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single celled or multicellular organisms whose primary role on the planet is to serve as decomposers of dead plants and animals, returning them to the soil are called:
fungi
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list 2 unicelluar types of funig:
list 1 multicellular fungi:
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although there are many types of fungi, how many are found to cause disease in humans:
50 -300
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how do most exposure to pathogenic fungi occur:
inhalation of fungal spores or by handling contaminated soil
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a route for invasive fungi to enter the body and infect the internal organs is the:
lungs
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fungal infections of overgrowth of normal flora occur in:
mouth or vagina
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in addition to causing infection, fungal spores may trigger ______ response in susceptible pts., resulting in allergies to mold or mildew:
hypersensitivity
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fungi attack a person with a healthy immune system often distinctly from those that infect pts. who are immunocompromised.
pts. with intact immune systems are afflicted with:
immunocompromised:
intact immune
community acquire infections - sporotrichosis
- blastomycosis
- histoplasmosis
- coccidioidomycosis
- immunocomprommised
- nosocomial settings (hospital)
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infections caused by fungi are called:
mycoses
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affecting the scalp, skin, nails, and mucous membranes such as the oral cavity and vagina are called:
how are tese types of mycoses usually treated:
- superficial mycoses (dermatophytic)
- treated: with topical drugs
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affecting the internal organs, typically the lungs, brain, and digestive organs are called:
how are these mycoses tx'ed:
- systemic (invasive) mycoses
- tx: agressive oral/parenteral meds (adverse effects than topical)
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fungi have _____________ rather than cholesterol in their cell membranes:
ergosterol
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how does the largest class of antifungals work:
cause the fugnal plasma (ergosterol) membrane to become porous or leaky
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the preferred drug for systemic fungal infections since the 60's, which can cause a # of serious side effects is called:
amphotericin B
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what is the MOA for amphotericin B:
MOA: acts by binding to ergosterol in fungal cell membranes
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what are the adverse effects of amphotericin B:
- ototoxicity (hearing loss, vertigo, unsteady gait, tinnitus (ringing in ears))
- cardiac arrest
- hypotension
- dysrhythmias
- phlebitis (during IV therapy)
- nephrotoxicity
- electrolyte imbalance (hypokalemia)
- fever, chills, vomiting, headache
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how to maange pt. care for amphotericin B:
determine if the pt is 3 things:
monitor which 3 things:
why do we need to monitor weight:
how do we assess for ototoxicity:
how do we asses for hypokalemia:
- determine if: has renal impairment, bone marrow suppression, or pregnant
- monitor: VSs, I&O, weight
- monitor weight: HF, nephrotoxicity, and/or CHF
- ototoxicity: decreased hearing, vertigo, unstady gait, tinnitus
- hypokalemia: irregular/slow pulse, constipation, weakness, decreased UOP
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interfering with the biosynthesis of ergosterol, depleting the fungal cells of ergosterol, imparing their growth is the MOA of:
azoles
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why are systemic azoles preferred over Amphotericin B:
they can be administered PO, and are much less toxic
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what are the advantages of using itraconzaole in therapy for systemic mycoses:
- less hepatotoxic
- given orally or IV
- broader spectrum
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what are the adverse effect os azoles (8):
- nausea/vomiting
- anaphylaxis
- rash
- hepatitis (with ketaconazole- Nizoral)
- metrorrhagia (uterine bleeding)
- decreased testosterone production
- gynecomastia (enlarged breast tissue in males)
- Rx-Rx interactions leading to serious arrhythmias
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list 2 oral tx's that accumulate in the nail beds, allowing them to remain active for a long time:
- itracozaole (sporanox)
- terbinafine (lamisil)
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know how to manage the side effects of nystatin:
- dont apply if contact dermatitis develops at the site where the drugs it to be applied
- allow troches (lozonges) to dissolve completely
- pt. shouldnt have anything to eat or drink 30 mintues after
- remove dentures before using swish and spit or troches
- anti-fungal vaginal suppositories should be inserted high into the vagina and the pt. should remain recumbent for 15 minutes after
- with topical anti fungals, report any redness, rashs
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biocidal chemicals used to kill or inhibit fungi or fungal spores are called:
fungicidal
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nonliving agents that infect bacteria, plants, and animals, that contain none of the cellular organelles neccesary for self-survival that are present in living organisms are called:
viruses
- cant survive independently
- needs to get into cells to reproduce and cause an infection
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the neccessary information needed for viral replication are found in which 2 forms:
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what is the preferred target that the HIV virus attaches to once it enters the body:
CD4 receptor on T4 (helper) lymphocytes
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the virus uncoats and the genetic material of HIV, single stranded RNA, enters the host cell. HIV converts its RNA strand to double-stranded DNA using the viral enzyme:
reverse transcriptase
it may remain in host DNA for years before it becomes activted to produce more viral particles (latent peroid)
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the viral enzyme _____ cleaves some proteins associated with the HIV DNA and enablies the virion to infect other T4 lymphocytes:
protease
- the this viral DNA is activated, new viron particles are produced and they create holes in the helper T4's cell membranes as they bud and exit the cell.
- this budding stimulates an immune response, but too late to prevent the infection
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because of their "backward" or reverse , the HIV viriuses are called retroviruses, and the drugs used to treat HIV infections are called:
antiretrovirals
- because HIV replicates so quickly, drug resistance is very common.
- stopping the very expensive drugs quicly leads to a viral resurgence.
- full cure isnt possible but viral replication can be decreased
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list the 7 viral infections for which there are anti-viral drugs:
- HSV
- HIV
- CMV
- Epstein-Barr
- Herpes zoster
- RVS
- influenza
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what is the MOA for antiviral for herpesviruses:
preventing DNA synthesis, decreases the duration and severity of acute herpes episodes
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when does the influenza vaccine start to work and how long after its given does it confer immunity:
adequate immunity is achieved about 2 weeks after vaccination and lasts for several months up to a year
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