Welcome to episode 545 of the Divine Intervention Podcasts.

Into these podcasts, we're going to be continuing the rapid review series for the USMLA Step 2, Sikk and Step 3 exams.

This is going to be series number 116.

So let's get right into it.

So what if they give you a question about a 32-year-old male, and they tell you that he has

what appears to be tini of his nails? How's that? The thing is, what I want to focus on here is somewhat different from what I know you're kind of worried nails. How's that? The thing is what I want to focus on here is somewhat different from what

I know you're kind of worried about. So let's get into my focus. So this person has what

appears to be some kind of teeny of his nails, right? Some kind of dermatophyte fungal infection.

Well, when you see something like this, first things first, what do they have? Well, this person

has onycomycosis. Remember, whenever a person has a temia, it's typically going to be caused by one of three bugs on your exams. And I'm going to talk about them from the context of the most common cause, the second most common cause and the third most common cause, right? The most common cause is going to be the trichofiting species. Trikofo fighting is going to be the most common cause. Second most common cause and the third most common cause, right? The most common cause is going to be the trichophyting species.

Trichofiting is going to be the most common cause.

Second most common cause is going to be the microsporum species.

And then the third most common cause is going to be the epidermal fighting species.

You need to know those in order because our friends at the MBMEs have been known to write questions

where they put all

three as answers, so you've got to pick the right one. So we know that when people have tinea,

especially that involving the nails, that's on ecomicosis or that involving the head, right? Tinia capitis.

In those circumstances, you cannot afford to use topical aesols like you use for regular

ringworm on the skin. You're going to have to use like tribina fin or graze your fovin.

Now, one nifty kind of MBME question you could see is they can put both as answers, right?

They'll put tribina fin as an answer. They'll putziofuvian as an answer and then they'll ask you

which one should be selected for management of this tina that the person has if they had you pick

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