which of th efollowing is the most common fungal infection in the united states?
1. coccidiodomycosis
2. histoplasmosis
3. san Joaquin valley disease
4. blastomycosis
2. histoplasmosis
incidence of histoplasmosis is especially high in which of the following area(s)?
1. arizona
2. mississippi
3. nevada
4. texas
2. mississippi
the condtion called desert bumps, desert arthritis, or desert rheumatism is associated with which fungal disorder?
1. ohio valley fever
2. blastomycosis
3. coccidiodomycosis
4. aspergilliosis
3. coccidiodomycosis
which of the following is or are used to treat fungal disease:
1. streptomycin
2. amphotericin B
3. penicillin G
4. itracanazole
d. amphotericin B and itracanazole
which of the following forms of histoplasmosis is characterized by healed lesions in the hilar lymph nodes as well as a positive histoplasmin skin test response?
1. disseminated infection
2. latent asymptomatic disease
3. chronic histoplasmosis
4. self limiting primary disease
b. latent asympotomatic disease
a frothy yeast like substance is caused by
inhaled fungal spores
what comes in and moves into the infected areas to engulf the fungal spores
histoplasma capsulatum source of infection comes from what
heavy cleaning reffered to as as soil contamanited with bird and bat droppings, old houses (attics), farms (barn, chicken coops
Histoplasmosis
infection course: true or false
1. initial phase is controlled by macrophages
2. spores are inhaled, travel to lymph nodes at hilum and mediastinum, and spreads from lungs, lymph to liver, spleen and marrow
true
Histoplamisis
second phase is controlled by cellular immunity true or false
1. occurs 10-14 days after spore inhalation
2. infected sites necrose, caseate, and fibrose
3. calcified granulomas within few yrs
4. disseminated infection if cellular immunity defect
true
who are at risk for disseminated infection
1. infants and young children
2. intense exposure to airborne spores
3. immunocomprimised patients
all of the above
when would consider immunocompromised patients:
1. undifferentiated fever
2. pneumonia
3. mucocutaneous disease
all of the above
endemic areas are
ohio and Mississippi river valleys
endemic cities are
Indianapolis, Kansas city, houston
diagnosis in sputum culture requires
1. 2 mths
2. 2-6wks growth
3. 1 day
2. 2-6 wks growth
skin test diagnosis is 80-90% endemic area will test positive true or false
true
is it difficult to obtain sputum
yes because cough is unproductive
fungal stain is how much accurate:
1. 10%
2. 50%
3. 100%
3. 100% accurate
what are the round thin walled cells called when spores are inhaled, settle in lungs and begin to germinate
spherules that produce endospores that make more spherules ( they multiply)
what are speric fungi carried by wind borne dust particles called
coccidioldes immitis which are endemic in hot dry regions such as California Arizona, Nevada, new mexico, texas, Utah therefroe 80% of people in san joanquin valley test positive skin testing
coccidiodoidomycosis fungus can be isolated from
soils, plants and large number of vertebrates
if you get thrush (candida albicans) in the mouth what kind of treatment can be used after giving steroid