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USMLE Step 1 Flash Cards
USMLE Step 1 Flash Cards
USMLE Step 1 Flash Cards
USMLE Step 1 Flash Cards
USMLE Step 1 Flash Cards

USMLE Step 1 Flash Cards

Dimorphic Fungi  B lastomyces H istoplasma   C occidioides  S porothrix B
Dimorphic Fungi  B lastomyces H istoplasma   C occidioides  S porothrix B
Dimorphic Fungi  B lastomyces H istoplasma   C occidioides  S porothrix B
Dimorphic Fungi  B lastomyces H istoplasma   C occidioides  S porothrix B

Dimorphic Fungi

Dimorphic Fungi  B lastomyces H istoplasma   C occidioides  S porothrix B ody

Blastomyces Histoplasma

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Coccidioides

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Sporothrix

H istoplasma   C occidioides  S porothrix B ody H eat C hanges S
H istoplasma   C occidioides  S porothrix B ody H eat C hanges S
H istoplasma   C occidioides  S porothrix B ody H eat C hanges S
H istoplasma   C occidioides  S porothrix B ody H eat C hanges S
H istoplasma   C occidioides  S porothrix B ody H eat C hanges S

Body Heat Changes Shape

for the dimorphic fungi

Pseudohyphae (Candida albicans)

Hyphae with constrictions at each septum

Spore types  Conidia  Asexual spores; formed off hyphae; common; air-borne  Blastoconidia 
Spore types  Conidia  Asexual spores; formed off hyphae; common; air-borne  Blastoconidia 
Spore types  Conidia  Asexual spores; formed off hyphae; common; air-borne  Blastoconidia 
Spore types  Conidia  Asexual spores; formed off hyphae; common; air-borne  Blastoconidia 

Spore types

Conidia

Asexual spores; formed off hyphae; common; air-borne

Blastoconidia

“Buds” on yeasts (asexual budding daughter yeast cells)

Arthroconidia

Asexual spores formed by a “joint”

Spherules and Endospores (Coccidioides)

Spores inside the spherules in tissues

Malassezia furfur  Normal skin flora (lipophilic yeast)  Patient with blotchy hypo-pigmentation of skin

Malassezia furfur

Normal skin flora (lipophilic yeast)

Patient with blotchy hypo-pigmentation of skin

KOH scrapping shows “spaghetti and meatballs” or “bacon and eggs” yeast clusters & short curved septate hyphae

Treatment :

Topical selenium sulfide; recurs

Dermatophytes (group of fungi)  Filamentous (monomorphic) fungi  Three genera:  Trichophyton – skin,

Dermatophytes (group of fungi)

Filamentous (monomorphic) fungi

Three genera:

Trichophyton skin, hair and nails

Mircrosporum hair and skin

Epidermophyton skin and nails

Patient with scaly, ringlike lesions (Tineas) of skin. May involve hair shaft or

nails.

KOH scrapping shows athroconidia and hyphae

Treatment :

Topical imidazole or tolnafate

hyphae  Treatment :  Topical imidazole or tolnafate ID reaction (dermatophyt ID ) = allergic
hyphae  Treatment :  Topical imidazole or tolnafate ID reaction (dermatophyt ID ) = allergic

ID reaction (dermatophytID) = allergic response to circulating fungal antigens.

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Sporothrix schenckii  Subcutaneous mycoses  Patient with subcutaneous/lymphocutaneous mycetoma  Gardener,
Sporothrix schenckii  Subcutaneous mycoses  Patient with subcutaneous/lymphocutaneous mycetoma  Gardener,

Sporothrix schenckii

Subcutaneous mycoses

Patient with subcutaneous/lymphocutaneous mycetoma

Gardener, florist, basket weaver, or alcoholic rose- garden sleeper disease (homeless)

Cigar-shaped yeast in pus

Treatment : intraconazole or amphotericin B

Histoplasma capsulatum  Deep fungal infection; dimorphic fungi  Normal patient with acute pulmonary; IC
Histoplasma capsulatum  Deep fungal infection; dimorphic fungi  Normal patient with acute pulmonary; IC
Histoplasma capsulatum  Deep fungal infection; dimorphic fungi  Normal patient with acute pulmonary; IC

Histoplasma capsulatum

Deep fungal infection; dimorphic fungi

Normal patient with acute pulmonary; IC patient with chronic pulmonary or disseminated infection (FUNGUS FLU)

States following drainages of Great Lakes to Gulf of Mexico

Exposure to bird or bat excrement

Sputum or blood cultures with mononuclear cells packed with

yeast cells (tiny yeast inside macrophages)

Treatment : Ketoconazole, amphotericin B

Coccidioides immitis  Deep fungal infection; dimorphic fungi  Normal patient with erythema nodosum or

Coccidioides immitis

Deep fungal infection; dimorphic fungi

Normal patient with erythema nodosum or self-resolving

pneumonia

IC patient with calcifying chronic pulmonary or disseminated infections

Pregnant female in 3 rd trimester, disseminated infection

Desert southwest

Sputum has spherules with endospores

Treatment : Amphotericin B

Blastomyces dermatitidis  Deep fungal infection; dimorphic fungi  Normal patient with acute pulmonary symptoms

Blastomyces dermatitidis

Deep fungal infection; dimorphic fungi

Normal patient with acute pulmonary symptoms

IC patient with chronic pulmonary or disseminated infection

North and South Carolina (otherwise coexists with

Histoplasma)

Sputum has broad-based, budding yeasts with double, refractile cell walls.

Treatment : Amphotericin B

Aspergillus fumigatus  Monomorphic filamentous OPPORTUNISTIC fungi  Patient with asthma allergies – growing

Aspergillus fumigatus

Aspergillus fumigatus  Monomorphic filamentous OPPORTUNISTIC fungi  Patient with asthma allergies – growing

Monomorphic filamentous OPPORTUNISTIC fungi

Patient with asthma allergies growing mucous plugs in lung

Patient with cavitary lung lesions fungus ball

Patient with burns cellulitis, invasion

IC patient pneumonia, meningitis

Septate hyphae branch at acute angles

Treatment : Itraconazole or Amphotericin B

Candida albicans  OPPORTUNISTIC fungi  Forms germ tubes at 37˚C; pseudohyphae & true hyphae
Candida albicans  OPPORTUNISTIC fungi  Forms germ tubes at 37˚C; pseudohyphae & true hyphae
Candida albicans  OPPORTUNISTIC fungi  Forms germ tubes at 37˚C; pseudohyphae & true hyphae

Candida albicans

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OPPORTUNISTIC fungi

Forms germ tubes at 37˚C; pseudohyphae & true hyphae when invades

tissues

Germ tube test demonstrates pseudohyphae and hyphae

IC patient, overuse of antibiotics thrush, spread down GIT,

septicemia

IV drug abusers - endocarditis

Treatment :

topical or oral imidazoles; nystatin

Disseminated : Amphotericin B or fluconazole

Cryptococcus neoformans  Encapsulated (monomorphic) yeast; OPPORTUNISTIC fungi  Pigeon breeder with acute

Cryptococcus neoformans

Encapsulated (monomorphic) yeast; OPPORTUNISTIC fungi

 Encapsulated (monomorphic) yeast; OPPORTUNISTIC fungi  Pigeon breeder with acute pulmonary symptoms 

Pigeon breeder with acute pulmonary symptoms

Hodgkins/AIDS patient with meningitis



India Ink mount of CSF with encapsulated yeasts

Treatment : Amphotericin B + flucytosine until afebrile (minumum 10 wks), then fluconazole

Mucor, Rhizopus, Absidia  Ketoacidotic diabetic or leukemic patient with rhinocerebral infection  Biopsy with

Mucor, Rhizopus, Absidia

Ketoacidotic diabetic or leukemic patient with rhinocerebral infection

Biopsy with non-septate irregular-width hyphae branching at 90˚ angles.

Treatment :

High fatality rate (rapid growth and invasion)

Debride necrotic tissue & start Amphotericin B fast.

Pneumocystis jiroveci  Obligate extracellular parasite  Premature infant or AIDS patient with atypical pneumonia
Pneumocystis jiroveci  Obligate extracellular parasite  Premature infant or AIDS patient with atypical pneumonia

Pneumocystis jiroveci

Obligate extracellular parasite

Premature infant or AIDS patient with atypical pneumonia

Biopsy with honeycomb exudates and silver-staining cysts

X-ray ground glass

Treatment :

TMP-SMX for mild

Dapsone for moderate to severe