Term
| T/F the cell immune response is a key factor at staving off opportunistic mycoses? |
|
Definition
| True - there is a delicate balance of factors |
|
|
Term
| 5 sites of normal Candida colonization |
|
Definition
| mucosal surfaces of oral cavity, vagina, lower GI, rectal area and skin surfaces |
|
|
Term
| When are people normally colonized with Candida? |
|
Definition
|
|
Term
| Who gets infected with Candida? |
|
Definition
| Those with immune system out of balance |
|
|
Term
| What are 4 morphologies of Candida? |
|
Definition
| Yeast, pseudohypahe, germ tube, and Hypha |
|
|
Term
| What is the Germ Tube test? |
|
Definition
| Incubate yeast cells @ 37 C - hyphal outgrowth = candida |
|
|
Term
| T/F Germ tube candida are more adhesive? |
|
Definition
| True - antigens and proteins on tube have affinity for mucosal cells |
|
|
Term
| What non-biologic surface does Candida attach to? Mechanism? |
|
Definition
| Plastic - hydrophobic and electrostatic interactions |
|
|
Term
| 3 biological sites of candida albicans attachment |
|
Definition
| mucosal cells, vagina, and GI |
|
|
Term
| Other mechanisms for Candida albicans attachment (3) |
|
Definition
| Fibronectin binding, proteinase activity, ECM binding |
|
|
Term
| When are infants at risk for mucosal/cutaneous candidiasis? |
|
Definition
| Prior to the establishment of normal bacterial flora |
|
|
Term
| What increases the risk of infant candidiasis? |
|
Definition
| Maternal vaginal candidiasis |
|
|
Term
| Presentations of infant candidiasis (3)? |
|
Definition
| Oral Thrush, severe diaper rash and perianal/genital infections |
|
|
Term
| What is the white material in oral thrush? |
|
Definition
| Budding yeast cells and pseudohyphae |
|
|
Term
| What are 5 typical sites of adult cutaneous candidiasis? |
|
Definition
| sites of trauma, burn and abrasions, opposing skin folds and underneath nails |
|
|
Term
| T/F Candida albicans can not infect under nails? |
|
Definition
| False - it often destroys the nail lining |
|
|
Term
| What is the incidence rate of Vaginal Thrush among women? If pregnant? |
|
Definition
| 10-17%, double if pregnant |
|
|
Term
| What factors increase the incidence of vaginal thrush? |
|
Definition
| Antibiotics, pregnancy, oral contraceptives. All disrupt balance |
|
|
Term
| Who is primarily at risk for adult mucocutaneous candidiasis? |
|
Definition
| Those with compromised cell mediated immunity (AIDS patients) |
|
|
Term
| Risk factors for adult mucocutaneous candidiasis? |
|
Definition
| Corticosteroid treatment, diabetes (endocrine disturbance), hematologic malignancies, immunosuppressive drugs, and radiation therapy |
|
|
Term
| T/F Candida is the most common systemic MYCOSES? |
|
Definition
| True - is also 4th most common nosocomial systemic infector |
|
|
Term
| Name 4 risk factors for systemic candidiasis |
|
Definition
| Immunosuppressive treatment, intravenous lines, indwelling catheters, improperly cleaned skin around injection sites |
|
|
Term
| What are the potential systemic problems with systemic candidiasis? |
|
Definition
| Endocarditis, meningitis, esophagitis, eyes have patches of candida |
|
|
Term
| What is CMC? C/O? Lasts? Treatment? |
|
Definition
| Chronic mucocutaneous candidiasis, predisposed conditions (impaired T cell response), can last lifetime, can treat with antifungals - but will come back |
|
|
Term
| What is the single reservoir of pneumocystis jirovecii? P. carinii? |
|
Definition
|
|
Term
| What is the classification of pneumocystic jirovecii (fungus/protozoa)? |
|
Definition
| It fits in both, but we categorize it as fungi |
|
|
Term
| What are fungal features of pneumocystic jirovicii? |
|
Definition
| morphology, rRNA sequences, mito DNA, Chitin cell wall |
|
|
Term
| What are the protozoan features of pneumocystic jirovecii? |
|
Definition
| DNA content/cell, absence of fungal EF3, susceptible to anti-protozoan (not anti-fungal) therapeutics |
|
|
Term
| T/F pneumocystic jirovecii are treated with anti-fungals |
|
Definition
| False - use anti-protozoan treatments |
|
|
Term
| T/F Pneumocystic jirovecii human strains can be cultured? |
|
Definition
|
|
Term
| What is the life cycle of pneumocystic jirovecii? |
|
Definition
| Begins as cyst with 8 sporozoites which break open the cyst and become feeding trophozoites which form new cyst of 8 |
|
|
Term
| Who is at risk for pneumocystic pneumonia? |
|
Definition
| Anyone with compromised immune system - almost everyone is colonized by age 4 |
|
|
Term
| T/F Pneumocystis pneumonia is an opportunistic, latent infection? |
|
Definition
| True - it hangs around till it has a chance to infect - especially in AIDS patients |
|
|
Term
| T/F pneumocystis jirovecii always produces disease on infection |
|
Definition
| False - only those with low T cell response |
|
|
Term
| In pneumocystic pneumonia where is the invader found, and what does it do? |
|
Definition
| It fills alveoli and causes death by progressive asphyxia |
|
|
Term
| In animal models of pneumocystic pneumonia what initiates infection (2)? |
|
Definition
| Corticosteroids and starvation |
|
|
Term
| What is a typical treatment for pneumocystic pneumonia infection? |
|
Definition
| Prophylaxis and therapeutics |
|
|
Term
| What are the four primary systemic mycoses? |
|
Definition
| Histoplasma capsulatum, coccidioides immitis, blastomyces dermatitidis, and cryptococcus neoformans |
|
|
Term
| In systemic mycoses, where is the site of initial infection and the common symptoms? |
|
Definition
|
|
Term
| When do systemic mycoses become systemic? |
|
Definition
| In an immunocompromised person |
|
|
Term
| T/F Each sytemic mycoses has characteristic secondary organ tropism |
|
Definition
|
|
Term
| Which of the four systemic mycoses are dimorphic? |
|
Definition
| Histoplasma capsulatum, coccidioides immitis, and blastomyces dermatitidis |
|
|
Term
| T/F systemic mycoses are part of the normal flora? |
|
Definition
|
|
Term
| Describe the growth of Histoplasma capsulatum |
|
Definition
| mold grows in soil with bat and bird droppings, using the nitrogen |
|
|
Term
| Who is infected with histoplasma capsulatum? |
|
Definition
| Humans and bats - NOT birds |
|
|
Term
| Route of histoplasma capsulatum entry? Site of growth? |
|
Definition
| Inhalation into lungs, intracellular (in macrophages) |
|
|
Term
| T/F Histoplasma capsulatum causes lung calcification? |
|
Definition
|
|
Term
| The normal pathology of histoplasma capsulatum is? |
|
Definition
| nothing beyond a calcified lung lesion, some have fever, malaise, chills, and cough |
|
|
Term
| What are the systemic effects of histoplasma capsulatum? |
|
Definition
| Involves the reticuloendothelial (macrophage) system, can also cause lung, bone, heart, meningial, kidney, liver, and intestinal problems and be seen in eye |
|
|
Term
| Where is histoplasma capsulatum geographically common? |
|
Definition
| Ohio/Mississippi river areas - most residents have evidence of previous infection |
|
|
Term
| T/F histoplasma capsulatum has a capsule? |
|
Definition
|
|
Term
| What is the morphology and appearance of Coccidioides immitis? |
|
Definition
| dimorphic, large distinct spherules in lung containing multiple endospores |
|
|
Term
| How does coccidioides enter body? |
|
Definition
| Inhaled conidia that lodge in alveoli |
|
|
Term
| What is the mortality of disseminated coccidioides immitis? |
|
Definition
|
|
Term
| Which mycoses is most virulent of all human mycotic pathogens? |
|
Definition
|
|
Term
| Where does coccidioides immitis grow? |
|
Definition
| In deserts - like NV, AZ, and CA and west TX; enhanced by bat/rat droppings; 50% of residents have been exposed |
|
|
Term
| Presentation of systemic coccidioides immitis? |
|
Definition
| affect bones, joints, skin, and meninges |
|
|
Term
| When does coccidioides immitis become systemic? |
|
Definition
| For the immune compromised (less than 1%) |
|
|
Term
| Normal presentation of coccidioides immitis? |
|
Definition
| malaise, cough, chest pain, and fever that lasts 2-6 weeks; aka valley fever, desert rheumatism |
|
|
Term
| What is a physical presentation of coccidioides immitis? |
|
Definition
|
|
Term
| Where is blastomyces dermatitidis found? |
|
Definition
| North america and parts of Africa, primarily the Ohio/Mississippi rivers |
|
|
Term
| Who is most susceptible to blastomyces dermatitidis? |
|
Definition
|
|
Term
| Morphology of blastomyces dermatitidis? |
|
Definition
|
|
Term
| What is the physical presentation of systemic blastomyces dermatitidis? |
|
Definition
|
|
Term
| T/F blastomyces dermatitidis is the last you get, but the worst to have? |
|
Definition
|
|
Term
| How are histoplasma, coccidioides, and blastomyces like TB? |
|
Definition
| Inhaled, primary lung infection, lung granulomas/calcification, skin test like PPD, can disseminate, can be asymptomatic, mild, severe, or chronic infection |
|
|
Term
| How are histoplasma, coccidioides, and blastomyces not like TB? |
|
Definition
| NO person-to-person transmission, fungi w/spores, NOT acid-fast |
|
|
Term
| Where is Cryptococcus Neoformans typcially found? |
|
Definition
| Found worldwide in weathered pigeon droppings and in contaminated soil |
|
|
Term
| What is the resevoir of cryptococcus neoformans? |
|
Definition
| soil, humans, birds not infected! |
|
|
Term
| T/F Cryptococcus neoformans is encapsulated? |
|
Definition
|
|
Term
| How is the capsule of cryptococcus neoformans visualized? |
|
Definition
|
|
Term
| What is the most common cause of fungal meningitis? |
|
Definition
|
|
Term
| What is the tropism of cryptococcus neoformans? |
|
Definition
|
|
Term
| Where are cryptococcus neoformans antigens found? |
|
Definition
|
|
Term
| What is the physical presentation of cryptococcus neoformans that has disseminated? |
|
Definition
| skin lesions - especially in immunocompromised |
|
|
Term
| Where is Aspergillosis sp normally found? |
|
Definition
| Everywhere in nature, especially in vents - in hospital |
|
|
Term
| What is the organ involvement of Aspergillosis? |
|
Definition
| colonization of lungs that can spread to other tissues |
|
|
Term
|
Definition
| A collection of aspergillosis within the cavity of the lung, happen in brain |
|
|
Term
| T/F You want an immunocompromised patient inhaling aspergillosis? |
|
Definition
|
|
Term
| T/F Zygomycosis are abundant in nature? |
|
Definition
|
|
Term
| What are the common tissues involved in Zygomycosis infection? |
|
Definition
| The blood vessels, eye, central nervous system, nose, sinuses and lungs |
|
|
Term
| Who is most at risk for Zygomycosis infection? |
|
Definition
| Diabetes, burns, immunosupression |
|
|
Term
| T/F Zygomycosis is a serious nosocomial infection involved in organ transplants |
|
Definition
|
|
