![]() ![]() E – Zoster is caused by a reactivation of latent varicella virus (aka chickenpox) from dorsal root ganglion.None of the other choices are fatty acid oxidation disorders (and consequently associated with a build-up of fatty acids) These disorders can be fatal, as affected individuals cannot break down fats into usable energy during times of fasting/starvation. C – Thankfully, painful biochemistry really isn’t all that common on Step 1.In the lower extremity, that’s foot to knee to groin. C – Lymphatic spread of disease moves through lymphatic channels from distal to proximal.Handwashing with soap is necessary, and equipment should be autoclaved to clean it. Alcohol-based rubs are not sufficient to kill the spores. D – Antibiotic-associated diarrhea caused by clostridium difficile can be tenacious, difficult to treat, and even fatal.Superior rectal varices cause internal hemorrhoids. Periumbilical varices can cause caput medusa. B – Esophageal varices are a big deal and can be fatal.Paracoccidioidomycosis from Mexico and South America. Histoplasmosis is endemic to Ohio River valley. Coccidiomycosis comes from the southwest (i.e. B – You don’t necessarily have to know a ton clinically about differentiating endemic fungal diseases, but you do have to know which areas they come from and what they look like.Thankfully, there’s a vaccine for that now. D – HPV (particularly strains 16 and 18) causes squamous cell carcinoma of the cervix. ![]() This can be done by saturating the alcohol dehydrogenase enzyme with intravenous alcohol or through the use of fomepizole (a competitive inhibitor). The trick in treatment is to prevent the conversion of the original alcohols into their toxic metabolites.
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