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Exam 2 - Micro/Immun

Introduction to Fungi

TermDefinition
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
Created by: 576937752774223