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Exam 2 - Micro/Immun
Introduction to Fungi
Term | Definition |
---|---|
Moulds | grow by multicellular hyphae, "mould"=fungus, "mold"=shaping |
Yeast-like | reproduce by budding (spherical-shaped) |
Moulds | dark & fuzzy, <0.1%, cell wall: chitin = 10-20%, beta-1,3-glucan only, 20-30% galactomannans |
Yeasts | smooth & creamy, 8-10%, cell wall: chitin = 1-29%, beta-1,3 andbeta-1,6-glucans, 30-50% mannoproteins |
An available assay brand, Fungitell is used to detect (1,3)beta-D glucan in serum. A positive Fungitell indicates patient infected w/ what fungi? | Moulds/yeasts |
An assay detects galactomannan in respiratory samples. A positive galactomannan indicates that a patient is infected w/ what fungi? | Moulds, bc. it's the primary pathogen that has galactomannon in its cell wall |
Yeast-Like Pathogenic Fungi | Opportunistic (Candida spp.) and Endemic |
Moulds Pathogenic Fungi | Aspergillus spp. (A. fumigatus) and Weird Moulds |
Opportunistic yeast | Candida spp.(C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. krusei), Cryptococcus spp., Pneumocystis jiroveci |
Endemic yeast | Coccidioides spp., Histoplasma spp., Blastomyces spp. |
Aspergillus spp. mould | A. fumigatus, A. flavus, A. niger, A. terreus |
Weird moulds | Zygomycetes (Rhizopus oryzae, Rhizomucor spp., Mucor supp.), Fusarium spp., Scediosporium spp. |
An available assay brand, Fungitell is used to detect (1,3)beta-D glucan in serum. A positive Fungitell indicates patient infected w/ what fungi? | A. fumigatus, C. albicans, C. glabrata |
An assay detects galactomannan in respiratory samples. A positive galactomannan indicates that a patient is infected w/ what fungi? | A. flavus, A. terreus |
JCPP Pharmacists' Patient Care Process | 1. Collect 2. Assess 3. Plan 4. Implement 5. Follow-up: monitor & evaluate for safety and effectiveness |
What fungal infections are you most likely to encounter as a community pharmacist? List at least 5 from most likely to least likely. | Tinea pedis (athlete's foot), tinea corporis (ringworm), tinea capitis (scalp ringworm), tinea cruris (jock itch), tinea unguium (onychomycosis, nail fungus), vulvovaginal candidiasis (yeast infection) & orpharyngeal candidiasis (thrush) |
Candida sp. (yeast) | accounts for about 15-50% mortality if it becomes a blood infection |
Aspergillus pneumonia (mould) | causes pulmonary/lung infections |
A patient has a lesion on her arm. It is tinea corpris (ringworm). It is a fungi, not severe & can treat as an outpatient. What do we do to treat the patient with? | Terbinafine cream = antifungal |
What treatment would you recommend for a toe nail fungus? | Oral terbinafine = the nail fungus is below the nail and in the nail matrix which is not exposed |
Epidemiology of Invasive Candidiasis | #1 Cause of Invasive Fungal Infections: 9% incidence and 39.2% mortality |
Invasive Candidiasis | yeast, smooth & creamy |
What is the most common Candida species isolated from patients with invasive candidiasis or candidemia? | Candida albicans |
Mortality of Invasive Aspergillosis (Mould) | Allogeneic & Autologous Hematopoietic Stem Cell Transplant = 78-92% mortality |
Invasive Aspergillosis | mould, dark & fuzzy |
Patients that suffer from these types of invasive fungal infections are likely to suffer from severe signs and symptoms requiring hospitalization | candidemia, endemic mycoses, and pulmonary aspergillosis |
The 2 primary mechanisms by which fungi become resistant to antifungal agents include | Target site alteration and Efflux |
Target site mechanism | glucan synthase looks are changed and Echinocandins can not bind and now you have resistance |
Efflux mechanism |