Treatment, Prevention, and Control of Fungal Infection

Rizka A. Maghfirah

1. Which antifungal that is inhibit of elongation factor 3?

Nystatin
Sordarin
Caspofungin
Amphotericin B
Ticonazole
2
2

2. Mention 5 primary indication of using Amphotericin B

invasive candidiasis, cryptococcosis, aspergillosis, mucormycosis, blastomycosis,
coccidioidomycosis, histoplasmosis, paracoccidioidomycosis, penicilliosis
(talaromycosis) marneffei, and sporotrichosis
3

3. Which fungi species that is resistant to Amphotericin B

Candida albicans
Cryptococcus neoformans
Aspergillus terreus
Histoplasma capsulatum
Blastomyces dermatitidis

3
Aspergillus terreus, Fusarium spp., Pseudallescheria boydii, Scedosporium
prolificans, Trichosporon spp., and certain dematiaceous fungi may be resistant to
amphotericin B. Likewise, reduced susceptibility to amphotericin B has been noted
among some strains of Candida guilliermondii, Candida glabrata, Candida krusei,
Candida lusitaniae, and Candida rugosa
4

4. What is the primary adverse effect of Amphotericin B

The main adverse effects of amphotericin B include nephrotoxicity and infusion-
related side effects such as fever, chills, myalgias, hypotension, and bronchospasm
5

5. What is the different of imidazole and triazole

The number of Nitrogen in azole ring (imidazole : 2, triazole : 3)
6

6. Among imidazole, which one has systemic activity?

Ketoconazole
Bifonazole
Tioconazole
Sulconazole
Econazole
1
7

7. What is the MoA of Azole?

inhibiting the fungal cytochrome P450-dependent enzyme lanosterol 14-αdemethylase
(Figure 61-4). This enzyme is involved in the conversion of lanosterol to
ergosterol, and its inhibition disrupts membrane synthesis in the fungal cell
8

8. Which antifungal that is disrupt fungal DNA and RNA synthesis

Flucytosine
Ketoconazole
Nystatin
Nikkomycin Z
1
9

9. inhibit the synthesis of 1,3-β-glucans is MoA of what antifungal agent?

Aminocandin
Nystatin
Nikkomycin Z
Griseofulvin
1
10

10. How Echinocandin is administered?

IV
11

11. What is the MoA of Allylamine?

Inhibition of DNA and RNA synthesis
Inhibits lanosterol 14-α-demethylase cytochrome P450-dependent enzymes
Binds to ergosterol, causing direct oxidative membrane damage
Inhibition of fungal cell wall chitin synthesis
Inhibition of squalene epoxidase
5
12

12. Which antifungal agent that is inhibit fungal growth by interaction with
microtubules within the fungal cell, resulting in inhibition of mitosis
Aminocandin
Nystatin
Nikkomycin Z
Griseofulvin
Sordarin
4
13

13. What is the treatment of Hortaea werneckii infection?

IV Aminocandin
Oral Nystatin
Topical terbinafine
Topical flucytosine
topical therapy, including Whitfield ointment, azole creams, and terbinafine
14

14. What is the drug of choice of widespread tinea versicolor?

topical azoles
selenium sulfide shampoo
Oral ketoconazole
IV Aminocandin

3
Treatment consists of the use of topical azoles or selenium sulfide shampoo. For
more widespread infection, oral ketoconazole or itraconazole may be used.
15

15. What is the treatment of white piedra and black piedra?

Hair cut,
16
16. How are antifungal administered if dermatophytic infections are localized and
do not affect hair or nails?
Topical
Topical agents include azoles (miconazole, clotrimazole, econazole, tioconazole,
and itraconazole), terbinafine, and haloprogin
17

17. Systemic activity of dermatophytes can be treated by using what antifungal?

Aminocandin
Nystatin
Nikkomycin Z
Griseofulvin
Sordarin
Oral antifungal agents with systemic activity against dermatophytes include
griseofulvin, itraconazole, fluconazole, and terbinafine. The azoles and
terbinafine are more rapidly and broadly efficacious than griseofulvin, especially
for treatment of onychomycosis.
18

18. What is the classic treatment of rose handler’s disease?

Potassium iodide
19

19. What is the current treatment of choice of rose handler’s disease?

Itraconazole
Patients who do not respond may be given a higher dose of itraconazole,
terbinafine, or potassium iodide. Fluconazole or posaconazole may be used if the
patient cannot tolerate these other agents
20

20. What is the adverse effect of classic treatment of rose handler’s disease?
Nausea and salivary gland enlargement
21

21. Before you administering antifungal agent what you should do first in patient
with chromomycosis?
shrink larger lesions with local heat or cryotherapy
22

22. What is the definitive treatment of eumycotic mycetoma?

amputation
23

23. What is the nonpharmacological treatment of Conidiobolus coronatus infection?

Facial reconstructive surgery
24

24. What is the main treatment of subcutaneous phaeohyphomycosis?

Surgical excision
25

25. CNS complication of blastomycosis should be treated with...

Amphotericin B
Aminocandine
Ketoconazole
Itracconazole
Terbinafine
1
Amphotericin B, preferably a lipid formulation, is the agent of choice for the
treatment of life-threatening or meningeal disease. Mild or moderate disease may be
treated with itraconazole. Fluconazole, posaconazole, or voriconazole may be
alternatives for those patients unable to tolerate itraconazole

26

26. What is the antifungal agent to maintenance AIDS patient with this fungal
infection before?
Azole
amphotericin B is the initiate therapy
27

27. What is the antifungal agent to treat CNS complication of this fungal
infection?
fluconazole or itraconazole
28

28. What is the treatment of Chronic pulmonary infection of this fungal?

Ketoconazole
Terbinafine
Amphotericin B
Nystatin
3
29

29. What is the drug of choice of this fungal infection?

Itraconazole
30

30. What is the drug of choice to maintenance AIDS patient to prevent relapses of
this fungal infection?
lifelong treatment with itraconazole or voriconazole to prevent relapses of the
infection
31

31. Mucosal and cutaneous infection of these organism can be treated with what
antifungal?
topical creams, lotions, ointments, and suppositories containing various azole
32

32. Cytitis that is caused by these organism can be treated with what antifungal?
amphotericin B directly into the bladder (bladder wash) or by oral administration
of fluconazole
33

33. BSI that is caused by these organism can be treated with what antifungal?
IV Fluconazole
fluconazole-resistant C. glabrata require treatment with either amphotericin B
(conventional or lipid formulation) or an echinocandin (anidulafungin, caspofungin,
or micafungin).
34

34. What is the initial drug to treat CNS complication of this fungal infection?
amphotericin B plus flucytosine
amphotericin B plus fluconazole
Fluconazole plus flucytosine
Itraconazole
1
35

35. When you do mycologic monitoring (including check up sterilization of CSF) in

the CNS infection of this fungal infection?
2 weeks after induction therapy
36

36. What is the treatment of fungemia caused by Malassezia spp.?

IV aminocandine
Oral itraconazole
Oral ketoconazole
Stop lipid infusion
4
37

37. Trichosporon spp. Are resistant to what antifungal?

Aminocandin
Itraconazole
Posaconazole
Terbinafine
1
38

38. Mention one antiparasitic agent that must include in management of

microsporidial infection
albendazole
39

39. How you minimize the exposure of Aspergillus conidia to immunocompromised

patient?
Install air filtered in ventilation
40

40. What is the antifungal choice for this fungal infection?

Amphotericin B
Ketoconazole
Aminocandin
Terbinafine
Amphotericin B or voriconazole
41

41. What is the antifungal choice for this fungal infection

Amphotericin B
Voriconazole
Aminocandin
Terbinafine
Amphotericin B
Voriconazole
Aminocandin
Terbinafine
2
A. terreus is resistant to amphotericin B
42

42. First line therapy of this fungal infection?

Amphotericin B
Voriconazole
Aminocandin
Terbinafine
1
43

43. This fungi are resistant to what antifungal agent?

Amphotericin B
44

44. What is the main treatment of cutaneous infection of this fungal?

Surgical excision
45

45. What is the drug that is used as prophylaxis of this fungus in AIDS patient
Trimethoprim-sulfametoxazole
46

46. The treatment?

No treatment, self-limited
47

47. The main treatment?

repeat debridement, irrigation with Dakin solution, and gauze packing and removal
for drainage and granulation
48

48. Main treatment?

Surgical excision
49

49. olecranon bursitis that is caused by this agent can be treated by?
bursectomy
50

50. What is the combination of drug that is useful to treat orbital infection of
this agent?
itraconazole and terbinafine
51

ka raja : 84
Ka gelvi : 48
Ka Sonya : 90

Mycotoxin
Rizka 82
Ka raja 90
Ka sonya 92