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COMLEX 1 > Key Associations > Flashcards

Key Associations Flashcards

1
Q

mitochondrial inheritance

A

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

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2
Q

intellectual disability

A

Down syndrome, fragile X syndrome

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3
Q

vitamin deficiency (USA)

A

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

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4
Q

lysosomal storage disease

A

Gaucher disease

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5
Q

Food poisoning (exotoxin mediated)

A

S. aureus

B. cereus

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6
Q

Osteomyelitis

A

S. aureus (most common overall)

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7
Q

Bacterial meningitis (adults and elderly)

A

S. pneumoniae

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8
Q

Bacterial meningitis (newborns and kids)

A

Newborns: Group B streptococcus/E. coli/Listeria monocytogenes
Kids/teens: S. pneumoniae/N. meningitidis

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9
Q

Bacteria associated with gastritis, peptic ulcer disease, and gastric malignancies (e.g. adenocarcinoma, MALToma)

A

H. pylori

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10
Q

Opportunistic infections in AIDS

A

Pneumocystis jirovecii pneumonia

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11
Q

Helminth infection (US)

A

Ascaris lumbricoides

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12
Q

Myocarditis

A

Coxsackie B

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13
Q

Infection secondary to blood transfusion

A

Hepatitis C

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14
Q

Osteomyelitis in sickle cell disease

A

Salmonella

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15
Q

Osteomyelitis with IV drug use

A

Pseudomonas, Candida, S. aureus

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16
Q

UTI

A 
E. coli
Staphylococcus saprophytic (young women)
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17
Q

Sexually transmitted disease

A

C. trachoma’s (usually co-infected with N. gonorrheae)

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18
Q

Nosocomial pneumonia

A

S. aureus, Pseudomonas, other enteric gram negative rods

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19
Q

Pelvic inflammatory disease

A

C trahcomatis, N gonorrhoeae

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20
Q

infections in chronic granulomatous disease

A

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

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21
Q

metastases to bone

A

prostate, breast > lung, thyroid, kidney

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22
Q

Metastases to brain

A

lung > breast > prostate > melanoma > GI

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23
Q

metastases to liver

A

colon&raquo_space; stomach > pancreas

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24
Q

S3 heart sound

A

increased ventricular filling pressure (e.g. mitral regard, HF), common in dilated ventricles

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25
Q

S4 heart sound

A

Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)

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26
Q

Constrictive pericarditis

A

Developing world: TB

Developed world: idiopathic, viral illness

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27
Q

Holosystolic murmur

A

VSD, tricuspid regurgitation, mitral regurgitation

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28
Q

Ejection click

A

Aortic stenosis

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29
Q

Mitral valve stenosis

A

Rheumatic heart disease

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30
Q

Opening snap

A

mitral stenosis

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31
Q

heart murmur, congenital

A

mitral valve prolapse

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32
Q

chronic arrhythmia

A

atrial fibrillation (associated with high risk of emboli)

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33
Q

cyanosis (early; less common)

A

tetralogy of fallot, transposition of great vessels, trunks arteriosus, total anomalous pulmonary venous return

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34
Q

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

A

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

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35
Q

Congenital cardiac anomaly

A

VSD

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36
Q

Hypertension, secondary

A

renal artery stenosis, chronic kidney disease (e.g. polycystic kidney disease, diabetic neuropathy), hyperaldosteronism

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37
Q

Aortic aneurysm, thoracic

A

Marfan syndrome (idiopathic cystic medial degeneration)

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38
Q

Aortic dissection

A

hypertension

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39
Q

Aortic aneurysm, abdominal

A

atherosclerosis, smoking is major risk factor

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40
Q

Aortic aneurysm, ascending or arch

A

tertiary syphilis (syphilitic aortitis), vasa vasorum destruction

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41
Q

site of atherosclerosis

A

abdominal aorta > coronary artery > popliteal artery > carotid artery

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42
Q

cardiac manifestations of lupus

A

marantic/thrombotic endocarditis (nonbacterial)

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43
Q

heart valve in bacterial endocarditis

A

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

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44
Q

endocarditis presentation associated with bacterium

A

S. aureus (acute, IVDA, tricuspid valve)
S. viridans (subacute, dental procedures)
S. bovis (colon cancer)
culture negative (Coxiella, Bartonella, HACEK)

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45
Q

temporal arteritis

A

Risk of ipsilateral blindness due to occlusion of ophthalmic artery; polymyalgia rheumatica

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46
Q

Recurrent inflammation/thrombosis of small/medium vessels in extremities

A

Buerger disease (strongly associated with tobacco)

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47
Q

Cardiac primary tumor (kids)

A

Rhabdomyoma, often seen in tuberous sclerosis

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48
Q

Cardiac tumor (adults)

A

metastasis, myxoma (90% in LA; ‘ball valve’)

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49
Q

congenital adrenal hyperplasia, hypotension

A

21-hydroxylase deficiency

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50
Q

Cushing syndrome

A

iatrogenic (from corticosteroid therapy)
adrenocortical adenoma (secretes excess cortisol)
ACTH-secreting pituitary adenoma (Cushing disease)
paraneoplastic (due to ACTH secretion by tumors)

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51
Q

Tumor of the adrenal medulla (kids)

A

Neuroblastoma (malignant)

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52
Q

tumor of the adrenal medulla (adults)

A

pheochromocytoma (usually benign)

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53
Q

Cretinism

A

iodine deficit/congenital hypothyroidism

54
Q

HLA-DR3

A

DM 1, SLE, Graves disease, Hashimoto thyroiditis (also assoc with HLA-DR5), Addison disease

55
Q

Thyroid cancer

A

papillary carcinoma (childhood irradiation)

56
Q

hypoparathyroidism

A

accidental excision during thyroidectomy

57
Q

primary hyperparathyroidism

A

adenomas, hyperplasia, carcinoma

58
Q

secondary hyperparathyroidism

A

hypocalcemia of chronic kidney disease

59
Q

hypopituitarism

A

pituitary adenoma (usually benign tumor)

60
Q

HLA-DR4

A

DM 1, rheumatoid arthritis, Addison disease

61
Q

Refractory peptic ulcers and high gastrin levels

A

Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas), associated with MEN1

62
Q

esophageal cancer

A

squamous cell carcinoma (worldwide)

adenocarcinoma (US)

63
Q

acute gastric ulcer associated with CNS injury

A

Cushing ulcer (increase intracranial pressure stimulates vagal gastric H+ secretion)

64
Q

acute gastric ulcer associated with severe burns

A

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

65
Q

bilateral ovarian metastases from gastric carcinoma

A

Krukenberg tumor (mucin-secreting signet ring cells)

66
Q

chronic atrophic gastritis (autoimmune)

A

predisposition to gastric carcinoma (can also cause pernicious anemia)

67
Q

gastric cancer

A

adenocarcinoma

68
Q

alternating areas of transmural inflammation and normal colon

A

skip lesions (Crohn’s disease)

69
Q

diverticulum in pharynx

A

Zenker diverticulum (dx by barium swallow)

70
Q

site of diverticula

A

sigmoid colon

71
Q

hepatocellular carcinoma

A

cirrhotic liver (associated with hep B and C, alcoholism, and hemochromatosis)

72
Q

liver disease

A

alcoholic cirrhosis

73
Q

primary liver cancer

A

hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, alpha1-antitrypsin deficiency, Wilson disease)

74
Q

congenital conjugated hyperbilirubinemia (black liver)

A

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

75
Q

Hereditary harmless jaundice

A

Gilbert syndrome (bening congenital unconjugated hyperbilirubinemia)

76
Q

Hemochromatosis

A

multiple blood transfusions or hereditary HFE mutation (can result in heart failure, ‘bronze diabetes’, and increase risk of hepatocellular carcinoma)

77
Q

pancreatitis (acute)

A

gallstones, alcohol

78
Q

pancreatitis (chronic)

A 
alcohol (adults)
cystic fibrosis (kids)
79
Q

autosplenectomy (fibrosis and shrinkage)

A

sickle cell disease (Hgb S)

80
Q

microcytic anemia

A

iron deficiency

81
Q

bleeding disorder with GpIb deficiency

A

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

82
Q

DIC

A

severe sepsis, obstetric complications, cancer, burns, trauma, major surgery, acute pancreatitis, APL

83
Q

hereditary bleeding disorder

A

von Willebrand disease

84
Q

Malignancy associated with noninfectious fever

A

Hodgkin lymphoma

85
Q

Type of Hodgkin lymphoma

A

nodular sclerosing (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)

86
Q

t(14;18)

A

Follicular lymphomas (BCL-2 activation, anti-apoptotic oncogene)

87
Q

t(8;14)

A

Burkitt lymphoma (c-myc fusion, transcription factor oncogene)

88
Q

type of non-hodgkin lymphoma

A

diffuse large B-cell lymphoma

89
Q

primary bone tumor (adults)

A

multiple myeloma

90
Q

age ranges for patient with ALL/CLL/AML/CML

A

ALL: child // CLL: adult >60
AML: adult ~65 // CML: adult 45-85

91
Q

malignancy (kids)

A

leukemia, brain tumors

92
Q

death in CML

A

blast crisis

93
Q

t(9;22)

A

Philadelphia chromosome
CML (BCR-ABL oncogene, tyrosine kinase activation)
more rarely assoc with ALL

94
Q

vertebral compression fracture

A

osteoporosis (type I: postmenopausal; type II: elderly man or woman)

95
Q

HLA-B27

A

psoriatic arthritis, ankylosing spondylitis, IBD-associated arthritis, reactive arthritis (formerly Reiter syndrome)

96
Q

death in SLE

A

lupus nephropathy

97
Q

tumor of infancy

A

strawberry hemangioma (grows rapidly and regresses spontaneously by childhood)

98
Q

actinic (solar) keratosis

A

precursor to squamous cell carcinoma

99
Q

cerebellar tonsillar herniation

A

Chiari I malformation

100
Q

atrophy of mammillary bodies

A

Wernicke encephalopathy - thiamine deficiency causing ataxia, ophthalmoplegia, and confusion

101
Q

viral encephalitis affecting temporal lobe

102
Q

hematoma - epidural

A

rupture of middle meningeal artery (trauma; lentiform shape)

103
Q

hematoma - subdural

A

rupture of bridging veins (crescent shaped)

104
Q

dementia

A

alzheimer disease, multiple infarcts (vascular dementia)

105
Q

demyelinating disease in young woman

A

multiple sclerosis

106
Q

brain tumor (adults)

A

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

107
Q

pituitary tumor

A

prolactinoma, somatotropic adenoma

108
Q

brain tumor (kids)

A

Infratentorial: medulloblastoma (cerebellum)
Supratentorial: craniopharyngioma

109
Q

mixed (UMN and LMN) motor neuron disease

A

amyotrophic lateral sclerosis

110
Q

primary hyperaldosteronism

A

adrenal hyperplasia or adenoma

111
Q

nephrotic syndrome (adults)

A

membranous nephropathy

112
Q

nephrotic syndrome (kids)

A

minimal change disease

113
Q

glomerulonephritis (adults)

A

Berger disease (IgA nephropathy)

114
Q

kidney stones

A

calcium = radiopaque
struvite (ammonium) = radiopaque (formed by urease + organisms such as Klebsiella, Proteus species, and S saprophyticus)
uric acid = radiolucent
cystine = faintly radiopaque

115
Q

obstruction of male urinary tract

116
Q

renal tumor

A 
renal cell carcinoma: assoc with von Hippel-Lindau and cigarette smoking
Paraneoplastic syndromes (EPO, renin, PTHrP, ACTH)
117
Q

primary amenorrhea

A

turner syndrome (45, XO or 45, XO/46,XX mosaic)

118
Q

neuron migration failure

A

Kallmann syndrome (hypogonadotropic hypogonadism and anosmia)

119
Q

clear cell adenocarcinoma of the vagina

A

DES exposure in utero

120
Q

ovarian tumor (benign, bilateral)

A

serous cystadenoma

121
Q

ovarian tumor (malignant)

A

serous cystadenocarcinoma

122
Q

tumor in women

A

leiomyoma (estrogen dependent, not precancerous)

123
Q

gynecologic malignancy

A 
endometrial carcinoma (most common in US)
cervical carcinoma (most common worldwide)
124
Q

breast mass

A

fibrocystic change, carcinoma (in postmenopausal women)

125
Q

breast tumor (benign, young woman)

A

fibroadenoma

126
Q

breast cancer

A

invasive ductal carcinoma

127
Q

testicular tumor

A

seminoma (malignant, radiosensitive), increase placental ALP

128
Q

right heart failure due to a pulmonary cause

A

cor pulmonale

129
Q

hypercoaguability, endothelial damage, blood stasis

A

Virchow triad (increase risk of thrombosis)

130
Q

pulmonary hypertension

A

idiopathic, heritable, left heart disease (e.g. HF), lung disease (e.g. COPD), hyperemic vasoconstriction (e.g. OSA), thromboembolic (e.g. PE)

131
Q

SIADH

A

small cell carcinoma of the lung

COMLEX 1 (14 decks)

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