
What you need to know: gram-negative rod that causes cat-scratch disease. It gets into the body through a cat scratch or bite and is taken up by macrophages.
What to expect on the exam: a patient with cat exposure, fever, malaise, and regional lymphadenopathy. That is Bartonella until proven otherwise.
What you need to know: a dimorphic fungus found in soil, moss, wood, and plants. It enters through a skin puncture.
What to expect on the exam: a gardener/outdoor worker with a single skin nodule that spreads into more nodules along lymphatics. The phrase they want you to think of is nodular lymphangitis.
What you need to know: an obligate intracellular protozoan spread by the sand fly. It lives inside macrophages.
What to expect on the exam: one of three patterns.
Cutaneous = skin ulcer.
Mucocutaneous = destructive lesions of mucosa.
Visceral = fever + splenomegaly + anemia.
If they mention sand fly + macrophages, they want Leishmania.
What you need to know: a nonenveloped DNA virus that infects erythroid precursor cells.
What to expect on the exam: the big giveaway is slapped-cheek rash in a child. The higher-yield complication stem is aplastic crisis in someone with underlying hematologic disease, or hydrops fetalis in pregnancy.
What you need to know: a protozoan parasite spread by the Ixodes tick. It infects RBCs and causes hemolysis.
What to expect on the exam: fever, fatigue, anemia, and a smear showing either ring forms or the Maltese cross. If they say Ixodes + hemolysis + Maltese cross, the answer is Babesia.
They will not ask you for every tiny detail. They will usually give one strong clue and expect you to connect it fast.
Gardener + nodules along lymphatics = Sporothrix.
Sand fly + macrophages = Leishmania.
Slapped cheek or aplastic crisis = Parvovirus B19.
Ixodes + Maltese cross = Babesia.