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5 Written questions

5 Matching questions

  1. Bastomyces dermatitidis Disease
  2. Histoplasma capsilatum Clinical Symptoms
  3. Histoplasma capsulatum Morphology
  4. Coccidiodes immitis Diagnosis
  5. Blastomyces dermatitidis Reservoir
  1. a 1. fevers, sweats, weight loss
    2. in disseminated disease, skin & subcutaneous nodules and mucous membrane ulcerations are not unusual (tongue, larynx)
  2. b 1. Mississippi river valley extending north to the great lakes
    2. Resides in soil or rotten wood
    3. Respiratory transmission
  3. c 1. 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. 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 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. 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
  2. Dimorphic
    1. Mycelial forms with spores at 25 C
    2. Yeast forms at 37 C
  3. 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. 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
  5. 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 True/False questions

  1. Histoplasma capsilatum Treatment1. 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

          

  2. Blastomyces dermatitidis Immunity1. Itraconazole (1st choice)
    2. Amphotericin B (2nd choice)

          

  3. Coccidioides immitis TreatmentOnly for disseminated:
    1. Fluconazole (1st choice)
    2. Ampothericin B (2nd choice)

          

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

          

  5. Paracoccidioides brasiliensis 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