DIP Ep 554: What is this antibiotic used for? (Extremely HY for Step 1-3)

Um it's kind of a hard topic to prepare for and this is one of those podcasts I will encourage you um listen to it over and over again. You're gonna get numerous questions right from this. So what's this mysterious This mysterious topic is what is this antibiotic What is this antibiotic here?

In today's podcast I'm just gonna focus primarily on antibacterials because that's what they're used for. So I'm not gonna spend time talking about mechanism of action or anything like that. All I'm just gonna talk about is hey This antibiotic, what do they use it for in a USMLE exam? So this is a quick and dirty podcast, but it's really gonna help you a ton on your exams. So let's just jump right into it. Okay, number one, penicillin.

What are we gonna use penicillin for on the US ML? Well, you can use it for syphilis. That's a very, very big one. You can use it for syphilis, syphilis, syphilis, syphilis, penicillin. Um and also if you think of a person having Like draining sulfur granules or whatever, uh like cervical facial infections, actinomyces really high. That's also treated with penicillin on the US ML. And then remember for most cases of streptococcal pharyngitis, you're also gonna be using penicillin.

Okay, don't get me wrong, are there other situations where you can use penicillin? Yes, but these are the main ones. Another one you can maybe throw in there is rheumatic fever. Rheumatic fever, that's a big indication for penicillin on the exam. Alright, we're gonna be done. Now let's move on to the amino penicillins, right? So the big ones here are ammoxicillin and ampicillin. What's the big thing to know about amoxicillin? Amoxicillin, we use it to treat acute otitis media.

So when a person has an ear infection, red bulgent tympanic membrane, you give ammoxicillin. If amoxicillin doesn't work, go ahead and slap some clavolanic acid on that. So amoxicillin plus clavolanic acid that's augmenting. Um so you can use it. I'm be selling. What's the big thing with I'm be selling? Don't forget I'm be selling for a while. Listeria. Lester uh I'm saying it's the big big gun for.

hysteria is the drug of choice for listeria. So usually you're gonna slot in some ampicillin when you're dealing with uh bacterial meningitis and you want to do empiric treatment for bacterial meningitis and a person that's over fifty or a neonate you you gotta covers a listeria. And then don't forget that you can also use um amoxicillin picillin for groby.

You can even throw in penicillin actually for that. So groby straphylaxis, uh, when a woman is in trapartum, you can certainly use it for those purposes. Okay. Now there are other situations where you can use amoxys. Right. So like for example, uh in many GI infections, you can do ampicillin gen. Um and also you can also use you can also use um amoxicillin if you're worried about Lyme disease in a high risk population, right? Like a pregnant woman.

So again, I'll say that those are many of the classic situations where you use ampicillin or ammoxicillin. Maybe one other ampicillin indication you can throw in there is if a person has coriamnionitis. Coriamonitis, you can treat it on ampicillin. Um and then um remember endometritis which is an analogous infection, that's a uterine infection versus chori amnitis, which is a amniotic fluid infection for endometritis.

You can use clandamycin and gentamycin. Maybe we'll confuse those treatments and just kinda figure

All right. And then um if we talk about these other kind of special penicillin aceleno or napsillin, where do you see them used? That's pretty straightforward. They're pretty much used for mastitis. So again, these things I'm saying, there are many other uses for these antibiotics that you may have seen in some uh rare instance. I'm just trying to give you the quick and dirty like, hey,

If you think of this antibiotic, what is like the first thing you should think about on your exams? So clocks cloxacelin, dicloxacillin, oxacillin.

Naphtiline, they're gonna be used primarily for mastitis, right? You're gonna see a woman that's recently started breastfeeding, has a warm, tender breast, may have like a mild fever. Um, think of mastitis. Again, you're gonna use um tools anti- Okay, and again, uh one thing I'm just gonna say is that many people they always ask me, Divine, when should I ever pick paper asylum and taso bath?

My answer is gonna be never. Don't pick it on you. On an MBME exam, don't do it. If not, you're gonna be picking very likely the wrong answer. Zolcine works extremely well. It's just the US MLEs have a huge issue with it. So please just don't do it. Don't do it. Simple as that. And um, so don't again, that that beta lactam, beta lactamase inhibitor.

amoxicillin clavolanic acid. Remember I said it's second line for acuteotitis media. Um peperacylintazo backam they pretty much never want you selecting that. And Picillin and Solbactam is another beta beta lactam, beta lactamase inhibitor. And typically the one situation the the classic situation you're gonna see that used in actually on the US MLEs is when you're dealing

With a person potentially having some very serious throat infections, right? So say for example a person has epiglottitis, you can use it for that purpose. You can absolutely use it And also, if a person potentially has like infection of the mastoid ear cells, acute mastoiditis, you can also certainly use ampicillim. All right. Uh that ampicolin sorbacter makes it rarely tested. Most times they like amox clavolanic acid for.

second line for acuteotitis media. Please again I'm begging you. Piprazylintazobactum, I've never seen it be right on any exam ever. So just FYI. I'm

I've you I've I'm pretty sure I've prescribed it before, but again, just not on exams. All right. It won't be smart. All right. So now let's go to the cephalosporins, right? So the first gen cephalosporins, again, uh, what are the big ones? the big ones here don't forget your cephalxin and cefazolin cefazolin the big thing to know about it is surgery surgery surgery right before you do surgery on a person before you slice them open you should give them

Ancef. I feel like ANCF is the only antibiotic uh surgeons. No, I'm just kidding. Right? But ANCF, right? Cefazolin, cephazolin, cefazolin, cefazolin. Okay, and then cephalexin is another big one. So, you know what? Why do they like cephalexin a lot? They like cephalexin because you can use it for a bunch of.

Um you can use it especially for skin and soft tissue infections. So like cellulitis, oh cephalexin is great. Cephalexin is amazing for that purpose. Uh believe it or not, you can actually also use cephale. You can also use uh cephalexin for um you can also use cephalexin actually for

uh for UTIs in pregnant women. It actually works pretty, pretty great for that purpose. So that's something you want to keep at the back of your mind. Okay, now, um the other generations of cephalosporins like the second generation, they almost never right so like the cefuroxine they don't really test it but let's go to the third generation third generation really really high yield right so that's where you have your ceftriaxon and that's where you have your

Um ceptazidim. Now, ceftazidim, the only thing you should know about ceptazidim is it's a third generation cephalosporin that covers pseudomonas. But ceftriaxone is used for a ton of stuff, right? You can use ceftriaxone to treat uh spontaneous bacterial uh peritonitis. You can use uh ceftriaxone or a close causing of it called cephaltaxin. You can also use cephaltaxin.

Um and then uh cefotaxin, by the way, is also a third gen cephalosporine. You can also use ceftraxon for many GI infections. It's amazing, amazing, amazing for GI infections, especially when you combine it with metronidal. Another use for ceftriaxone is when you're trying to cover nicereal species, right? So for example, if you're trying to cover nicera meningitis, use ceftriaxone. You're trying to cover nicera gonorrhea, use ceftriaxone.

Right. And remember, empiric treatment of meningitis in a in a person over age fifty, you're gonna use seftriaxone plus vencomycin plus ampicillin. Right. And also, we tend to use that combination as well when we're talking about neonates. Although, for neonits, we swap out the ceftraxone and use cephaltoxin instead. Again, don't forget.

Don't forget cephaltoxin is a third gen cephalosporine. The only times you see them used on exams are when you're dealing with pediatric situations because you know ceftraxin can cause in dry particle stasis because it can chelate calcium and cause, you know.

stasis of your bile but cephotaxin they also tend to just throw you every now and then for SBP spontaneous bacteria peritonitis but I just like to think of it as like the close causing of ceftri axon the close causing of And again you can also use F traction for Uh commonly acquired pneumonia, especially when the person is gonna be an impatient uh individual, right? A person that's impatient, you should probably use it for commonly acquired pneumonia.

Okay, now fourth generation, sefe pimp sefe pimp sefe pimp sefe pimp sefe pimp sefe pimp. Right? You're gonna use sephipim on your exam. Sephipim covers pseudomonas, right? Think of it as something you use for a person that has febrile neutropenia. Whenever a person has feber neutropenia, you're always worried about gram negatives. Gram negatives, gram negatives, gram negatives. Don't correct me wrong, they can also have gram positive issues, but

Uh gram negatives are a huge issue, especially you want to cover Pseudomonas in those circumstances. So you want to use Cepheidm for those circumstances, or what's the third generation cephalosporine that covers Pseudomonas as well? Seftazidim. Seftazi deem. Okay, now the fifth generation of Sevlosporin. We're not going to talk about it. I think it's called Septaroline. Super low yield. Not going to talk about it. All right. Now let's go to the carbapenic.

Your cara penems are your things like Imipen M, Meropen M, Erda Penam, Dori Pen M. Okay, so what are you gonna use these things for? E? You're dealing with it When they give you a question and they tell you that ooh they do some culture, some gram stain or whatever, and they get extended strip spectrum beta lactomies, what are you reaching out for in your test?

a carbapenum. If you're taking a carbapenim, you should probably be in the ICU. If you're taking a carbapenim, that person is in serious trouble, right? That person is is literally in serious trouble. Person is literally in serious trouble. Alright, so that's it. Extended spectrum beta lactamase organisms quite unused.

Okay. Now Vencomycin, Vencomycin, Vencomycin. What do you use vencomycin for? Well remember you can use vencomycin in the oral form for C. diff, right? Post antibiotic, water your bloody diuretic. Another thing you can also use vencomycin for your exams for MERSA infections, for MERSA infections. You can see for what? For MERSA infections. For MERSA infections.

I remember what are the antibiotics we've talked about that cover MSSA? Methicillin-sensitive staph oras? You know, like we see mastitis. Hmm. I wonder what those were oxacillin, dicloxacyline? Nafselin, right? Again, keep those in mind. I'm trying to do these like mini like go back and review. already in just a slightly different way. Alright, so those that's largely what you're gonna be using Venk for your on your exams. Okay, now there's this kind of weird antibiotic call-of-

So uh phospomycin actually we use it mostly for UTIs. It's a UTI drug, it's one of these weird antibiotics you see, just kind of shows up uh out of the blow on your. Wh where did that

And don't worry about the mechanism of action. It does some stuff involving like phospho, you know, pyruvate synthase. I'm not gonna talk about that super low yield for your test. But again, phosphomycin for UTIs. And I guess since we're kind of talking about CDF, remember you can also use another antibiotic called phedaxomycin. Daxomycin for C diff. Actually, it works extremely well for C diff. All right. Now let's jump into the macro lids, macrolids, macrolids, right? Erythromycin.

Clarithromycin, azythromycin. So clarithromycin. Where do they like to use clarithromycin on the USM at least? They love clarithromycin for H bylorie. Remember, clarithromycin. Oxicillane and the PPI, boom. You can use that as tripotherapy for H. pylori. Although you can use any other macrolid you want. But I don't know, they just like clarithromycin a lot for H. pylori. I throw that out there. And then another classic situation where

Macrolids is quadruple therapy as well, right? So uh macrolid, base move, a tetracycline, and a PPI. That's quadruple therapy. Alright. Now remember you can also use erythromycin, it's more like a second line. Gastroparesis because it's a motiline receptor agonist. Now, what if you see a person they cough and brrrrrr they pass out after they cough? That sounds an awful lot like pertosis, so pertosis. We also treat that with the macrolid. What if you see a young person that has been feeling

Crappy for a few days. Low grade fever. Barely coughing up anything. They're still able to go to work. Sounds like walking pneumonia. We also use a few. For that purpose. What if you see a person that was exposed to bad water supplies has an interstitial pneumonia? Typonatremia sounds like Legionnaires disease by Legionella, which read Legionella with macrolides as well. All right. So, um

So those are the big, big, big, big, big uses of macrolides. And by the way, you can also just use a straight macrolid, especially especially azithromycin for community-acquired pneumonia. Now, one thing I want to say about azithromycin is that if a person has a COPD exacerbation and acute COPD exacerbation, And they kinda have like, you know

Like man, does this person have an infection going on as well? Go ahead and slap some azithromycin on those on those folks. Okay. And don't forget that um your macrolids they can also cover uh Mycobacterium marinum, right? Mycobacterium marinum, you know, skin and soft tissue infection in a person that is, you know, kind of works at SeaWorld or in an aquarium or a fish type.

Alright, so let's jump to clindamycin. What do we use clindamycin for? Whenever a person has neck fashion, clindamycin should be part of the drug regimen. Basically, if you have any infection rates, toxins that Messing up your life, you you should do clean the mycin, right? So 50S inhibitor, um, protein synthesis inhibitor, toxins are proteins, right? So it's gonna help in that.

And also if you're dealing with anaerobes, if you're worried about anaerobes, clindamycin, right? Like a person hasn't having like a long abscess. Uh Clinda is not a bad idea in those folks. Remember Clinda and that C diff association there. Okay, don't forget Clinda. And what else have I talked about Clinda with? Hm woman three days after C. Ooh My lower abdomen hurts. My lower abdomen hurts. Sounds a lot like endometritis. You're gonna use what? You're gonna use Clinda for that. Remember.

Dometritis, that's a urine infection. Biggest risk factor for that is what? Recen C section. Give Clinda and Gent. Clinda mycin and gentamycin. Again, all these things you may think that I'm kind of joking. I'm just trying to make this uh kind of 'Cause I know people hate antibiotics, right? And I understand antibiotics learning all this stuff is not fun. But hey, you gotta know it. Why do you think I had to learn this back in the day? Because uh I was higher for

You wanna practice medicine or anything like that. So you should probably know this stuff. I I promise you this podcast is gonna be one of weird podcast that you listen to from Divine and then you're like, gee, there's like 20 questions on 30 questions on my exams that I see from this one single podcast. So you you gotta Like don't don't mess around with with

Now, uh chloramphenicol is another antibiotic. Um, you should maybe not pick this for like actually trading anything on your exams, but remember that this thing causes gray baby syndrome. Right? It caused grey causes gray baby syndrome and causes a plastic anemia. So they test it more for the side effects than the actual use because I would hope uh if you're taking a USML exam, you're not using chloramphenicor.

Now, another classic antibiotic, Linazolid. Linazolid, Linazolid, Linazolid. Remember, Linazolid. What are some big things to know about Nilinzoolite? VRE. For person has enterococcal infections that are resistant to vencomycin VRE. Υπότιτλοι AUTHORWAVE Linizolid. Linizolit's a fifty inheritance.

It's a 50S inhibitor. So use linazolate. And linazolid also covers MERSA. That's something you gotta know about Linazole. Don't mess around with that stuff on your exams. Now, one thing I want to say about linazolate. special is that it also happens to be a monoamine oxidase inhibitor. So Don't be surprised if a person has a hypertensive crisis on linazole after they just consume some pizza or eight cheese. Hmm. What am I referring to there? Tyramine effect, tyramine effect.

Or you see a person that is like, ooh, they have depression. Ooh, they take an SSRI. Ooh, didn't start taking linezolate. Because they have some kind of uh heart infection like endocrineitis or whatever. You know, you have to cover VR or you have to cover MRSA for whatever bizarre reason. And then boom, they start having clonus and hyperreflexia. What does that sound like folks?

Serotonin syndrome. Exactly. Serotonin syndrome can be caused by linezole. Keep that drug interaction in mind. All right. Now let's talk about our aminoglycosides, right? They're endemic. Remember those things can torture your ears just like vencomycin. Uh that that combination of nephrotoxicity and nodotoxicity. We see that with what? With Venc? We see that with your amino gas.

Now, amino glycosides, don't forget, they're very, very good for UTIs. Very especially, you know, pylonephritis, they're very good for those situations. Remember the chovagram negatives are amazingly. cover gram negatives amazingly well. Remember, what else have we talked about with gentamycin today in Obigayne world? Hmm. Endometritis, Clinda and Gent, Coramnionitis, and Picillin and Gent. Don't forget your aminoglycosides for those are circumstances. Okay? Don't forget your amino glycides.

Don't forget you have me to go.

Alright. Now remember you can also use gen for GI infections when you combine it with an ampicillin and Alright, now how about your tetracyclines? Right, you know they all end Minocycline, doxycycline, Tigacycline. Uh Tigacycline, they pretty much almost never test it. The only claim to fame of Tigacycline is that it can cover MRSA. Now remember, you can use your

What you can use it for Rocky Mountain spotted fever. Even if you're pregnant, if you don't get the tetracycline, you're probably gonna die, right? So we use tetracyclines for rocky mountain spotted feed feed. We also use tetracyclines for um chlamydia infections. In fact they are preferred these days over macrolides, yeah, just because of less treatment rates.

pelvic inflammatory disease PID you can throw in some doxycycline for that amongst other things you use. And remember doxycycline you can actually use it for malaria prophylaxis. Believe it or not there are some MBME questions. Usually people get the malur prophylaxis. Yeah you can use for malaria prophylaxis. And don't forget that you can also use it for acne. Right? We use uh

Actually quite good for for acne. Now don't forget your tetracycline's photosensitivity is a big problem with those drugs. Photosensitivity. Photosensitivity. Photosensitivity. Photosensitivity. In fact, there's this pneumonic. Years ago for the drugs that cause photosensitivity, uh sat for photo, you know, sat for a photo. I lent it back.

So the S stands for sulfonamide, the E stands for uh um amuterone, and then the T stands for tetracycline, stands for tetracycline. Okay, uh remember you can also use tetracyclines as part of quadruple therapy. for H. pylori. What's triple therapy for H. pylori? Remember microlated

Toxicillin and a PPI. What's quadruple therapy? Macrolid, bismuth, subsalicylate, tetracycline and a PPI. All right. Now, next group I'll talk about, talk about the fluoroquinolones. So, what do we use fluoroquinolones for? Well, flourquin alone, uh, you can use them for UTIs. Occasionally they kind of pop up in that regard on the US MLE exam. For UTIs, and also you can use them as SBP prophylaxis. Pontions bacteria peritonitis.

Our fluoroquinolones are actually quite good for that purpose. Again, the USMLEs these days, they've started de-emphasizing fluoroquinolones quite a bit. Um, because I just have a bunch of problems, right? You know, prolong your QT interval. explode your Achilles tendon, you know, they cause a bunch of problems. Um now, one thing I want to say is if you also have like just many of these infectious diarrheas, they actually cover quite well.

By fluoroquinolons. Okay. How about rifampine? Rifampine, what do you use rifampine for on the USMLEs? What do you use rifampine for? You can use rifampine for mycobacterium marin. I'm saying that first because it's one of those things people ignore. So I just want to say it first. You can also use it for many T B infections, right? Like you you should know. And also, you know, let's say you intubated a person that came in with no co-rigidity and they have like Petiki and purple on the skin.

What does that sound like? Meningococcal infection. Close contact. You inhale their sec uh their respiratory secretions. If you don't want to end up on a bed next to them in the ICU, you should probably take rifampin as close contact prophylaxis for meningococcal infection.

Remember you can also use ceftraxon for that purpose as well. But they like rifampine quite a bit because they know that ceftraxon, everybody knows that, ooh, you use ceftraxon for treatment meaning coccal infections. So they like to test the rifampine part because something that people do not pay attention to.

And also, if you have a prosthetic valve endocarditis, rifampin is also a kind of a good adjunct, but that's rarely tested, pretty pretty low yield. And also, let me ask you this: Is there another person? That may have meningitis from a particular bug.

That you may have been exposed to, that you're like, hmm, we should take crafampine as close contact prophylaxis. Don't forget meningitis from hemophilos influenza type B. If you've been exposed to person that has meningitis from a hemorrhous influenza type B and you're a close contact, E you need what?

Refampine prophylaxis. Okay, so don't forget nice reminingitis and H flute B. Okay, please keep those things at the back of your mind. Okay, how about metronidazole? Metronidazole, remember, protozoan, protozoan, protozoan, protozoone. Like what?

You know, trichomoniesis. You can use it for trichomoniaasis. Uh you can use it for giardia, right? You can use it for entamiba histolytica. Remember that's the protozoan that causes bloody diarrhea and liver abscess. You can use metronidazole for bacterovaginosis. And also, metronidazole is good for GI infections. You know why? Because it covers what? Covers on aerobs pretty well.

Okay, covers anaerobes pretty well. And um please I made a small mistake. Uh I just want to correct myself. So I said that triple therapy for H pylori is macrolid, amoxicillin and a PPI. That is correct. Now please Let me bother you a bit for that quadruple therapy. Quadruple therapy is actually metronidazole bismuth tetracycline and a PPI. I don't know, I have been saying macrolade, bismuth, tetracycline and a PPI. No, that's wrong.

Metronidazole base move tetracycline and a and a PPI. Um and you know back in the day we used to use uh so please take note of that correction. So back in the day, we used to use a metronidazole for C.

Don't do that again on your exams, right? That'll be a bad idea. Okay. Now, daptomycin. What's a big thing to know about daptomycin? Okay, let me s slot in one bonus for metronidazol, disulfurum side effect. Remember? It inhibits that acetaldehyde dehydrogenase. It's a nice biochem association there. Okay, let's keep going. Now daptomycin on your exams, what is it gonna be used for? MERSA?

Where you don't see Venc as an answer for whatever bizarre reason, you can also use it for VRE, vengomycin resistant enterococcus. So, what is the other drug we talked about that can be used for VRE on the US? Linazoleid. Remember the MEOI activity? So remember that serotonin syndrome association I talked about? Remember that tyrement crisis association I talked about? Know that for your test. All right. Again.

TMPSMX Trimethhoprim sulfur methoxazole. What's the number one use on the USMLEs? Easy, easy, easy, easy HIV, HIV. Right. And you can also use it to prophylax against Toxoplasma. Right, you can use prophylax against toxoplasmosis. But you don't use it to treat toxoplasmosis. Toxoplasmosis is treated with pyramethamine and sulfodiazine. Okay? So we prophylax against toxo with trimethyl and sulfur methoxasone. But we treat toxoplasmosis infections with pyramethemine and sulfur.

Diazine, pyramethamine and sulfur diazine. TMPSMX is also good for skin and soft tissue infections, especially for MERSA. It does cover MRSA. You can use it for UTIs. You can use it for what? For UTIs. You can use it for what? For UTIs. You can use it for UT. Okay. Um you can even use it for pylonephritis. Okay, now how about nitrofurontoin? Nitropurontoin, we pretty much use it in women that have cystitis, even pregnant women.

Okay, do not use it for any other purpose on your exams. It's just for cystitis in women. Do not use it for any other kind of UTI and never use it in men. Use it in men. You'll be picking the wrong answer on your exams. And then don't forget the other drugs we use for. right i talked about right fumping already but don't forget you iconize it don't

Don't forget you a thambu tall. Remember that ripe regimen for active TB, right? Rifampane, isoniacid, perazidamide, and a thambu tall. And then what are the what do we use dapsone for on the USMLE? Dapson, um, kind of low yield, but kind of high yield too. Uh dapsone can be used for PCP prophylaxis. Ooh. What? Yeah. You can easily for him. Divine, seriously? Yeah. Yeah, yeah. Absolutely.

absolutely can use it for that purpose. So you should certainly know that for your exams. Okay. You should certainly know that for your exams. You can use DAPSO for PCB prophylaxis. We also use uh DAPSON as part of the treatment regimen for leprosy caused by mycobacterium leprae. And then Don't forget that you can also use um dapsone to treat what thin in some person with malabsorption like celiac disease. Dermatitis herpediformis. Okay. You can use dapson for dermatitis herpediformis.

on your exams. Okay. You can use it for what? For dermatitis, herpediformis on your exams. Please keep that at the back of your mind for ten. And then one I guess kind of weird thing I want to talk about with back trim, trimethoprim sulfamethoxol. Don't forget that back trim can cause neutropenia. Back trim can absolutely cause. Bactium can absolutely cause neutropenia. So let me just do a quick drive-by of certain things, just core things to kind of wrap.

Remember, what are the things that cover pseudomonas? What are the antibody classes just in general? So you can have it on your fingertips or summarizing like thirty. Your fluoroquinolones cover pseudomonas. Your amino glycoside covers physics.

Piperacilin tasobactum, the antibiotic you should never pick as an answer in your exams, also covers Pseudomonas. Ceftacidim, third gen cephalosporin covers Pseudomonas. Cefepim, fourth gen cephalosporin covers pseudomonas. Yocarpapenems also covers pseudomonas. Okay, how do you cover MSSA on your exams with the sensitive staff or else? Cloxacillin, dichloxacillin.

Napselin. You can also use a first generation cephalosporing, you know, like cephalexin, for example. Those cover MSSA. What are some things that cover MERSA on the USMLEs? Clindamycin. Clindamycin covers. Um TMPSMX back trim covers Mersa, especially for Mersa. infections. Venc covers MRSA. Linizolid covers MRSA. Daptomycin covers MRSA. Believe it or not, your tetracyclines also cover MRSA. Okay. Now how about vencomycin resistant?

Again, I said this Daptomycin linazolid on your test. There's also a tetracycline that covers VRE called Tigacycline, but again, super low yield almost certainly will not be tested on your exams. Almost certainly will not be tested. And then we talked about uh anaerobes, right? Remember anaerobes, clenda, metronidazole, amazing for those. Also your carbapenem.

also cover anaerobs and again again again I kept hitting things like triple therapy for H. pylori like what like a macrolid amoxicity and a PPI quadruple therapy metronidazole bismuth tetracycline and a ppi endometritis we talked about it so uterine infect Clinda and gent, chromionitis, amniotic fluid infection, and piscin and genta mycin. All right.

Stop here. All right. Podcast is done. Now, if you like the way I teach, and don't worry, you know, uh most times I like to go into mechanisms of action and make all these integrations like I did today. If you're interested, I have a bunch of classes starting today. So, you know, have a test digging class today, uh Biostats class tomorrow, social sciences and ethics class on uh you know QI healthcare systems class on Wednesday, I have uh

Last minute review for step two, step three on Thursday. So the classes from Monday to Wednesday are for step one to step three, level one to three. But the class on Thursday, uh going forward uh into next week Monday, uh so it's Thursday, Friday. Sunday and Monday. Um that's uh step two, step three, level two level.

Again, if you're interested, I have a separate podcast where I discuss those classes. Um again, check these podcasts out on Apple Podcasts, Google Podcasts, Spotify. Uh I have a YouTube channel you can check out. For divine intervention, USMLE podcasts and videos. And then I have these podcasts on the website as well, divine intervention.

These podcast apps only let me upload the most recent one hundred fifty podcast. So if you want everything from the very beginning, episode one, where it all started to now, the present time. Go to the website, you don't even have to use any login for that. Just go find the podcast you're looking for, download it and leave. And then I also have um I also offer a one-on-one tutoring for all the US ML and Complex. And I have another website called Divine Intervention Like

Divine Intervention Life Lessons.com. Every week I post about a podcast or two where from a biblical perspective I discuss a life lesson. Uh there's actually a website for that, Divine Intervention Life Lessons.com. There's an Apple podcast attached to that called the Divine Intervention Life. Uh many people have listened to those podcasts found them to be extremely helpful. I'm kinda getting to almost three hundred So thank you for listening to me today. Please

Listen to this podcast over and over again. I promise you, you will get many questions right from your exams. It's just simple as that. Listen to this podcast at the beginning of your dedicated period. Listen to it at the end of your dedicated period. Listen to it when you're working out. It's gonna help you. All right. next time. God bless you. Bye for now. Thank you.