USMLE Step 1 First Aid - Key Associations Flashcards

1
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Actinic (solar) keratosis

A

Most common/important associations: Squamous cell carcinoma

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2
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Acute gastric ulcer associated w/ CNS injury

A

Most common/important associations: Cushing’s ulcer (increased ICP stimulates gastric secretion)

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3
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Acute gastric ulcer associated w/ severe burns

A

Most common/important associations: Curling’s ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)

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4
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Alternating areas of transmural inflammation and normal colon

A

Most common/important associations: Skip lesions (Crohn’s disease: autoimmune)

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5
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Aneurysm, dissecting

A

Most common/important associations: HTN

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6
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Aortic aneurysm, abdominal and descending aorta

A

Most common/important associations: Atherosclerosis

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7
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Aortic aneurysm, ascending

A

Most common/important associations: Tertiary syphilis

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8
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Atrophy of the mammillary bodies

A

Most common/important associations:

Wernicke’s encephalopathy (the Triad symptoms of ataxia, ophthalmoplegia, and confusion), caused by thiamine deficiency

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9
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Autosplenectomy (fibrosis and shrinkage)

A

Most common/important associations: Sickle cell anemia (HbS)

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10
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Bacteremia/pneumonia (IV drug user)

A

Most common/important associations: S. aureus

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11
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Bacteria associated w/ stomach cancer

A

Most common/important associations: H. pylori

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12
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Bacterial meningitis (adults and elderly)

A

Most common/important associations: Streptococcus pneumoniae

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13
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Bacterial meningitis (newborns and kids)

A

Most common/important associations: Group B streptococcus (newborns), S. pneumoniae/Neisseria meningitidis (kids)

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14
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Benign melanocytic nevus

A

Most common/important associations: Spitz nevus (most common in first two decades)

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15
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Bleeding disorder w/ GpIb deficiency

A

Most common/important associations: Bernard-Soulier dz (defect in platelet adhesion)

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16
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Brain tumor (adults)

A

Most common/important associations: Supratentorial: mets < astrocytoma (including glioblastoma multiforme) < meningioma < schwannoma

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17
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Brain tumor (kids)

A

Most common/important associations:

Infratentorial: medulloblastoma (cerebellum) or

supratentorial: craniopharyngioma (cerebrum)

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18
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Breast cancer

A

Most common/important associations: Infiltrating ductal carcinoma (in USA, 1 in 9 women will develop breast cancer)

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19
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Breast mass

A

Most common/important associations: 1.) Fibrocystic change 2.) Carcinoma (in postmenopausal women)

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20
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Breast tumor (benign)

A

Most common/important associations: Fibroadenoma

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21
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Bug in debilitated, hospitalized pneumonia patient

A

Most common/important associations: Klebsiella

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22
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Cardiac primary tumor (kids)

A

Most common/important associations: Rhabdomyoma

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23
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Cardiac manifestation of lupus

A

Most common/important associations: Libman-Sacks endocarditis (nonbacterial, affecting mitral)

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24
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Cardiac tumor (adults)

A

Most common/important associations: 1.) metastasis 2.) Primary myxoma (4:1 Left to right atrium; “ball and valve”)

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25
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Cardiomyopathy

A

Most common/important associations: Dilated cardiomyopathy (40% are familial)

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26
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Cerebellar tonsillar herniation

A

Most common/important associations: Arnold-Chiari malformation (often causes hydrocephalus)

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27
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Chronic arrhythmia

A

Most common/important associations: Atrial fibrillation (associated w/ high risk of emboli)

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28
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Chronic atrophic gastritis (the autoimmune version of the dz)

A

Most common/important associations: Predisposition to gastric carcinoma (can also cause pernicious anemia)

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29
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Clear cell adenocarcinoma of the vagina

A

Most common/important associations: DES exposure in utero

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30
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Congenital adrenal hyperplasia

A

Most common/important associations: 21-hydroxylase deficiency

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31
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Congenital cardiac anomaly

A

Most common/important associations: VSD

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32
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Congenital conjugated hyperbilirubinemia (black liver)

A

Most common/important associations: Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)

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33
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Constrictive pericarditis in developing world

A

Most common/important associations: Tuberculosis

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34
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Coronary artery involved in thrombosis

A

Most common/important associations: LAD < RCA < LCA

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35
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Cretinism

A

Most common/important associations: Iodine deficit/hypothyroidism

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36
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Cushing’s syndrome

A

Most common/important associations: 1.) Corticosteroid therapy 2.) Excess ACTH secretion by pituitary

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37
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Cyanosis (early; less common)

A

Most common/important associations: Tetralogy of Fallot, transposition of the great vessels, truncus arteriosus

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38
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Cyanosis (late; more common)

A

Most common/important associations: VSD, ASD, PDA

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39
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Death in CML

A

Most common/important associations: Blast crisis

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40
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Death in SLE

A

Most common/important associations: Lupus nephropathy

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41
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Dementia

A

Most common/important associations: 1.) Alzheimer’s disease 2.) Multiple infarcts

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42
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Demyelinating disease

A

Most common/important associations: Multiple sclerosis

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43
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: DIC

A

Most common/important associations: Gram-negative sepsis, obstetric complications, cancer, burn trauma

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44
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Dietary deficit

A

Most common/important associations: Iron

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45
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Diverticulum in pharynx

A

Most common/important associations: Zenker’s diverticulum (diagnosed by barium swallow)

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46
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Ejection click

A

Most common/important associations: Aortic/pulmonic stenosis

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47
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Esophageal cancer

A

Most common/important associations: Squamous cell carcinoma

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48
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Food poisoning

A

Most common/important associations: S. aureus

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49
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Gene involved in cancer

A

Most common/important associations: p53 tumor suppressor gene

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50
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Glomerulonephritis (adults)

A

Most common/important associations: Berger’s disease (IgA nephropathy)

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51
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Gynecologic malignancy

A

Most common/important associations: Endometrial carcinoma

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52
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Heart murmur

A

Most common/important associations: Mitral valve prolapse

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53
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Heart valves involved in bacterial endocarditis

A

Most common/important associations:

Mitral (rheumatic fever)

Tricuspid (IV drug abuse)

Aortic (2nd affected in rheumatic fever)

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54
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Helminth infxn (in USA)

A

Most common/important associations:

  1. ) Enterobius vermicularis
  2. ) Ascaris lumbricoides
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55
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Hematoma - epidural

A

Most common/important associations: Rupture of middle meningeal artery (arterial bleeding is fast)

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56
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Hematoma - subdural

A

Most common/important associations: Rupture of bridging veins (trauma; venous bleeding is slow)

57
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Hemochromatosis

A

Most common/important associations: Multiple blood transfusions

(can result in CHF and increased risk of hepatocellular carcinoma)

58
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Hepatocellular carcinoma

A

Most common/important associations: Cirrhotic liver (often associated w/ Hepatitis B and C)

59
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Hereditary bleeding disorder

A

Most common/important associations: von Willebrand’s dz

60
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Hereditary harmless jaundice

A

Most common/important associations: Gilbert’s syndrome (benign congenital unconjugated hyperbilirubinemia

61
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: HLA-B27

A

Most common/important associations: Ankylosing spondylitis, Reiter’s syndrome, ulcerative colitis

62
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: HLA-DR3 or -DR4

A

Most common/important associations: DM1, rheumatoid arthritis, SLE

63
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Holosystolic murmur

A

Most common/important associations: VSD, tricuspid regurgitation, mitral regurgitation

64
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Hypercoagulability, endothelial damage, blood stasis

A

Most common/important associations: Virchow’s triad (results in venous thrombosis)

65
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Secondary hypertension

A

Most common/important associations: Renal dz

66
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Hypoparathyroidism

A

Most common/important associations: Thyroidectomy

67
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Hypopituitarism

A

Most common/important associations: Adenoma

68
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Infection in blood transfusion

A

Most common/important associations: Hepatitis C

69
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Kidney stones

A

Most common/important associations:

  1. ) Calcium = radiopaque
  2. ) Struvite (ammonium) = radiopaque (formed by urease-positive organisms such as Proteus vulgaris and Staphylococcus)
  3. ) Uric acid = radiolucent
70
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Late cyanotic shunt (uncorrected L–<L)

A

Most common/important associations: Eisenmenger’s syndrome (caused by ASD, VSD, PDA; results in pulmonary HTN/polycythemia)

71
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Liver dz

A

Most common/important associations: Alcoholic liver dz

72
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Lysosomal storage dz

A

Most common/important associations: Gaucher’s dz

73
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Male cancer

A

Most common/important associations: Prostatic carcinoma

74
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Malignancy associated w/ noninfectious fever

A

Most common/important associations: Hodgkin’s lymphoma

75
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Malignant skin tumor

A

Most common/important associations: Basal cell carcinoma (rarely metastasizes)

76
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Mental retardation

A

Most common/important associations: 1.) Down syndrome 2.) Fragile X syndrome

77
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Mets to bone

A

Most common/important associations: Breast, lung, thyroid, testes, prostate, kidney

78
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Mets to brain

A

Most common/important associations: Lung, breast, skin (melanoma), kidney (renal cell carcinoma), GI

79
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Mets to liver

A

Most common/important associations: Colon, gastric, pancreatic, breast, and lung carcinomas

80
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Mitral valve stenosis

A

Most common/important associations: Rheumatic heart dz

81
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Motor neuron dz

A

Most common/important associations: ALS

82
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Myocarditis

A

Most common/important associations: Coxsackie B

83
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Neoplasm (kids)

A

Most common/important associations: 1.) ALL 2.) Cerebellar medulloblastoma

84
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Nephrotic syndrome (adults)

A

Most common/important associations: Membranous glomerulonephritis

85
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Nephrotic syndrome (kids)

A

Most common/important associations: Minimal change disease (associated w/ infxns/vaccinations; Tx w/ corticosteroids)

86
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Obstruction of male urinary tract

A

Most common/important associations: BPH

87
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Opening snap

A

Most common/important associations: Mitral stenosis

88
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Opportunistic infxn in AIDS

A

Most common/important associations: Pneumocystis jiroveci (formerly carinii) pneumonia

89
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Organ receiving mets

A

Most common/important associations: Adrenal glands (due to rich blood supply)

90
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Organ sending mets

A

Most common/important associations: Lung < breast, stomach

91
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Osteomyelitis

A

Most common/important associations: S. aureus

92
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Osteomyelitis in pts w/ sickle cell dz

A

Most common/important associations: Salmonella

93
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Osteomyelitis in IV drug users

A

Most common/important associations: Pseudomonas

94
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Ovarian metastasis from gastric carcinoma or breast cancer

A

Most common/important associations: Krukenberg tumor (mucin-secreting signet-ring cells)

95
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Ovarian tumor (benign)

A

Most common/important associations: Serous cystadenoma

96
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Ovarian tumor (malignant)

A

Most common/important associations: Serous cystadenocarcinoma

97
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Pancreatic tumor

A

Most common/important associations: Adenocarcinoma (head of pancreas)

98
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Pancreatitis (acute)

A

Most common/important associations: EtOH and gallstones

99
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Pancreatitis (chronic)

A

Most common/important associations: EtOH (adults), cystic fibrosis (kids)

100
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Pts with ALL/CLL/AML/CML

A

Most common/important associations:

ALL: child

CLL: Adult >60

CML: Adult 35-50

101
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Pts w/ Hodgkin’s dz

A

Most common/important associations: young male (except nodular sclerosis type: female)

102
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Pelvic inflammatory dz

A

Most common/important associations: Neisseria gonorrhoae (monoarticular arthritis)

103
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Philadelphia chromosome t(9;22) (bcr-abl)

A

Most common/important associations: CML (may sometimes be associated with ALL/AML)

104
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Pituitary tumor

A

Most common/important associations: 1.) Prolactinoma 2.) Somatotropic “acidophilic” adenoma

105
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Pneumonia (hospital-acquired)

A

Most common/important associations: Klebsiella

106
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Primary amenorrhea

A

Most common/important associations: Turner’s syndrome (XO)

107
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Primary bone tumor (adults)

A

Most common/important associations: Multiple myeloma

108
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Primary hyperaldosteronism

A

Most common/important associations: Adenoma of adrenal cortex

109
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Primary hyperparathyroidism

A

Most common/important associations:

  1. ) Adenomas
  2. ) Hyperplasia
  3. ) Carcinoma
110
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Primary liver cancer

A

Most common/important associations: Hepatocellular carcinoma (aka hepatoma)

111
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Pulmonary HTN

A

Most common/important associations: COPD

112
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Recurrent inflammation/thrombosis of small/medium vessels in extremities

A

Most common/important associations: Buerger’s dz (strongly associated w/ tobacco)

113
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Renal tumor

A

Most common/important associations: Renal cell carcinoma:

associated w/ von Hippel-Lindau dz, and

adult polycystic kidney disease;

paraneoplastic syndromes (EPO, renin, PTH, ACTH)

114
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Right heart failure due to a pulmonary cause

A

Most common/important associations: Cor pulmonale

115
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: S3 (protodiastolic gallop)

A

Most common/important associations: Increased ventricular filling (L–<R shunt, mitral regurgitation, LV failure [CHF])

116
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: S4 (presystolic gallop)

A

Most common/important associations: Stiff or hypertrophic ventricle (caused by aortic stenosis, or restrictive cardiomyopathy, et. al.)

117
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Seconary hyperparathyroidism

A

Most common/important associations: Hypocalcemia caused by chronic kidney failure

118
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Sexually transmitted disease

A

Most common/important associations: Chlamydia

119
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: SIADH

A

Most common/important associations: Small cell carcinoma of the lung

120
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Site of diverticula

A

Most common/important associations: Sigmoid colon

121
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Site of metastasis

A

Most common/important associations: 1.) Regional lymph nodes 2.) Liver

122
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Sites of atherosclerosis

A

Most common/important associations: Abdominal aorta < coronary < popliteal < carotid

123
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Stomach cancer

A

Most common/important associations: Adenocarcinoma

124
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Stomach ulcerations and high gastrin levels

A

Most common/important associations: Zollinger-Ellison syndrome (gastrinoma of duodenum or pancreas)

125
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: t(14;18)

A

Most common/important associations: Follicular lymphomas (bcl-2 activation)

126
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: t(8;14)

A

Most common/important associations: Burkitt’s lymphoma (c-myc activation)

127
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: t(9;22)

A

Most common/important associations: Philadelphia chromosome, CML (bcr-abl hybrid)

128
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Temporal arteritis

A

Most common/important associations: Risk of ipsilateral blindness due to thrombosis of ophthalmic artery

129
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Testicular tumor

A

Most common/important associations: Seminoma

130
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Thyroid cancer

A

Most common/important associations: Papillary carcinoma

131
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Tumor in women

A

Most common/important associations: Leiomyoma (estrogen dependent)

132
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Tumor in infancy

A

Most common/important associations: Hemangioma

133
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Tumor of the adrenal medulla (adults)

A

Most common/important associations: Pheochromocytoma (usually benign)

134
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Tumor of the adrenal medulla (kids)

A

Most common/important associations: Neuroblastoma (malignant)

135
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Type of Hodgkin’s

A

Most common/important associations: Nodular sclerosis (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)

136
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Type of non-Hodgkin’s

A

Most common/important associations: Diffuse large cell

137
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: UTI

A

Most common/important associations: E. coli, Staphylococcus saprophyticus (young women)

138
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Viral encephalitis

A

Most common/important associations: HSV

139
Q

Give the most common/important Association for each Disease/Finding

Disease/finding: Vitamin deficiency (in USA)

A

Most common/important associations: Folic acid (pregnant women are at high risk; body stores only 3- to 4-month supply)