MYCOLOGY AND PARASITOLOGY Flashcards
(164 cards)
1
Q
How do you diagnose A) Toxo B) Naelgeria and C) Trypanosoma brucei?
A
A) serology and biopsy B) amoebas in CSF C) blood smear or CSF sample for later disease
1
Q
How do you treat Tanea solium intestinal infection? Neurocystericosis?
A
Intestinal = Praziquantel; Neurocysterocosis = Praziquantel + Mebendazole
2
Q
Which systemic mycosis often forms granulomatous nodules in the skin?
A
Blastomyces dermatidis
2
Q
What kind of parasite is Onchocerca volvulus?
A
nematode
3
Q
What is melarsoprol used to treat?
A
Trypanosoma brucei in the CSF
3
Q
What kind of parasite is Echinococcus granulosus?
A
Cestode (tapeworm)
3
Q
What is the Tx for Loa loa?
A
Diethylcarbamazine
3
Q
Which worms (2) cause microcytic anemia? Which worm (1) causes macrocytic anemia?
A
Microcytic = Necator americanus and Ancyclostoma duodenale; Macrocytic: Diphyllobothrium latum
3
Q
How do you treat Paragonismus westermani? How does it present?
A
Praziquantel; lung inflammation with hemoptysis
4
Q
Which systemic mycosis is common in the San Joaquin Valley?
A
Coccidiodes immitis
5
Q
What should you think if a newborn has hydrocephalus, intracranial calcifications, and chorioretinitis?
A
Congenital toxoplasmosis
5
Q
What is the Tx for Leishmania donovani?
A
Sodium stibogluconate
5
Q
How is the Tx of trichomonas different from that of bacterial vaginosis?
A
Trichomonas vaginalis and BV (gardnerella overgrowth) are both Tx’d with metronidazole, but T. vaginalis is an STD so requires Tx of the partner as well
6
Q
Which protozoal infection is an STD?
A
Trichomonas vaginalis
7
Q
What route does Cryptococcus use to get to the meninges?
A
hematogenous from lungs
7
Q
What is the reservoir for Trichomonas vaginalis?
A
Humans because cannot form cysts
7
Q
How do you become infected with Strongyloides stercoralis?
A
Larvae penetrate the skin
7
Q
How do you treat Schistosoma haematobium?
A
Praziquantel
8
Q
Name 5 nematode infections of tissues (not intestines)
A
Loa loa, Onchocerca volvulus, Dracunculus medinensis, Wucheria bancrofti, and Toxocara canis
8
Q
What protozoal infection is sodium stibogluconate used to tx?
A
Leishmania donovani
9
Q
What should you test for before beginning intravenous quinidine for malaria?
A
G6PD deficiency
10
Q
How does Naegleria fowleri infect the brain, what Tx has proven effective for a few survivors?
A
via the cribriform plate; amphotericin B
10
Q
Which nematodes can cause microcytic anemia (2)?
A
The hookworms: they suck blood from intestine = Ancyclostoma duodenale and Necator americanus
11
Q
What do microsporum, trichophyton, and epidermophyton cause?
A
These are dermatophytes and cause any of the tineas
11
KOH prep of rose gardeners disease would have what shape?
Cigar shaped dimorph (Sporothrix schenckii)
11
What kind of parasite is Loa loa?
nematode
11
What is the feared complication of Schistosoma haematobium?
Bladder cancer (hangs out in the venous plexus)
13
What is the most specific test for Cryptococcus neoformans?
Latex agglutination test
14
What will you see on KOH prep of a dermatophyte infection?
mold hyphae
15
What is the DOC for candidal vulvovaginitis (2)?
Topical Azole (inhibit ergosterol synthesis)
16
What is the treatment for systemic candidiasis (3)?
Amphotericin B (pores in membrane by binding ergosterol), Fluconazole (inhibit ergosterol synthesis), Caspofungin (inhibit cell wall by binding D glucan)
17
What is nitazoxinide used to treat?
Cryptosporidium in AIDS patients
18
How do you treat Schistosoma mansoni?
Praziquantel
19
Which fungus causes frontal lobe abscesses? What acid base status would be likely in this patient and why?
Mucor; infects ppl with DKA = metabolic acidosis with compensatory respiratory alkalosis
21
What is the Tx for Entamoeba histolytica?
Metronidazole
21
How do you get infected with Chlonorchis sinensis? Associated with what cancer? Tx?
Undercooked fish; Cholangiocarcinoma; Praziquantel
22
Which systemic mycosis is most likely found in Latin America?
Paracoccidiodes braziliense
23
Which fungus is associated with hepatocellular carcinoma?
Aflatoxins of Aspergillus can cause hepatocellular carcinoma
23
Regarding Aspergillus and Mucor/Rhizopus, which is septate and which is aseptate?
Septate = Aspergillus; Aseptate = Rhizopus
25
What fungus can cause endocarditis in an IV patient?
Candida albicans
25
What are the 3 major protozoa that cause CNS infections?
Toxoplasma gondii, Naegleria fowleri, Trypanosoma brucei (gambiense and rhodesiense)
25
What drug blocks heme polymerase in Plasmodium spp?
Chloroquine and for resistant strains, mefloquine
27
What is the Tx of Ascaris lumbricoides?
Bendazoles or pyrantel pamoate
27
What kind of parasite are Ancyclostoma duodenale and Necator americanus?
Hookworms but still nematodes
29
Why is pigmentation affected in Tinea versicolor?
The degradation of lipids by Malassezia furfur (it pefers areas with more sebaceous glands) yields acids that damage melanocytes leading to hypo or hyperpigmented patches
29
What are the 3 main dermatophytes?
Microsporum, Trichophyton, and Epidermophyton
29
What kind of parasite is Wucheria bancrofti?
nematode
30
What transmits T. cruzi?
Reduviid bug in SA
30
What transmits Leishmania donovani?
Sandfly
31
What 2 pt demographics are likely to get mucormycosis?
Diabetic Ketoacidotics and Leukemia
32
How are all flukes (schistosomes) treated?
Praziquantel (Paragonismus, Clonorchis, Schistosoma)
34
Why does African Sleeping Sickness have a recurring course?
Antigenic variation of the trophozoites
35
What would you see on a sputum sample of a person with Histoplasmosis pneumonia?
Macrophages filled with Histoplasma
36
What causes Visceral Larval Migrans? Explain.
Toxocara canis is a dog parasite so gets confused in human and stays in skin (from Keller: Ancyclostoma braziliense)
37
How do you get Diphyllobothrium latum? How do you treat it?
larvae from raw freshwater fish; praziquantel
38
How do you get Dracunculus medinensis? What is the Tx?
Drinking water (nearly eradicated by better sanitation); Surgical removal of worm (SLOWLY to prevent breaking), like wrapping it around a stick.
39
What are the 4 major GI protozoal infections?
Entamoeba histolytica, Giardia lamblia, Cryptosporidum parvum, Isospora spp.
40
What kind of parasite is Paragonismus westermani?
Trematode (fluke)
41
What is the vector for Babesia microti?
Ixodes tick
42
What are the protozoal hematologic infections?
Plasmodia (vivax, ovale, falciparum, malariae) and Babesia microti
43
What term for visceral leishmaniasis means "black fever"?
Kala-azar
45
Which systemic mycosis can disseminate to skin and bone?
Blastomyces dermatidis; sometimes Coccidiodes also (Blasto is the main one)
46
What is the Tx for ascending lymphangitis after a thorn prick?
Itraconazole or Potassium iodide (Sporothrix Schenkii)
47
What causes valley fever?
Coccidiodes immitis
47
What bug is associated with liver abscesses with an anchovy paste exudate?
Entamoeba histolytica
49
What dimorph is cigar shaped?
Sporothrix schenckii
50
Which trematode causes pigmented gallstones?
Clonorchis sinensis
51
What plasmodium spp. Causes quartan malaria?
Plasmodium malariae
52
What is the Tx for Wucheria bancrofti?
Diethylcarbamazine
53
What transmits malaria?
Anopheles mosquito
54
Regarding the non-opportunistic systemic mycoses, what is usually the first sign of infection prior to dissemination?
They present as pneumonia
54
What infection with Aspergillus fumigatus are asthma and cystic fibrosis patients likely to acquire?
Allergic Bronchopulmonary Aspergillosis
54
Which dimorph can be treated with potassium iodide?
Sporothrix schenckii
55
What kind of parasite is Ascaris lumbricoides?
nematode
56
What is the Tx for elephantiasis?
Diethylcarbamazine
57
Which fungal infections tend to mimic TB?
The systemic mycoses
58
What kind of parasite is Enterobius vermicularis?
nematode
60
Which dimorphic fungi is not actually a "yeast" in the beast?
Coccidiodes is actually a spherule NOT a yeast
62
Which disease can be diagnosed with a blood smear with macrophages that contain amastigotes?
Leishmania donovani
63
What is the Tx for entamoeba histolytica in an asymptomatic carrier?
iodoquinol
64
What is the Tx of Babesia?
Atovaquone and azithromycin
65
Which fungus penetrates the cribriform plate to enter the brain? Which protozoan?
Mucor; Naegleria fowleri
67
What is the diagnostic histological feature of Paracoccidiodes?
Budding yeast with Captain's Wheal formation?
68
What is the Tx for Malassezia furfur (2)
Topical miconazole and selenium sulfide (aka Selsun Blue)
70
Name 5 dimorphic fungi
Coccidiodes immitis, Paracoccidiodes braziliense, Blastomyces dermatidis, Histoplasma capsulatum, Sporothrix schenkii
71
What plasmodium spp causes the most severe malaria?
Plasmodium falciparum
72
Which 2 types of malaria have hypnozoites?
Vivax and ovale thus these can recur years later
73
What fungus is identified with a latex agglutination test?
Cryptococcus neoformans
74
Which protozoon is associated with flask-shaped ulcers in ruptured colon abscesses?
Entamoeba histolytica
75
How do you treat Cryptosporidium parvum?
Nitazoxinide
76
How do you treat PCP pneumonia? (3 but 1 really important) When does prophylaxis begin?
TMP-SMX (main), dapsone, and pentamidine; When CD4 less than 200
78
What is the Tx for blood-borne Trypanosoma brucei? CSF?
Suramin, Melarsoprol
78
What form is ingested to cause Taenia solium neurocystericosis? Tx?
Egg; Praziquantel and bendazoles
79
Name 3 trematodes (flukes)
Schistosoma, Clonorchis sinensis, and Paragonismus westermani
81
What is suramin used to treat?
Blood-borne trypanosoma brucei
82
What kind of parasite is Chlorchis sinensis?
Trematode (fluke)
83
What does the sandfly transmit?
Leishmania donovani
84
What kind of parasite is Toxocara canis?
nematode
86
What is a trophozoite ring on blood smear diagnostic for?
Plasmodium ring form but also Babesia; differentiate by Hx (mosquito vs. tick; U.S. vs. Africa)
87
How do you get Echinococcus granulosus?
from ingestion of eggs from dog feces
89
Name 3 tapeworms
Taenia solium, Diphyllobothrium latum, and Echinococcus granulosus
91
What kind of parasite is Schistosoma?
Trematode (fluke)
93
What do you use to stain for Pneumocystis jiroveci?
Methenamine silver
94
What are 2 visceral protozoal infections?
Trypanosoma cruzi, Leishmania donovani
95
What are the 2 Sx of Onchocerca volvulus?
Black skin nodules and African River Blindness
97
What is the classical triad of congenital toxoplasmosis?
chorioretinitis, hydrocephalus, and intracranial calcifications
99
What will you see on a blood smear of babesia that is pathognomonic for it?
Maltese cross; note: you can also see a ring form but this is also present in Plasmodium and is therefore not pathognomonic
101
What is Nitazoxinide for? Nifurtimox?
Cryptosporidium in AIDS patients; Trypanosoma cruzi
102
Which parasite can cause portal hypertension? Treatment?
Schistosoma mansoni; Praziquantel
103
Why is mucor so common in diabetic ketoacidosis?
Proliferates in blood vessels where there are lots of ketones
105
Which fungal infection is associated with an increase number of cases after earthquakes? Why?
Coccidiodes immitis, the earthquakes throw the spores up into the air
106
Foul smelling green vaginal discharge?
Trichomonas vaginalis
106
What bug is transmitted via undercooked crabmeat?
Paragonismus westermani
108
How do you get Ancyclostoma duodenale or Necator americanus?
Larvae penetrate the skin
109
Atovaquone and azithromycin is the combo given to Tx \_\_\_\_\_\_\_\_.
Babesia
110
Which intestinal infection is classically associated with IgA deficiency?
Giardia lamblia
112
What should you test for before beginning primaquine for vivax and ovale malaria?
G6PD deficiency
113
What kind of parasite is Taenia solium?
Cestode (tapeworm)
114
By prophylaxing for PCP pneumonia with __________ what other opportunistic infection are you covering?
TMP-SMX when CD4
115
What is the Tx for onchocerca volvulus?
Ivermectin
117
Which systemic mycosis is capable of causing meningitis? How would you treat it at this stage?
Coccidiodes immitis; Amphotericin B is Tx of disseminated systemic mycoses (which this is). If it were localized to lungs it would be itraconazole or fluconazole
118
Compare the transmission of Giardia, Entamoeba, and Cryptosporidium
ALL ARE FROM CYSTS IN WATER!
119
What is the DOC for oral or esophageal candidiasis (2)?
Fluconazole (inhibit ergosterol synthesis) or Caspofungin (inhibit Cell wall by binding D-Glucan)
120
What is the prophylactic Tx of toxoplasma? What is the treatment of active infection?
TMP-SMX (when CD4 under 100, but already covered by PCP); Pyrimethamine and sulfadiazine
121
What agar do you grow Cryptococcus on? What 2 stains can be used to identify it?
Sabaurod's agar? Mucicarmine and India ink
122
Name 2 parasites treated with diethylcarbamazin
Loa loa and Wucheria bancrofti
123
What is a risk factor for severe babesiosus?
Asplenia
124
What form is ingested to cause Tanea solium intestinal infection? Treatment?
Cyst form; praziquantel
125
What is the diagnostic histological feature of Coccidiodes?
Spherule
127
What causes desert bumps?
Coccidiodes (if disseminated to skin)
128
What immunodeficiency are recurrent Aspergillus infections associated with and why?
Chronic Granulomatous disease (NADPH oxidase deficiency); Aspergillus is catalase positive
129
What is the pathognomonic finding on KOH prep for tinea versicolor?
Malassezia furfur = Spaghetti and Meatballs
130
Regarding Aspergillus and Mucor, which is acute angle branching and which is right angle branching?
Right angle = Mucor and Rhizopus; Acute angle branching = Aspergillus
131
What is the Tx for visceral larval migrans?
Albendazole or mebendazole
132
Which parasite is associated with cholangiocarcinoma?
Chlonorchis sinensis
134
What kind of parasite is Diphyllobothrium latum?
Cestode (tapeworm)
136
How do you get Enterobius vermicularis? What is the treatment?
Food contaminated with eggs, mebendazole (or pyrantel pamoate)
137
Which 2 nematodes are hookworms?
Ancyclostoma duodenale, Necator americanus
138
What are the 4 NON-OPPORTUNISTIC systemic mycoses? What is the Tx for local and disseminated disease?
Coccidiodes immitis, Paracoccidiodes braziliense, Blastomyces dermatidis, and Histoplasma capsulatum; Local = fluconazole or itraconazole; Systemic = amphotericin B
139
What parasite is transmitted by the black fly?
Onchocerca volvulus
140
What is the host for Schistosoma spp.?
Snails; cercariae penetrate skin in dirty water
141
What is the triad of leishmaniaisis?
Spiking fevers, hepatosplenomegaly, and pancytopenia
142
How do surgeons prevent anaphylaxis from cyst disruption when treating hydatid cyst disease? What organism?
Inject ethanol into cyst; Diphyllobothrium latum (fish tapeworm, cestode)
143
What are the 3 chronic complications of T. cruzi how do you treat?
Megaesophagus, Megacolon, Cardiomyopathy--Tx symptomatically at that point NOT nifurtimox
144
What bacterial infection can the systemic mycoses mimic?
Tuberuclosis due to the formation of granulomas
146
What kind of parasite is Strongyloides stercoralis?
nematode
147
How do you get Loa loa?
Deerfly, Mango fly, and Horsefly
148
What systemic mycosis can cause meningitis? What opportunistic fungus?
Systemic = Coccidides immitis; Opportunistic = Cryptococcus neoformans
149
What infection is a likely antecedent to an Aspergilloma?
TB; An Aspergilloma is a "fungal ball", TB leaves cavities and Aspergillus gets in and forms a fungal ball
150
What is the Tx for Toxocara canis?
Albendazole or mebendazole
151
What does the Tsetse fly transmit?
Trypanosoma brucei (African Sleeping Sickness)
152
How do you get Giardia? What is the Tx of nonpregnant vs. pregnant?
Cysts in water; metronidazole; paraMOMycin for pregnant moms
153
What causes soap bubble lesions of the brain? Soap bubble lesions of bone?
Cryptococcus neoformans; Giant cell tumor of bone (osteoclastoma)
154
What "vector" is Histoplasma associated with?
Bird and bat droppings (In Ohio and Mississippi river valleys)
155
Which cutaneous mycosis is treated with topical miconazole and selenium sulfide?
Malassezia furfur = Spaghetti and Meatballs
156
What are 5 major opportunistic fungi?
Cryptococcus neoformans, Aspergillus fumigatus, Candida albicans, Mucor and Rhizopus, and Pneumocystis jiroveci
157
What is the Tx of Strongyloides stercoralis?
Ivermectin or albendazole
158
What kind of parasite is Dracunculus medinensis?
nematode
159
What is the treatment for B12 deficiency caused by the fish tapeworm?
Praziquantel
160
Name 4 intestinal protozoal infections
Giardia lamblia, Isospora, Crytptosporidium parvum, and Entamoeba histolytica
161
What Plasmodium spp. Cause tertian malaria?
Ovale and vivax
162
What is the pathognomic histology of Blastomyces?
Broad Based Budding
163
What is the Tx of ancyclostoma duodenale and Necator americanus?
Bendazoles or pyrantel pamoate
164
What kind of parasite is Trichinella spiralis?
nematode
