Test 3 Wk11: 11 Respiratory Fungal Infections - Shah

Question 1

North American Blastomycosis Causative Agent:

Answer 1

B.dermatitidis

Question 2

B.dermatitidis is — in nature

Answer 2

dimorphic

Question 3

B.dermatitidis location

Answer 3

Ohio & Mississippi River
valleys, the Great Lakes,
and in the southeast

Question 4

Clinical Presentation

Blastomycosis : B.Dermatitidis

Answer 4

Flu like symptoms

Question 5

B.Dermatitidis Acute pulmonary

Answer 5

Acute pulmonary: lobar
segmental consolidation,

Mimics bacterial pneumonia .

Question 6

B.Dermatitidis Chronic pulmonary

Answer 6

Chronic pulmonary lobar infiltrates

Mimics tuberculosis or lung
cancer

Question 7

— Can disseminate to skin & bone in immunocompromised patients

Answer 7

B.Dermatitidis

Question 8

B.Dermatitidis is acquired by

Answer 8

acquired by inhaling spores:
dissemination Suppurative
granulomatous;

Question 9

— often misdiagnosed are carcinoma

Answer 9

B.Dermatitidis

Question 10

Diagnosis & Treatment :

B.Dermatitidis

Answer 10

KOH preparation:

Sputum, BAL, lung tissue, skin biopsy,

Question 11

B.Dermatitidis Yeast form is

Answer 11

Yeast form is large (8-12 um), round, thick walled and

hyaline

Question 12

Histoplasmosis:

Answer 12

H. capsulatum

Question 13

H. capsulatum location

Answer 13

Ohio and Mississippi

river valleys in the USA.

Question 14

H. capsulatum elicits — similar to —

Answer 14

Elicits granulomas; TB

Question 15

H. capsulatum animals

Answer 15

birds and bats

Question 16

H. capsulatum comes from soil that is

Answer 16

high N content

Question 17

H. capsulatum forms — in the body

Answer 17

histocytes

Question 18

H. capsulatum is

Answer 18

dimorphic

Question 19

Histoplasmosis

clinical presentation

Answer 19

variable

asx in healthy; can dissiminate in immunosuppressed

Question 20

Histoplasmosis

clinical presentation rare cases

Answer 20

Acute Respiratory Distress Syndrome

Question 21

Acute respiratory distress syndrome in Histoplasmosis

Answer 21

10% inflammatory sequelae, such as persistent
lymphadenopathy with bronchial obstruction,
arthritis, arthralgias , or pericarditis,

Question 22

Mediastinal fibrosis: ARDS Histoplasmosis

Answer 22

Persistent host response to
the organism may result in massive fibrosis and
constriction of mediastinal structures, including
the heart and great vessels.

Question 23

H. capsulatum

Diagnosis & Treatment

Answer 23

Direct microscopy

Culture of blood, bone, marrow or other material

enzyme immunoassay

Question 24

The yeast phase of H. capsulatum organism can be detected in:

Answer 24

Sputum, BAL, fluid,
peripheral blood films, bone
marrow, and tissue stained

Question 25

H. capsulatum found can be seen in tissue stained with

Answer 25

with Giemsa, GMS, or PAS | stains

Question 26

H. capsulatum PAS stain | appears

Answer 26

appears as a small yeast about 5-6 microns in diameter

Question 27

Coccidioidomycosis

Answer 27

C. Immitis & C.posadasii

Question 28

Coccidioidomycosis located in

Answer 28

southwest

Question 29

Coccidioidomycosis also known as

Answer 29

San Joaquin Valley Fever

Question 30

Coccidioidomycosis environment

Answer 30

Arid, alkaline soils, hot | summers.

Question 31

Coccidioidomycosis outbreaks

Answer 31

dust storm and earthquakes

Question 32

which Coccidioidomycosis accounts for the majority of infections outside of California

Answer 32

C. posadasii

Question 33

Coccidioidomycosis are

Answer 33

dimorphic

Question 34

Coccidioidomycosis forms --- at 37C

Answer 34

Spherules

Question 35

Coccidioidomycosis spherules can be mistaken as

Answer 35

toxoplasma gondii tissue cysts

Question 36

Coccidioidomycosis forms --- in the environment

Answer 36

Arthroconidia

Question 37

Coccidioidomycosis Clinical presentation

Answer 37

Variable; usually self limited; can be life threatening;

Question 38

Coccidioidomycosis is known as the great imitator and mimics

Answer 38

syphilis, typhoid,

Question 39

Coccidioidomycosis sx

Answer 39

fever, cough, chills, pleurisy, arthralgia

Question 40

Coccidioidomycosis extrapulmonary sites of infection

Answer 40

``` skin soft tissue bones joints meninges ```

Question 41

Coccidioidomycosis risk factors

Answer 41

Filipino, African American, Native American, Hispanic Male Women in 3rd trimester Depressed cell mediated immunity

Question 42

Coccidioidomycosis pathology

Answer 42

Necrotizing granulomatous inflammation pneumonitis huge (20 60 µm) round thick walled spherule under microscope full of smaller endospores

Question 43

Diagnosis: Coccidioides immitis

Answer 43

``` sputum pus from skin lesions gastric washings CSF biopsy ```

Question 44

Coccidioides immitus stain

Answer 44

Calcofluor white stain

Question 45

Paracoccidiodes brasiliensis is

Answer 45

dimorphic

Question 46

Paracoccidiodes brasiliensis forms --- at 37C

Answer 46

"pilots wheel" multipolar arrangement

Question 47

Paracoccidioidomycosis | Clinical Presentation

Answer 47

Granulomatous disease of mucous membranes, skin, and pulmonary system.

Question 48

25% patients exhibit, pulmonary manifestations of Paracoccidioidomycosis can

Answer 48

which can disseminate to | extrapulmonary sites w/out tx

Question 49

Paracoccidioidomycosis Diagnosis

Answer 49

Examination of sputum BAL scrapings or biopsy pus draining from lymph nodes CSF tissue

Question 50

Paracoccidioidomycosis Histopathology

Answer 50

multiple buds forming a "Captain's wheel.“ “Pilot’s wheel”

Question 51

C. Neoformans

Answer 51

Capsule

Question 52

Aspergillilus hyphae

Answer 52

Mold with septate

Question 53

Pneumocystis jirovecii

Answer 53

Cup shaped fungus

Question 54

Histoplasma capsulatum , a dimorphic fungus, is found in soil heavily contaminated with bird droppings. Which of the following statements best describes the presence of the organism in tissue biopsies?

Answer 54

Oval Budding yeast inside macrophages

Question 55

Histoplasma is prevalence in which part of the USA?

Answer 55

Ohio and Mississippi | river valleys in the USA.

Question 56

Coccidioides immitis

Answer 56

A dimorphic fungus, which produces “Spherule” in its tissue phase.

Question 57

Blastomyces dermatitidis

Answer 57

A dimorphic fungus most commonly found in soils of Northeastern USA which is also an important veterinary problem

Question 58

Cryptococcus neoformans

Answer 58

A yeast acquired by inhalation that causes respiratory infection primarily in immunocompromised patients