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First Aid for the USMLE Step 1 (2020)
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First Aid for the USMLE Step 1 (2020) | Physician Assistant (PA) School Study Aid

Page 479 -
6 Picmonics to Learn | 17 mins
Genital Herpes
Mechanism
Herpes Simplex Virus 1 and 2 (HSV)
Assessment
May Be Asymptomatic
Oral or Genital Lesions
Vesicles in Clusters
Pain
Flu-like Symptoms
Antiviral Medications
Acyclovir
Valacyclovir
Famciclovir
Considerations
Infectious During Recurrences
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2 mins
Herpes Simplex Virus (HSV)
Characteristics
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
Type 1 HSV
Gingivostomatitis
Keratoconjunctivitis
Encephalitis of Temporal Lobes
Latent in Trigeminal Ganglia
Type 2 HSV
Genital Vesicles
Neonatal Herpes
TORCHES
Latent in Sacral Ganglia
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusions
Treatment
Acyclovir
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2 mins
Pox Virus
Characteristics
Enveloped
Double-Stranded DNA
Linear
Non-Icosahedral
Signs and Symptoms
Smallpox
Cowpox
Molluscum Contagiosum
Umbilicated Flesh-Colored Domed Lesions
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1 min
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
Necrotizing Fasciitis Pathophysiology and Characteristics
Bacterial Infection of Muscle Fascia and Subcutaneous Fat
Polymicrobial or Monomicrobial
Polymicrobial: Anaerobe + Gram Negative Enterobacteriaceae
Monomicrobial: Group A Streptococcus or Staph Aureus
Clinical Manifestations
Edema Extending Beyond Erythema
Crepitus
Pain Out of Proportion (POOP)
Anesthesia Over Affected Area (Late Finding)
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5 mins
Necrotizing Fasciitis Diagnosis and Treatment
Diagnosis/Workup
Usually a Clinical Diagnosis
Soft Tissue Gas On CT
Management
Emergent Surgical Debridement
Vasopressors and Fluids
IV Immune Globulin If Strep Toxic Shock Syndrome
Antibiotic Regimen
Carbapenem Or Piperacillin-Tazobactam
PLUS Clindamycin
PLUS MRSA Coverage
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4 mins

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