SA Med b E1/1

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HLW
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170116
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SA Med b E1/1
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2012-09-10 21:09:16
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SA Med E1
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SA Med b E1/1
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  1. What is not a contagious disease, infection is due to contact with organisms in environment, and inhalation is common?
    systemic mycoses
  2. What dimorphic soil dwelling fungus has 2 phases (mycelial phase and yeast phase)?
    histoplasma capsulatum (histoplasmosis)
  3. What is the number one route of infection of histoplasmosis?
    inhalation (number 2 is ingestion)
  4. What cells does histoplasmosis infect?
    macrophages
  5. What is the incubation period of histoplasmosis?
    12-16 days (relatively short)
  6. What type of response does histoplasmosis generate?
    granulomatous or pyogranulomatous response
  7. What is the most common form of histoplasmosis?
    subclinical (self limiting) infection confined to the lungs
  8. What is the least common form of histoplasmosis?
    severe fulminant granulomatous pneumonia
  9. In acute pulmonary form of histoplasmosis, what lymph nodes are moderately enlarged?
    hilar lymph nodes
  10. What form of histoplasmosis is more common than the acute form?
    chronic pulmonary form
  11. What form of histoplasmosis causes MASSIVELY enlarged hilar lymph nodes?
    chronic pulmonary form
  12. Where is the intestinal form of Histoplasmosis more commonly located?
    colon
  13. What are the most common clinical signs of Histoplasmosis?
    intractable diarrhea and progressive weight loss
  14. What is the most common form of histoplasmosis in cats?
    Disseminated form (extrapulmonary)
  15. What is necessary for definitive diagnosis of histoplasmosis?
    cytology or histopathology
  16. What is very effective way to diagnose histoplasmosis?
    antigen testing (mira vista)
  17. How are you able to characterize histoplasmosis?
    surrounded by a characteristic clear halo or pseudocapsule which results from shrinkage of cytoplasm from cell wall during fixation
  18. What is the treatment of choice for histoplasmosis that is not life threatening, and must treat for a minimum of 4-6 months and 1-2 months beyond clinical resolution?
    itraconazole
  19. What is preferred for treating a severe, rapidly progressing infection of histoplasmosis?
    itraconazole plus amphotericin B
  20. What type of treatment for histoplasmosis is not as effective as itraconazole, but is used for refractory ocular and neurologic infection?
    fluconazole
  21. What is the primary source of infection for Blastomycosis?
    inhalation of airborne spores
  22. How can focal skin infection of blastomycosis occur?
    from direct cutaneous inoculation through a wound
  23. Where is extrapulmonary dissemination of Blastomycosis common?
    extrapulmonary dissemination is common
  24. What is the incubation period for blastomycosis?
    1-3 months (longer than histoplasmosis)
  25. What animals are more susceptible to blastomycosis? Cats or Dogs?
    dogs
  26. Lung lesions present in what amount of cases of blastomycosis?
    85%
  27. What percentage of the disseminated form of blastomycosis involves the peripheral lymph nodes?
    50-60%
  28. What percentage of the disseminated form of blastomycosis involves the skin?
    40%
  29. What percentage of the disseminated form of blastomycosis involves the eyes?
    40%
  30. What percentage of the disseminated form of blastomycosis involves the bone?
    20%
  31. What is the best treatment of blastomycosis?
    itraconazole
  32. What types of forms of blastomycosis does fluconazole treat?
    refractory ocular or CNS forms
  33. Why does treatment of blastomycosis normally fail?
    severe hypoxemia pulmonary disease, CNS involvement, Widespread dissemination (3 or more organ systems)
  34. What is the most common type of disseminated form of coccidioidomycosis?
    bone
  35. What does high IgG titers in Coccidioidomycosis mean?
    indicate severe pulmonary or disseminated disease
  36. Why may coccidioidomycosis need lifelong azole treatment?
    disseminated coccidioidomycosis is difficult to cure, esp when bones are involved
  37. What form of cryptococcus is more common in dogs?
    C. neoformans
  38. What form of crytococcus is more common in cats?
    C. gatti
  39. What is the most common systemic fungal disease of cats?
    cryptococcus
  40. In cats where does cryptococcus have a predilection for and what does it cause?
    nasal cavity, granulomatous rhinitis and sinusitis
  41. What are the preferred sites for cryptococcal dissemination?
    skin, CNS, and eyes
  42. What is a common way to diagnose cryptococcus?
    capsular antigen test
  43. Cats with CNS involvement and dogs with any form the cryptococcus have what type of prognosis?
    guarded
  44. What is the most frequently reported rickettsial disease in the US, and the most fatal rickettsial disease?
    RMSF
  45. How is RMSF transmitted?
    transovarially in ticks (nymphs and larvae are infected without feeding- different than erhlichiosis)
  46. What is the minimal amount of time a tick must be on the body to transmit RMSF?
    5 hours
  47. After infection, the majory of cases of RMSF are what?
    subclinical

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