasis infections? (Aka these are how you should be thinking of these infections presenting in the ED)

Oral thrush
Esophageal
Epiglottis
Onychomycosis
Vulvovaginal

6

Who are some patients that would develop mucocutaneous candidasis?

Those w/ defective T cells:
- Corticoidsteroids (inhaler)
- AIDs
- Women on birth control
- Diabetes
- Babies
- Antibiotics
- Elderly

7

What are some examples of systemic/deep candida infections?

Candidemia
Endocarditis
Heptosplenic

8

Which patients are at risk for systemic candida infections?

Leukemia/lymphoma (neutropenic)
+ Catheter to ICU pt
Trauma, burns
Transplant pts
EYES!

9

What will you see on scraping sample for candida infections?

All 3!
Hyphae
Pseudohyphae
Budding cells

10

What inherited condition would present with skin candida infections?

APECED - recessive
- Polyendocrinopathy
- Candidosis
- Ectodermal dystrophy

11

Treat mucocutaneous candidiasis

Topical clotrimazole
Severe: PO fluconazole

12

Treat systemic candidiasis

Echinocandins - big guns!!

13

Candida VFs

Surface receptors = adhesion
Enzymes
Host mimcry
Dimorphism - opposite of usual!

14

What toxin does aspergillus produce? Why is this so concerning?

Aflatoxin
Liver toxic/carcogenic!

15

Where in the environment would you find aspergillus/its toxin?

Peanut or grain plants

16

Talk through the pathogenesis of aspergillosis invasion and infection in the LUNG

Inhale conidia
Impaired immune host - alveolar macrophages don't kill the inhaled fungus
Germinate
Hyphae invade lung parenchyma
Angioinvasion b/c defective neutrophils
- Infarction
May or may not spread throughout vasculature

17

Shape and classification of aspergillus

Angular
Dichotomous (Y)
Branching
Septate
W/ hyphae

18

What is the difference between the pathogenesis for aspergillus infection in neurtopenic vs immune suppressed patients?

Neutropenia:
- Coag necrosis
- Dissemination (nothing to fight it leaving site of infection)

Immune suppression
- Inflam necrosis
- Local invasion

19

What are the 2 lung lesions you might see with aspergillus infection?

Halo sign
Crescent sign

20

Treat aspergillosis

Voriconazole