Human Fungal Pathogens and Treatments
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Questions and Answers

What examination features are expected with a left-sided pneumothorax?

  • Increased breath sounds on the affected side
  • Tracheal deviation to the left
  • Increased tactile fremitus on the affected side
  • Hyperresonance on the affected side (correct)

Which statement accurately reflects the characteristics of bronchial breath sounds when heard over lung tissue?

  • There is no pause between inspiration and expiration
  • They are higher pitched and louder (correct)
  • They are soft and low pitched
  • They are normal when heard over lung fields

What does polycythaemia indicate regarding red blood cells?

  • Excessive destruction of red blood cells
  • Normal hematocrit levels
  • Decreased production of red blood cells
  • Increased concentration of red blood cells in the blood (correct)

What can result from incorrect placement of a chest drain?

<p>Perforation of the pericardium (B)</p> Signup and view all the answers

What is the primary function of thoracic splanchnic nerves?

<p>Innervate thoracic organs (C)</p> Signup and view all the answers

Which condition primarily affects women under 30 and involves the upper limbs?

<p>Takayasu arteritis (A)</p> Signup and view all the answers

Which type of vascular tumor is primarily associated with HIV?

<p>Kaposi's sarcoma (B)</p> Signup and view all the answers

What is the primary initial cause of atherosclerosis?

<p>Hypertension and smoking (D)</p> Signup and view all the answers

Which of the following diseases manifests as high fever and conjunctival lesions in children?

<p>Kawasaki disease (D)</p> Signup and view all the answers

Which condition involves granulomatous inflammation of large and small arteries and typically affects individuals over 50?

<p>Giant cell temporal arteritis (C)</p> Signup and view all the answers

What is a key characteristic of polyarteritis nodosa?

<p>It affects small-sized muscular arteries. (B)</p> Signup and view all the answers

Which of the following is a benign tumor of the vascular system?

<p>Hemangioma (A)</p> Signup and view all the answers

The formation of foam cells during atherosclerosis is primarily due to what process?

<p>Engulfing oxidized LDL by macrophages (D)</p> Signup and view all the answers

Which of the following conditions is indicated by a hyper resonant sound during percussion?

<p>Pneumothorax (A)</p> Signup and view all the answers

What role does valsartan play in the sacubitril/valsartan combination therapy?

<p>It prevents increased angiotensin II levels (A)</p> Signup and view all the answers

Which molecule is likely to accumulate in total body water?

<p>Ethanol (A)</p> Signup and view all the answers

In the context of drug interaction, what is a consequence of hypoalbuminaemia?

<p>Increased free drug levels (D)</p> Signup and view all the answers

How is isoprenaline primarily used in medical emergencies?

<p>To manage bradycardia/heart block (D)</p> Signup and view all the answers

Which anatomical borders define the anterior triangle of the neck?

<p>Inferior border of mandible, anterior border of SCM, midline (C)</p> Signup and view all the answers

Which condition represents a risk factor for air embolism related to central venous catheter placement?

<p>External jugular vein puncture (C)</p> Signup and view all the answers

What is a primary characteristic of drugs that can pass the blood-brain barrier?

<p>Lipophilicity and low mol wt (B)</p> Signup and view all the answers

Which statement is true regarding the administration of medications through continuous infusion?

<p>Uses a dedicated IV site for administration (C)</p> Signup and view all the answers

What is the typical reason for performing a vocal resonance test during a dull percussion note?

<p>To assess for consolidation or fibrosis (C)</p> Signup and view all the answers

What is the mechanism of action of terbinafine?

<p>Inhibits squalene epoxidase, accumulating toxic sterols in cell wall (D)</p> Signup and view all the answers

Which condition is treated with amphotericin B?

<p>Invasive aspergillosis (C)</p> Signup and view all the answers

Which of the following statements about fluconazole is true?

<p>It is fungistatic and excreted largely unchanged in urine. (B)</p> Signup and view all the answers

Which treatment is appropriate for a patient with chronic HBV?

<p>Pegylated IFNalpha (A)</p> Signup and view all the answers

What is the primary mechanism of action of echinocandins?

<p>Inhibits 1,3-beta-glucan in the cell wall (A)</p> Signup and view all the answers

What class of drugs does griseofulvin belong to, and what is its mechanism of action?

<p>Antifungal; inhibits fungal mitosis (C)</p> Signup and view all the answers

How do neuraminidase inhibitors like oseltamivir function?

<p>They competitively bind to the neuraminidase binding site, preventing viral release. (A)</p> Signup and view all the answers

Which drug class is contraindicated in a patient with severe hepatic impairment?

<p>Tri-azoles (C)</p> Signup and view all the answers

What is the major difference between flucytosine (5-FC) and amphotericin B?

<p>5-FC inhibits protein synthesis and has potential hepatotoxicity, while amphotericin B displaces cell membrane permeability. (B)</p> Signup and view all the answers

Which is the best treatment for invasive candidiasis if the patient is clinically stable?

<p>Fluconazole (C)</p> Signup and view all the answers

Which of the following drugs has a mechanism that includes blocking the reverse transcriptase?

<p>Tenofovir (B)</p> Signup and view all the answers

Which drug is specifically indicated for the treatment of invasive aspergillosis?

<p>Voriconazole (A)</p> Signup and view all the answers

What is the primary action of glucocorticoids in the treatment of asthma?

<p>Modify the immune response and inhibit inflammation (D)</p> Signup and view all the answers

In the management of acute severe asthma, which medication is standard therapy?

<p>SABA via nebulizer (C)</p> Signup and view all the answers

What physiological change occurs in the blood due to acute altitude adaptation?

<p>Increased hemoglobin concentration to 200g/L (B)</p> Signup and view all the answers

What is a major consequence of nitrogen narcosis during diving?

<p>Altered mental state or impaired judgement (B)</p> Signup and view all the answers

Which intervention stimulates lung development in congenital diaphragmatic hernia?

<p>Trachea blocked with an inflated balloon (A)</p> Signup and view all the answers

During which stages of lung development are the primitive alveoli formed?

<p>Canalicular stage (B)</p> Signup and view all the answers

What is the main consequence of reduced intrapleural pressure during inspiration?

<p>Increased lung volume with air influx (B)</p> Signup and view all the answers

Which condition is characterized by decreased lung compliance due to fibrous tissue deposition?

<p>Pulmonary fibrosis (C)</p> Signup and view all the answers

What feature of emphysema leads to increased airway resistance?

<p>Collapse of the alveoli during expiration (B)</p> Signup and view all the answers

What characterizes the normal function of surfactant in the alveoli?

<p>Lowers surface tension at the air-liquid interface (A)</p> Signup and view all the answers

Which factor is primarily responsible for the positive pressure during expiration?

<p>Elastic recoil of the lung tissue (C)</p> Signup and view all the answers

What metabolic consequence is associated with respiratory alkalosis due to decreased PaCO2?

<p>Stimulation of bicarbonate reabsorption (C)</p> Signup and view all the answers

What is the most important muscle involved in raising the rib cage during breathing?

<p>Sternocleidomastoid (SCM) (C)</p> Signup and view all the answers

Which type of genetic mutation can cause different severity levels of the same disease?

<p>Variable expression (C)</p> Signup and view all the answers

In relation to lung capacity, what does functional residual capacity encompass?

<p>Expiratory reserve volume and residual volume (A)</p> Signup and view all the answers

What is the primary first-line treatment for a patent ductus arteriosus (PDA)?

<p>Ibuprofen (B)</p> Signup and view all the answers

What is the most common type of atrioventricular septal defect (AVSD) found in Down syndrome?

<p>Complete AVSD (D)</p> Signup and view all the answers

Which of the following conditions is characterized by a continuous murmur and bounding peripheral pulses?

<p>Patent ductus arteriosus (D)</p> Signup and view all the answers

What is the common consequence of untreated large ventricular septal defects (VSD)?

<p>Eisenmenger's syndrome (D)</p> Signup and view all the answers

Which of the following types of lung disorders shows a reduced FEV1 but a normal or elevated FEV1%, indicating a restrictive pattern?

<p>Restrictive lung disorder (A)</p> Signup and view all the answers

Which anatomical structure is primarily involved in maintaining ductal patency in a neonate?

<p>Ductus arteriosus (C)</p> Signup and view all the answers

Which heart defect is commonly associated with Turner’s syndrome and shows signs of cyanosis and systemic hypertension in adults?

<p>Aortic coarctation (D)</p> Signup and view all the answers

What physiological phenomenon increases blood flow 4-7 times normal when blood supply is temporarily blocked?

<p>Reactive hyperemia (D)</p> Signup and view all the answers

Which drug class is contraindicated in patients with bilateral renal artery stenosis due to the risk of worsening renal function?

<p>ACE inhibitors (A)</p> Signup and view all the answers

Which type of heart failure is characterized by preserved ejection fraction but impaired diastolic filling?

<p>Diastolic dysfunction (A)</p> Signup and view all the answers

What is the major first-line antibiotic treatment used during the intensive phase for tuberculosis?

<p>Rifampicin (A)</p> Signup and view all the answers

In a patient with patent ductus arteriosus, which of the following clinical signs is an indication of poor systemic perfusion?

<p>Failure to thrive (B)</p> Signup and view all the answers

What condition contributes to the development of necrotizing enterocolitis in preterm infants with patent ductus arteriosus?

<p>Decreased systemic perfusion (B)</p> Signup and view all the answers

Which laboratory value is typically monitored to assess myocardial injury in cases of myocardial infarction?

<p>CK-MB (B)</p> Signup and view all the answers

In which type of study is relative risk commonly used to evaluate treatment outcomes?

<p>Cohort studies (A)</p> Signup and view all the answers

What is the expected change in blood flow due to increased intra-thoracic pressure during the Valsalva maneuver?

<p>Decreased blood pressure (A)</p> Signup and view all the answers

Flashcards

Surgical Emphysema

A condition where air leaks from the lungs or airways into the surrounding tissue, causing swelling and a crackling sensation on palpation.

Vesicular Breath Sounds

A type of breath sound that is normal over most lung fields, characterized by a soft, low-pitched sound with inspiration being longer and louder than expiration.

Bronchial Breath Sounds

A type of breath sound that is abnormal when heard over lung tissue, but normal over the trachea, characterized by a higher pitched, louder sound with a pause between inspiration and expiration.

Polycythemia

This occurs when there is an increased concentration of red blood cells (RBCs) in the blood, resulting in higher hematocrit levels.

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Pneumothorax

A condition where air fills the space between the lung and the chest wall, causing the lung to collapse.

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Giant Cell Arteritis

Inflammation of large and small arteries, often affecting the temporal, ophthalmic, and vertebral arteries.

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Takayasu Arteritis

Inflammation of medium and large arteries, mainly affecting the upper limbs and aortic arch. Often leads to claudication in the arms.

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Polyarteritis Nodosa

Inflammation of medium-sized muscular arteries, particularly in the kidneys, heart, liver, and GI tract. Often leads to fibrinoid necrosis and can be fatal if left untreated.

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Kawasaki Disease

A self-limiting disease affecting children under 4 years old, characterized by high fever, conjunctivitis, and oral lesions.

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Angioma

A benign tumor of blood vessels.

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Angiosarcoma

A malignant tumor of blood vessels, often associated with HIV.

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Atherosclerosis

A common vascular disease characterized by the buildup of plaques within the arteries, leading to narrowing and blockage.

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Fatty Streak

The initial stage of atherosclerosis where LDL cholesterol accumulates in the intima of the artery wall.

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Superficial Fascia

A layer of subcutaneous fat and connective tissue that lies beneath the skin, providing insulation and cushioning.

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Pectoralis Major

A large muscle in the chest that helps with arm movement and breathing.

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External intercostal

Muscles that run between the ribs, helping with breathing.

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Endo-thoracic fascia

A thin layer of connective tissue that lines the inside of the chest cavity.

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Parietal pleura

A membrane that lines the chest cavity and surrounds the lungs.

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Hyper resonant

A type of chest percussion sound that indicates emphysema (lung condition) or pneumothorax (collapsed lung).

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Visceral pleura

A dense, fibrous connective tissue that surrounds the organs in the chest cavity.

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Dull

A type of chest percussion sound that suggests a problem with the lung tissue, such as collapse, consolidation, or fibrosis.

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Sacubitril/valsartan

A combination medication used to treat heart failure, it consists of a neprilysin inhibitor and an angiotensin II receptor blocker.

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Ranolazine

A medication used for refractory angina (chest pain) that doesn't respond to other treatments.

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Superficial mycoses

A group of fungal infections that affect the outermost layer of the skin, hair, and nails.

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Tinea versicolor

A type of superficial mycosis caused by the yeast Malassezia furfur. It can cause skin discoloration, scaling, and itching.

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Cutaneous mycoses

A group of fungal infections that affect the deeper layers of the skin, hair, and nails. It's commonly known as 'ringworm'.

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Tinea capitis

A type of cutaneous mycosis that affects the scalp, causing hair loss and scaling.

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Tinea cruris

A type of cutaneous mycosis that affects the groin area, causing itching and a red, scaly rash.

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Tinea pedis

A type of cutaneous mycosis that affects the feet, causing itching, scaling, and cracking of the skin.

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Subcutaneous mycoses

A type of fungal infection that affects the deeper layers of the skin, subcutaneous tissues, and sometimes bones. It is caused by fungi that live in the soil.

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Sporotrichosis

A type of subcutaneous mycosis caused by the fungus Sporothrix schenckii. It is characterized by small, painless nodules that form along the lymphatic vessels.

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Mycotic mycetoma

A type of subcutaneous mycosis that affects the deeper tissues, causing swelling and draining sores.

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Systemic mycoses

A group of fungal infections that affect internal organs, such as the lungs, brain, and heart.

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Candidiasis

A type of systemic mycosis caused by the yeast Candida albicans. It can cause infections in the mouth, throat, vagina, and skin.

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Cryptococcosis

A type of systemic mycosis caused by the fungus Cryptococcus neoformans. It can cause meningitis, pneumonia, and other infections.

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Histoplasmosis

A type of systemic mycosis caused by the fungus Histoplasma capsulatum. It is found in soil contaminated with bird or bat droppings and can cause lung infections.

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Aspergillosis

A type of systemic mycosis caused by the fungus Aspergillus fumigatus. It can cause lung infections, aspergillomas, and allergic bronchopulmonary aspergillosis (ABPA).

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Central Chemoreceptor Adaptation at Altitude

Increased ventilation rate at altitude due to adaptation of central chemoreceptors, leading to decreased PaCO2 and respiratory alkalosis. Kidneys compensate by decreasing acid excretion, normalizing blood pH.

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Rightward Shift at Altitude

A rightward shift in the oxygen-hemoglobin dissociation curve, caused by increased production of 2,3-DPG, promoting oxygen release to tissues.

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Nitrogen Narcosis

A condition where nitrogen dissolves into tissues at high pressure, causing a state of euphoria and impaired judgment.

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Transpulmonary Pressure

The pressure difference between the air inside lung alveoli and the pressure on the outer surfaces of the lungs.

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Alveolar Pressure

The pressure of air inside lung alveoli.

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High Lung Compliance

The smallest increase in transpulmonary pressure results in a large increase in lung volume, indicating low elastic recoil.

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Residual Volume

The volume of air remaining in the lungs after the most forceful expiration.

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Vital Capacity

The volume of air that can be breathed in by maximum inspiration following maximum expiration.

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Surface Tension

A measure of the force acting to pull liquid surface molecules together at an air-liquid interface.

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Surfactant

A substance that reduces surface tension in alveoli, preventing collapse and improving gas exchange.

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Congenital Diaphragmatic Hernia

Condition where the fetus has a diaphragmatic hernia, commonly posterolateral, affecting lung development.

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Earliest Survival Age for Premature Baby

The earliest age a premature baby can survive, due to lung development.

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FETO

A disorder where the trachea is blocked by an inflated balloon, stimulating lung development in utero.

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Congenital Pulmonary Airway Malformation

A condition where the lung lobe is replaced by non-functional cystic tissue, often asymptomatic.

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DiGeorge's Syndrome

Genetic disorder caused by a deletion on chromosome 22, affecting pharyngeal pouches and leading to heart and thymus defects.

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Coarctation of the Aorta

A congenital heart defect characterized by a narrowing of the aorta, leading to reduced blood flow to the lower body. Signs include systemic hypertension and a delay in the pulse felt in the femoral artery compared to the radial artery.

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Patent Ductus Arteriosus (PDA)

A defect in the heart where the ductus arteriosus, a blood vessel connecting the aorta and pulmonary artery, fails to close after birth. This leads to increased blood flow to the lungs.

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Atrial Septal Defect (ASD)

A congenital heart defect where there is a hole in the septum between the atria, allowing blood to flow from the left atrium to the right atrium. This can lead to increased blood flow to the lungs and right ventricular hypertrophy.

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Ventricular Septal Defect (VSD)

A defect in the heart where there is a hole in the septum between the ventricles, allowing blood to flow from the left ventricle to the right ventricle. This can lead to increased blood flow to the lungs and pulmonary hypertension.

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Pulmonary Valve Stenosis

A congenital heart defect where the pulmonary valve is narrowed, restricting blood flow from the right ventricle to the pulmonary artery. This can lead to right ventricular hypertrophy and cyanosis.

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Duct-Dependent Coarctation of the Aorta

A rare but serious type of coarctation of the aorta where the aorta is dependent on the patent ductus arteriosus for blood flow. When the ductus closes, severe heart failure can occur.

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Eisenmenger Syndrome

A life-threatening condition that occurs when a large VSD remains untreated. Blood flows from the high-pressure left ventricle to the low-pressure right ventricle, leading to pulmonary hypertension and right heart failure.

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Orthostatic Hypotension

A medical condition characterized by an abnormally low blood pressure when a person stands up from a lying position.

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Ductus Arteriosus Closure

The process by which the ductus arteriosus closes naturally after birth. This involves both functional closure within the first hour and structural closure over the following months.

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Hyperthermia

A condition where a person has a high body temperature without fever.

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Hypovolemic Shock

A type of shock caused by a significant reduction in blood volume.

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Needle Aspiration for Tension Pneumothorax

A method for treating tension pneumothorax by inserting a needle into the pleural space to relieve pressure.

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Myth: More Pain = More Damage in MI

A common misconception about heart attacks, believing that more pain indicates more damage to the heart.

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Cardiac Rehabilitation (CR)

A group of exercises tailored for patients with chronic conditions like heart disease, aiming to improve their overall fitness and well-being.

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SMART Goals

A framework for setting goals that are specific, measurable, achievable, realistic, and time-bound.

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Study Notes

Human Fungal Pathogens

  • Superficial mycoses include Malassezia furfur
  • Cutaneous mycoses include tinea capitis, cruris, and pedis
  • Subcutaneous mycoses include sporotrichosis and mycotic mycetoma
  • Systemic mycoses include Candida, Cryptococcus, Histoplasmosis, and Aspergillus

Fluconazole

  • Fungistatic
  • Dose-dependent fungicidal action
  • Excreted largely unchanged in urine, useful in candiduria
  • Reduced dose if eGFR is less than 50 mL/minute/1.73m2

Polyenes

  • Nystatin is used for local infections (oral, perioral, oropharyngeal)
  • Amphotericin B treats systemic infections, but it is highly protein bound and poorly penetrates tissues
  • Liposomal formulations of Amphotericin B are less toxic and have better tissue penetration.

5-FC + Amphotericin B

  • Amphotericin B increases cell permeability
  • 5-FC forms false nucleotides, disrupting nucleic acid and protein synthesis
  • 5-FC causes hepatotoxicity and blood disorders

Echinocandins

  • Fungicidal against Candida but fungistatic against Aspergillus

Griseofulvin

  • Treats dermatophytosis
  • Disrupts mitotic spindle, inhibiting mitosis
  • Induces hepatic CYP450
  • Causes dyspepsia or fatigue

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Description

Explore the world of human fungal pathogens, including superficial and systemic mycoses, as well as various antifungal treatments like Fluconazole and Amphotericin B. This quiz covers key fungal species, drug mechanisms, and therapeutic applications essential for understanding medical mycology.

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