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Skin Dr Blue1


What fungus is Pityriasis versicolor? malassezia furfur
What does Malassezia furfur look like? depigmentaions/pigmentations at sight of growth
Where does Pityriasis versicolor reside in teh skin? superficial layer
Is pitryiasis versicolor inflammatory no
What causes Pitryiasis versicolor? poor hygiene
Is Pitryiasis versicolor a tinea? no
Where does Pitryiasis versicolor infect? crhonic, mild infection of stratum corneum which results in scaly leasions
What kind of yeast is Pitryiasis versicolor? lipophilic
is malassezia furfur normal flora yes
What does malassezia furfur use as nutrition? sebum for fatty acids adn sweat for moisture.
Does malassezia furfur break down keratin no
what fungus looks like spaghetti and meatballs under a microscope? malassezia furfur
What does malassezia furfur look like under a microscope spaghetti and meatballs
What fungus will show up under fluoresce under a wood light? malassezia furfur
What is Cradle Cap? seborrheic dermatitis
What is dandruff seborrheic dermatitis
What can Malassezia furfur cause besides Pitryiasis versicolor seborrheic dermatitis; cradle cap and dandruff
What fungus causes Tinea nigra? exophilia werneckii
What does Exophiala werneckii cause? Tinea Nigra
Where is Exophiala werneckii found? soil and shower curtains
What symptoms are seen with tinea nigra none
What can tinea nigra be mistaken for? melanoma
how does tinea nigra present on teh skin? brown-black pigmented yeasts
Is tinea nigra inflammatory no
What does Exophiala werneckii eat? keratin
What does Piedraia hortae cause? black piedra
What does Trichosporon beigelli cause? White Piedra
What fungus's cause black/white piedra? Piedraia hortae, trichosporon beigelli
What is black/white piedra? infection of external hair shaft
What areas of the world is black/white piegra found? tropical areas
What are the subcutaneous diseases? black/white piedra; tinea nigra; seborrheic dermatitis; Pitryriasis versicolor
What are dermaphytoses? Tineas
Are tineas inflammatory? yes
what do tineas infect? cutaneous skin
What is Tinea corporis? ringworm of trunk, legs
what disease does tricophyton rubrum and mentagrophytes cause? tinea corporis and pedis
What diesase does microsporum cause? tinea corporis
What fungi cause tinea corporis? trichophyton rubrum; microsprum canis; trichophyton mentagrophytes
What is tinea imricata? concentric rings of scales over trunk, legs and forearms
What fungi cause tinea imricata trichophyton concentricum
what disease does trichophyton concentricum cause? tinea imricata
Are tineas comunicable? yes
What causes the inflammatory response with tineas? metabolization of keratin
What is tinea pedis? athletes foot
What kind of pattern does tinea pedis leave? moccasin pattern
What is seen on the foot with Tinea pedis? lateral side of foot. Itching and skin cracks.
What does tinea nigra digest? mostly dead keratin
What is recurrence rate of tinea pedis? 60-80%
What fungi are responsible for tinea pedis? trichophyton mentagrophytes,Epidermophyton floccsum
What is Tinea cruris? jock itch
What fungi cause jock itch trichophyton rubrum, epidermophyton floccusum and trichophyton mentagrophytes
What do men get jock itch they scratch themselves after having athletes foot
what is tinea capitis scalp ringworm, favus
Who gets tinea capitis? cildren
Waht is ectothrix candidia on outside of hair shaft
What is endothrix? candidia on inside of hair shaft
What is tinea capitis confused with? dandruff
How is tinea capitis confused with dandruff? tinea capitis is inflammatory
what fungi cause tinea capitis trichophyton tonsurans, microsporum audouinii, canis, trichophyton schoenleinii, trichophyton violaceum
What is tinea barbae infection of the hair and skin around the bearded area from uncleaned razors and sharing razors; also from pets because they are soil organisms
What fungi are responsible for tinea barbae? Trichophyton verrucousm, T. mentagrophytes
What is Tinea unguium? onychomycosis of the nails
What fungi are responsible for tinea unguium? Tricophyton rubrum, T. mentagrophytes, Furasuium sp. candida sp.
How does Tinea unguium occur? thru cuts, digging thru dirt, soaking in lots of water
What kind of infection is chromoblastomycosis? subcutaneous fungal infection; presents as wart-like, cauliflower, pigmented lesions
What fungal infection looks like "copper penny spores" under microscopy? Chromoblastomycosis
What fungi are responsible for Chromobastomycosis? Fonsecaea, cladosporium, Pilaophora sp.
where is chromoblastomycosis seen? usually of the foot or hands
what does chromoblastomycosis feed on? organic matter over keratin (dead organic)
What form is chromoblastomycosis in when present in subcutaneous layer? yeast
What kind of people get chromoblastomycosis? barefooted workers experiencing trauma. Takes a lot of force to get it there.
How long does chromoblastomycosis take to develop? months to YEARS
How id chromoblastomycosis treated? surgery and itrconazole
What is Sporotrichosis? Rose thorn Disease;
What do "asteroid bodies" seen in microscopy respresnt? Sporotrichosis
What fungus is associated with sporotricosis? sporothrix schenckii
Where does sporothrix schenckii grow? bark and thorns of rose bushes
What does Sporothrix schenckii look likeunder the microscope? asteroid body
What kind of patients present with sporotrichosis? opptorunistic with AIDS
what is the clincial presentation of sprorotrichosis? nodular granulomas and with ulcerative papules that spread via draining in the lymph channels
What is Fungal mycetoma? madura foot
What is the clincial presentation of madura foot? initially small painless papules and nodules; leads to bone and tissue destruction
What is the pathogenesis of fungal mycetoma? grows quicker than other fungi. sinus tract formation leads to spread. Deeper tissue infiltration leads to bone destruction of a period of months/years
What organism is responsible for fungal myecetoma Madurella
How is fungal mycetoma gven to the host? infection is via thorns and splinters; seen in tropical areas
Waht happens if fungal mycetoma is nto treated quickly? amputation
When is spaghetti and meatballs seen? malasezzia under a microscope after KOH digestion of skin scraping
When are Ids seen/ often accompany cutaneous fungal ifnections.
What are Ids? papules that conatin no fungal infection but arise in distal areas due to cutaneous infections
What are copper penny spores? yeast form of fungus seen in microscopy in chromoblaqstomycosis. Not really spores
what is most common candida Candida albicans
What is candida albicans normal flora that everyone has in gi tract and some have in skin and mucous membranes
What is candida tropicalis? true commensalist. does nto cause a problem unless the environment it lives in is disrutped allowing it to grwo and cause disease
How is candida aquired? water, soil, food, animals adn people
What is candida parapsilosis? commensalist. only becomes a problem when environment is disrupted to allow overgrowth
Where is candida tropicalis seen? under teh skin, GI tract adn mucus membranes
Where is candida parapsilosis seen in humans? sking, Gi tract adn mucus membranes
What is candida glabrata commensalist; resistant to antifungal treatments; not a problem unless environment allows overgrowth
What is candida krsei? commensalist; not aproblem unless overgrowth occurs; resistent to some antifungals
Which candida are drug resistant? C. glabrata, C guilliermondii; c. drusei
What is candida dubliniensis? true pathogen; primarily in african adn surrounding nations
What is most common sites of candida infections? oral, penial, vaginal
Where are most cutaneous candida infections seen? skin folds
What is folliculits? associated with hair
what is balantitis? penile infection usually associated with skin around the glans and the skin underneathwhere it is moist
what is intertrigo? skin fold appearance of infection. combined infection of candida and commensual bacteria
what is most common cause of diaper rash? candida
how does candida cause diper rash? part of normal gi tract flora so present in feces
When do you have systemic candida disease? under debilitating disease or immunodeficient disease
Where do systemic candida infections originate? GI tract; also main cause of death
What is candidemia? hematogenous spread to any organ of candida
what is seen in CNS candida infection? meningitis; encephalitis; brain abscesses
what is seen in respiratory candida infection pneumonia
what is seen in CV candida infection? seeding of the heart valevs; endocarditis; pericarditis; myocarditis
what is seen in ABD candida infection? peritonitis affecting liver, spleen, gallbadder, pancreas
When is abdominal candida infection usually seen? ABD surgery
what What is seen with candida infection of the bladder? UTI
What is main cause of candida UTIs? urinary catheterizaion
what is acute pseudomembranous candidiasis? oral thrush
what is vulvovaginal candidiasis? yeast vaginitis. most common
how does candida infect the esophagus? esophagitis is caused by being spread down the mouth to the esophagus
when does gastrointestinal candidiasis seen? high powered antibiotics wipe outnormal flora of the GI and candida takes over
When is candida considered the #1 cause of infection? Immunodeficiency; DM; cancers; long term corticosteroids; neutropenia; long term antibiotics; prolonged hospital stay; alterasions in GI mucosa
why does cancer help promote candida infection? immunodeficiency that the cancer chemotherapeutic agents induce
why are diabetics prone to candida? usually dysfunction of the neutrophils and prone to the opportunistic infections from their own candida albicans as well as candida from outside
How is a gram stain used to differentiate between yeast and bacterial disease 100x bigger than bacteria. used freaquently on skin sites; if yeast greater than bacterial count then yeast is cause of disease
Explain KOH gets rid of tissue in order to see the yeast better. psuedohyphae can still be seen.
In a differential diagnosis of candida on an agar plate what colors are represented? blue -- tropicalis; white -- parapsilosis; -- green -- albicans
What do green streaks on an agar plate represent? C. albicans
Waht does a blue streak on an agar plate represent? C. tropicalis
What does a white streak on agar represent? C. parapsilosis
What are the pathogenic factors of Candida? adherence; proteinases; phospholipases; phenotypic switching
How is adherence important with Candida? stronger the adherence, the more virulent it is; Candida can adhere to medical devices adn contact lenses
what causes color differentiation in differential agar? carbohydrate utilization
How can Candida be diagnosed? agar, gram stain, blood culture, germ tube test, species-specific enzymem tests, carbohydrate utilization tests, antigen, antibody dectction, PCR, anti-fungal susceptibility tests
How is germ tube test used to diagnose? drop it in serum (rabbit most common); candida in serum will put out fibriles;
how is carbohydrate utilization test used to diagnose Candida? single carbohydrate utilization tests for strains other than the five most common
What is the problem with antigen, antibody detection tests? part of normal flora therefore the presence of Candida antibody really doesn't mean much
when are virulence factors true for candida? only when there are opptorunistic conditions
is formation of pseudohyphae dimorphism? no
what is pseudohyphae? elongation of the coccal form of the yeast... buds do not separate
can hyphae change over in candida... yes but it is very rare
what do proteinases and phopholipases do for virulence help break down lipids to give Candida invasive quality
What does Phenotypic switching allow for in Candida? ability to alter nutrient sources; form pseudohyphae;survive neutrophil killing; antifungal resistance
Explain antifungal resistance genes turn off and on in phenotypic switching to resist -AZOLE drugs. Only certain species
What is oral thrush? acute pseudomembranous candidosis
where is oral thrush usually seen? infants and elderly 2nd
why does oral thrush happen? infants don't have a fully functional immune system yet
How do infants acquire candida? can be exposed in vaginal canal but is usually oral acquistion... they are not born with it; may be received thru breast feeding
How can oral thrush be passed to a neonate thru vaginal canal of the mother; then with breast feeding can keep getting reinfected; if infant has thrush, mother's nipple should be examined for candida
What shoudl be considered if an adult or adolescent gets oral thrush? immunodeficiecy or metabolic problem; check for DM and immunodeficienicy; may be first sign of HIV
where will oral thrush be seen? tongue, buccal-mucous membranes
what dos thrush look like? cottage cheese patches
where does thrush appear in geriatrics? dentures due to lack of hygeine; allows candida to grow around the surface of teh gums and on palate in back of mouth
what is treatment for oral thrush nystatins, -AZOLE drugs 2nd line
is a swabbing showing candida in vaginal swab diagnostic for vaginal thrush? NO, it is normal flora
how is Candida passed in yeast infections? normal flora of vagina and occasionally from fecal transmision or sexually from a partner
what is a key to causing vaginal thrush? pH of vagina
what is normal pH of vagina? 4.5
what environment in the vagina allows overgrowth? down to 4.0 or lower
what environment in vagina allows for bacterial growth? to 7 or higher (alkaline)
how is Candida passed to a male sexually? Balantis (glans)
what are are predispositions for vaginitis? diabetes adn constant oral contraceptive use
how does DM cause vaginal thrush? changes the bacterial flora which will ead to change in pH thus causeing crhonic flora overgrowth
how does constant oral contraceptive use cause vaginal thrush? will change the bacterial flora compenent leading to a change in pH
what is the odor of candida? distince yeast
what is color and consistency of candida infection? cury adn lumpy; white
what clinical features are assoicaated with vaginal thrush and bacteria? fishy; abundant discharge that is frothy, grey and white
what clincial features are seen with trichomonas vaginal thrush? foul odor; frothy discharge that is greeish-yellow
what is vaginal ining in fungal thrush? dry, red
what is vaginal lining in bacterial thrush? pink
what is vaginal lining with trichomonas? tender, red
what is easies way to differentiate the vaginal thrush? gram stain; diffentiate between causitive agent; predominant organism is the cause
do gram positive rods indicate bacterial vaginal thrush? NO! lactobacillus is normal flora
what do gram negative rods in vaginal thrush indicate? gardnerella
what is treatment for vaginal thrush? diflucan (-AZOLE drugs)
when do you use nystatin in vaginal thrush? if resistant to -AZOLE
where is cutaneous candidiasis seen? skin and nails
can Candida peentrate intact skin? no
where is cutaneous candida seen? on surface of skin
What is diaper rash 75% of the tiem? candida
what usually causes diaper rash? child sitting ina wet soiled diaper for an extended period of time
why does fecal matter allow growth of candida? it is very acidic
wht rash is seen with diaper rash? pruritic rash; vesicular to pustular
waht os onychomycosis? nail bed infection with fungus
what is paronychia? fungral growth of the nail bed
what conditions make you susceptible to candida nail bed infection? hands in water constantly; glvoed canstantly with moist conditions
Created by: Todd Jamrose Todd Jamrose