Micro Drills (Step 1)

1. What organism expresses Protein A?

a. S. aureus
2. What organisms secrete IgA protease? “SHiN”
a. S. pneumo
b. H. influenzae type b
c. Neisseria
3. What organism expresses M protein?
a. Group A strep
4. What is the difference between Heat-Labile and Heat-stable toxin (& what organism expresses)?
a. Enterotoxigenic E. coli
b. Heat-Labile = over (+) adenylate cyclase (↑ cAMP)
c. Heat-stable = over (+) guanylate cyclase (↑ cGMP)
5. What organism expresses Edema factor?
a. B. anthracis
6. What organism expresses α toxin?
a. C. perfringens
7. What organism expresses Erythrogenic Exotoxin A?
a. S. pyogenes
8. What are your different endotoxins? “END2OTOXI2NS”
a. Edema
b. Nitric oxide
c. DIC/Death
d. Outer membrane
e. TNF-α
f. O-antigen + core polysaccharide + lipid A
g. eXtremely heat stable
h. IL-1 and IL-6
i. Neutrophil chemotaxis
j. Shock
9. MCC of bacterial meningitis in neonates (0-4wks) – “Baby BEL”
a. Group B strep, E. coli, Listeria
10. MCC of bacterial meningitis in infants (1-23mo)
a. S. pneumoniae, N. meningitides, H. influenzae
11. MCC of bacterial meningitis in 2-50yo
a. S. pneumoniae, N. meningitides
12. MCC of bacterial meningitis in >50yo
a. S. pneumoniae, N. meningitides, Listeria
13. CSF Findings in meningitis:
a. Bacterial = ↑ opening pressure, ↑ PMNs, ↑ protein, ↓ glucose
b. Fungal/TB = ↑ opening pressure, ↑ lymphocytes, ↑ protein, ↓ glucose
c. Viral = NL/↑ opening pressure, ↑ lymphocytes, NL/↑ protein, NL glucose
14. MC bulls-eye rash in North East – Lyme Dz (erythema chronicum migrans)
a. Borrelia burgdorferi
15. MCC of bulls-eye rash outside of the North East
 a. Babesiosis
16. MCC of sporadic encephalitis
a. HSV-1
17. HSV-1 is MC latent where
a. Trigeminal ganglia
18. HSV-2 is MC latent where
a. Sacral (Sensory) ganglia
19. MC complication of shingles
a. Post-herpetic neuralgia
20. MC animal with rabies in U.S.
a. Bats (#1 cause), raccoons, skunks, foxes
21. MC animal with rabies worldwide
a. Dogs
22. MC location of rabies virus
a. Within Purkinje cells of cerebellum and in hippocampal neurons
23. MCC of Bronchiolitis?
a. RSV
24. MC organism of pediatric pneumonia in preschool age child?
a. S. pneumoniae
25. MC organism of pediatric pneumonia in older age child?
a. Mycoplasma
26. MCC of bacterial pneumonia in CF patients <20yo?
a. S. aureus
27. MCC of bacterial pneumonia in CF patients >20yo?
a. Pseudomonas
28. MC nosocomial infection in newborn nursery?
a. CMV + RSV
29. MC etiology of neonatal conjunctivitis (aka opthalmia neonatorum)?
a. Chlamydia
30. Young child presents with stridor, barking cough, and subglottic swelling. Most likely dx?
a. Croup
b. BONUS: What family does Croup belong to?
i. Paramyxoviruses > Parainfluenza > Croup
31. MCC of early onset (<7yo) sepsis (in a kid)?
a. Group B Strep
32. MCC of neonatal sepsis?
a. Group B Strep
33. MCC of osteomyelitis in sickle cell patients?
a. Salmonella, S. aureus
34. Autosplenectomy ↑ risk of infection with what kind of bacteria?
a. Encapsulated
35. MCC of pediatric stroke?
a. Sickle cell disease
36. What are the different strains of Plasmodium & what dz do they cause?
a. Malaria
b. P. falciparum, P.vivax, P. ovale, P. malariae
c. BONUS: What are the fever patterns for each?
i. Falciparum = irregular fever patterns
 ii. Vivax = 48h cycle
iii. Ovale = 48h cycle
iv. Malariae = 72h cycle
37. What is the transmission of Plasmodium?
a. via bites of female Anopheles mosquito
38. What are the different stages of Plasmodium in Humans?
a. Sporozoite, Hypnozoite, Merozoite, Trophozoite, Schizont, Gametocyte
b. BONUS: Which is the dormant stage for vivax and ovale?
i. Hypnozoite