Rapid Review: Key Associations 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.
2
Q
Actinic (solar) keratosis
A
Precursor to SCC
3
Q
Acute gastric ulcer associated with severe burns
A
Curling’s ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
4
Q
Alternating areas of transmural inflammation and normal colon
A
Skip lesions (Crohn’s disease)
5
Q
Aneurysm, dissecting
A
Hypertension
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
7
Q
Aortic aneurysm, abdominal and descending aorta
A
Atherosclerosis
8
Q
Atrophy of the mammillary bodies
A
Wernicke’s encephalopathy (thiamine deficiency)
- ataxia, ophthalmoplegia, confusion
9
Q
Autosplenectomy (fibrosis and shrinkage)
A
Sickle cell anemia (HbS)
10
Q
Bacteria associated with gastritis, PUD, stomach cancer
A
H. pylori
11
Q
Bacterial meningitis (adults and elderly)
A
S. pneumo
12
Q
Bacterial meningitis (kids)
A
S. pneumo
N, meningitidis
13
Q
Bacterial meningitis (newborns)
A
Group B strep
14
Q
Bleeding disorder with GpIb deficiency
A
Bernard-Soulier disease (defect in platelet adhesion to von Willebrand’s factor)
15
Q
Benign melanocytic nevus
A
Spitz nevus (most common in first 2 decades)
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!)
17
Q
Brain tumor (kids)
A
Intratentorial: medulloblastoma (cerebellum)
- PNET, Homer-Wright rosettes
Supratentorial: craniopharyngioma (cerebrum)
- remnant of Rathke’s pouch
18
Q
Breast mass
A
- Fibrocystic changes
2. Carcinoma (in postmenopausal women)
19
Q
Breast cancer
A
Infiltrating ductal carcinoma
20
Q
Breast tumor (benign)
A
Fibroadenoma
21
Q
Cardiac primary tumor (kids)
A
Rhabdomyoma (benign tumor of striated muscle), often seen in tuberous sclerosis
22
Q
Cardiac tumor (adults)
A
- Metastasis
- Primary atrial myxoma (4:1 L to R shunt, “ball and valve” obstruction, “tumor plop” on auscultation, risk of afib, embolism)
23
Q
Cardiac manifestation of lupus
A
- Pericarditis
- Libman-Sacks endocarditis
- nonbacterial, affecting both sides (atria and ventricle) of MV
- small vegetations made of strands of fibrin, neutrophils, lymphocytes, and histiocytes
24
Q
Cerebellar tonsillar herniation
A
Chiari malformation (often presents with progressive hydrocephalus or syringomyelia)
25
Chronic arrhythmia
Atrial fibrillation (associated with high risk of emboli)
26
Clear cell adenocarcinoma of the vagina
DES exposure in utero
- synthetic nonsteriodal estrogen
- used off-label to prevent adverse pregnancy outcomes in women with a history of miscarriage
27
Chronic atrophic gastritis (autoimmune)
Predisposition to gastric carcinoma (can also cause pernicious anemia)
28
Compression fracture
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)
29
Congenital adrenal hyperplasia, hypotension
21-hydroxylase deficiency
30
1. Newborn with HTN, hypokalemia, low sex hormone levels (pseudohermaprodite male or normal internal sex organ female)
vs.
2. HTN and masculinization
1. CAH, 17alpha-OH deficiency
| 2. CAH, 11beta-OH deficiency
31
Congenital cardiac anomaly
VSD (most common)
32
Congenital conjugated hyperbilirubinemia
Dubin-Johnson (black liver); Rotor's (not black)
| - inability to hepatocytes to secrete conj BR into bile
33
Constrictive pericarditis (developing vs. developed world)
TB (developing world)
| SLE (developed world)
34
Coronary artery involved in thrombosis
LAD > RCA > LCA
35
Cretinism
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
36
Cushing's syndrome
1. CS therapy
2. Excess ACTH secretion by pituitary
3. SCLC
37
Cyanosis (early; less common)
Tetralogy of Fallot, TGA, Truncus arteriosus
38
Cyanosis (late; more common)
VSD, ASD, PDA
39
Death in CML
Blast crisis
40
Death in SLE
Lupus nephropathy
41
Dementia
1. Alzheimer's
| 2. Multiple infarcts
42
Demyelinating disease in young women
MS
43
DIC
1. Gram-neg sepsis
2. Obstetric complications
3. Cancer
4. Burn trauma
44
Dietary deficit
Iron
45
Diverticulum in pharynx
Zenker's diverticulum (diagnosed by barium swallow)
46
Ejection click
Aortic/pulmonic stenosis
47
Esophageal cancer
Squamous cell carcinoma (worldwide);
| Adenocarcinoma (US)
48
Food poisoning (exotoxin mediated)
S. aureus (enterotoxin)
| B. cereus (enterotxin; heat labile and stable)
49
Glomerulonephritis (adults)
Berger's disease (IgA nephropathy)
50
Gyn malignancy
```
Endometrial carcinoma (MC in US);
Cervical carcinoma (MC worldwide)
```
51
Heart murmur, congenital
MVP
52
Heart valve in bacterial endocarditis
Mitral (rheumatic fever);
Tricuspid (IVDU);
Aoritc (2nd in RF)
53
Helminth infection (US)
1. Enterobius vermicularis (pinworm, Scotch tape test, egg ingestion)
2. Ascaris lumbricoides (egg ingestion, fecal fertilizer/contaminated food)
Treat with -bendazoles or pyrantel pamoate
54
Hematoma - epidural
Rupture of middle meningeal artery (trauma, lentiform/lens shaped)
55
Hematoma - subdural
Rupture of bridging veins (crescent shaped)
56
Hemochromatosis
Multiple blood transfustions or hereditary HFE (Human hemochromatosis protein) mutation.
- Can result in CHF, "bronze diabetes," and incr risk of HCC
57
Hepatocellular carcinoma
Cirrhotic liver (assoc w/ HBV, HCV)
58
Hereditary bleeding disorder
von Willebrand's disease
59
Hereditary harmless jaundice
Gilbert's syndrome (benign congenital unconjugated hyperbilirubinemia)
60
HLA-B27
Ankylosing spondylitis, Reiter's syndrome, IBD (ulcerative colitis), psoriasis
61
HLA-DR3 or DR4
T1DM, RA, SLE
62
Holosystolic murmur
VSD, TR, MR
63
Hypercoagulability, endothelial damage, blood stasis
Virchow's triad (results in venous thrombosis)
64
Hypertension, secondary
Renal disease
65
Hypopituitarism
Pituitary adenoma (usually benign tumor)
66
Infection secondary to blood transfusion
Hepatitis C
67
Infections in CGD
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
Kidney stones
1. Calcium = radiopaque
2. Struvite (ammonium) = radiopaque (formed by urease-positive organisms e.g. Proteus vulgaris or Staph)
3. Uric acid = radiolucent
69
Late cyanotic shunt (uncorrected L-->R becomes R-->L)
Eisenmenger's syndrome (caused by ASD, VSD, PDA, results in PAH/polycythemia)
70
Liver disease
Alcoholic cirrhosis
71
Lysosomal storage disease
Gaucher's (AR - vs. Fabry's is XR)
| - Glucocerbrosidase deficiency, accumulated glucocerebroside
72
Male cancer
Prostatic carcinoma
73
Malignancy associated with noninfectious fever
Hodgkin's lymphoma
74
Malignant skin tumor
Basal cell carcinoma (rarely metastasizes)
75
Mental retardation
1. Down syndrome
| 2. Fragile X syndrome
76
Metastases to bone
Breast, lung, thyroid, testes, prostate, kidney
77
Metastases to brain
Lung, breast, skin (melanoma), kidney (RCC), GI
78
Metastases to liver
Colon, gastric, pancreatic, breast, lung
79
Mitochondrial inheritance
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
Mitral valve stenosis
Rheumatic heart disease
81
Mixed (UMN and LMN) motor neuron disorder
ALS
- UMN: spasticity, hyperreflexia, Babinksi
- LMN: fasiculations, weakness, atrophy
82
Myocarditis
Coxsackie B
| - Picornavirus: +ssRNA, iscosahedral, PERCH
83
Neoplasm (kids)
1. ALL
| 2. Cerebellar medulloblastoma
84
Nephrotic syndrome (adults)
FSGS
85
Nephrotic syndrome (kids)
Minimal change disease (associated with infections, vaccinations, treat with corticosteroids!)
86
Neuron migration failure
Kallmann syndrome (anosmia and hypogonadism--GnRH deficiency)
87
Nosocomial pneumonia
Klebsiella, E. coli, Pseudomonas
88
Obstruction of the male urinary tract
BPH
89
Opening snap
Mitral stenosis
90
Opportunistic infection in AIDS
1. Pneumocystic jirveci (PCP) pneumonia: TMP/SMX at CD4 <50
91
Osteomyelitis
S. aureus
92
Osteomylitis in SCD
Salmonella
93
Osteomyelitis in IVDU
Pseudomonas, S. aureus
94
Ovarian metastasis from gastric carcinoma or breast cancer
Krukenberg tumor (mucin-secreting signet-ring cells)
95
Ovarian tumor (benign, bilateral)
Serous cystadenoma
96
Ovarian tumor (malignant)
Serious cystadenocarcnioma
97
Pancreatitis (acute)
Gallstones, alcohol
98
Pancreatitis (chronic)
Alcohol (adults), CF (kids)
99
Patient with ALL/CLL/AML/CML
```
ALL = child
CLL = adult > 60
AML = adult ~60
CML = adult 30-60
```
100
PID
Neisseria gonorrhoeae (monoarticular arthritis)
101
Philadelphia chromosome t(9;22)
bcr-abl: tyrosine kinase, oncogene
| CML (sometimes ALL/AML)
102
Pituitary tumor
1. Prolactinoma
| 2. Somatotrophic "acidophillic" adenoma (acidophiles: prolactin or GH producing cells, stain red)
103
Primary amenorrhea
Turner syndrome (XO)
104
Primary bone tumor (adults)
Multiple myeloma
105
Primary hyperaldosteronism
Adenoma of adrenal cortex
106
Primary hyperparathyroidism
1. Adenomas
2. Hyperplasia
3. Carcinoma
107
Primary liver cancer
Hepatocellular carcinoma (chronic helpatitis, cirrhosis, hemochromatosis, alpha-1 antitrypsin)
108
Pulmonary hypertension
COPD
109
Recurrent inflammation/thrombosis of small/medium vessels in extremeties
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
Renal tumor
RCC: associated with vHL and adult polycystic kidney disease (AR/AD); paraneoplastic syndromes--EPO, renin, PTH, ACTH
111
RHF due to pulmonary cause
```
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
S3 (protodiastolic gallop)
Incr ventricular filling (L-->R shunt, MR, LVF/CHF)
113
S4 (presystolic gallop)
Stiff/hypertrophic ventricle (AS, restrictive cardiomyopathy)
114
Secondary hyperparathyroidism
Hypocalcemia of chronic kidney disease
115
Sexually transmitted disease
Chlamydia (usually co-infected with GC)
116
SIADH
Small cell lung cancer
117
Site of diverticula
Sigmoid colon
118
Sites of atherosclerosis
Abdominal aorta > coronary > popliteal > carotid
119
Stomach cancer
Adenocarcinoma
120
Stomach ulcerations and high gastrin levels
Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)
121
t(14;18)
Follicular lymphoma (bcl-2 activation, oncogene, anti-apoptotic molecule/incr cell survival)
122
t(8;14)
Burkitt's lymphoma (c-myc activation, oncogene, TF)
123
t(9;22)
Philadelphia chromosome, CML (bcr-abl fusion, abl is an oncogene, tyr kinase)
124
Temporal arteritis
Risk of ipsilateral blindness due to thrombosis of ophthalmic artery, polymyalgia rheumatica
125
Testicular tumor
Seminoma
126
Thyroid cancer
Papillary carcinoma
- Orphan Annie nuceli
- Lymphatic spread
- Previous radiation to the head and neck
127
Tumor in women
Leiomyoma (estrogen dependent, not precancerous)
128
Tumor of infancy
Hemangioma (usually regresses spontaneously by childhood)
129
Tumor of the adrenal medulla (adults)
Pheochromocytoma (usually benign)
130
Tumor of the adrenal medulla (kids)
Neuroblastoma (malignant)
131
Type of Hodgkin's
Nodular sclerosis (vs. mixed cellularity, lymphocytic predominancy, lymphocytic depletion)
132
UTI
E. coli
Staph sap (young women)
- No StRES
133
Viral encephalitis, temporal lobe
HSV-1
134
Vitamin deficiency (U.S.)
Folic acid (pregnant women are at high risk; body stores only 3-4 month supply; prevents NTDs)
