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NBME > Key Associations > Flashcards

Key Associations Flashcards

Given the disease/finding provide the most common/important association

1
Q

Primary liver cancer

A

Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, alpha-1 antitrypsin deficiency)

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2
Q

Congenital cardiac anomaly

A

VSD

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3
Q

Aortic aneurysm, abdominal and descending aorta

A

Atherosclerosis

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4
Q

Hypercoagulabilty, endothelial damage, blood stasis

A

Virchow’s triad (results in venous thrombosis)

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5
Q

Gynecologic malignancy

A

Endometrial carcinoma (most common in US); cervical carcinoma (most common worldwide)

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6
Q

Late cyanotic shunt (uncorrected left to right becomes right to left)

A

Eisenmenger’s syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)

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7
Q

Philadelphia chromosome t(9;22) (bcr-abl)

A

CML (may sometimes be associated with ALL/AML)

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8
Q

Actinic (solar) keratosis

A

Precursor to squamous cell carcinoma

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9
Q

Brain tumor (kids)

A

Infratentorial: medullablastoma (cerebellum) or supratentorial: craniopharyngioma (cerebrum)

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10
Q

SIADH

A

Small cell carcinoma of the lung

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11
Q

Vitamin deficiency (US)

A

Folate (pregnant women are at high risk; body stores on 3- to 4-month supply; prevents neural tube defects)

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12
Q

Osteomyelitis with IV drug use

A

Pseudomonas, S. aureus

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13
Q

t(9;22)

A

Philadelphia chromosome, CML (bcr-abl fusion)

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14
Q

Sexually transmitted disease

A

Chlamydia (usually coinfected with gonorrhea)

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15
Q

Primary bone tumor (adults)

A

Multiple myeloma

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16
Q

Primary hyperparathyroidism

A

Adenomas, hyperplasia, carcinoma

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17
Q

Helminth infection (US)

A

Enterobius vermicularis, Ascaris lumbricoides

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18
Q

Hypertension, 2o

A

Renal disease

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19
Q

t(8;14)

A

Burkitt’s lymphoma (c-myc activation)

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20
Q

Hemochromatosis

A

Multiple blood transfusions or hereditary HFE mutation (can result in CHF, “bronze diabetes”, and increased risk of hepatocellular carcinoma)

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21
Q

Chronic arrhythmia

A

Atrial fibrillation (associated with high risk of emboli)

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22
Q

Cardiac manifestations of lupus

A

Libman-Sacks endocarditis (nonbacterial, affecting both sides of mitral valve)

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23
Q

Heart murmur, congenital

A

Mitral valve prolapse

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24
Q

Hereditary bleeding disorder

A

von Willebrand’s disease

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25
Q

Renal tumor

A

Renal cell carcinoma: associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndromes (EPO, renin, PTH, ACTH)

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26
Q

Type of Hodgkin’s lymphoma

A

Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)

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27
Q

S3 (protodiastolic gallop)

A

Increased ventricular filling (left to right shunt, mitral regurgitation, LV failure [CHF])

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28
Q

UTI

A

E. coli, Staphylococcus saprophyticus (young women)

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29
Q

Stomach ulcerations and high gastrin levels

A

Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)

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30
Q

Esophageal cancer

A

Squamous cell carcinoma (worldwide); adeoncarcinoma (US)

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31
Q

Pulmonary hypertension

A

COPD

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32
Q

Holosystolic murmur

A

VSD, tricuspid regurgitation, mitral regurgitation

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33
Q

Type of non-Hodgkin’s lymphoma

A

Diffuse large cell

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34
Q

Pituitary tumor

A

Prolactinoma, somatotropic “acidiophilic” adenoma

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35
Q

Mixed (UMN and LMN) motor neuron disease

A

ALS

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36
Q

Cushing’s syndrome

A
  • Iatrogenic Cushing’s (from corticosteroid therapy) - Adrenocortical adeonoma (secretes excess cortisol) - ACTH-secreting pituitary adeonoma (Cushing’s disease) -Paraneoplastic Cushing’s (due to ACTH scretion from tumors)
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37
Q

Liver disease

A

Alcoholic cirrhosis

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38
Q

Constrictive pericarditis

A

Tuberculosis (developing world); systemic lupus erythematous (developed world)

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39
Q

Neuron migration failure

A

Kallmann syndrome (hypogonadotrophic hypogonadism and ansomia)

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40
Q

Tumor in women

A

Leiomyoma (estrogen dependent, not precancerous)

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41
Q

Nephrotic syndrome (kids)

A

Minimal change disease

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42
Q

Cyanosis (early; less common)

A

Tetralogy Fallot, transposition of great vessels, truncus arteriosus

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43
Q

Nephrotic syndrome (adults)

A

Focal segmental glomerulosclerosis

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44
Q

Tumor of adrenal medulla (kids)

A

Neuroblastoma (malignant)

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45
Q

Thyroid cancer

A

Papillary carcinoma

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46
Q

Ovarian tumor (malignant)

A

Serous cystadenocarcinoma

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47
Q

Patient with ALL / CLL / AML / CML

A
  • ALL: child
  • CLL: adult > 60
  • AML: adult ~ 65
  • CML: adult 30-60
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48
Q

Congenital conjugated hyperbilirubinemia (black liver)

A

Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)

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49
Q

Mitral valve stenosis

A

Rheumatic heart disease

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50
Q

Dementia

A

Alzheimer’s disease, multiple infarcts

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51
Q

Bacteria associated with gastritis, peptic ulcer disease, and stomach cancer

A

H. Pylori

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52
Q

Nosocomial pneumonia

A

Klebsiella, E. coli, Pseudomonas aeruginosa

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53
Q

Malignancy (kids)

A

ALL, medulloblastoma (cerebellum)

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54
Q

Clear cell adenocarcinoma of the vagina

A

DES (diethylstilbestrol) exposure in utero

55
Q

Temporal arteritis

A

Risk of ipsilateral blindness due to thrombosis of opthalmic artery; polymyalgia rheumatica

56
Q

Metastases to liver

A

Colon >> stomach, pancreas

57
Q

Myocarditis

A

Coxsackie B

58
Q

Hereditary harmless jaundice

A

Gilbert’s syndrome (benign congenital unconjugated hyperbilibrubinemia)

59
Q

Alternating areas of transmural inflammation and normal colon

A

Skip lesions (Crohn’s disease)

60
Q

Osteomyelitis

61
Q

Metastases to bone

A

Prostate, breast > lung > thyroid,testes

62
Q

Opportunistic infection in AIDS

A

Pneumocystis jirovecii (formely carinii) pneumonia

63
Q

Aneurysm, dissecting

A

Hypertension

64
Q

Diverticulum in pharynx

A

Zenker’s diverticulum (diagnosed by barium swallow)

65
Q

Food poisoning (exotoxin mediated)

A

S. aureus, B. cereus

66
Q

Bacterial meningitis (adults and elderly)

A

Streptococcus pneumoniae

67
Q

Metastases to brain

A

Lung > breast > genitourinary > osteosarcoma > melanoma > GI

68
Q

Aortic aneurysm, ascending

A

Marfan’s syndrome (idiopathic medial degeneration)

69
Q

HLA-B27

A

Ankylosing spondylitis, Reiter’s syndrome, ulcerative colitis, psoriasis

70
Q

Stomach cancer

A

Adenocarcinoma

71
Q

Dietary deficit

72
Q

Autosplenectomy (fibrosis and shrinkage)

A

Sickle cell anemia (hemoglobin S)

73
Q

Site of diverticula

A

Sigmoid colon

74
Q

Hypoparathyroidism

A

Accidental excision during thyroidectomy

75
Q

Kidney stones

A
  • Calcium = radiopaque
  • Struvite (ammonium) = radiopaque (formed by urease-positive organisms such as Proteus vulgarism or Staphylococcus)
  • Uric acid = radiolucent
76
Q

Hepatocellular carcinoma

A

Cirrhotic liver (associated with hepatitis B and C and with alcoholism)

77
Q

t(14;18)

A

Follicular lymphoma (bcl-2 activation)

78
Q

Tumor of adrenal medulla (adults)

A

Pheochromocytoma (usually benign)

79
Q

Heart valve in bacterial endocarditis

A

Mitral>aortic (rheumatic fever), tricuspid (IV drug abuse)

80
Q

Breast tumor (benign)

A

Fibroadenoma

81
Q

Infection 2o to blood transfusion

A

Hepatitis C

82
Q

Cyanosis (late; more common)

A

VSD, ASD, PDA

83
Q

Ovarian tumor (benign, bilateral)

A

Serous cystadenoma

84
Q

Opening snap

A

Mitral stenosis

85
Q

Cretinism

A

Iodine deficit / hypothyroidism

86
Q

Acute gastric ulcer associated with CNS injury

A

Cushing’s ulcer (increase ICP stimulates vagal gastric secretion)

87
Q

Hypopituitarism

A

Pituitary adenoma (usually benign tumor)

88
Q

Coronary artery involved in thrombosis

A

LAD>RCA>LCA

89
Q

S4 (presystolic gallop)

A

Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)

90
Q

Hematoma-subdural

A

Rupture of bridging veins (crescent shaped)

91
Q

Congenital adrenal hyperplasia, hypotension

A

21-hydroxylase deficiency

92
Q

Sites of atherosclerosis

A

Abdominal aorta > coronary artery > popliteal artery > carotid artery

93
Q

Pancreatitis (chronic)

A

Alcohol (adults), cystic fibrosis (kids)

94
Q

Mitochondrial inheritance

A

Disease occurs in both males and females, inherited through females only

95
Q

Compression fracture

A

Osteoporosis (type 1: postmenopausal woman; type II: elderly man or woman)

96
Q

Testicular tumor

97
Q

Right heart failure due to a pulmonary cause

A

Cor pulmonale

98
Q

Secondary hyperparathyroidism

A

Hypocalcemia of chronic kidney disease

99
Q

Ejection click

A

Aortic/pulmonic stenosis

100
Q

Cardiac 1o tumor (kids)

A

Rhabdomyoma, often seen in tuberous sclerosis

101
Q

Osteomyelitis in sickle cell disease

A

Salmonella

102
Q

Viral encephalitis affecting temporal lobe

103
Q

Acute gastric ulcer associated with sever burns

A

Curling’s ulcer (greatly reduced plasma results in sloughing of gastric mucosa)

104
Q

Obstruction of male urinary tract

105
Q

Benign melanocytic nevus

A

Spitz nevus (most common in first two decades)

106
Q

Ovarian metastasis from gastric carcinoma or breast cancer

A

Krukenberg tumor (mucin-secreting signet-ring cells)

107
Q

Tumor of infancy

A

Hemangioma (usually regresses spontaneously by childhood)

108
Q

Bacterial meningitis (newborns and kids

A

Group B streptococcus (newborns); Streptococcus pneumoniae / Neisseria meningitidis (kids)

109
Q

Death in SLE

A

Lupus nephropathy

110
Q

Glomerulonephritis (adults)

A

Berger’s disease (IgA nephropathy)

111
Q

Male cancer

A

Prostatic carcinoma

112
Q

Breast mass

A

Fibrocystic change, carcinoma (in postmenopausal women)

113
Q

Demyelinating disease in young women

A

Multiple sclerosis

114
Q

Aortic aneurysm, arch

A

Tertiary syphilis (syphilitic aortitis), vasa vasorum destruction

115
Q

Cerebellar tonsillar herniation

A

Chiari malformation (often presents with progressive hydrocephalus or syringomyelia)

116
Q

Recurrent inflammation/thrombosis of small/medium vessels in extremities

A

Buerger’s disease (strongly associated with tobacco)

117
Q

Pelvic inflammatory disease

A

Chlamydia trachomatis, Neisseria gonorrhoease

118
Q

Chronic atrophic gastritis (autoimmune)

A

Predisposition to gastric carcinoma (can also cause pernicious anemia)

119
Q

Brain tumor (adults)

A

Supratentorial: metastasis>astrocytoma (including glioblastoma multiforme)>meningioma>schwannoma

120
Q

Primary amenorrhea

A

Turner syndrome (45, XO)

121
Q

Pancreatitis (acute)

A

Gallstones, alcohol

122
Q

Malignancy associated with noninfectious fever

A

Hodgkin’s lymphoma

123
Q

Mental retardation

A

Down syndrome, fragile X syndrome

124
Q

HLA-DR3 or -DR4

A

Diabetes mellitus type 1, rheumatoid arthritis, SLE

125
Q

Hematoma-epidural

A

Rupture of middle meningeal artery (lentiform shaped)

126
Q

Breast cancer

A

Infiltrating ductal carcinoma (in the US, 1 in 9 women will develop breast cancer)

127
Q

Lysosomal storage disorder

A

Gaucher’s disease

128
Q

DIC

A

Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery

129
Q

Cardiac tumor (adults)

A

Metastasis, 1o myxoma (4:1 left to right atrium; “ball and valve”)

130
Q

Bleeding disorder with GpIb deficiency

A

Bernard-Soulier syndrome (defect in platelet adhesion to von Willebrand’s factor)

131
Q

Atrophy of the mammillary bodies

A

Wernicke’s encephalopathy (thiamine deficiency causing ataxia, opthalmoplegia, and confusion)

132
Q

Infections in chronic granulomatous disease

A

Staphylococcus aureus, E. coli, Aspergillus (catalase positive)

133
Q

Primary hyperaldosteronism

A

Adenoma of adrenal cortex

134
Q

Death in CML

A

Blast crisis

NBME (5 decks)

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