Microbiology - Mycology & Parasites Flashcards
(84 cards)
1
Q
Systemic mycoses
A
- can cause pneumonia and can desseminate
- dimorphic fungi
- cold (20 C) = mold; heat (37C) = yeast
- Only exception is coccidioidmycosis, which is spherule (not yeast)
- can mimic TB (granuloma formation) except there is no person to person contact
2
Q
Treatment for systemic mycoses
A
Fluconazole or Itraconazole for LOCAL infecton
3
Q
Systemic mycoses (Name them) - Hint 4
A
Histoplasmosis
Blastomycosis
Coccidiomycosis
Paracoccidiomyocosis
4
Q
Histoplasmosis
A
- found in MIssissippi and Ohio River Valleys
- Causes pneumonia
Macrophage filled with Histoplasma (smaller than RBC) - Found in bird or bat droppings
5
Q
Blastomycosis
A
- found in states east of MS River or Central America
- Causes inflammatory lung disease and can disseminate to skin and bone
- Forms granulomatous nodules
- Broad-base budding (same size as RBC)
6
Q
Coccidiomycosis
A
- found in Southwestern US, California
- Causes pneumonia and meningitis
- Can desseminate to bone and skin
- Case rate increases after earthquakes (spores in dust are thrown up in aire and becomes spherules in lungs)
- Spherules flled with endospores (much larger than RBC)
7
Q
Paracoccidiomycosis
A
Latin America
Budding yeat with “captain’s wheel” formation (much larger than RBC)
8
Q
Tinea versicolor
A
- caused by Malassezia furfur
- degradation of lipids that causes acids that damages melanocytes and cause hypopigmented and/or hyperpigmented patches
- Occurs in hot, humid weather
9
Q
Treatment for tinea versicolor
A
Topical miconazole, selenium sulfide (Selsun
10
Q
“Spaghetti and meatball” appearance on KOH prep
A
Tinea versicolor
11
Q
Other tinae
A
Tinea pedis (foot) Tinea cruris (groin) Tinea corporis (ringworm on body) Tinea capitis (head, scalp) Tinea unguium (Onychomycosis, on fingernails)
12
Q
Appearance of tinea
A
Pruritic lesions with central clearning resembling ring, caused by dermatophytes (Microsporum, Trichophyton, Epidermophyton)
- See mold hyphae on KOH
13
Q
Candida albicans
A
- opportunistic fungal infections
- systemic or superficial infection
- oral or esophageal thrush in immunocompromised pts (AIDS, diabetes, steroids, neonates)
- vulvovaginitis (diabetic patents)
- endocarditis in IV drug users
14
Q
Treatment of Candida albicans
A
- Topical azole for vulvovaginitis
- fluconazole or caspofungin for oral/esophageal thrush
- Fluconazole, amphotericine B or caspofungin for systemic disease
15
Q
Aspergillus fumigatus
A
Invasive aspergillosis, especially in immunocompromised and those with chronic granulomatous disease
- Aspergillomas found in lung cavities, especially after TB infection
- Acute Angles in Aspergillus
16
Q
Aspergillus fumiagtus infection with asthma or CF
A
Allergic bronchopulmonary aspergilosis (APBA)
17
Q
Discuss Aspergillus and Hepatocellular carcinoma
A
- some Aspergillus species produce ANAFLATOXINS associated with HCC
18
Q
Cryptococcus neoformans
A
Opportunistic fungal infection
Cryptococcal meningitis, Cryptococcosis
Heavily encapsulated yeast. Not dimorphic.
- Acquired through inhalation with hematogenous dissemination to meninges
- “Soap bubble” lesions in brain
19
Q
Diagnosis for Cryptoccocus neoformans
A
- “Soap bubble” lesions in (HIV patienty?)
- Culture on Sabouraud’s agar
- Stains with India ink
- Latex agglutination test detects polysaccharide capsular antigen (is more specific)
20
Q
Mucor and Rhizopus spp.
A
Mucormycosis
- Disease mostly in ketoacidotic diabetic and leukemic patients
- Fungi proliferate when there is excess ketone and glucose, penetrate cribiform plate, and enter brain
- Rhinocerebral, frontal lobe abcesse
21
Q
Sx: Occurs in ketoacidotic diabetic and leukemic patients
Headache, facial pain, black necrotic eschar on face, may have cranial nerve involvement
A
Mucor and Rhizopus spp.
22
Q
Pneumocystis jirovecci
A
Causes PCP, a diffuse interstitial pneumonia
- Inhaled. Most infections are assymptomatic
- Immunosuppression (e.g. AIDS) predisposes to disease.
23
Q
Diagnosis of Pneuocystis jirovecci
A
- Diagnosed by lung biopsy or lavage
- Disc shaped yeat forms on methenamine silver stain of lung tissue
- Diffuse, bilateral CXR
24
Q
Tx of pneumocystis jirovecci
A
TMP-SMX, pentamidine, dapsone
- Start prophylaxis when CD4 drops < 200 cells/mm
25
Sporothrix schenckii
Sporotrichosis
Dimorphic, cigar shaped budding yeast that lies on vegetation
- "Rose Gardner's disease" - when spores are traumatically introduced by skin (e.g. thorn)
- Causes local pustule or ulcer with nodules along draining lymphatics (ascending lymphaginitis)
- Little systemic illness
26
Treatment of sprothrix schenckii
Itracanazole or Potasium iodid
27
Opportunistic Fungal Infections
- Candida albicans
- Aspergillus fumagitus
- Cryptococcus neoformans
- Pneumocystis jirovecci
- Sporothrix schenckii
- Mucor and Rhizopus spp
28
GI infection protozoas
Giardia lamblia
Entamoeba histolytica
Cryptosporidium
29
Giardia lamblia
Giardiasis: bloating, flatulence, foul-smelling, fatty diarrhea (often seen in campers/hikers) -
30
Giardia lamblia transmission
Cysts in water
31
Diagnosis of Giardia lamblia
Trophozoites or cysts in stool
32
Treatment of Giardia Lamblia
Metronidazole
33
Entamoeba histolytica
Amebiasis: bloody diarrhea (dysentery), liver abscess ("anchovy paste" exudate
- RUQ pain
- Histology: flash-shaped ulcer is submucosal ulcer in colon ruptures
34
Transmission of Entamoeba histolytica
Cysts in water
35
Treatment of Entamoeba histolytica
Metronidazole
| Iodoquinol for assymptomatic cyst passers
36
Diagnosis of Entamoeba histolytica
Serology and/or
Trophozoites (with RBCs in the cytoplasm)
Cysts (with multiple nuclei) in stool
37
Cryptosporidium
```
Severe diarrhea in AIDS
Mild disease (watery diarrhea in healthy individuals)
```
38
Transmission of cryptosporidium
Cysts in water
39
Diagnosis of Cryptosporidium
Cysts in acid-fast stain
40
Treatment of Cryptosporidium
Prevention ( by filtering city water supplies)
| Nitazoxamide in immunocompotent host
41
Protoza-CNS infections
```
Toxoplasma gondaii
Naegleria fowleri
Trypanosomas brucei
T. gambiense
T. rhodesiense
```
42
Toxoplasma gondii
Brain abscess in HIV (seen in ring-ENHANCING lesions on CT/MRI)
43
Triad of Congenital Toxoplasmosis
Chorioretinitis
Hydrocephalys
Intracranial calcifications
44
Transmission of toxoplasma gondii
```
Cysts in meat or cat feces;
Crosses placenta (pregnant women should avoid cats)
```
45
Diagnosis of Toxoplasma Gondii
Serology
Biopsy
"Crescent shaped trophozoite within macrophages)
46
Treatment of Toxoplasma Gondii
Sulfadiazine + Pyremethamine
47
Naegleria fowleri
Rapidly fatal meningoencephalitis
- transmitted by swimming FRESHWATER lakes, enters via cribiform plate
- diagnosed by amoebas in spinal cord
Tx: amphotericin (for the few survivors)
48
Trypanosoma brucei
African sleeping sickness
- enlarged lymph nodes, recurring fever (due to antigenic variation)
- Somnolence, Coma
- transmitted by Tsetse fly, a painful bite
- diagnosed by blood smear
49
Treatment of Trypanosoma brucei (African sleeping sickness)
Suramin for blood borne disease
Melarsoprol for CNS penetration
Melatonin helps with sleep
50
Protozoa for Hematologic infections
Plasmodium
| Babesia
51
Plasmodium
P. vivax/ovale
P. falciparum
P. malariae
Malaria: fever, headache, anemia, splenomegaly - seen in Africa, India
- transmitted by Mosquito (Anopheles)
52
P. vivax/ovale
malaria
- 48 hour cycle (tertian; includes fever on 1st day thus fevers are 48 hours apart)
- Dormant form (hypnozite) in liver - infects NEW RBCs
53
P. faciparum
sever; irregular fever patters
parasitized RBCS - infects ALL RBCs
- occlude capillaries in brain (cerebral malaria), kidneys, lungs
54
P. malariae
72 hours cycle
55
Malaria Diagnosed
Blood smear
Trophozoite ring form
RBC schizpont with merozoites
56
Treatment of malaria
Chlorquine - blocks Plasmodium heme polymerase
- Mefloquine
- Life threatening: quinidine (but test for G6PD deficiency
- Vivax/ovale - add primaquine if hypnozoite (test for G6PD deficiency)
57
Trypanosoma cruzi
Chagas disease:
- dilated cardiomyopathy
- mega colon, megaesophagus
- predominantly in South America
- transmitted by Reduviid bug ("kissing bug")
- diagnosed by blood smear
- treated with Nirfurtimox
58
Leischemasia donovani
Visceral leischmaniasis
(kala-azar)- hyperpigmented skin pattches
Sx: Spiking fevers, Hepatosplenomegaly
Pancytopenia
- transmitted by sandfly
- diagnosed with macrophages containing amastigotes)
- treated with Sodium stibogluconate
59
Trichomonas vaginalis
Vaginitis: foul-smelling, GREENISH discharge; itching and burning
- transmitted by sex (can't exist outside of human)
- diagnosed by trophozoites (MOTILE) on wet mount
- treatmetn: metronidazole for patient and partner
** Not be confused with Gardnerella vaginella (bacterium)
60
Enterobious vemicularis (pinworm)
- nematodes (roundworm)
- get by ingesting food contaminated with eggs
- intestinal infection causing anal pruritis (diagnosed via Scotch tape tes)
- treated with benzadoles or pyrantel pamoate
61
Ascaris lumbricoides (giant roundworm)
- nematodes (roundworm)
- transmitted fecal-orally; eggs visible in feces in microscope
- intestinal infection
- - treated with benzadoles or pyrantel pamoate
62
Strongyloides stercolaris
- nematodes (roundworm)
- larvae in soil penetrate the skin
- intestinal infection causing VOMITING, DIARRHEA, ANEMIA
- treatment: ivermectin or albendazole
63
Acylostoma duodenale, Nectar americanicus
| Hook worms
- nematodes (roundworms)
- larvae penetrate skin
- intestinal infection causing anemia by sucking blood from intestinal walls
- treatment: bendazoles or pyrantel pamoate
64
Dracunulus medinesis (Guinea worm)
- nematodes (roundworms)
- found in drinking water
- causes skin inflammation and ulceration
- treatment: slow extraction of worm
65
Onchocera volvuls
- nematodes (roundworm)
- transmitted by female blackfly bite
- causes hyperpigmented skin and river blindness
- possible allergic reaction to microfilaria
- treatment: ivermectin
66
Loa Loa
- nematodes
- roundworm
- transmitted by deerfly, horsefly, mangofly
- causes swelling in skin, worm in conjunctiva
- treatment: diethylcarmabazine
67
Wuchereria bancrofti
- nematodes
- block lymphatic vessels
- elephantiasis: takes 9 months - 1 year after bite to become symptomatic
- treatment: diethylcarbamazine
68
Toxocara canis
- nematodes
- transmitted by food containing eggs
- causes visceral larva migrans (moving larvae)
- treatment albendazole or mebendazole
69
Nematodes routes of infection
Ingested ("EAT") - Enterobius, Ascaris, Toxocara
Cutaneous ("SANd") - Strongyloides, Ancylostoma, Necator
70
Taenia solium
- tapeworm
- ingestion of larvae in undercooked pork
- ingestion of eggs
- can cause intestinal infection and cystercosis (infect skeletal muscle),
neurocysticosis
- treatment: praziquantel (and - bendazole for neurocysticercosis)
71
Diphyllobothrium latum
- tapework
- tapeworm (cestodes)
- ingesting of larvae from raw fish
- can cause Vitamin B12 deficiency (tapeworm competes for Vitamin B12) --> anemia
- treatment: praziquantel
72
Echinococcus granulosus
- tapeworm
- cestodes (tapeworm)
- ingestion from eggs from dog feces
- cysts in liver, causing anaphylaxis if antigens release (surgeons inject ethanol to kill cysts)
- treatment: - bendazoles
73
Shistosoma
- trematodes (flukes)
- transmitted by snailes; cercarie penetrate human skin
- cause liver and spleen granulomas and inflammation
- chronic infection with S. haematobium can lead to SCC of bladder
- treatment: praziquantel
74
Clonorchis sinensis
- trematodes (flukes)
- found in undercooked fish
- can cause biliary tract inflammation --> pigmented gallstones
- associated with cholangiocarcinoma
- treatment: praziquantel
75
Paragonimus westermani
- trematodes
- found in undercooked crab meat
- can cause lung inflammation and secondary bacterial infection, with hemoptysis
- treatment: praziquantel
76
Parasite : Brain cysts, seizures
Taenia solium (cysticercosis)
77
Parasite: liver cysts
Echinococcus granulosus
78
Parasite: Vitamin B 12 deficiency
D. latum
79
Parasite: Biliary tract disease, cholangiosarcoma
Clonorchis sinesis
80
Parasite: Hemoptysis
Paragonimus westermani
81
Parasite: Portal hypertension
Schistosoma mansoni
82
Parasite: Hematuria, bladder cancer
Schistosoma haematobium
83
Parasite: microcytic anemia
Ancylostoma, Necator
84
Paraisite: perianal pruritis
Enterobius
