NBME 22 Disruption of the pathogen cell membrane (NBME Answers)

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submitted by ∗haliburton(225)

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pathogen: cryptococcus

Treatment options: Ampho B: binds ergosterol -> pores in fungal membrane -> leaks contents. can add Flucytosine: converted to 5-FU to inhibit nucleic acid synthesis

https://step1.medbullets.com/microbiology/104161/flucytosine https://step1.medbullets.com/microbiology/104158/amphotericin-b

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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. +1

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) +1

imgdoc Play odds, he's HIV positive with meningitis...cryptococcus +