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5 Written questions

5 Matching questions

  1. Histoplasma capsilatum Pathogenesis
  2. Blastomyces dermatitidis Diagnosis
  3. Histoplasma capsulatum Reservoir
  4. Blastomyces dermatitidis Treatment
  5. Paracoccidioides brasiliensis Pathogenesis & Clinical disease
  1. a 1. Mississippi valley
    2. Present in bird and bat droppings
    3. Respiratory transmission
  2. b 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
  3. c 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)
  4. d 1. Itraconazole (1st choice)
    2. Amphotericin B (2nd choice)
  5. e 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 Multiple choice questions

  1. 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
  2. 1. Itraconazole
    2. Amphotericin B (in immunocompromised patients)
  3. 1. trimethoprim/sulfamethoxazole (TMP sulfa): 1st choice
    2. itraconazole and amphotericin B
  4. 1. The shift from mold to yeast involves induction of the heat shock response and uncoupling of oxidative phosphorylation
    2. This is followed by shutdown of RNA synthesis
    3. The cells then pass through a metabolically inactive phase
    4. The metabolism in the yeast phase shifts to sulfhydryl compounds
    5. This is reversible and is one of the major virulence factors of these organisms
  5. 1. Pulmonary Infection
    2. Cough
    3. Fever
    4. Malaise
    5. Weight loss

5 True/False questions

  1. Paracoccidioides brasiliensis Reservoir1. Central and S. America
    2. Brazil

          

  2. Histoplasma capsilatum Diagnosis1. 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)

          

  3. Coccidiodes immitis DiagnosisCoccidioidomycosis 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. Coccidioides immitis Pathogenesis1. 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. Coccidioides immitis Reservoir1. Desert areas of the southwestern US & northern Mexico
    2. Respiratory transmission

          

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