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USMLE Step 1 > Rapid Review: Key Associations > Flashcards

Rapid Review: Key Associations Flashcards

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USMLE® Step 1 flashcards
1
Q

Acute gastric ulcer associated with CNS injury

A

Cushing’s ulcer (aka Rokitansky-Cushing syndrome)

  • incr ICP stimulates vagal gastric secretion
  • Vagus releases Ach, which stimulates the M3 receptor on the parietal cell and activates the second messenger to stimulate IP3/Ca2+ to stimulate the H+/K+ ATPase pump which will increase gastric acid production.
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2
Q

Actinic (solar) keratosis

A

Precursor to SCC

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3
Q

Acute gastric ulcer associated with severe burns

A

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

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4
Q

Alternating areas of transmural inflammation and normal colon

A

Skip lesions (Crohn’s disease)

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5
Q

Aneurysm, dissecting

A

Hypertension

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6
Q

Aortic aneurysm, ascending

A

Marfan’s syndrome (idiopathic cystic medial degeneration)
- degenerative breakdown of collagen, elastin, and smooth muscle caused by aging contributes to weakening of the wall of the artery

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7
Q

Aortic aneurysm, abdominal and descending aorta

A

Atherosclerosis

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8
Q

Atrophy of the mammillary bodies

A

Wernicke’s encephalopathy (thiamine deficiency)

- ataxia, ophthalmoplegia, confusion

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9
Q

Autosplenectomy (fibrosis and shrinkage)

A

Sickle cell anemia (HbS)

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10
Q

Bacteria associated with gastritis, PUD, stomach cancer

A

H. pylori

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11
Q

Bacterial meningitis (adults and elderly)

A

S. pneumo

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12
Q

Bacterial meningitis (kids)

A

S. pneumo

N, meningitidis

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13
Q

Bacterial meningitis (newborns)

A

Group B strep

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14
Q

Bleeding disorder with GpIb deficiency

A

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

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15
Q

Benign melanocytic nevus

A

Spitz nevus (most common in first 2 decades)

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16
Q

Brain tumor (adults)

A

Supratentorial: mets > astrocytoma (including GBM) > meningioma > schawnnoma

Astrocytoma: GFAP
Meningioma: arachnoid cells, psammoma bodies
Schwannoma: S-100 (like melanoma bc they both come from neural crest!)

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17
Q

Brain tumor (kids)

A

Intratentorial: medulloblastoma (cerebellum)
- PNET, Homer-Wright rosettes
Supratentorial: craniopharyngioma (cerebrum)
- remnant of Rathke’s pouch

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18
Q

Breast mass

A
  1. Fibrocystic changes

2. Carcinoma (in postmenopausal women)

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19
Q

Breast cancer

A

Infiltrating ductal carcinoma

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20
Q

Breast tumor (benign)

A

Fibroadenoma

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21
Q

Cardiac primary tumor (kids)

A

Rhabdomyoma (benign tumor of striated muscle), often seen in tuberous sclerosis

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22
Q

Cardiac tumor (adults)

A
  1. Metastasis
  2. Primary atrial myxoma (4:1 L to R shunt, “ball and valve” obstruction, “tumor plop” on auscultation, risk of afib, embolism)
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23
Q

Cardiac manifestation of lupus

A
  1. Pericarditis
  2. Libman-Sacks endocarditis
    - nonbacterial, affecting both sides (atria and ventricle) of MV
    - small vegetations made of strands of fibrin, neutrophils, lymphocytes, and histiocytes
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24
Q

Cerebellar tonsillar herniation

A

Chiari malformation (often presents with progressive hydrocephalus or syringomyelia)

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25
Q

Chronic arrhythmia

A

Atrial fibrillation (associated with high risk of emboli)

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26
Q

Clear cell adenocarcinoma of the vagina

A

DES exposure in utero

  • synthetic nonsteriodal estrogen
  • used off-label to prevent adverse pregnancy outcomes in women with a history of miscarriage
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27
Q

Chronic atrophic gastritis (autoimmune)

A

Predisposition to gastric carcinoma (can also cause pernicious anemia)

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28
Q

Compression fracture

A

Osteoporosis: normal bone mineralization and lab values, but loss of trabecular meshwork

  • Type I: postmenopausal (incr bone resorp due to decr estrogen)
  • Type II: elderly man or woman, >~70 (decr ability of osteoblasts to divide and produce osteoid)
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29
Q

Congenital adrenal hyperplasia, hypotension

A

21-hydroxylase deficiency

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30
Q
  1. Newborn with HTN, hypokalemia, low sex hormone levels (pseudohermaprodite male or normal internal sex organ female)
    vs.
  2. HTN and masculinization
A
  1. CAH, 17alpha-OH deficiency

2. CAH, 11beta-OH deficiency

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31
Q

Congenital cardiac anomaly

A

VSD (most common)

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32
Q

Congenital conjugated hyperbilirubinemia

A

Dubin-Johnson (black liver); Rotor’s (not black)

- inability to hepatocytes to secrete conj BR into bile

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33
Q

Constrictive pericarditis (developing vs. developed world)

A

TB (developing world)

SLE (developed world)

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34
Q

Coronary artery involved in thrombosis

A

LAD > RCA > LCA

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35
Q

Cretinism

A

Iodine deficit/hypothyroidism (in newborn)

  • Dull look
  • Puffy face
  • Thick tongue that sticks out
  • Decreased muscle tone
  • Failure to grow
  • Hoarse-sounding cry or voice
  • Short arms and legs
  • Very large soft spots on the skull (fontanelles)
  • Wide hands with short fingers
  • Widely separated skull bones
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36
Q

Cushing’s syndrome

A
  1. CS therapy
  2. Excess ACTH secretion by pituitary
  3. SCLC
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37
Q

Cyanosis (early; less common)

A

Tetralogy of Fallot, TGA, Truncus arteriosus

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38
Q

Cyanosis (late; more common)

A

VSD, ASD, PDA

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39
Q

Death in CML

A

Blast crisis

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40
Q

Death in SLE

A

Lupus nephropathy

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41
Q

Dementia

A
  1. Alzheimer’s

2. Multiple infarcts

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42
Q

Demyelinating disease in young women

A

MS

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43
Q

DIC

A
  1. Gram-neg sepsis
  2. Obstetric complications
  3. Cancer
  4. Burn trauma
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44
Q

Dietary deficit

A

Iron

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45
Q

Diverticulum in pharynx

A

Zenker’s diverticulum (diagnosed by barium swallow)

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46
Q

Ejection click

A

Aortic/pulmonic stenosis

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47
Q

Esophageal cancer

A

Squamous cell carcinoma (worldwide);

Adenocarcinoma (US)

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48
Q

Food poisoning (exotoxin mediated)

A

S. aureus (enterotoxin)

B. cereus (enterotxin; heat labile and stable)

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49
Q

Glomerulonephritis (adults)

A

Berger’s disease (IgA nephropathy)

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50
Q

Gyn malignancy

A 
Endometrial carcinoma (MC in US);
Cervical carcinoma (MC worldwide)
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51
Q

Heart murmur, congenital

A

MVP

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52
Q

Heart valve in bacterial endocarditis

A

Mitral (rheumatic fever);
Tricuspid (IVDU);
Aoritc (2nd in RF)

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53
Q

Helminth infection (US)

A
  1. Enterobius vermicularis (pinworm, Scotch tape test, egg ingestion)
  2. Ascaris lumbricoides (egg ingestion, fecal fertilizer/contaminated food)

Treat with -bendazoles or pyrantel pamoate

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54
Q

Hematoma - epidural

A

Rupture of middle meningeal artery (trauma, lentiform/lens shaped)

55
Q

Hematoma - subdural

A

Rupture of bridging veins (crescent shaped)

56
Q

Hemochromatosis

A

Multiple blood transfustions or hereditary HFE (Human hemochromatosis protein) mutation.
- Can result in CHF, “bronze diabetes,” and incr risk of HCC

57
Q

Hepatocellular carcinoma

A

Cirrhotic liver (assoc w/ HBV, HCV)

58
Q

Hereditary bleeding disorder

A

von Willebrand’s disease

59
Q

Hereditary harmless jaundice

A

Gilbert’s syndrome (benign congenital unconjugated hyperbilirubinemia)

60
Q

HLA-B27

A

Ankylosing spondylitis, Reiter’s syndrome, IBD (ulcerative colitis), psoriasis

61
Q

HLA-DR3 or DR4

A

T1DM, RA, SLE

62
Q

Holosystolic murmur

A

VSD, TR, MR

63
Q

Hypercoagulability, endothelial damage, blood stasis

A

Virchow’s triad (results in venous thrombosis)

64
Q

Hypertension, secondary

A

Renal disease

65
Q

Hypopituitarism

A

Pituitary adenoma (usually benign tumor)

66
Q

Infection secondary to blood transfusion

A

Hepatitis C

67
Q

Infections in CGD

A

Catalase (+)! Organisms can degrade the limited H2O2.
S. aureus, E. coli, Aspergillus

  • Deficient in NADPH oxidase; lack of ROS/respiratory burst; neg nitroblue tetrazolium test

Also: Serratia, Pseudomonas, Candida, Listeria (SSPACEL)

68
Q

Kidney stones

A
  1. Calcium = radiopaque
  2. Struvite (ammonium) = radiopaque (formed by urease-positive organisms e.g. Proteus vulgaris or Staph)
  3. Uric acid = radiolucent
69
Q

Late cyanotic shunt (uncorrected L–>R becomes R–>L)

A

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

70
Q

Liver disease

A

Alcoholic cirrhosis

71
Q

Lysosomal storage disease

A

Gaucher’s (AR - vs. Fabry’s is XR)

- Glucocerbrosidase deficiency, accumulated glucocerebroside

72
Q

Male cancer

A

Prostatic carcinoma

73
Q

Malignancy associated with noninfectious fever

A

Hodgkin’s lymphoma

74
Q

Malignant skin tumor

A

Basal cell carcinoma (rarely metastasizes)

75
Q

Mental retardation

A
  1. Down syndrome

2. Fragile X syndrome

76
Q

Metastases to bone

A

Breast, lung, thyroid, testes, prostate, kidney

77
Q

Metastases to brain

A

Lung, breast, skin (melanoma), kidney (RCC), GI

78
Q

Metastases to liver

A

Colon, gastric, pancreatic, breast, lung

79
Q

Mitochondrial inheritance

A

Disease occurs in both males and females, inherited through females only
- Heteroplasmy: mixture of more than one type of an organellar genome (mtDNA or plastid DNA) within a cell or individual–mutation affects some mt and not others. Factor for disease severity.

80
Q

Mitral valve stenosis

A

Rheumatic heart disease

81
Q

Mixed (UMN and LMN) motor neuron disorder

A

ALS

  • UMN: spasticity, hyperreflexia, Babinksi
  • LMN: fasiculations, weakness, atrophy
82
Q

Myocarditis

A

Coxsackie B

- Picornavirus: +ssRNA, iscosahedral, PERCH

83
Q

Neoplasm (kids)

A
  1. ALL

2. Cerebellar medulloblastoma

84
Q

Nephrotic syndrome (adults)

A

FSGS

85
Q

Nephrotic syndrome (kids)

A

Minimal change disease (associated with infections, vaccinations, treat with corticosteroids!)

86
Q

Neuron migration failure

A

Kallmann syndrome (anosmia and hypogonadism–GnRH deficiency)

87
Q

Nosocomial pneumonia

A

Klebsiella, E. coli, Pseudomonas

88
Q

Obstruction of the male urinary tract

A

BPH

89
Q

Opening snap

A

Mitral stenosis

90
Q

Opportunistic infection in AIDS

A
  1. Pneumocystic jirveci (PCP) pneumonia: TMP/SMX at CD4 <50
91
Q

Osteomyelitis

A

S. aureus

92
Q

Osteomylitis in SCD

A

Salmonella

93
Q

Osteomyelitis in IVDU

A

Pseudomonas, S. aureus

94
Q

Ovarian metastasis from gastric carcinoma or breast cancer

A

Krukenberg tumor (mucin-secreting signet-ring cells)

95
Q

Ovarian tumor (benign, bilateral)

A

Serous cystadenoma

96
Q

Ovarian tumor (malignant)

A

Serious cystadenocarcnioma

97
Q

Pancreatitis (acute)

A

Gallstones, alcohol

98
Q

Pancreatitis (chronic)

A

Alcohol (adults), CF (kids)

99
Q

Patient with ALL/CLL/AML/CML

A 
ALL = child
CLL = adult > 60
AML = adult ~60
CML = adult 30-60
100
Q

PID

A

Neisseria gonorrhoeae (monoarticular arthritis)

101
Q

Philadelphia chromosome t(9;22)

A

bcr-abl: tyrosine kinase, oncogene

CML (sometimes ALL/AML)

102
Q

Pituitary tumor

A
  1. Prolactinoma

2. Somatotrophic “acidophillic” adenoma (acidophiles: prolactin or GH producing cells, stain red)

103
Q

Primary amenorrhea

A

Turner syndrome (XO)

104
Q

Primary bone tumor (adults)

A

Multiple myeloma

105
Q

Primary hyperaldosteronism

A

Adenoma of adrenal cortex

106
Q

Primary hyperparathyroidism

A
  1. Adenomas
  2. Hyperplasia
  3. Carcinoma
107
Q

Primary liver cancer

A

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

108
Q

Pulmonary hypertension

A

COPD

109
Q

Recurrent inflammation/thrombosis of small/medium vessels in extremeties

A

Buerger’s disease (Thromboangiitis obliterans, strongly associated with tobacco, corkscrew appearance of vessels)
vs. Raynaud’s which is decr BF upon exposure to cold

110
Q

Renal tumor

A

RCC: associated with vHL and adult polycystic kidney disease (AR/AD); paraneoplastic syndromes–EPO, renin, PTH, ACTH

111
Q

RHF due to pulmonary cause

A 
Cor pulmonale
Acute:
1. Massive pulmonary embolization
2. Exacerbation of chronic cor pulmonale
Chronic:
1. COPD
3. Primary Pulmonary Hypertension
3. Asthma
4. Recurrent Pulmonary Embolism
5. Loss of lung tissue following trauma or surgery
6. Pierre Robin sequence
7. End stage Pneumoconiosis
8. Sarcoidosis
9. T1-4 Vertebral subluxation
10. Obstructive sleep apnea
11. Altitude sickness
12. Sickle cell anemia
13. Bronchopulmonary dysplasia (in infants)
112
Q

S3 (protodiastolic gallop)

A

Incr ventricular filling (L–>R shunt, MR, LVF/CHF)

113
Q

S4 (presystolic gallop)

A

Stiff/hypertrophic ventricle (AS, restrictive cardiomyopathy)

114
Q

Secondary hyperparathyroidism

A

Hypocalcemia of chronic kidney disease

115
Q

Sexually transmitted disease

A

Chlamydia (usually co-infected with GC)

116
Q

SIADH

A

Small cell lung cancer

117
Q

Site of diverticula

A

Sigmoid colon

118
Q

Sites of atherosclerosis

A

Abdominal aorta > coronary > popliteal > carotid

119
Q

Stomach cancer

A

Adenocarcinoma

120
Q

Stomach ulcerations and high gastrin levels

A

Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)

121
Q

t(14;18)

A

Follicular lymphoma (bcl-2 activation, oncogene, anti-apoptotic molecule/incr cell survival)

122
Q

t(8;14)

A

Burkitt’s lymphoma (c-myc activation, oncogene, TF)

123
Q

t(9;22)

A

Philadelphia chromosome, CML (bcr-abl fusion, abl is an oncogene, tyr kinase)

124
Q

Temporal arteritis

A

Risk of ipsilateral blindness due to thrombosis of ophthalmic artery, polymyalgia rheumatica

125
Q

Testicular tumor

A

Seminoma

126
Q

Thyroid cancer

A

Papillary carcinoma

  • Orphan Annie nuceli
  • Lymphatic spread
  • Previous radiation to the head and neck
127
Q

Tumor in women

A

Leiomyoma (estrogen dependent, not precancerous)

128
Q

Tumor of infancy

A

Hemangioma (usually regresses spontaneously by childhood)

129
Q

Tumor of the adrenal medulla (adults)

A

Pheochromocytoma (usually benign)

130
Q

Tumor of the adrenal medulla (kids)

A

Neuroblastoma (malignant)

131
Q

Type of Hodgkin’s

A

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

132
Q

UTI

A

E. coli
Staph sap (young women)
- No StRES

133
Q

Viral encephalitis, temporal lobe

A

HSV-1

134
Q

Vitamin deficiency (U.S.)

A

Folic acid (pregnant women are at high risk; body stores only 3-4 month supply; prevents NTDs)

USMLE Step 1 (13 decks)

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