Welcome to episode 58 of the Divine Intervention podcast.

In today's podcast, we're going to be continuing the series on the Step 1, 3,120.

I really want to try to get done with this series because there is a bunch of other kind of important topics I want to discuss.

But again, I want to try to finish this.

So try to manage my time as best as I can.

So question 51 so he's part

six a 37 year old man comes to the office because of a three-week history of itchy patches of

skin and a burning sensation in his feet he works as a dishwasher and says he frequently works in

wet shoes and socks vital signs are within normal. Physical examination shows the findings in the photograph.

These findings are also present on the soles of both feet.

The most appropriate pharmacotherapy for this patient will inhibit the activity of which of the following enzymes.

So if we look at this image, right, we see, you know, this person has things in between his toes and he has risk factors, right?

You know, wet socks, wet environments.

Pseudomonas loves those environments, but also fungi love those environments.

So this person probably has what we call like athletes' foot.

You know, they'll probably use the term tiniapidus on your exams. And tiniapidus, you want to manage you with an antifungal, an appropriate antifungal. So basically, we want to see, and I talked about antifungals at the tail end of the last podcast, just as a preview of coming attractions. So option E says inhibiting chitin synthase. I don't know of any antifungal that is tested, that does that.

Option B talks about one three-beterd-de-glucanthase complex. So that's inhibited by echinocandins.

Echinocandins, we use those for serious candidal infections. Again, tiniapidus is caused by the trichophyting

species, the microsperum species, or the epidermermal fighting species, in that order, you know, number one, number two, and number three. Not really caused by candida, so that doesn't make sense to pick option B. Option C says Fosophyllip is D. That will be wrong. That will be wrong. So that will be wrong. I don't know of any antifungal that really works by targeting that. Option D talks about squilling mono-oxygenase. I'm going to go with that. You know, that's inhibited by the drug of Turbinophen. Trebinophine. Trubinifine is a pretty good antifungal. Trubina fiend, right? Remember, other good antifungals

I kind of talked about, right?

I kind of talked about. And remember, typically for most of these tinias, you can use topical antifungals, but if you're dealing with tini of the toes, like onico, like of the nails, sorry, onichomycosis of the head, tinea capitis. You have to use oral antifungals, like, you know,

like oral Turbin Afinafine, oral-o-Grozyrophovin. But again, Turbinafin works by inhibiting squalidomone oxygenase, right? So option D is right. Option Eithimidylid synthase is wrong. That's the drug that's targeted by five fluorore ural. Also, remember, it's also targeted by 5 flu cytosine that we use to treat cryptocococcal meningitis. That 5 flu ciduzine is

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