All right. Welcome. My name is Divine. This is episode 635 of the Divine Intervention podcast. And in today's

podcast, I'm going to be, I'm continuing our rapid review series for the US Emily Step 2, CK and Step 3 exams.

This is going to be series 600, series 133. And into this podcast, I'm going to be focusing a lot on some mechanisms.

I just decided to kind of collate some kind of strange mechanisms that people do not

pay attention to, but actually end up showing up a lot on the USMLA exams.

They tend to be a little kind of basic sciencey, but again, very important.

Although we'll also just discuss some classic vignettes as we go.

So what if they give you a question about a 24-year-old female?

And they tell you that for the past four days, she has been having a lot of joint pain.

And they tell you that on physical exam, she has this vesicular rash that's kind of diffuse,

and that she also has tenderness like on her wrists and in her fingers and things like that.

What should you be thinking about here?

Well, I really hope you're saying that, oh, divine, this person has gonococcal arthritis, right?

This person has a septic arthritis caused by Nicerogonorrhea, right?

So what is the classic presentation of that septic arthritis going to be?

Well, it's going to be a person that is sexually active, right?

A person that is sexually active, although on the USMLA exams, they can also give it to a person

that has a terminal complement protein defect, right? So remember, when people have a C5 or C6 or C7

or C8 or C9 defects, it does increase their risk of nicerral infections, either Niceramene

meningitis or Nicerogonorrhea, right? So if a person has a terminal complement protein defect, a C5 to C9 defect, it's going to increase

the risk of nicerial infections, both gonocococcus or meningocococ.

So the person has septic arthritis in this case caused by nicerogonorrhea.

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