chat transcript - microbiology

[Anonymous]

21:10:43 [Step_1] ok, gen stuff first. which gram stain will have outer member? gram + or - bact?

21:10:54 acestep1 enters this room

21:11:09 [Step_1] hi ace

21:11:12 [Lorena] gram -

21:11:16 [Lorena] hi ace!

21:11:17 [period1] hi ace

21:11:24 [acestep1] hi everybody

21:11:24 [period1] gram neg

21:11:36 [Step_1] gram - will have an outer membrane. good lorena and period

21:11:38 [acestep1] hi lorena n period

21:11:44 [acestep1]

21:11:52 [acestep1] n step1

21:12:31 [Step_1] lets talk about capsules. which organism will have a capsule? n. meningitidis or ghonorrhea?

21:12:43 [period1] hi ace.good morning

21:12:48 [Lorena] n. meningitidis

21:12:51 [acestep1] meningitidis

21:13:00 [period1] n.meningitis

21:13:02 [acestep1] gd morning period

21:13:07 [Step_1] meningitidis will have capsule (reason for vaccine) good job. mneumonic is .....

21:13:25 [Step_1] "some killers have pretty nice capsules".....

21:13:56 [acestep1] yes caplan

21:14:10 [acestep1]

21:14:15 [Step_1] strep pneuomo, kebsiella, haemophilus, pseudomonas, N. meningitis, cryptococcus

21:14:29 [Lorena]

21:15:08 [acestep1] ok 1 pt u know pyongenes also has a capsule

21:15:20 [acestep1] s. pyogenes

21:15:43 [Lorena] anthrax ..what' s special about this capsule?

21:15:55 [Step_1] these are not the only capsules, but just some of the most tested

21:16:07 [Step_1] the only one made by protein

21:16:15 [acestep1] its madeup of aminoacid

21:16:23 [Lorena] yes! very good

21:16:31 noorain enters this room

21:16:31 [acestep1] yes

21:16:42 [Step_1] i'll name either an organism or medium, you name the opposite. so cornebacterium, which medium?

21:17:09 [Lorena] loefflers medium

21:17:32 [acestep1] agree

21:17:40 [Step_1] corynbact is lofflers and tellurite. very good. legionella? which medium?

21:18:12 [Lorena] charcoal yeast

21:18:37 [Lorena] and it requires iron and cysteine for culture

21:18:47 [Step_1] charcoal yeast extract for legionella is correct. now a tricky one. chocolate agar, which organism? what about thayar martin.

21:19:05 [Step_1] good job lorena

21:19:28 [Lorena] Tmartin is for n. gonorrhoeae

21:19:36 [acestep1] neisseria

21:19:40 [Lorena] chocolate agar is for N. meningitidis?

21:20:04 [Lorena] thank you step

21:20:21 [acestep1] no actually thayer martin i think is mdeia with antibiotics

21:20:27 [Step_1] both are neisseria, but chocolate is for meningitidis because its sterile site, and TM is for ghonnorhea because it has antibiotics to kill normal flora

21:20:37 [acestep1] tht inh funcal n gm + bug growth

21:20:54 [acestep1] k

21:21:05 [acestep1] thnx

21:21:11 canman enters this room

21:21:30 [Step_1] cysteine is used for which organisms?

21:22:00 [Lorena] legionella

21:22:15 [period1] f,b,l,p

21:22:51 [Step_1] "the 4 sister 'ellas' worship at the cysteine chapel, except for bortadella b/c see got bored".....

21:22:54 Gianna enters this room

21:23:09 [Step_1] francisella, brucella, legionella, pasteurella

21:23:20 [Lorena] great way to remember

21:23:41 [acestep1] wow

21:23:49 [acestep1] yes definitely

21:24:07 [Step_1] which are the spore formers?

21:24:09 Bill_Cornbread enters this room

21:24:29 [Step_1] hi canman, gianna, bill

21:24:34 [Lorena] hello gianna, canman and Bill

21:24:48 [Gianna] hi

21:25:07 [Lorena] B anthracis, clostridium t and b and p

21:25:16 [acestep1] bacillus n clostridium

21:25:22 Bill_Cornbread exits from this room

21:25:41 [Step_1] the only 2 spore formers are clostridium and bacillus....good job

21:26:00 kokushubila enters this room

21:26:03 [Step_1] spirocetes?

21:26:13 [Step_1] hi kokush

21:26:16 [kokushubila] Hi everybody

21:26:20 [acestep1] ?

21:26:29 [acestep1] hi kokush

21:26:35 [Lorena] T. pallidum, Borrelia burgdorferi

21:26:40 [Lorena] hi koku

21:26:42 [kokushubila] Good to "see" you again guys

21:26:48 [period1] hi kokush,how r u today

21:27:01 [acestep1] same here koku

21:27:05 [Lorena] hope you are feeling better

21:27:24 [Step_1] sorry, i meant what organisms are spiroshetes (shorthand)....good job lorena

21:27:38 [kokushubila] Thank you I am GOOD!

21:27:58 [Step_1] thats great to hear kokush

21:28:05 [acestep1]

21:28:17 [acestep1] ya

21:28:21 [Lorena]

21:28:23 [acestep1] np step1

21:28:26 [Step_1] spirochetes are treponema, borrelia, leptospira

21:28:44 [kokushubila] I am Fit

21:28:56 [Lorena] leptospira....yes

21:29:07 [period1] hey ,thats nice

21:29:13 [Step_1] is staph epidermidis part of normal flora, if so, where?

21:29:15 [Lorena] had too much coffee koku?

21:29:20 [acestep1]

21:29:26 [Lorena]

21:29:34 [acestep1] skin

21:29:49 [Step_1] big improvement kokush

21:29:53 [Lorena] yes, it is , cutaneous surfaces

21:29:54 [kokushubila]

21:30:34 [Step_1] yes, in the skin. good lorena and ace. what about staph aureus and strep viridans?

21:30:57 [kokushubila] S.auresu in the nasopharynx

21:31:05 [Lorena] viridans strep live in oropharynx

21:31:09 [kokushubila] Ooops -aureus

21:31:10 [acestep1] thnx

21:31:31 [Lorena] stap aureus in nose?

21:31:34 [acestep1] aureus- nose

21:31:42 [Step_1] staph aureus is in nose and strep viridans is in oropharynx.....excellent

21:31:55 [acestep1] n virinads is in mouth , propharynx

21:32:10 [acestep1] viridans imeant - oops

21:32:20 [acestep1] n oropharynx

21:32:27 [Step_1] thats right ace

21:32:40 [Lorena] do we have normal flora in stomach?

21:32:46 [acestep1] thnx

21:32:55 [acestep1] hmm . i dont think so

21:33:03 [period1] no

21:33:09 [Step_1] nope...acid kills them

21:33:15 [period1] NF is not there in stomach

21:33:28 [Lorena] where else is sterile?

21:33:36 [Step_1] csf

21:34:01 [Lorena] yes

21:34:10 [Step_1] blood, internal organs,soft tissues, lower resp tract

21:34:17 [kokushubila] I read somewhere-HACEK-Haemophilus,Actinobacillus,CArdiobaterium,Eikenell a,Kingella spp are present in the oral cavity in Kap lanQ

21:34:22 [Lorena] excellent step

21:34:27 [acestep1] yes

21:34:54 [Step_1] i see that in kap lan notes too

21:34:55 [acestep1] coo l koku

21:34:58 [Step_1] thx lorena

21:35:01 [kokushubila] though not sure

21:35:14 [Lorena] i saw a tv prgram about medical detectives, they caught the killer because a bite from the victim and had eikenella

21:35:58 [Step_1] so this stuff is actually used for more than just to drive us nuts trying to learn it

21:36:07 [kokushubila] Ohhh!

21:36:26 [Lorena] lol

21:36:27 [acestep1] k

21:36:36 [Step_1] which organisms mode of action include inactivation of EF-2?

21:36:38 [acestep1] lol

21:37:16 [Lorena] pseudomona and corynebacterium

21:37:47 [acestep1] agree

21:37:51 [Step_1] C. diptheria and pseudomonas aerginosa are the 2 big ones often tested. know that one for sure. good job.

21:37:56 [acestep1] adpribosylation

21:38:03 [Lorena] the diff between those toxins is the target tissues

21:38:16 [Step_1] thats right ace

21:38:30 [Lorena] for corynebacterium is heart , nerves and epithelium; for pseudomona is liver

21:38:36 [acestep1]

21:38:50 [Step_1] good point lorena

21:38:50 [acestep1] ok inf lorena

21:39:15 [kokushubila] Sorry, step_1 what is EF (too many stuffs I can't remember

21:39:38 [Lorena] elongation factor

21:39:58 [kokushubila] Thanks Lor

21:40:23 [acestep1] the protein syn is of 3 steps initaion elongation n termination

21:40:27 [Step_1] EF-2 is a biochem term for elogation factor, but only those 2 organisms would likely be tested for it

21:40:34 [acestep1] ef = for elongation

21:41:17 [acestep1] yes. sorry koku . imeant ef is for elongation

21:41:19 [Lorena] what is babes ernst bodies?

21:41:22 [kokushubila] Thanks to u all

21:41:57 [Lorena] you 're welcome

21:42:21 [acestep1] ya. mention not koku

21:42:26 [acestep1]

21:42:58 [acestep1] lori . no idea

21:43:03 [acestep1]

21:43:42 [Lorena] they are granules produced by corynebacterium d. on a loefflers coagulated serum media

21:43:54 [Lorena] diagnostic of this bug

21:44:07 [acestep1] oh ok. thnx

21:44:16 [acestep1]

21:44:28 [Step_1] thought i remember something about that from web prep, but not sure. thanks

21:44:50 [Lorena] it is in ka pl an

21:45:20 [Step_1] the vaccine for Neisseria is called what? is it for meningitidis or gonorrhea?

21:45:42 [Lorena] for meningitidis...i dont remember how its called though

21:46:02 Bayda enters this room

21:46:28 [Lorena] hi bayda

21:46:37 [kokushubila] Meningitidis -Rifampicin

21:46:41 [period1] for meningitis

21:46:55 [Bayda] hi

21:46:57 [kokushubila] Also Ciproflaxin can be used

21:47:06 [kokushubila] Hi Bayda

21:47:07 [Step_1] its for meningitidis because it has a capsule and its from 4 capsular polysaccharides....Y,W, C,A. given to military recruits...i remember it because similar to YMCA and once of the village people should be a military guy

21:47:15 [Lorena] rifampin and cipro is tx for close contacts

21:47:55 [acestep1] hey guys sorry i got dc

21:48:00 [Lorena] good one step!

21:48:06 [Lorena] welcome back ace

21:48:16 [Step_1] np ace....at least you're back

21:48:20 [acestep1] thnx lorena

21:48:27 [kokushubila] Ok , saw it step_1 in Ja Wetz

21:48:28 [Step_1] tnx lorena

21:48:32 [acestep1] then step1

21:49:10 [Lorena] also is given for students in dormitories

21:49:14 [Step_1] now the real micro, lets talk about bacteriology

21:49:30 [acestep1] k

21:49:41 [acestep1] oops i meant thnx step1

21:49:46 [Lorena] oh oh

21:49:47 [kokushubila] What about the Gonococci , very HY

21:49:52 [acestep1] k . sure

21:50:11 [Step_1] thats part of bacteriology

21:50:17 [kokushubila] I mean prevention! ooops condoms

21:50:35 [Lorena] and tx?

21:50:42 [Step_1] how to distinguish between different staph organisms? which one has what distinguishing feature?

21:50:59 [kokushubila] Ok

21:51:20 [period1] coagulase

21:51:29 [acestep1] agree

21:51:31 [Lorena] coagulase, mannitol salt tolerant

21:51:40 [period1] staph.aureus-+

21:51:54 [period1] rest of staph _

21:52:01 [Step_1] staph aureus is coagulase + and the other 2 are - (epidermidis and saprophyticus

21:52:01 [acestep1] yes agree with lorena n period

21:52:08 [Step_1] good job

21:52:18 [kokushubila] S.aureus Coagulase+ve, S.epidermidis and others -ve

21:52:29 [Step_1] distinugiuish between staph and strep?

21:52:31 [acestep1] also aureus is b hemolytic

21:52:33 [Lorena] S. aureus is coagulase + and manitol salt tolerant, epidermidis is coagulase -and manitols salt sens

21:52:43 [Bayda] catalase

21:52:45 [period1] and also b-hemolytic

21:52:54 [Bayda] staph is cat+

21:52:58 [acestep1] catalase , glden yellow colonies on b hemolysis

21:53:08 [Step_1] didnt know about the manitol lorena...thnx

21:53:14 [acestep1] n also staph is in clusters

21:53:15 [kokushubila] S.epiderm novobiotin sensitive, S.saprophyticus Novobiotin resistant

21:53:21 [Lorena]

21:53:35 [period1] staph arranged in clusters,streo-chains or pairs

21:53:39 [acestep1] yes agree koku

21:53:42 [period1] d staph is catalase +

21:53:45 [acestep1]

21:53:55 [Bayda] baby 2 months with meningitis

21:53:56 [period1] srtep is catalase _

21:54:03 [acestep1] agree period

21:54:08 [Step_1] staph is cat + and a seen in clusters while strep is cat - seen in chains.

21:54:13 [Step_1] good

21:54:20 [kokushubila] Now the Strep..

21:54:34 [Step_1] n meningitidis

21:54:35 [acestep1] k

21:54:48 [Bayda] correct

21:54:54 [acestep1] also listeria nn e. coli -bayda

21:55:00 [Bayda] + Listeria + Strep B

21:55:22 [Lorena] strept b , listeria

21:55:35 [Lorena] E coli

21:55:45 [Lorena] agree ace

21:55:47 [kokushubila] Beta hemolytic Bacitracin resistant

21:55:54 [kokushubila] Who is this?

21:55:55 [Step_1] listeria, ecoli and strep B are more common below 1 month old. the most common from 1 month to 18 yrs is N meningitidis

21:56:08 [Lorena] S agalactiae

21:56:12 [acestep1]

21:56:28 [period1] s.agalctiae

21:56:30 [acestep1] ic

21:56:41 [Lorena] tell me the bugs in endocarditis ....normal valves and previous damaged valves

21:56:43 [kokushubila] Correct Lor

21:57:00 [Lorena] thanx koku

21:57:59 [kokushubila] Normal valve-S .aureus , damaged ???

21:57:59 [Bayda] Strep B for normal staph for damaged

21:58:21 [Lorena] normal valves S. aureus in IV drug abusers , and S. epidermidis

21:58:50 [Lorena] in damaged valves after dental procedures viridans group, after abdominal procedures S. faecalis

21:58:57 [Step_1] for strep it goes by the next letter in alphabet (groups) . so group A -Bacitacin, B- cAMP, D-Esculin, Pmneumo-Optochin

21:59:35 [Lorena] wow step

21:59:53 [kokushubila] Thanks

22:00:44 [Lorena] writing your tips down

22:00:49 [acestep1] hey lorena wht abt pesudomonas

22:01:06 [acestep1] yes gd1 step1

22:01:31 [Step_1] any edge we can take

22:01:48 [acestep1]

22:01:56 [Step_1] if you have cutaneous strain of strep pyogens, can this result in rhematic fever, acute glomerulonephritis, or both?

22:02:15 [acestep1] gn i think

22:02:38 [Lorena] i didnt get you rquestion ace about pseudomonas?

22:02:52 [Lorena] both step?

22:02:59 [period1] acute glomerulo nephritis

22:03:05 [Step_1] if you have pharngitis, it can lead to either rheumatic or acute GN. but if only cutaneuous infection, you are at risk for only the GN. good job ace.

22:03:31 [Lorena] thanx

22:03:51 [acestep1] ok from wht i rmeb iv drug abuser have acute endocarditis from teh flowwing bugs - s aureus spudomonas n s. eidpermidis

22:04:02 [acestep1] thnx step1

22:04:24 [Lorena] oh, i didnt know about pseudomona ace, thanks

22:04:32 [acestep1] np

22:04:37 [acestep1]

22:04:56 [Step_1] from my understanding, staph aureus is the one to know for IV drug users as far as acute endocarditis

22:05:06 [acestep1] i remb this cuz was always confused which one is m common in iv abusers

22:05:19 [Step_1] and it will infect the tricuspid vavle

22:05:22 [acestep1] yes step1 thst teh m . common

22:05:24 [Lorena] but when the questio is about endocarditis just be careful if it is a previous damaged or a previous normal valve before choosing the bug

22:05:51 [acestep1] yes . v true lorena

22:06:24 [Step_1] thnx lorena and ace

22:06:46 [kokushubila] NAd remember they don't ask straight-just structures!!!

22:06:48 [acestep1] np. step1 . anytime:0

22:06:59 [acestep1]

22:07:17 [kokushubila]

22:07:18 [acestep1] koku didnt get u

22:07:33 [acestep1] umean they ask structures as well

22:07:41 [Lorena] adult meningitis , what bugs?

22:08:02 [Bayda] Neiseria

22:08:11 [Step_1] strep pneumo is MC

22:08:17 [kokushubila] I mean they will ask like bacitracin, small G =ce cocci and lots of bla bla

22:08:34 [Bayda] enenterovirus

22:08:40 [acestep1] ic. thnx loku

22:08:49 [Lorena] thanks koku

22:08:51 [acestep1] hmm i think both r common

22:08:58 [kokushubila] U r welcome

22:09:17 [acestep1] 1mnth - 18 yrs meningitidis

22:09:20 [Lorena] yes, strept. pneumoniae and N. meningitidis

22:09:43 [acestep1] n rest is peumonea

22:10:07 [kokushubila] Neonates?

22:10:09 [Step_1] <18 is not adult ;_

22:10:12 [acestep1] k

22:10:19 [Step_1]

22:10:21 [Bayda] so meningitis newborn - Strep B, E coli, Listeria

22:10:38 [Lorena] in neonates is strept agalactiae, E coli and listeria

22:10:43 [Step_1] agree

22:10:45 [acestep1]

22:10:51 [Bayda] adult - Neiseria, S pneumoniae, enterovirrus

22:11:11 [kokushubila] Good jod Drs

22:11:28 [Lorena]

22:11:51 [Lorena] lets talk about toxins

22:12:15 [Step_1] k

22:13:02 [Lorena] MOA botulinum toxin

22:13:07 [Bayda] mommy feeds bab 2 months with honey - respiratory problems

22:13:35 hiwa enters this room

22:13:44 [Step_1] you 2 are thinking alike

22:13:59 [Lorena]

22:14:03 [Step_1] inhibits Ach

22:14:31 [Lorena] yes!

22:14:32 [period1] sorry all.i got to go

22:14:48 [Step_1] good chatting with you period.

22:14:54 [Lorena] nice to chat with you period

22:14:54 [period1] anyhow meet u all next wednesday

22:15:02 [period1] bye

22:15:09 [Lorena] yes! have a nice rest of the weekend

22:15:12 [kokushubila] Thanks, Bye

22:15:12 [Lorena] bye

22:15:16 [Bayda] what is for next wedn?

22:15:33 [Step_1] path....we need to decide what parts

22:15:35 [Lorena] until whjat chapter guys?

22:15:44 [kokushubila] Yeah too many stuffs

22:16:08 [Step_1] i'm studying goljan for path, so not sure if it coincides with kap lan or not

22:16:22 [Lorena] genetic disorders and immunipathology , we kind a covered that , right? when we talked about genetics and immuno

22:16:42 [kokushubila] CVS and RS

22:16:46 [Step_1] thats true lorena

22:16:53 [Bayda] true

22:17:00 [acestep1] yes

22:17:30 [Lorena] Rs is respiratory?

22:17:43 [kokushubila] Yeah Lor

22:17:54 [acestep1] yes i think so

22:17:57 [Lorena] sounds good

22:17:59 [acestep1]

22:18:12 [Lorena] neoplasia too

22:18:13 [Step_1] ok

22:18:53 [Bayda] good

22:18:57 [Step_1] sure, path is lots of material, so we should try for the bulk on wed, and whatever we dont cover we do with rest of topics on sat.

22:19:14 [acestep1] hey guys i wont b able 2 amke it next week

22:19:21 [Lorena] yes

22:19:25 [kokushubila] K , Good back to toxin, What did the kid eating honey had?

22:19:38 [Step_1] thats too bad ace

22:19:40 [acestep1] botulinm

22:19:40 [Lorena] botulism

22:19:45 [Bayda] Cl botulinum

22:19:51 [Lorena] sorry to hear that ace

22:19:54 [Step_1] clostridium botulism will only affect infants? why? what changes?

22:19:57 [acestep1] ya . step1 . my ex just gd married

22:20:03 [kokushubila] Thanks

22:20:13 [Lorena] i wont make it for next saturday , but i will be here next wednesday

22:20:25 [acestep1] just got marraied so wasnt able 2 study last week

22:20:30 [Bayda] then he liked it frist time

22:20:38 [Step_1] ouch ace

22:20:50 [Lorena] gastrointestinal sytem is not mature yet....something like that, thats why not recommended honey the first year

22:20:59 [acestep1] ya

22:21:11 [acestep1] ok back 2 work

22:21:24 [Lorena] i see ace..... you deserve something better!

22:21:34 [kokushubila] :wink , Cool

22:21:43 [Step_1] sorry to hear that. but things happen for a reason. you may not realize it now, but you'll probably meet somebody better as a result

22:21:53 [acestep1] thnx

22:22:08 [acestep1] yes thst wht everybody tells me

22:22:11 [Lorena] agree completely with step 1, cheer up ace

22:22:35 [acestep1] yes

22:22:41 [kokushubila] Sorry Ace but let it go , You will get someone nicer

22:22:50 [acestep1] im orite now

22:23:01 [acestep1] yes i hope so

22:23:09 [acestep1] ok back2 work

22:23:16 [Step_1] i know you dont want to hear it and you think everyone is just saying that cause thats what i thought too, but its very true and than you will look back and realize it

22:23:22 [acestep1] lest study

22:23:27 [kokushubila] Just don't let it tear up your heart

22:23:54 [Lorena]

22:24:01 [Bayda] so why are babies more sensetive? - immature?

22:24:07 [acestep1] yes. step1 n koku

22:24:21 [acestep1] thnx . all of u

22:24:23 [Lorena] something to see with the inetstinal flora , i think

22:24:27 [acestep1]

22:24:36 [Step_1] not that the system is not mature, but because no normal flora until they start crawling and picking up the bugs

22:24:55 [acestep1] hmm yes . now i remb step1

22:25:04 [Bayda] sometimes you eat the bear sometimes the bear eats you

22:25:15 [acestep1] lol

22:25:25 [Step_1]

22:25:32 [Lorena] lol

22:25:49 [acestep1]

22:25:58 [Step_1] MOA of clostridum tetani?

22:26:28 [Lorena] blocks release of glycin and GABA

22:26:37 [acestep1] i think travels retrograde. n inh ach

22:27:20 [Step_1] blocks release of inhibitory mediators (glycine and GABA)....good job. inhibition of Ach is the MOA for C. botulism

22:27:24 [kokushubila] Blocks glycine release (inhibitory neurot.) from Renshaw cells in the spinal cord

22:27:38 [acestep1] ok .

22:27:53 [acestep1]

22:28:09 [Step_1] which are the three important anaerobes to remember?

22:28:24 [Lorena] another dif between tetanus and botulinum toxin is that botulinum is absorbed in gut and transported by blood

22:28:45 [acestep1] yes

22:28:53 [acestep1] gd pt lorena

22:29:03 [acestep1]

22:29:03 [Step_1] good point

22:29:22 [acestep1] hmm . i think bacteriodes fragilis

22:29:40 [acestep1] clostridium

22:29:49 [Step_1] hint, we just spoke about one . yes ace thats another of the ABCs

22:29:54 [Lorena] agree, and nocardia

22:30:13 [Step_1] not nocardia, but very close

22:30:26 [acestep1] actinomycetes?

22:30:36 [acestep1] its a wild guess

22:30:36 [Bayda] A. israeli?

22:30:38 [kokushubila] Clostridium, Bacteroides and Actinomyces

22:30:44 [Step_1] exactly....Its the ABC Actinomyces, Bacteroides, Clostridium

22:31:02 [acestep1] k . thnx

22:31:18 [Lorena]

22:31:30 [Bayda] so Actinomyces is the one that causes absceess in mandibula?

22:31:36 [acestep1] u know step1 ur teh best . i learn alot from ur meumonics

22:32:20 [Bayda] I am confusing Nocardia with Actinomyces always

22:32:30 [Step_1] i just happen to be closest to the exam. everyone is way ahead of schedule here....you all will do great

22:32:31 [Lorena] yes bayda, lumpy jaw is by A. israeli

22:33:01 [Lorena] me too ....

22:33:03 [Bayda] so which one forms sulfur granules?

22:33:11 [kokushubila] They lack catalase,superoxide dismutase thus susceptible to oxidative damage.C features -foul smelling,difficult to culture and produce gas in tissue

22:33:20 [Step_1] nocardia and actinomyces are very similar, just a couple of distinctions to remember

22:33:36 [Lorena] c. perfringens koku?

22:33:54 [acestep1] agree

22:33:57 [Step_1] sulfur granules is actrinomyces

22:34:17 [kokushubila] I meant clinical featuires of Anerobes

22:34:23 [Step_1] which one is acid fast (partially)?

22:34:27 [acestep1] k

22:34:34 [Bayda] Nocardia

22:34:35 [acestep1] noacrdia

22:34:37 [Lorena] nocardia

22:34:42 [acestep1] nocardia

22:34:56 [Step_1] yep....nocardia

22:34:57 [Bayda] it's like has some features from Tb

22:35:09 [Bayda] causes lung infection too

22:35:17 [Lorena] aerobic like tb,,,,true

22:35:20 [kokushubila] Ohhh thanks didn't know that

22:35:22 [Step_1] which one is anaerobic?

22:35:35 [Bayda] type IV response?

22:35:43 [Lorena] actinomyces

22:35:44 [kokushubila] Actinomycets

22:36:25 [acestep1] agree

22:36:31 [Step_1] just remember the ABC, so Actinomyces is anaerobic (almost always part of stem and that will give it away right there...the rest is bonus )

22:36:57 [acestep1] k . thnx

22:37:03 [Lorena] cool!

22:37:05 [kokushubila]

22:37:33 [Step_1] another distinction is that actinomyces is part of normal flora, which means that nocardia is common in immunocompromised

22:37:54 [Step_1] because nocardia is not part of normal flora

22:37:58 [acestep1] gd 1 step1

22:38:02 [kokushubila] Back 2 Clostridium , which toxin does it produce?

22:38:17 [kokushubila] I mean C.perfringes

22:38:25 [Lorena] C. perfringens produces alfa toxin

22:38:26 [Bayda] alpha

22:38:49 [Step_1] alpha lecithinase

22:39:13 [Step_1] enterotoxin in food poisoning

22:39:16 [kokushubila] Alpha toxin lecithinase that causes myonecrosis-GOOD JOB Drs

22:40:13 [Step_1] by the way, there is a difference in enterotoxin and endotoxin. but the most important thing is that endotoxins will only be found in what...gram + or gr - bact?

22:40:28 [acestep1] gm -

22:40:36 [Bayda] -

22:40:43 [Bayda] except Listeria

22:40:51 [Lorena] you diagnose C. perfringens with Naegler's reaction which detects the lecithinase activity of the alpha toxin on an egg yolk agar

22:40:57 [Step_1] it is produced in the outer membrane which is only found in gram - bact, especially neiserria.

22:41:20 [Lorena] thank you step

22:41:21 [acestep1] hey guys i gtg now

22:41:41 [Step_1] great chat ace

22:41:45 [acestep1] ill cya guys in pharma session

22:41:49 [Bayda] see you ace!

22:41:59 [Step_1] PM me if you want to talk ace

22:42:00 [Lorena] take care ace

22:42:03 [acestep1] yes definitely

22:42:08 [Bayda] I will go too -back to my qbnk

22:42:17 [Bayda] really hate it

22:42:25 [acestep1] thnx all of u

22:42:32 [Bayda] spend all day there

22:42:33 [Step_1] ok bayda. thanks for the questions

22:42:44 [acestep1] k . thxn step1

22:42:54 [acestep1] thts really sweet of u

22:43:00 [Lorena] think that you are very smart ace and something better will result of all this

22:43:04 [acestep1]

22:43:19 [kokushubila] Bye bye , Smile and this is no the time to think it!

22:43:21 [Lorena] thanx bayda, see you next chat

22:43:23 [acestep1] thnx lorena . ya i hope so 2

22:43:31 [acestep1]

22:43:54 [acestep1] thnx koku

22:44:06 Bayda exits from this room

22:44:11 [acestep1] ya i dont think abt it now

22:44:29 [Lorena] hey bayda "big succes requires big sacrifice!"

22:44:42 [acestep1] byebye n take care . all of u . n thnx for teh wonderful support

22:44:43 [Step_1] hey, bayda actually used the exit

22:45:11 [Lorena] yes

22:45:17 [Step_1] take care ace.

22:45:18 [kokushubila] :wave

22:45:19 [acestep1] yes shes in gen

22:45:30 [acestep1] u2 step1

22:45:34 [kokushubila] Ooopss got it wrong !

22:45:35 [acestep1]

22:45:43 [acestep1] byee

22:45:49 [acestep1]

22:45:53 [Step_1] oh, nevermind, i dont think anyone has found the exit yet

22:46:27 [kokushubila] Ok back to this little animals

22:46:27 [Step_1] hospital diarrhea following 1 wk of antibiotics? what bug? treatment?

22:46:47 [Lorena] c. difficile, tx is with metronidazole

22:46:52 [kokushubila] C.difficile

22:47:19 [Step_1] very good lorena and kokush. what if metro is not avail or doesnt work?

22:47:39 [Lorena] vancomycin

22:47:53 [kokushubila] Vancomycin

22:48:01 [Step_1] vanco for resistant strains...good. what antibiotic likely caused it

22:48:18 [kokushubila] Clinamycin

22:48:25 [Lorena] agree

22:48:28 [kokushubila] Sorry Clindamycin

22:48:44 [Step_1] clindamycin most likely cause

22:49:29 [Step_1] i think we missed a couple of big gr pos. want to just hit high points than move on?

22:49:33 [kokushubila] Lets go to Food poisoning stuffs

22:49:51 wolfvgang22 enters this room

22:50:02 [Lorena] yes

22:50:02 filhawaiian enters this room

22:50:24 [Step_1] eat fried rice or tacos and get food poisoning a few hours later....what bug>

22:50:32 [filhawaiian] hello

22:50:33 [Lorena] hi wolfv and filhawaiian

22:50:44 [kokushubila] B.cereus

22:50:49 [wolfvgang22] hi here to learn lol

22:50:50 [Lorena] bacillus cereus

22:50:58 [kokushubila] Welcome W and F

22:51:05 [Step_1] Bacillus cereus ("Be serious") is correct

22:51:16 [kokushubila] ha ha ha

22:51:21 [Step_1] hi wolf and filhawiian

22:51:21 [filhawaiian] mneumonic - Food poisoning from fried rice? Be serious

22:51:35 [Lorena] good

22:52:00 [kokushubila] Good one!

22:52:08 [Lorena] name some oxidase + bacteria

22:52:09 [filhawaiian] need to ask a quick off topic question. Is it ok with you guys?

22:52:47 [Step_1] actually...its more like the pt said "I ate at that cheap restrant down the street...left over freid rice......Be serious!!

22:53:01 [Lorena] lol

22:53:21 [Step_1] go ahead hawiian

22:53:25 [filhawaiian] BTW on the last question about ABx causing pseudomemb cololitis....any ABx can cause it. Clindamycin is one of the first.

22:53:38 [kokushubila]

22:54:04 [filhawaiian] My off topic question is have any of you had any experience buying those so called <a target=new href="http://click.linksynergy.com/fs-bin/click?id=c97WUMRO5hY&offerid=47491.10000058&type=3 &subid=0" >Kaplan</a> videos (not web prep)

22:54:07 [Lorena] yes fil thanks

22:54:09 [Step_1] i agree. probably metronidazole wont cause it though because thats the treatment

22:54:26 [kokushubila] Sure Fil,

22:54:58 [Step_1] no, not the videos, only the web prep

22:55:46 [Step_1] btw, try not to type things like kap lan or it will make that link above

22:56:02 [Lorena] i dont know either fil

22:56:20 [Lorena] are you from hawaii?

22:56:20 [filhawaiian] Probably a fake. Someone emailed me offering the videos. I told that person he/she is lying because Kplan is careful with their videos.

22:56:31 [filhawaiian] anyway back to micro

22:56:40 [filhawaiian] yep

22:56:51 [Step_1] yes, be careful with fakes

22:56:53 [Lorena] cool, live in hawaii too

22:57:08 [filhawaiian] where?

22:57:20 [Lorena] hono

22:57:25 [Lorena] and you?

22:57:32 [wolfvgang22]

22:58:01 [filhawaiian] I'm from Ewa Beach, now called "Kapolei"

22:58:19 [Lorena] i see

22:58:32 [Lorena] sorry guys..lets continue

22:58:42 [Step_1] ok, lots to cover, so lets move to gram negative

22:59:02 [Step_1] which neisseria is maltose positive?

22:59:14 [Lorena] . meningitidis

22:59:37 [Step_1] Meningitidis = Maltose pos (notice the M) good job

22:59:52 [Lorena] neisseria that starts with m ...maltose positive

23:00:00 [Lorena] good one step

23:00:36 [kokushubila] Good thanks

23:01:05 [Step_1] which bug is common in CF, burn patients, and cath patients? what else common in?

23:01:08 [Lorena] treatment for helicobacter p?

23:01:30 [Lorena] pseudomona

23:01:41 [filhawaiian] MeninGitidis = ferments Maltose & Glucose

23:01:49 [filhawaiian] lorena is right pseudomonas

23:01:58 [filhawaiian] PPI

23:02:02 [Lorena] flowers , raw vegetables, external ear

23:02:07 [Step_1] triple therapy of pepto bismol, H blocker and antibiotic

23:02:09 [filhawaiian] ie. omeprazole

23:02:26 [Step_1] yes, psudomana is correct

23:02:40 [Step_1] external ear in what type of pt?

23:02:50 [Lorena] swimmers

23:03:24 [kokushubila] Diabetes

23:03:31 [Step_1] not sure about swimmers, but probably right. i was looking for diabetics because i got than question in qbnk

23:04:01 [Lorena] yes, tx for helicobacteris omeprazole+amoxicillin + clarithromycin

23:04:19 [Lorena] ok

23:04:47 [Lorena] i think swimmers because they get extrenal ear infections with pseudomona

23:05:09 [kokushubila] Not sure Lor ,

23:05:11 [Step_1]>[Lorena] makes sense

23:05:20 [filhawaiian] IF Q ask the single best treatment the answer ie PPI otherwise the ans is triple therapy.

23:05:58 [Step_1] didnt know that...thanks

23:06:02 [Lorena] it also causes hot tub folliculitis

23:06:13 [filhawaiian] If the ask the triple therapy, it's be 2 ABx plus bismuth or PPI or H2 blocker.

23:06:14 [Lorena] pesudomona loves the water

23:06:25 [Lorena] thanks fil

23:07:08 [filhawaiian] oop my typing is screwed up. I meant to say if they ask the triple therapy, it's 2 ABx + bismuth or PPI or H2

23:07:27 [Step_1] 65 yr old pt returning from convention develops atypical pneumonia. charcoal yeast extract used to diagnose. what is the bug?

23:07:32 [kokushubila] Thanks Lor , didn't know

23:07:58 [Lorena] Legionella pneumophila

23:08:09 [filhawaiian] pseudomonas is the answer for OE if it's malignant. If it's a regular OE the ans is staph aureus

23:08:21 [filhawaiian] lorena is right L.pneumophilia

23:08:25 vladi enters this room

23:08:32 [Step_1] legionnaires dz caused by Lefionella pneumonia. the mech is that it is in the AC and effects immunocompromised people

23:08:35 [kokushubila] M.pneumoniae?

23:08:36 [Lorena] hi vladi

23:08:47 [Step_1] hi vladi

23:08:55 [filhawaiian] vladi welcome. I've seen you on usmle.net forum

23:08:56 [kokushubila] Welcome Vlad

23:09:03 [vladi] hi everybody

23:09:10 [Lorena] maybe they had air conditioning at the convention

23:10:06 [Step_1] yes lorena because it loves the water and will live in the air conditioners moisture

23:10:22 [Lorena] filhawaiian> sure

23:10:49 [vladi] what's that AC step1

23:11:15 [Step_1] sorry AC= air condition

23:11:18 [filhawaiian] HOw do I PM on this forum

23:11:42 [kokushubila] Thanks Step 1 n Lor

23:12:12 [Lorena] i'll PM you and then you just answer me back

23:12:17 [Step_1] on any post there is an option to pm the author of the post. or you can look up the person in the online study group.

23:12:35 [vladi] it comes from meeting in Pensylvania where they got all this disease

23:12:54 [kokushubila] What does walking pneumonia means? kind of confusing me

23:13:07 [filhawaiian] O.K. Thanks step 1 and lorena. No disrespect to anyone. I just have a few private questions for Lorena

23:13:42 [Step_1] here is the list of PMs for the study group if you need it this was a real question. something to do a bacterial infection of the throat and lymphocytosis is seen. What bug.

23:13:52 [Step_1] ooops....that was the next question

23:13:53 [filhawaiian] walking pneumonia is atypical pneumonia. Px is not severely ill and can still attend classes, go to work etc. It's usually cause by M.pneumonia

23:13:54 [vladi] mycoplasma- w/o clear fever and clinical manifestation

23:14:08 [Step_1] http://www.valuemd.com/groupcp.php?g=11344

23:14:10 [Lorena] bordetella p

23:14:49 [kokushubila] Ok , Understood

23:15:00 [Lorena] lymphocytosis can appear like a lymphoma because so high

23:15:21 [Lorena] i didnt know about walking pneumonia, thanx

23:15:26 [vladi] step1-it;s EBV-mononycleosis (?)

23:15:40 [kokushubila] EBV

23:15:48 [Step_1] yes bortella pertussis is the answer I think....real question

23:16:14 [Lorena] and it says bacterial

23:16:15 [kokushubila] Oooh,thanks

23:16:50 [Step_1] according to kap lan, you will get lymphocytosis, hypoglycemia, inc histamine sensitivity

23:16:55 [filhawaiian] thanks

23:17:10 [vladi] very poor legend- why not EBV- there are atypical lymphocytosis either

23:17:52 [filhawaiian] vladi, Q is asking for a bacteris not a virus

23:18:06 [vladi] ooo-i got it -thanks Lorena- it's bacterial

23:18:11 [kokushubila] Ok thanks Fil

23:18:15 [filhawaiian] darn, my typing is messed up...I meant bacteria

23:18:15 [Lorena] you're welcome

23:18:40 [filhawaiian] lorena check your PM

23:18:57 [vladi] what's MOA of bortella- i mean secondary messages

23:19:17 [Lorena] how do i check it without getting oput of the chat?

23:19:50 [Step_1] oh my typing is terrible on these chats....so sorry a million times so far

23:20:12 [Lorena] i got it

23:20:26 [filhawaiian] I don't know, I clicked on that link earlier and another browser opened up

23:20:55 [Step_1] something to do with cAMP

23:21:07 [Lorena] thanks , i figured out

23:21:49 [Lorena] it inhibits messages to the inside of the cell

23:22:01 [Step_1] the cAMP toxins are B. pertussis, E. coli, V. Choera, B. Anthrax

23:23:11 [Step_1] what bug from cat scratch? what about cat bite? same bug or different?

23:23:43 [Lorena] pasteurella multocida

23:24:25 [Lorena] i dont know...is it the same?

23:24:30 [vladi] bordetella turn off of Gi protein stimulating adenylate cyclase by ADP ribolyzation- HY Q

23:24:51 [Step_1] pasturella is the cat bite (picture the cat playing in the pastures). cat scratch is the henslae one

23:25:12 [Lorena] you are the best!

23:25:35 [kokushubila] thank u step 1

23:25:38 [vladi] i got a printed version of our schedule- next Wednesday is going to be talk about pathology a whole week and at saturday either

23:26:24 [Step_1] path is one of the big P's that is huge for test.

23:26:29 [Lorena] yes, vladi, we agreed we would focus mostly in cardiovascular and respiratory , neoplasia next chat ....

23:26:49 [Lorena] and the rest and waht we didnt cover on saturday

23:27:16 [Lorena] also genetics disorders and immuno we kind a covered that already in the genetics and immuno chat before

23:27:37 [vladi] actually i can refer you to a discussion about scratch and bite of cat at usmle,com- a couple weeks ago - but i forgor for scatch what's causebut not hense-step 1

23:27:49 [Step_1] which bug caused by a tick bite from a rabbit?

23:27:56 microphage enters this room

23:28:17 [Lorena] franciscella tularensis

23:28:18 [filhawaiian] Lorena cat bite = P.multocida

23:28:39 [kokushubila] WHat is the most common cause of septic arthritis in an otherwise healthy sexually active adult?

23:28:39 [filhawaiian] Lorena cat scratch = B.hensalae

23:28:55 [filhawaiian] N.gonorrhea

23:28:55 [Step_1] franciscella for rabbits....good job

23:29:08 [Lorena] thanks fils, i wrote it down

23:29:13 [vladi] agree with lorena

23:29:27 [Step_1] n gonorrhea...agree

23:29:30 [Lorena] agree with fils, n. gonorroeae

23:30:17 [kokushubila] Good

23:30:27 [Lorena]

23:30:44 [Step_1] middle age male presents with acute monoarticular joint pain and bilateral Bells palsey. what is likely dz and how did he get it?

23:31:29 [vladi] i found this HY Q at Princeton course- hunter cooked and eaten rabbit- francisella tularensis

23:31:30 [Lorena] Lyme disease, tick bite?

23:32:09 [kokushubila] Agreed Lyme disease

23:32:10 [Step_1] lyme dz , ixodes tick vector. there is a good case study posted in the step 1 forum about this with pics and all. try to take a look at it when you get a chance.

23:32:21 [vladi] lyme

23:32:32 [Lorena] yes step they are great, thank you

23:32:46 [filhawaiian] I think the key word on that question is the bilateral bell's palsy.

23:32:48 [Step_1] darn...i gave away the answer to one of the case study questions

23:33:03 [Lorena] lol

23:33:16 [filhawaiian] not too many dse present as a bilateral bell's palsy. The ans was at the tip of my tongue

23:33:52 [kokushubila]

23:33:53 microphage exits from this room

23:34:01 [vladi] thak you so much for your excellent review step 1- i'm very striking- you have create your own notes or book- i can help you to sell it out

23:34:04 [Lorena] what bug requires hemin factor X and NAD factor V for culture?

23:34:06 [filhawaiian] by microphage

23:34:12 [filhawaiian] oops...bye

23:34:18 [Step_1] bilateral i think is only lyme....unilateral is a different story

23:34:21 [filhawaiian] H. influenza

23:34:50 [vladi] fil- agree with you- bilaterall bell's- it's key word in this stem

23:34:51 [Step_1] H influ

23:34:53 [Lorena] yes fils!

23:34:57 [filhawaiian] yep unilateral Bell's has a wide range of DDx

23:35:19 [vladi] agree fil

23:35:31 [Lorena] H. parainfluenza requires only factor V and ducreiyi only factor X

23:35:45 [filhawaiian] vladi, are you the same vladi on the usmle.net forum?

23:36:26 [kokushubila] Ok , Thanks Lor

23:36:37 [Step_1] ah, that reminds me, is the chancre in h. ducreyi painful or painless? which is the other dz with chancre?

23:36:54 [Step_1] thx lorena

23:36:56 [filhawaiian] painful you Do Cry

23:37:13 [Lorena] ducreiyi is painful , makes you CRY

23:37:16 [vladi] fil- yes i am, but i like much more this site- it's more democratic and useful

23:37:20 [filhawaiian] chancre - syph

23:37:26 [Lorena] siphylis is painless

23:37:39 [filhawaiian] I'm discharged! on the usmle.net forum

23:37:40 [Step_1] with Haemophilus, "You do cry" sounds like Ducreyi...very good

23:37:51 [filhawaiian] yes sy is painless

23:37:54 [Step_1] syphillis is painless

23:38:53 [vladi] fil- taht's what i mean- igot tired with some comments of monsters of this site

23:38:54 [Lorena] bugs that cause otitis media?

23:39:00 [kokushubila] Hi guys, Thanks for A very nice chat.Gotta go and cook for my husband will join u later

23:39:22 [filhawaiian] O.K. by kok

23:39:26 [filhawaiian] oops...bye

23:39:31 [Lorena] thank you koku!!! nice to talk to you and i am happy you are completely recovered

23:39:39 [Step_1] glad to hear you're felling better....bye

23:39:43 [Lorena] see you nect chat!

23:40:10 [vladi] str.pneum>mozzarella>hem.ihf

23:40:36 [vladi] by kok

23:40:36 [Lorena] very good vladi

23:40:45 [kokushubila] Thank you be right back!

23:41:04 [Step_1] oops missed the question....i guess i'll agree with vladi

23:41:16 [vladi] thanks

23:41:47 [filhawaiian] actually vladi the order is Strep pneunmonia, H. influ, then M.catarrhalis

23:41:51 [Step_1] ah, found it....otitis media causes

23:42:02 [Lorena] yes, agree with fils

23:42:32 [vladi] thaks you also step 1-early before vaccination of hif- it was on second place, but right away displayced to third position

23:43:12 [filhawaiian] I agree. But the way

23:43:16 [filhawaiian] oops

23:43:20 [Step_1] good point

23:43:51 [Step_1] i think it used to be first not that long ago

23:43:54 [vladi] sorry i just used my mneumonic for this bug using italian cheese mozarella- my favorite stuff

23:44:06 [filhawaiian] I agree. But the way they will phrase the question will be something like: px was not vaccinated what is the etio of his/her OM? (Strep will not be listed)

23:44:33 [Lorena] the vaccine is for what strains?

23:45:25 [Lorena] i think is for type b, and the cause of otitis is non typypeable strain

23:45:27 [filhawaiian] I don't know...the H.influenza causing OM is nontypable

23:45:30 [vladi] you are right- fil- it's extremely important to get their trick and digest completely the stem

23:46:00 [vladi] hem.inf-lor

23:46:08 [Step_1] type B 95%

23:46:35 [Step_1] if you mean H influ that is

23:47:11 [vladi] great step 1 for completion

23:47:26 [Lorena] i have in my ka pl an notes that H influenza was the major causative agent before vaccine but of epiglotitis

23:48:14 [filhawaiian] yes that is correct. In the <a target=new href="http://click.linksynergy.com/fs-bin/click?id=c97WUMRO5hY&offerid=47491.10000058&type=3 &subid=0" >Kaplan</a> lecture they said if they as etio of epiglotitis, ans H.influenza

23:48:39 [kokushubila] Vaccine containing type b capsular polysaccharide conjugated to diphtheria toxin

23:48:58 [Lorena] but i think for otitis , the vaccine has not helped because it is non typeable strain (no vaccine for this one)

23:49:04 [kokushubila] Sorry Toxoid

23:49:22 [vladi] for otitis media either-lor

23:49:27 [filhawaiian] Specifically Hib. (other causes = S.aureus)

23:50:04 [vladi] thanks guy for chat- i gootta go -sgood night

23:50:17 [Step_1] your right kap lan says non typable strains for otitis media

23:50:23 [filhawaiian] bye vladi

23:50:31 [Lorena] i thought it was just to prevent epiglotitis and mostly meningitis

23:50:34 [Step_1] bye vladi

23:50:41 [Lorena] bye vladi , see you next chat!!

23:50:59 [filhawaiian] Lorena everyone is going to sleep. We still have a lot of sun. only 5:50pm

23:51:04 [Step_1] its listed under meningitis in kap lan

23:51:54 [Step_1] we should get moving to other material.

23:51:54 [Lorena] yes, be careful....dont confond meningitis, with otitis ....

23:52:07 [Lorena] the vaccination is good to prevent meningitis

23:52:33 [Step_1] i agree with lorena....i had them mixed up before....good point

23:52:40 [Lorena] yes fil , beautiful day as usual in hawaii

23:52:43 [filhawaiian] Lorena what HS, College and Medical school did you attend?

23:53:11 [Lorena] i have lived in hawaii only for ayear

23:53:18 [kokushubila] Hi , Bye bye

23:53:27 [filhawaiian] Sorry step_1 for the off topic post, there's not too many medical students in hawaii

23:53:31 [Lorena] are you leaving again koku?

23:53:48 [Step_1] no prob...i understand

23:53:54 [Step_1] wish i was there too

23:53:57 [filhawaiian] koku I though you left already?

23:54:09 [Lorena] true, i dont know anybody

23:54:27 [filhawaiian] I'll send you some aloha sun

23:54:41 [Lorena] guys i must leave too, have to visit a friend at the hospital

23:54:45 [filhawaiian] that was for step 1

23:55:03 [Lorena] we'll send you all our aloha step !!

23:55:10 [Step_1] great chatting with lorena

23:55:24 [Step_1] thanks for the aloha

23:55:30 [filhawaiian] anyway, back to micro. I ran into a couple of questions regarding UTI

23:55:49 [filhawaiian] Some were asking the MCC of UTI in a non-sexually active woman

23:55:51 [Step_1] ok

23:56:02 [filhawaiian] one asked MCC of UTI in a sexually active woman

23:56:04 [Lorena] see you next chat , take care

23:56:05 [Step_1] e coli?

23:56:17 [filhawaiian] one asked MCC of UTI in a woman w/a urinary cath

23:56:31 [filhawaiian] bye

23:56:32 [Step_1]

23:57:27 [filhawaiian] I don't know the right ans. I answered E.coli on all of them

23:58:05 [filhawaiian] Thoughts anyone? Is UTI always due to E.coli irregardless of clinical situation?

23:58:13 [Step_1] i think that e coli is mcc overall. 2 would be staph sprophyticus

23:58:37 [filhawaiian] When would you answer staph sprophyticus?

23:58:53 [filhawaiian] what scenerio?

23:59:26 [Step_1] uti in a newly married couple....otherwise known as honeymoon cystitis or something like that

00:00:09 [filhawaiian] so someone who is sexually active ans S.sprophyticus otherwise ans E.coli?

00:00:54 [Step_1] probably will give something like gram pos as clue. still the most common is uti in any situation i think. you will need to look for other clues about the bug

00:01:11 [filhawaiian] ok.

00:01:32 [Step_1] sorry meant mcc is e coli regardless i think

00:01:54 [filhawaiian] Step 1 nice chatting with you. I'll see you again next sat. Got to eat dinner. (Yes E.coli is the MCC of UTI)

00:02:26 [Step_1] ok, see you on wed. also look for some questions in the step 1 forum

00:02:37 [Step_1] enjoy your dinner

00:02:44 [filhawaiian] thanks. bye

00:02:51 [Step_1] bye