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First Aid for the USMLE Step 1 (2021)
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First Aid for the USMLE Step 1 (2021) | Medicine (MD/DO) School Study Aid

Page 118 -
21 Picmonics to Learn | 50 mins
Sepsis Assessment
Signs and Symptoms
Systemic Infectious Process
Fever
Hypotension
Change in LOC
Increased WBC
Shift to the Left
Tachycardia
Tachypnea
Hyperglycemia
Edema
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2 mins
Pseudomonas Aeruginosa Characteristics
Characteristics
Gram-Negative
Bacillus
Aerobic
Pyocyanin Pigment
Blue-green Pigment
Grape like odor
Non-lactose Fermenting
Polysaccharide Capsule
Catalase-Positive
Oxidase-Positive
Inactivates Elongation Factor 2
Exotoxin A
Endotoxin
Water sources
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3 mins
Streptococcus Pneumoniae Characteristics
Characteristics
Gram-Positive
Diplococci
Lancet-Shaped
Catalase-Negative
Optochin-Sensitive
Bile Soluble
Alpha-Hemolytic
Polysaccharide Capsule
Positive Quellung Reaction
IgA Protease
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1 min
Haemophilus influenzae Characteristics
Characteristics
Gram-Negative
Coccobacilli
PRP Capsule in Type B
Positive Quellung Reaction
IgA Protease
Chocolate Agar
Factor V is NAD
Factor X is Hematin
Staph Aureus Provides Factor V
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2 mins
Neisseria Meningitidis
Characteristics
Gram-Negative
Diplococci
Chocolate Agar
Thayer-Martin Media
VPN
Oxidase-Positive
Maltose Fermentation
Glucose Fermentation
Endotoxin
Lipooligosaccharide (LOS) in Membrane
Polysaccharide Capsule
IgA Protease
Disease
Waterhouse Friderichsen Syndrome
Adrenal Insufficiency
Petechial Rash
Treatments
Ceftriaxone
Rifampin Prophylaxis
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5 mins
E. coli Overview
Characteristics
Gram-Negative
Bacillus
Purple Colony with Metallic Green Sheen
Lactose-Fermenting
Pink on MacConkey Agar
Disease
Diarrhea
Lipid A Septic Shock
P Pili Pyelonephritis and Cystitis
K Capsule Neonatal Meningitis
K Capsule Pneumonia
H Antigen Flagella
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2 mins
Salmonella Overview
Pathophysiology
Gram-Negative Rod
Oxidase Negative
Non Lactose Fermenter
White on Macconkey Agar
H2S Producing
Flagella
Invades GI Tract
Peyer's Patches
Considerations
Osteomyelitis in Sickle Cell Patients
Reactive Arthritis
Antibiotics Prolong Fecal Excretion
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3 mins
Klebsiella Characteristics
Characteristics
Gram-Negative
Bacilli
Oxidase-Negative
Intestinal Flora
Antiphagocytic Virulence Factor
Polysaccharide Capsule
Positive Quellung Reaction
Mucoid Colonies
Urease-Positive
Fast Lactose Fermenter
Pink on MacConkey Agar
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2 mins
Streptococcus agalactiae
Characteristics
Group B Streptococci
Gram-Positive
Cocci
Beta-Hemolytic
Bacitracin-Resistant
Catalase-Negative
Pyrrolidonyl Arylamidase (PYR) Negative
Polysaccharide Capsule
Hippurate Positive (+)
Produces CAMP Factor
Enlarges Area of Hemolysis by S. aureus
Disease
Mainly in Babies
Meningitis
Pneumonia
Sepsis
Colonizes Vagina
Treatment
Screen Pregnant Women at 35-37 Weeks
Penicillin
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3 mins
Staphylococcus aureus Characteristics
Characteristics
Gram-Positive
Cocci
Catalase-Positive
Coagulase-Positive
Beta-Hemolytic
Protein A Virulence Factor
Inhibits Phagocytosis
MRSA
Resistant to Beta Lactams Due to Altered Penicillin Binding Proteins (PBPs)
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2 mins
Nocardia
Characteristics
Aerobic
Gram-Positive
Catalase-Positive
Urease-Positive
Acid Fast
Branching
Beaded Filament
AIDS/Immunocompromised
Soil
Signs and Symptoms
Lung Cavitation
Brain Abscess
Kidney Abscess
Treatment
TMP-SMX
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2 mins
Cytomegalovirus (CMV)
Characteristics
Enveloped
Double Stranded DNA
Herpesvirus 5
Diagnosis
Non Heterophile Antibodies
Owl's eye inclusions
Signs and Symptoms
Congenital TORCH infection
Mononucleosis
Pneumonia
AIDS retinitis and esophagitis
Infection in transplant recipients
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2 mins
Epstein Barr Virus
Characteristics
Herpesvirus 4
Double Stranded DNA
Linear
Enveloped
Signs and Symptoms
Infectious Mononucleosis
Virus Attaches to CD21 in B Cells
Nasopharyngeal Carcinoma
Burkitt's Lymphoma
Hodgkin's Lymphoma
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1 min
Polyomavirus
Characteristics
Non-enveloped
Double-stranded DNA
Circular
Disease
BK Virus
Kidney Damage
JC Virus
Progressive Multifocal Leukoencephalopathy (PML)
HIV/AIDS
Oligodendrocyte
Demyelination of CNS
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4 mins
Varicella Zoster Virus (VZV)
Herpesvirus 3
Characteristics
Enveloped
Double Stranded DNA
Signs and Symptoms
Chickenpox
Pneumonia
Encephalitis
Trigeminal and Dorsal Root Ganglia
Shingles
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusion
Treatment
Acyclovir
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2 mins
Candida Albicans
Fungi
Yeast with Pseudohyphae at 20 Degrees C
Germ Tube Formation at 37 Degrees C
Pruritic Vaginitis
White Cottage Cheese Discharge
Fiery Red Mucosa
Diabetics
Antibiotic Use
Esophageal Thrush in Immunocompromised
Diaper Rash
Endocarditis in IV Drug Users
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2 mins
Pneumocystis jirovecii
Fungi
AIDS/Immunocompromised
Fever
Hypoxemia
Bronchoalveolar Lavage
Biopsy
Methenamine Silver Stain
Saucer/cup shaped yeast forms
Diffuse interstitial pneumonia CXR
TMP-SMX
Start prophylaxis when CD4 drops under 200
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1 min
Cryptococcus neoformans
Characteristics
Monomorphic
Encapsulated
Polysaccharide Capsule
Narrow-Based Buds
Latex Agglutination
Pigeons
India Ink
Mucicarmine stain
Signs and Symptoms
AIDS/Immunocompromised
Meningitis
Soap Bubble Lesions in Brain
Pneumonia
Treatment
Fluconazole
Flucytosine
Amphotericin
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3 mins
Giardia lamblia
Characteristics
Protozoa
Ingestion of Cysts
Seen in Campers
Daycare Centers
Mental Hospitals
Infects Small Intestine
Signs and Symptoms
Bloating
Flatulence
Fatty Diarrhea
Diagnosis
Crescent-shaped Protozoa Adjacent to Epithelial Brush Border
Predisposed if Low IgA
Treatment
Metronidazole
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3 mins
Aspergillus fumigatus
Characteristics
Fungi
Monomorphic
Septate Hyphae
Branch at Acute Angles
Fruiting Bodies
Disease
Allergic Bronchopulmonary Aspergillosis (ABPA)
Eosinophilia
Increased IgE
Glucocorticoids +/- Azoles
Pulmonary Aspergillosis
TB Cavity
Lung Aspergilloma
Hemoptysis
Invasive Aspergillosis
AIDS/Immunocompromised
Chronic Granulomatous Disease
Hemorrhagic Infarction
Necrotizing Bronchopneumonia
Voriconazole +/- Caspofungin
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3 mins
Mucor and Rhizopus
Characteristics
Fungi
Irregular Non-septate Hyphae
Branching Wide Angles over 90 degrees
Signs and Symptoms
Leukemic Patients
Proliferate due to excess ketones and glucose
Diabetic Ketoacidosis (DKA)
Rhinocerebral frontal lobe abscess
Penetrate cribriform plate into brain
Black Necrotic Eschars on Face
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2 mins

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