All right, welcome. My name is Divine. This is episode 623 of the Divine Intervention Podcasts.

In today's podcast, I'm going to be addressing a topic I've titled, Last Minute Microbiology Review for Step 2 and Step 3.

The last minute microbiology review for step 2 and step 3. Let's begin.

Now, what if they give you a question about a patient?

And they tell you that this patient had orthopedic surgery a few days ago.

And now, or this person was like in some kind of trauma, you know, some kind of motor vehicle accident or whatever.

And then the person has very

significant bone pain, you know, let's say like their left femur is hurting significantly.

They have fever. They have local cytosis. And then they ask about the most likely theology of

their presentation. What should you be thinking about? Well, I'd really hope you're saying that,

oh, divine, this sounds a lot like staphoreus, right?

This sounds a lot like staphoreus. The thing is just in non-specific fashion, if they give you a question about staphoreus, I mean, if they give you a question about like bone pain, fever, and things like that, you want to be thinking about osteomyelitis. And typically, the most common cause of osteomyelitis is going to be staphoreous right? Especially when you see an association with a person that was recently in surgery, right? Or recently had trauma. It doesn't even have to be orthopedic surgery. That's something that's actually pretty high to know for your exams, right? So don't forget star for us in those circumstances. And then don't forget, right, sickle cell disease patients. Think of salmonella, samonella, samonella.

There are some resources that are beginning to see things other than samonella. Don't do that to yourself on NBM exams. Number one is going to be salmonella in sickle cell patients. And then if you don't see that as an answer, that's when you have the license or authority to go with staffors. Now, remember on the US Emily exams, it's also helpful to know the drugs that I used to trick Mercer, right?

So don't forget your Mercer drug. staff worries. Now, remember on the USMLA exams, it's also helpful to know the drugs that I

used to treat Mercer, right? So don't forget your Mercer drugs, right? The classic ones, Vencomycin, right? Vencomycin, remember, that's a cell wall inhibitor. I remember the mode of resistance where you change Dalla Diyala, Dala. And then don't forget, Linazolid, linazolid is a 50s inhibitor right it's a protein synthesis

inhibitor and linazolid in addition to covering mercer also covers vancomycin resistant and terracococcus and then remember that linausolid also has the ability to inhibit monoamine oxidase so because it can inhibit more amino aminoxidase it can raise your levels of serotonin so if you combine with a serotonergic agent you may get serotonin syndrome right things like hyper reflexia myoclonos

and things of that nature and it can raise your levels of serotonin. So if you combine it with a serotonergic agent, you may get serotonin,

right? Things like hyperreflexia, myoclonus, and things of that nature. And then don't forget that daptomycin, daptomycin is also very, very good, very good, right? Daptomycin is very, very good for treating Mercer as well. And then there are a few others that people don't think about, right? but things like clandamacin. Clendamacin also covers Mercer. Things like doxycycline, right? Doxycline also covers Mercer. Especially if you're dealing with a Mercer skin infection, doxycline is not a terrible idea. And then don't forget that trimetoporine softamethythoxus or backtram also has the ability to cover Mercer, right? And then what if they give you a question about a guy that

is 68 years old and he comes to the physician's office, you know, because for the last two days,

he has been having very significant chest pain and he has been having like productive cough.

And you're told that his temperature is 102.1 degrees Fahrenheit. And then you're asked,

what is the most likely theology of this patient's presentation? Well, I would hope you're picking the answer that talks about gram-positive coxide, right? Obviously, this is strepneumo. But again, the USMLs, they know that if they put strepneumel as an answer, everybody is going to get it right. Everybody that has the job description, medical student, resident, blah, blah, blah, blah, blah. They know, oh, the most common cause of community acquired pneumonia is strepnemo. Everybody knows that, right? So, again, they'll put like some derivative. Remember, I've talked about derivatives a ton, right? So instead of putting the exact name you're looking for, they'll put something that is closely related, right? They're going to give you a strepneumal and they're going to give you something that's close to strepneae right so um they can put

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