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5 Written Questions

5 Matching Questions

  1. Coccidioides immitis Reservoir
  2. Histoplasma capsilatum Immunity
  3. Histoplasma capsulatum Morphology
  4. Histoplasma capsilatum Treatment
  5. Histoplasma capsilatum Clinical Symptoms
  1. a 1. Desert areas of the southwestern US & northern Mexico
    2. Respiratory transmission
  2. b 1. The main control of this organism is by cell mediated immunity
    -Mainly the T-cell activation of macrophages

    2. Neither B cells or antibody have a significant role
  3. c 1. Itraconazole
    2. Amphotericin B (in immunocompromised patients)
  4. d Dimorphic:
    1. Mycelial forms with spores at 25 C
    2. Yeast forms at 37 C
    3. NO Capsule 9despite name)
    4. Grow in macrophages
  5. e 1. fevers, sweats, weight loss
    2. in disseminated disease, skin & subcutaneous nodules and mucous membrane ulcerations are not unusual (tongue, larynx)

5 Multiple Choice Questions

  1. 1. Mississippi river valley extending north to the great lakes
    2. Resides in soil or rotten wood
    3. Respiratory transmission
  2. Only for disseminated:
    1. Fluconazole (1st choice)
    2. Ampothericin B (2nd choice)
  3. 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
  4. 1. Conidia are inhaled
    2. Once inside host, the conidia change into spherules due to increased temp, lower pH and interactions with phagocytes
    3. The spherule is a "sac" of endospores which are released and lead to new spherules
    4. Proteases released by the spherule are virulence factors
    5. They destroy collagen, elastin and immunoglobulins
  5. 1. Mycelial forms with spores at 25 C
    2. Yeast forms at 37 C

5 True/False Questions

  1. Histoplasma capsilatum Pathogenesis1. Lung biopsy
    A. Silver stain specimen
    B. Culture on Sabouraud's agar will reveal hyphae at 25 C, and yeast at 37 C
    2. Serology
    3. Skin test (tests for exposure only)

          

  2. Paracoccidioides brasiliensis Diagnosis1. Diagnosis is made by seeing the yeast with multiple blastoconidia (think of a ship's steering wheel)
    2. Measurement of antibodies have a 95% sensitivity

          

  3. Coccidioides immitis Clinical Symptoms1. "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

          

  4. Histoplasma capsilatum Clinical DiseaseHISTOPLASMOSIS
    1. Asymptomatic (in most persons)
    2. Pneumonia: lesions calcify, which can be seen on chest x-ray (may look similar to tuberculosis)
    3. Disseminated: can occur in almost any organ, especially the LUNG, SPLEEN, LIVER

          

  5. Histoplasma capsulatum Reservoir1. Itraconazole
    2. Amphotericin B (in immunocompromised patients)

          

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