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5 Written Questions

5 Matching Questions

  1. Paracoccidioides brasiliensis Reservoir
  2. Blastomyces dermatitidis Diagnosis
  3. Paracoccidioides brasiliensis Pathogenesis & Clinical disease
  4. Blastomyces dermatitidis Immunity
  5. Bastomyces dermatitidis Disease
  1. a 1. The conidia are inhaled and are usually contained and cleared
    2. Chronic disease with pulmonary and/or lymph node involvement
    3. If a person develops pulmonary infection, they develop cough, fever, malaise, weight loss
    4. Can also affect mucous membranes of the mouth, larynx
  2. b 1. Not clear what the predominant host response is
    2. Complement, antibody and cell mediated immunity are all involved
  3. c 1. Central and S. America
    2. Brazil
  4. d 1. Biopsy of affected tissue: lung, skin, etc
    A. silver stain specimen
    B. culture on Sabouraud's agar
    2. Serology
    3. Skin tests (tests for exposure only)

    *For skin infections, direct demonstration of the yeast with broad based budding is diagnostic
  5. e Blastomycosis
    1. Asymptomatic (uncommon)
    2. Pneumonia: lesions rarely calcify (most common)
    3. Disseminated (uncommon): present with weight loss, night sweats, lung involvement, and skin ulcers
    4. Cutaneous: skin ulcers

5 Multiple Choice Questions

  1. Only for disseminated:
    1. Fluconazole (1st choice)
    2. Ampothericin B (2nd choice)
  2. 1. "Valley Fever"
    A. malaise, cough, chest pain, fever, arthralgias
    B. lasts 2-6 wks
    C. chest xray is clear or has hilar adenopathy
    D. resolution is spontaneous 90%
    2. Dissemination
    A. skin, bone, meninges
    B. MENINGITIS (fever, headache, stiff neck)
    C. Risks:
    -African or Filipino ancestry
    -Men
    -Pregnant women
    -T-cell number / functional abnormalities
  3. Coccidioidomycosis aka "Valley Fever"
    1. Asymptomatic (in most persons)
    2. Pneumonia
    3. Disseminated (<1%): can affect the LUNGS, SKIN, BONES, & MENINGES

    Note: a small percentage of individuals with this infection will develop painful erythematous nodular lesions called erythema nodosum
  4. 1. Conidia are inhaled and reach the alveoli
    2. The conidia then convert to yeasts
    3. Survive by capturing iron and calcium from the macrophage
    4. Grow within macrophages
    5. Granulomatous inflammation similar to TB (cell-mediated immunity)
  5. 1. fevers, sweats, weight loss
    2. in disseminated disease, skin & subcutaneous nodules and mucous membrane ulcerations are not unusual (tongue, larynx)

5 True/False Questions

  1. Mechanism of Dimorphic Switch1. Life long immunity does develop
    2. Conidia can be phagocytosed and killed by PMNs
    3. The endospores cannot be handled until macrophages are activated by T-cells (Th1)
    4. Humoral immunity does not play a role
    5. Complement is not effective at opsonizing C. immitis

          

  2. Coccidioides immitis Immunity1. Life long immunity does develop
    2. Conidia can be phagocytosed and killed by PMNs
    3. The endospores cannot be handled until macrophages are activated by T-cells (Th1)
    4. Humoral immunity does not play a role
    5. Complement is not effective at opsonizing C. immitis

          

  3. Coccidiodes immitis Diagnosis1. Biopsy of affected tissue: lung, skin
    A. Silver stain or KOH prep
    B. Culture on Sabouraud's agar (warn lab!) 3-4 days
    2. Serology
    3. Skin tests (tests for exposire only)

          

  4. Histoplasma capsulatum Morphology1. Mississippi valley
    2. Present in bird and bat droppings
    3. Respiratory transmission

          

  5. Paracoccidioides brasiliensis Treatment1. Central and S. America
    2. Brazil

          

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