You have an appointment with Mrs. Jones, a patient who you saw in the hospital 3 months ago, for follow-up of CNS blastomycosis. When you see her in clinic, you notice that she has thinner hair and she reports several bald spots that have occured over the last month. She is currently on acyclovir, amlodipine, fluconazole, and a multivitamin. She is concerned that this is occuring and wanted to know if one of her medications is causing this.

Which of the following medications has been shown to have an association with hair loss?

Which patient populations are at risk for candida infections?

You are called by the MICU for a patient who is clinically unstable. They were transferred to MICU 2 days ago with persistent hypotension and they were broadened to vancomyin, meropenem, and micafungin. Since transfer they continue to worsen and were noted to have leukocytosis to 36,000 cell/uL this morning. The team is considering adding amphotericin just to make sure they have adequate fungal coverage....

Which of the following organisms have been shown to have amphotericin resistance?

True or False?

Blastomyces antibodies can cross-react with other endemic mycosis, such as histoplasma, when performing antibdy testing leading to a false positive test.

You recieve a call from trauma surgery for a neutropenic patient, Mr. Nygaard, who was admitted with a gun shot wound to the right hand after a "disagreement" at his home. He has been avoiding the hospital for the last 2 weeks, but decided to come in today due to increase pain, fevers and purulent drainage from the hand.

Which of the following fungal organisms is most likely to be isolated from the right hand wound?

True or False?

Most yeasts are readily recovered from blood cultures.

What are the risk factors for mucormycosis?

A 70 year old female is admitted for induction chemotherapy for AML. She develops altered mental status and vitals are notable for T 38.7C, HR 102, BP 100/80 mmHg, RR 21 and SPO2 93% on room air. Prior to admission, she was living at Ally's Awesome Abode, a nursing facility across town. Blood cultures obtained prior to empiric antibiotics are positive for Candida spp. and contact isolation is immediately ordered.

Which of the following Candida species should prompt patient isolation?

A 41 year old woman was seen in the hospital by dermatology for a new rash shown here. A biopsy is obtained and showed 45-degree branching hyphae. The tissue culture eventually grows Fusarium.

Which of the following is incorrect regarding invasive Fusarium infections?

A 54 year old woman with rheumatoid arthritis on rituximab and 20 mg prednisone is admitted with fever of 102F, tachypnea, tachycardia and a cough for 5 days. Her steroid dose was recently reduced from 60 mg to 20 mg 2 months ago. The patient was seen by her PCP and recieved a 5 day course of amoxicillin/clavulanate without any improvment in symptoms. In the ER, SPO2 was 84% on 2L NC. CT chest revealed multiple ground-glass opacities and nodules. Blood cultures are pending and sputum culture is pending collection. She is currently on vancomycin and piperacillin/tazobactam and was started on empiric PJP treatment. Social history notable for no travel outside of the US, no history of incarceration or homelessness, and having a pet dog at home.

What is the next appropriate step in diagnosis?

Which species of aspergiullus are the primary producers of an aflatoxin associated with HCC?

A 53 year old woman with PMH notable for type II diabetes and hypertension presented to the ER in DKA. She is admitted and initially reports 1 day history of acute sinusitis, nasal congestion, purulent nasal drainage, headache and sinus pain. Vitals are notable for T 38C, BP 135/85 mmHg, HR 102, RR 24, and SPO2 95% on room air. Exam is notable for left periorbital edema and there is a dark, flat patch noted on oral exam.

Which of the following is the next appropriate step in management?

Which of the following pathogens have the ability to spread from person to person?

A 35 year old man with history of cystic fibrosis undergoes a bilateral lung transplant without any complication. He is prepped for discharge after several days recovery in the hospital and develops a new dry cough, shortness of breath and fever. A sputum sample is obtained and sent for culture. A microscopic view of the sputum sample is shown here.

Which of the following is the most likely diagnosis?

A 40 year old man presented to his PCP with 4 week history of shortness of breath, fevers, cough, and myalgia. Two weeks ago, he presented to the ER for these symptoms and chest x-ray from that visit was notable for a focal infiltrate with hilar lymphadenopathy. He we sent home with a course of po antibiotics for CAP, but did not have improvement in symptoms. He recently moved from Missisipi for work as he previous worked as a farm hand while there and needed to move to be with family.

Which of the following is the most likely pathogen?

What is the primary mechanism of resistance towards fluconazole in Candida krusei?

Which of the following Candida spp. are suceptible to fluconazole and echinocandins?