Anti-Fungals and Fungi Flashcards

1
Q

From lipids, sweat (adolescents): hypopigmented patch, dandruff. selsun blue!

A

Pityriasis versicolor (malassezia furfur)

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2
Q

From skin (keratinases), contagious! Ringworm, athlete’s foot, jock itch, scalp lesions, toenail fungus (wrestlers, lotrimin, lamisil)

A

Dermatophytosis (trichophyton, microsporum, epidermophyton)

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3
Q

From soil in mexico, south america, gardeners and thorns: lymphatic spread, ulcerating nodules

A

sporotrichosis (sporothrix schenckii)

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4
Q

From pigeons: CNS, meningitis. (capsule leads to antibodies, ring-enhancing)

A

cryptococcus

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5
Q

From mucosal flora: can colonize skin. Thrush, yeast infection, intertriginous rash, disseminated

A

candida

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6
Q

from ubiquitous! Presents as ABPA, aspergilloma, invasive aspergillosis

A

aspergillis

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7
Q

from decaying acidic organic matter: DM, diarrhea, uremia. Presents as necrosis of nasal turbinates, facial pain, cough, hemoptysis

A

mucormycosis

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8
Q

from spelunking, birds and bats, ohio and mississippi river valley. Presents with pulmonary granulomas, reactivation, systemic sx inc GI

A

histoplasma

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9
Q

from American southwest, valley fever, productive cough, nodules, caseating necrosis, dissemination, reactivation

A

coccidioides

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10
Q

from Ohio and Mississippi River valleys. Pulmonary, skin pigmented, ulcerating nodules, urogential ulcers. Beavers, log cabins, camping

A

blastomyces

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11
Q

“spaghetti and meatballs,” fluorescent under woods lamp

A

tinea versicolor (malassezia furfur)

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12
Q

clinical Dx, KOH, wood’s lamp

A

Dermatophytosis (trichophyton, microsporum, epidermophyton)

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13
Q

clinical Dx, culture, biospy reveals scant cigar shaped yeasts

A

sporotrichosis (sporothrix schenckii)

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14
Q

india ink CSF. Large round yeasts highly visible

A

cryptococcus

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15
Q

visualize hyphae, positive cultures are not telling

A

candida

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16
Q

histopathology, ground glass “halo sign”, skin tests for IgE rxn

A

aspergillis

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17
Q

histopath, but too slow. Suspicion and surgery

A

mucormycosis

18
Q

diagnose with culture, titers, history of cave dwelling

A

histoplasma

19
Q

culture, stains reveal pomegranate spherules, seroligies

A

coccidioides

20
Q

diagnose with smear, culture, beavers

A

blastomyces

21
Q

hyphae: branches at right angles

A

mucormycosis

22
Q

sterol of the fungi membrane

A

ergosterol

23
Q

polyene. Amphoteric and amphophilic. Binds ergosterol, causes cell leak and death. IV only

A

AmB

24
Q

Sx: fever, chills, nausea, vomiting, nephrotoxic lessened with Na, anemia

A

AmB

25
Q

reduces Am B toxicity

A

lipid

26
Q

broad spectrum. Use for disseminated superficial, endemic, opprotunistic and severe fungal infections

A

AmB

27
Q

swish and swallow polyene for oral/GI candida

A

nystatin

28
Q

inhibit ergosterol synth. And CYP-450. all cover candida

A

azoles

29
Q

sx: reversible hepatotoxicity

A

azoles

30
Q

ocular and CNS penetrating, use in suspected/prophylatic candiditis, crytococcus, coccidioidomycosis

A

fluconazole

31
Q

if fluconazole is ineffective in crytococcus, coccidioidocomycosis

A

AmB

32
Q

poor CNS peneteration, high in adipose, keratin

A

intraconazole

33
Q

tx: nonsevere endemic sporotrichosis, severe superficial tinea versicolor and dermatophytosis, some aspergillus

A

intraconazole

34
Q

broader than fluco, intra. Expensive. Alters P450 so watch Asians for slow metabolism

A

voriconazole

35
Q

use for aspergillus! And candida

A

voriconazole

36
Q

always oral, with food. Use for candida prophylaxis, aspergillus, 2nd line mucormycosis

A

posaconazole

37
Q

Sx: QT prolongation

A

posaconazole

38
Q

IV only, inhibit cell wall linking. Treat candida, inferior treatment for aspergillus. Drug interactions and histamine response

A

echinocandins

39
Q

excellect CNS, used with AmB for cryptococcal meningitis, never alone (resistance!)

A

flucytosine

40
Q

OTC for dermatophytosis, onychiomycosis. Sx: taste disturbance and diarrhea

A

terbeniphine