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5 Written questions

5 Matching questions

  1. Blastomyces dermatitidis Pathogenesis
  2. Coccidioides immitis Disease
  3. Coccidioides immitis Clinical Symptoms
  4. Coccidioides immitis Treatment
  5. Bastomyces dermatitidis Disease
  1. a Only for disseminated:
    1. Fluconazole (1st choice)
    2. Ampothericin B (2nd choice)
  2. b 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
  3. c 1. Primary infection is by inhalation of the conidia
    2. A mixed inflammatory response occurs
    3. The organism then starts to grow as large yeasts with thick double walls
    4. Unlike Histoplasma, these yeasts are extracellular and much larger
  4. d 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. e 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 Multiple choice questions

  1. 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. 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)
  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. Central and S. America
    2. Brazil
  5. 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

5 True/False questions

  1. Coccidioides immitis MorphologyDimorphic
    1. Mycelial forms with spores at 25 C
    2. Yeast forms at 37 C

          

  2. Histoplasma capsilatum Clinical Symptoms1. fevers, sweats, weight loss
    2. in disseminated disease, skin & subcutaneous nodules and mucous membrane ulcerations are not unusual (tongue, larynx)

          

  3. Mechanism of Dimorphic Switch1. 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

          

  4. 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

          

  5. Blastomyces dermatitidis Reservoir1. Mississippi river valley extending north to the great lakes
    2. Resides in soil or rotten wood
    3. Respiratory transmission