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5 Written questions

5 Matching questions

  1. Histoplasma capsulatum Morphology
  2. Paracoccidioides brasiliensis Morphology
  3. Histoplasma capsilatum Pathogenesis
  4. Coccidioides immitis Immunity
  5. Paracoccidioides brasiliensis Reservoir
  1. a Dimorphic:
    1. Mycelial forms with spores at 25 C
    2. Yeast forms at 37 C
    3. NO Capsule 9despite name)
    4. Grow in macrophages
  2. b 1. Mycelial forms with spores at 25 C
    2. Yeast forms at 37 C
  3. c 1. Central and S. America
    2. Brazil
  4. d 1. 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
  5. e 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 Multiple choice questions

  1. 1. Itraconazole
    2. Amphotericin B (in immunocompromised patients)
  2. HISTOPLASMOSIS
    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
  3. 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
  4. 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. 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

5 True/False questions

  1. Blastomyces dermatitidis Pathogenesis1. 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

          

  2. Paracoccidioides brasiliensis Treatment1. trimethoprim/sulfamethoxazole (TMP sulfa): 1st choice
    2. itraconazole and amphotericin B

          

  3. Bastomyces dermatitidis Morphology1. Mycelial forms with spores at 25 C
    2. Yeast forms at 37 C

          

  4. Paracoccidioides brasiliensis Clinical Symptoms1. Pulmonary Infection
    2. Cough
    3. Fever
    4. Malaise
    5. Weight loss

          

  5. Bastomyces dermatitidis Disease1. 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

          

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