Path Y2B2
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| Pityriasis Versicolor | caused by Malassezia furfur which is a normal skin flora | superficial mycoses
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| Trichophyton, microsporum sp, epidermophyton (cutaneous mycoses) | species pathogenic to humans | superficial mycoses
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| cutaneous mycoses | direct contact from humans or animals; remain confined to keratinous zone of the skin | superficial mycoses
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| cutaneous mycoses | submit skin scrapings to calcofluor white staining and examine under a fleorescent microscope; submit skin scrapings to KOH and then look for hyphae | superficial mycoses
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| tinea capitis | Ringworm of the scalp | superficial mycoses
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| tinea capitis | often associated with alopecia | superficial mycoses
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| tinea capitis | a kerion is a raised, edematous lesion of the scalp that manifests granulomatous inflammation and is usually secondarily invaded by bacteria; may or may not be a/w inflammation | superficial mycoses
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| tinea barbae | fungal folliculitis | superficial mycoses
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| tinea corporis | only involves glabrous skin | superficial mycoses
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| tinea corporis | usually annular lesion w/ vesicopustular border | superficial mycoses
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| tinea cruris | Jock Itch (in the groin) | superficial mycoses
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| tinea cruris | frequently associated w/ tinea pedis | superficial mycoses
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| tinea pedis | Athletes Foot; may be dry and hyperkeratatoic | superficial mycoses
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| tinea pedis | maybe intertriginous and macerated w/ fissures; secondary bacterial infection is common; may manifest vesicles and pustules | superficial mycoses
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| tinea manus | infection of the hand w/ symptoms similar to tinea pedis | superficial mycoses
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| Sporotrichosis | inflammatory papule that frequently ulcerates (aka Plaque Sporotrichosis) w/ low grade lymphangitis | subcutaneous mycoses
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| Sporotrichosis | eruption of other inflammatory papules in the lyphatic drainage ("chain of lesions") which is called Lymphangitis Sporotrichosis | subcutaneous mycoses
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| histoplasmosis | risk factor: prolonged aerosol exposure to bat and bird droppings; immunodeficiency; prolonged aerosol exposure to soil and dust | systemic mycoses
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| histoplasmosis | multiple calcified granulomas in the lungs (mass of fibrotic scarification often a/w calcification); granulomatous (often caseating) inflammation | systemic mycoses
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| histoplasmosis | multiple calcified granulomas in the spleen (d/t asymtomatic dissemination) | systemic mycoses
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| chronic progressive pulmonary histoplasmosis (chronic fibrocavitary pneumonia) | occurs in pts w/ chronic lung diseases, such as COPD, Cystic Fibrosis, etc. | systemic mycoses
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| chronic progressive pulmonary histoplamosis | only a minority of pts w/ primary pulmonary histoplasmosis develop chronic disease; causes diffuse fibrosis, often w/ cavities followed by cor pulmonale | systemic mycoses
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| chronic progessive histoplasma mediastinitis | lymphatic spread from primary lung infection; intense fibrosis can lead to compromise of vital mediastinal structures | systemic mycoses
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| acute disseminated histoplasmosis | may involve the skin, mucous membranes, liver, heart valves, GI tract and CNS; occurs only in immunodeficient pts and simulates bacterial sepsis | systemic mycoses
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| acute disseminated histoplasmosis | Sx: hepatosplenomegaly, Leukopenia, DIC, adrenal insufficiency | systemic mycoses
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| chronic disseminated histoplasmosis | very uncommon, usu only occurs in immunocompetent older adults | systemic mycoses
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| ocular histoplasmosis syndrome | central retinal degeernation and fivrous leading to vision loss | systemic mycoses
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| ocular histoplasmosis syndrome | probably a Type IV hypersensitivity rxn rather than an active infection | systemic mycoses
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| coccidioidomycosis | San joaquin Vally (CA), southwern USA (AZ), Western TX | systemic mycoses
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| coccidioidomycosis | very large yeast form, fungal spherules contain multiple endospores, intense granulomatous inflammation | systemic mycoses
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| primary coccidioidomycosis pneumonia | "valley fever," most pts are asym., fever, chronic cough, sob, frequently a/w erythema multiforme or erythema nodosum as a Type IV hypersensitivity response which indicates a vigorous cell mediated response | systemic mycoses
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| coccidioidomycosis | lab: b/c of the level of infectivity of C. immitis, health care and lab personel who handle specimens are at risk of aerosol exposure; hospital outbreaks have occurred | systemic mycoses
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| coccidioidomycosis | self-limited in immunocompetent individuals, "coin-like" lesions in lung; can be latent for many yrs | systemic mycoses
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| acute disseminated coccidioidomycosis | can be hematogenously disseminated in pts w/ immune deficiency (lymph, bone, skin, subq. CNS) | systemic mycoses
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| cryptococcosis | pigeon feces, most strains have a thick polysaccharide capsule (C. neoformans), therefore few immunocompetent pts get this | systemic mycoses
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| cryptococcosis | prolonged aerosol exposure to soil and dust contaminated w/ pigeon droppings | systemic mycoses
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| cryptococcosis | India ink stain | systemic mycoses
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| candidiasis | C. albicans (mc) | opportunistic mycoses
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| candiasis | all form pseudohyphae EXCEPT C. glabrata | opportunistic mycoses
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| pseudohyphae | wall constriction separates strands rather than true septae | (blank)
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| candiasis | most common fungal pathogen; common in hospitals | opportunistic mycoses
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| candiasis | some risk factors: Diabetes, congenital immunodeficiency, post transplant w/ chronic corticosteroid use | opportunistic mycoses
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| mucocutaneous candiasis | oral thrush, vulvovaginal thrush, balanitis (penile surface) | opportunistic mycoses
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| mucocutaneous candiasis | scatterred erythematous lesions a/w "cottage cheese" exudate which forms pseudomembranes | opportunistic mycoses
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| mucocutaneous candiasis | candidal esophagitis | opportunistic mycoses
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| aspergillosis | acute branching hyphae | opportunistic mycoses
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| aspergillosis | aspergillus fumigate (mc) | opportunistic mycoses
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| aspergillosis | granulomatous inflammation is usu only in immunocompetent pts , NOT immunodeficient | opportunistic mycoses
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| aspergillosis | vasculotropic which leads to vascular destruction and down-stream necrosis and hemorrhage | opportunistic mycoses
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| aspergillosis | leads to chronic inflammation of lungs (pneumonitis); increase in eosinophils | opportunistic mycoses
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| Pneumonia- healthy pt | histoplasmosis, blastomycosis, cryptococcosis | (blank)
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| Pneumonia- immunodepressed | aspergillosis, pneumocystis carinii, zygomycosis | (blank)
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| meningitis | cryptococcosis, candida | (blank)
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| disseminated- healthy pt | histoplasmosis, blastomycosis, coccidioidomycosis | (blank)
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| disseminated- immunodepressed | candida, aspergillus, cryptococcosis | (blank)
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| pneumocystis carinii | NO ergosterol in cell membrane | opportunistic mycoses
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| pneumocystis carinii | "foamy" eosinophilic material in alveolar space; lead to alveolar damage, or spread via blood to other organs (liver, spleen, bone marrow, lymph, eyes) | opportunistic mycoses
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| malassezia furfur | disseminated infection only seen in pts on IV hyperalimentation soln | opportunistic mycoses
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| zygomycosis | broad, rarely septae, hyphae of uneven width | opportunistic mycoses
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| rhinocerebral zygomycosis | central facial swelling a/w dermal discoloration; purulent nasal discharge; proptosis, reduced level of consciousness | opportunistic mycoses
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| aspergillosis | Rx: CXR "target lesions" d/t central area of necrosis surrounded by hemorrhage and edema | opportunistic mycoses
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| aspergillosis | lab: galactomannan antigenELISA assay - cross reactive w/ some other fungal species | opportunistic mycoses
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| aspergilloma (fungal ball) | cavitating lesion of the lung | opp. mycoses
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| sinonasal aspergillosis | may become locally invasive causing a fibrosing, granulomatous inflammation | opp. mycoses
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| aspergillus otits externa | on cerumen and w/in the external auditory canal | opp. mycoses
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| acute invasive pulmonary aspergillosis | only in immunodeficient; simulates a bac. pneumonitis | opp. mycoses
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| cutaneous aspergillosis | forms an ulcerated lesion, only occurs in immunodeficient | opp. mycoses
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| chronic necrotizing pulmonary aspergillosis | commonly occurs in pts w/ chronic obstructive pulmonary disease | opp. mycoses
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| chronic necrotizing pulmonary aspergillosis | vasculotropic fungi cause vascular damage and multiple small pulmonary infarctions surrounded by hemorrhage | opp. mycoses
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| disseminated aspergillosis | usu begins as UTI or pneumonia and then disseminates; only in severely immunocompromised | opp. mycoses
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| ABPA (allergic bronc. asp.) | 1:10 asthmatics; 1:8 CF pts; NOT in lung tissue | opp. mycoses
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| malt worker's lungs (aspergillus) | aka Brewer's lung; very rare, hypersensitivity variant; mold forms on malt and is inhaled in large concentrations | opp. mycoses
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