i think this is correct on first look @herstein.jacob @Cameron @shmuelsash @Sameem @StanG
Looks fine to me
I think yersenia pestis has other routes too, such as dog poop or contaiminated mild? Does that count as zoonotic?
Agree with rats and prarie dogs as direct sources.
just came across this card and was going to make this same suggestion
Added accepted-suggestion, #deck-AnKing Overhaul for Step 1 & 2-AnKingMed and removed #deck-anking-overhaul-for-step-1–2-ankingmed, open-suggestion
Not a good update, as not all Yersinia pestis strains are encapsulated. A note should be appended indicating pathogenic strains are commonly unencapsulated.
@eri017 could you provide an acceptable source? On quick look, Amboss says it in encapsulated.
Gram-Negative Coccobacilli
Fiona J. Cooke, Mary P.E. Slack, in Infectious Diseases (Fourth Edition), 2017
“Yersinia pestis is urease-negative; Y. enterocolitica and Y. pseudotuberculosis are both urease-positive. Yersinia spp. grow on simple laboratory media and are tolerant of bile salts. The optimal temperature for growth is 82–86°F (27.8–30°C). They do not form spores or capsules, but Y. pestis produces a capsule-like envelope. They share antigens with other members of the Enterobacteriaceae*.*”
@eri017 thanks for bringing that up.
@Ahmed7 I couldn’t find any board source that says Y. pestis is encapsulated, only Y. enterocolitica. FA24 doesn’t mention capsule for either. Amboss does the same. Only mention I could find was for Y. enterocolitica in sketchy.
Associated NID 1506284781512 may also need a review.
Its better to think of the envelope as a “functional capsule” at 37°C, body temp, facilitating buboe formation in the lymphatic chain.
The next article has a good graphic describing the general pathophysiology: Yersinia pestis and plague: an updated view on evolution, virulence determinants, immune subversion, vaccination, and diagnostics | Genes & Immunity
I still don’t see a strong enough reason to remove this altogether from 2 cards. We need to check NBME and this AMBOSS question #AK_Step1_v12::#AMBOSS::icaJXj
@eri017 the sources you’ve listed are not one of the approved sources here: 📚 AnKing Step Deck Submission Guidelines
The update that states Yersinia pestis is encapsulated is factually wrong. That should be reason enough. Split the card to have information about the development of F1 Antigen at body temperatures.
It is likely you will not find a USMLE board question that specific. You might find something for Medical Microbiology or Infectious Disease boards, but those are beyond the scope of USMLE.
@Sameem @Ahmed7 We’ve discussed just deleting this card on the currently open suggestion here in the past; still stand by that discussion. Like we discussed then, this is really just a dupe of the other cards in the deck. If we have a compelling reason to change our stance on Yersinia pestis being encapsulated, should really be suggested for nid:1506284781512 (below)
Yersinia pestis is {{c1::encapsulated}}, protecting the bacteria from phagocytosis
Will continue the discussion in Slack