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NBME 22 Answers

nbme22/Block 4/Question#29 (25.7 difficulty score)
A 45-year-old man who is HIV positive comes ...
Disruption of the pathogen cell membraneπŸ”
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 +4 
submitted by haliburton(208),
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passplease  How did you know it was cryptoccocus and not something else like candidiasis? +1  
jsanmiguel415  Was stuck between cryptococcus and candida as well. I think the tip might be that Candida is in mold form at higher (body) temp. But amphotericin b can be used for both and given that it's a serious infection you would probably just go straight for that instead of fluconazole. +  
schep  Patients with T cell dysfunction (HIV) are more susceptible to cutaneous candida infections (esophagitis, etc). Patients with neutropenia (chemotherapy, post-transplant) are more susceptible to invasive candida infections (bloodstream infection, meningitis) +  



 +0 
submitted by drschmoctor(81),

Rule of thumb:

Amphotericin B is the "Big gun" for serious/systemic fungal infections.

It works by binding to ergosterol in the membrane.