Bites and stings: Clinical (To be retired)

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Bites and stings: Clinical (To be retired)

Subspeciality surgery

Cardiothoracic surgery

Coronary artery disease: Clinical (To be retired)

Valvular heart disease: Clinical (To be retired)

Pericardial disease: Clinical (To be retired)

Aortic aneurysms and dissections: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Pleural effusion: Clinical (To be retired)

Pneumothorax: Clinical (To be retired)

Lung cancer: Clinical (To be retired)

Anatomy clinical correlates: Thoracic wall

Anatomy clinical correlates: Heart

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Mediastinum

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

cGMP mediated smooth muscle vasodilators

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Plastic surgery

Benign hyperpigmented skin lesions: Clinical (To be retired)

Skin cancer: Clinical (To be retired)

Blistering skin disorders: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Burns: Clinical (To be retired)

ENT (Otolaryngology)

Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves

Anatomy clinical correlates: Trigeminal nerve (CN V)

Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves

Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves

Anatomy clinical correlates: Skull, face and scalp

Anatomy clinical correlates: Ear

Anatomy clinical correlates: Temporal regions, oral cavity and nose

Anatomy clinical correlates: Bones, fascia and muscles of the neck

Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck

Anatomy clinical correlates: Viscera of the neck

Antihistamines for allergies

Neurosurgery

Stroke: Clinical (To be retired)

Seizures: Clinical (To be retired)

Headaches: Clinical (To be retired)

Traumatic brain injury: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Brain tumors: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves

Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves

Anatomy clinical correlates: Trigeminal nerve (CN V)

Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves

Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves

Anatomy clinical correlates: Vertebral canal

Anatomy clinical correlates: Spinal cord pathways

Anatomy clinical correlates: Cerebral hemispheres

Anatomy clinical correlates: Anterior blood supply to the brain

Anatomy clinical correlates: Cerebellum and brainstem

Anatomy clinical correlates: Posterior blood supply to the brain

Anticonvulsants and anxiolytics: Barbiturates

Anticonvulsants and anxiolytics: Benzodiazepines

Nonbenzodiazepine anticonvulsants

Migraine medications

Osmotic diuretics

Antiplatelet medications

Thrombolytics

Ophthalmology

Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review

Eye conditions: Retinal disorders: Pathology review

Eye conditions: Inflammation, infections and trauma: Pathology review

Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves

Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves

Anatomy clinical correlates: Eye

Orthopedic surgery

Joint pain: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Trauma surgery

Traumatic brain injury: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Abdominal trauma: Clinical (To be retired)

Urology

Penile conditions: Pathology review

Prostate disorders and cancer: Pathology review

Testicular tumors: Pathology review

Kidney stones: Clinical (To be retired)

Renal cysts and cancer: Clinical (To be retired)

Urinary incontinence: Pathology review

Testicular and scrotal conditions: Pathology review

Anatomy clinical correlates: Male pelvis and perineum

Anatomy clinical correlates: Female pelvis and perineum

Anatomy clinical correlates: Other abdominal organs

Anatomy clinical correlates: Inguinal region

Androgens and antiandrogens

PDE5 inhibitors

Adrenergic antagonists: Alpha blockers

Vascular surgery

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Aortic aneurysms and dissections: Clinical (To be retired)

Anatomy clinical correlates: Anterior and posterior abdominal wall

Adrenergic antagonists: Beta blockers

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Thrombolytics

Assessments

Bites and stings: Clinical (To be retired)

USMLE® Step 2 questions

0 / 7 complete

Questions

USMLE® Step 2 style questions USMLE

of complete

A 17-year-old boy from Oklahoma is brought to the emergency department with two days of fever to 39.3°C (102.7°F), myalgia, abdominal pain, and vomiting. A maculopapular rash is noted on the trunk, back, extremities, palms, and soles. He had previously been in good health, with no unusual dietary or travel exposures and no sick contacts. He has been sexually active with multiple partners; he drinks socially but denies use of recreational drugs. He is not taking any medications and has no known drug allergies. Which of the following is the most appropriate next step in management?

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Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Elizabeth Nixon-Shapiro, MSMI, CMI

Jake Ryan

Bites and stings can be caused by a variety of animals, insects, snakes or yes, even humans!

The most common mammalian bites are from dogs, cats, and humans. And each bite transmits the polymicrobial flora that can be found in the mouth - including Staphylococcus aureus, group A Streptococcus species, Klebsiella, Enterococci, Prevotella and many more.

Dog bites can transmit a gram negative rod called Capnocytophaga canimorsus, which can cause gangrene at the bite site and can disseminate and cause sepsis, especially in asplenic individuals and those with liver disease.

Cat bites or scratches - particularly from kittens - can transmit Bartonella henselae, which causes cat scratch disease.

Both dog and cat bites can also transmit Pasteurella multocida which can cause cellulitis at the bite injury.

Finally, human bites can transmit Eikenella corrodens which is a gram negative anaerobe which can cause local and disseminated infection - including being a cause of culture-negative endocarditis - one of the HACEK organisms.

In general, bite wound infections cause local cellulitis and in some cases can lead to a local abscess and fevers.

Dog bites are the most common ones of all, and because dogs have strong jaws they often cause serious tissue injury, but infections aren’t that common.

In contrast, cats have long, thin teeth, that create deep puncture wounds, which very often get infected. Cat bites can even reach the underlying joint space or periosteum, leading to septic arthritis or osteomyelitis.

Like cat bites, human bites also have a high risk of infection.

Elsevier

Copyright © 2023 Elsevier, except certain content provided by third parties

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