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5 Written questions

5 Matching questions

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

5 Multiple choice questions

  1. 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
  2. Dimorphic:
    1. Mycelial forms with spores at 25 C
    2. Yeast forms at 37 C
    3. NO Capsule 9despite name)
    4. Grow in macrophages
  3. 1. Not clear what the predominant host response is
    2. Complement, antibody and cell mediated immunity are all involved
  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. Central and S. America
    2. Brazil

5 True/False questions

  1. 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

          

  2. 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

          

  3. Coccidioides immitis ReservoirCoccidioidomycosis 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. Histoplasma capsilatum Clinical Disease1. fevers, sweats, weight loss
    2. in disseminated disease, skin & subcutaneous nodules and mucous membrane ulcerations are not unusual (tongue, larynx)

          

  5. 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