First Aid Rapid Review - 4. Key Associations (JR)

jnaterman's version from 2016-05-17 02:32


Disease/FindingsMost Common/Important Associations
Actinic (solar) keratosisPrecursor to SCC
Acute epiglottisH flu Type B
Acute gastric ulcer associated w/ CNS injuryCushing's ulcer (↑ ICP stimulates vagal gastric secretion)
Acute gastric ulcer associated w/ severe burnsCurling's ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
Acute otitis mediaStrep pneumo > H flu (non-typable) > Moraxella
Alternating areas of transmural inflammation and normal colonSkip lesions (Crohn's disease)
Aneurysm, dissectingHypertension
Aortic aneurysm, abdominal (ABDOMINAL Aortic Aneurysm) (AAA)Atherosclerosis
Aortic aneurysm, arch (THORACIC Aortic Aneurysm)Tertiary syphilis (syphilitic aortitis), vasa vasorum destruction
Aortic aneurysm, ascending (THORACIC Aortic Aneurysm)Marfan's syndrome (idiopathic cystic medial degeneration)


Disease/FindingsMost Common/Important Associations
Aspiration pneumonia in alcoholics, nursing home diabeticsKlebsiella pneumoniae (red-currant jelly sputum)
Atrophy of the mammillary bodiesWernicke's encephalopathy (thiamine [B1] deficiency causing ataxia, ophthalmoplegia, and confusion)
Autosplenectomy (fibrosis and shrinkage)Sickle cell anemia (HbS), also SLE (if no sickle cell)
Bacteria in colon (most common)Bacteriodes fragillis > Enterobacteriaceae (E. coli = G- rod)
Bacterium associated w/ gastritis, peptic ulcer disease, and stomach cancerH. pylori
Bacterial Endocarditis (FROM JANE)Staph. aureus (acute), Viridans Strep (sub-acute), S. epidermidis (IV Drug user), S. bovis (colon cancer)
Bacterial meningitis (adults & elderly)Strep. pneumoniae
Bacterial meningitis (newborns & kids)Strep agalactiae [Group B] (newborns); S. pneumoniae/N. meningitidis (kids)
Benign melanocytic nevusSpitz nevus (most common in first 2 decades)
Berry aneurysm MOST common siteAnterior Communication Artery (of Circle of Willis) (seen in Adult PKD, Marfan's, Ehlers-Danlos)
Bleeding disorder w/ GpIb deficiencyBernard-Soulier disease (defect in platelet adhesion to vWF)
Brain tumor (adults)Supratentorial: metastasis > astrocytoma (including glioblastoma multiforme) > meningioma > schwannoma
Brain tumor (kids)Infratentorial: Pilocytic Astrocytoma > medulloblastoma (cerebellum) > ependymoma
Supratentorial: craniopharyngioma (cerebrum)
Breast cancerinfiltrating ductal carcinoma (in the US, 1/9 women will develop breast cancer)
Breast mass1. Fibrocystic change in childbearing women > cancer
2. Carcinoma (in postmenopausal women)
Breast tumor (benign)Fibroadenoma
Cardiac 1º tumor (kids)Rhabdomyoma, often seen in tuberous sclerosis
Cardiac manifestation of lupusLibman-Sacks endocarditis (nonbacterial, affecting both sides of mitral valve)
Cardiac tumor (adults)1. Metastasis
2. 1º myxoma (4:1 LA to RA; "ball and valve")
Cardiomyopathymost common = Dilated Cardiomyopathy
Cerebellar tonsillar herniationChiari malformation (often presents w/ progressive hydrocephalus or syringomyelia)
Chronic arrhythmiaAtrial fibrillation (associated w/ high risk of emboli)
Chronic atrophic gastritis (autoimmune)Predisposition to gastric carcinoma (can also cause pernicious anemia)
Clear cell adenocarcinoma of the vaginaDES exposure in utero
Common (most) childhood systemic vasculitisHenoch-Schonlein Purpura (IgA complex deposit)
Community acquired pneumonia in adults + elderlyStrep. pneumoniae
Complications after MIArrhythmias (V. fibrillation) and LV failure
Compression fractureOsteoporosis (type I: postmenopausal woman; type II: elderly man or woman)
Congenital adrenal hyperplasia, hypotension21-hydroxylase deficiency
Congenital cardiac anomalyVSD
Congenital conjugated hyperbilirubinemia (black liver)Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin in bile)
Congenital heart disease assocationsFetal Alcohol Syndrome (VSD)
Down Syndrome Trisomy 21, (Endocardial Cushion defect = ASD, VSD, AV septal defect)
Rubella Togavirus, RNA + enveloped, (PDA)
Maternal Diabetes (Transposition of Great Vessel)
Turner Syndrome 45XO, (Coarctation of Aorta distal to main braches but before PDA)
Marfan Syndrome Aortic Insufficiency
DiGeorge Syndrome 22q11 (TA, TOF)
Constrictive pericarditisTuberculosis (developing world); SLE (developed world)
Continuous Machine-like murmurPDA, associated w/ RUBELLA. Infraclavicular area
Coronary artery involved in thrombosisLAD > RCA > LCA
CretinismIodine deficit/hypothyroidism
Croup (Laryngo-tracheo-brinchitis)Parainfluenza Virus


Disease/FindingsMost Common/Important Associations
Cushing's syndrome1. corticosteroid therapy
2: excess ACTH secretion by pituitary
3: small cell lung carcinoma
Cyanosis (early; less common)Tetralogy of Fallot (pulmonary stenosis, VSD, RVH, overriding aorta), transposition of great vessels (need PDA!), truncus arteriosus (one outflow tract)
Cyanosis (late; more common)VSD, ASD, PDA
Death in CMLBlast crisis
Death in SLELupus nephropathy
Deadly causes of Chest PainMI, Aortic Dissection, Unstable Angina, Tension Pneumothorax, PE
Dementia1. Alzheimer's
2. Multiple infarcts
Demyelinating disease in young womenMultiple sclerosis
Diastolic murmur, wide pulses, bounding pulses, head bobbingAortic regurgitation (b/c of aortic root dilation, rheumatic fever). ↑ by hand grip (↑afterload)
DICGm(-) sepsis, obstetric complications, cancer, burn trauma
Dietary deficitiron
Diverticulum in pharynxZenker's diverticulum (dx by barium swallow)
Dysentery (amoebic)Entamoeba histolytica
Dysentery (bacterial)Shigella
Ejection clickAortic/Pulmonic STENOSIS (Ejection = getting blood out of heart). Crescendo-decresendo systolic ejection murmur after ejection click. AS = Weak pulses, b/c of bicuspid aortic valve (<60 yo) or calcified aortic valve (>60 yo)
Esophageal cancerSCC (worldwide); adenocarcinoma (US)
Expiration (effect on murmurs)↑ Right heart murmurs
Food poisoning (exotoxin mediated)S. aureus, B. cereus (rice)
Fibrinoid necrosisVasculitis + Malignant HTN
GFAP +Glioblastoma Multiforme (adults = most common CNS tumor), Pilocytic Astrocytoma (children = most common CNS tumor)
Ghon complexMyobacterium tuberculosis
Glomerulonephritis (adults)Berger's disease (IgA nephropathy)
Gram (-) sepsisE.coli > Kleb.
Gynecologic malignancyEndometrial carcinoma (US); cervical carcinoma (worldwide)
Hand grip (↑ TPR = ↑afterload)↑ intensity of MR, AR, VSD, MVP murmurs
Heart murmur, congenital, Mid-Systolic ClickMitral valve prolapse (Later systolic crescendo murmur w/ midsystolic click, ↑ by valsalva which ↓ preload)
Heart valve in bacterial endocarditisMitral (rheumatic fever), tricuspid (IV drug abuse), aortic (2nd affected in rheumatic fever)
Helminth infection (US)1. Enterobius vermicularis (pinworm)
2: Ascariasis lumbricoides (giantworm)
Hematoma - epiduralRupture of middle meningeal artery (trauma; lentiform shaped)
Hematoma - subduralRupture of bridging veins (crescent shaped)
HemochromatosisMultiple blood transfusions or hereditary HFE mutation (can result in CHF, "bronze diabetes", and increase risk of hepatocellular carcinoma)
Hepatocellular carcinomaCirrhotic liver (associated w/ Hep B & C and w/ Alcoholism)
Hereditary bleeding disordervon Willebrand's disease
Hereditary harmless jaundiceGilbert's syndrome (benign congenital unconjugated hyperbilirubinemia)
HLA-B27PAIR ( Psoriasis, Ankylosing spondylitis, Inflammatory Bowel Disease, Reiter's syndrome)


Disease/FindingsMost Common/Important Associations
Holosystolic murmurmitral regurgitation (apex - "blowing murmur"), VSD (new-born), tricuspid (left-sternal border)
Hyaline ArteriolosclerosisBenign HTN and DM (pink protein deposition in blood vessel wall)
Hypercoagulability, endothelial damage, blood stasisVirchow's triad (results in venous thrombosis)
Hyperplastic ArteriolosclerosisMalignant HTN (hyperplasia of smooth muscle = fibrinoid necrosis)
Hypertension, 2*Renal disease
Hypertension cutoffsNormal <120/80 mmHg,
Pre-HTN ≥120/80 mmHg,
HTN ≥140/90 mmHg,
Malignant HTN ≥180/120 mmHg
HypoparathyroidismAccidental excision during thyroidectomy
HypopituitarismPituitary adenoma (usually benign)
Infection 2* to blood transfusionHepatitis C
Infections associated w/ birdsHistoplasma, Cryptococcus, Chlamydophila Psittaci, H5N1 Influenza (Avian flu), West Nile Virus
Infections in chronic granulomatous diseaseStaph aureus, E. coli, Aspergillus (catalase positive)
Inspiration (effect on murmurs)↑ Left heart murmurs
Irregularly-irregular EKG rhythm, no P-waves (no atrial contraction), atrial stasis = stroke Atrial Fibrillation (Tx --> if <48 hrs = rate/rhythm manipulation, if >48 hrs = anti-coagulation)
Jugular Venous Pulses (At Carter's Xing, Vehicles, Yield) a = RA contraction, c = RV contraction (tricuspid bulges into RA), v = RA filling (increasing RA pressure against closed tricuspid valve)
Keratin pseudocystsSeborrheic Keratosis (benign)
Kidney stones1. calcium = radiopaque
2. struvite (ammonium) = radiopaque (formed by urease-positive organisms such as Proteus vulgaris or Staph)
3. Uric acid = radiolucent
Late cyanotic shunt (uncorrected L-->R becomes R-->L)Eisenmenger's syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)
Leukemia in adultsCLL (smudge cells, B-cell markers)
Leukemia in childrenALL (PAS +)
Liver diseaseAlcoholic cirrhosis
Lumbar puncture(Iliac Crest = L4) Adults = L3-L5 (To keep the cord alive, keep the needle between L3 and L5 --> Posteior Superior Iliac Crest = L3, put needle b/w L4-L5)
Children = L4-S1
Lung cancer metastasisbrain, liver, bone
LymphomaDiffuse Large-B Cell Lymphoma (Non-Hodgkin's Lymphoma)
Lysosomal storage diseaseGaucher's disease
Male cancerProstatic carcinoma
Malignancy associated w/ noninfectious feverHodgkin's lymphoma
Malignancy (Kids)ALL, medulloblastoma (cerebellum)
Malignant skin tumorBasal cell carcinoma (rarely metastasizes)
Mental retardation1. Down syndrome (trisomy 21)
2. Fragile X syndrome (CGG triplet repeat)
Metastases to boneProstate, breast > lung > thyroid > testes > kidney (prostate, thyriod/testes, breast)
Metastases to brainLung > breast > GU > osteosarcoma > melanoma > GI (lung > breast > skin)
Metastases to heartBreast, lungs
Metastases to liverColon >> stomach > pancreas > Breast > Lung (colon > stomach > pancreas)
Mitochondrial inheritancedisease occurs in both male & female; inherited through females only
Mitral valve stenosisRheumatic heart disease
Mixed (UMN and LMN) motor neuron diseaseALS
More than 3 consecutive QRS complexes, wide QRS >0.12 sec (>3 boxes) Ventricular Tachycardia (normal QRS = 0.12 sec = 3 small boxes)
Most common cancer associated w/ ionizing radiationAML/CML (myeloid leukemias)
Most common helminthic infection in USEnterobius vermicularis (perianal itch)
Most common protozoal infection in USGiardia lamblia (diarrhea in campes and hikers)
Mutation in BMPR2, plexiform lesionPrimary Pulmonary Hypertension (> 25 mmHg)
MyocarditisCoxsackie B (Bacteria = Staph aureus; Protozoa = Trypanosoma cruzi, Chagas (big-heart/esophagus/colon); Rheumatic Fever = J"O"NES; Endocarditis w/ Lupus)
Nephrotic syndrome (adults)Focal segmental glomerulosclerosis
Nephrotic syndrome (kids)Minimal change disease (associate w/ infections/vaccinations; tx w/ corticosteroids)
Neuron migration failureKallmann syndrome (defective development of GnRH cells and olfactory placode -> hypogonadism and anosmia) (hypogonadotropic hypogonadism & anosmia)
Nosocomial pneumoniaKlebsiella, E. coli, Pseudomonas aeruginosa
Obstruction of male urinary tractBPH
Opening snapMitral stenosis diastolic murmur. ↑ by expiration (↑ LV murmurs)
Opportunistic infection in AIDSPneumocystis jiroveci pneumonia
OsteomyelitisS. aureus
Osteomyelitis in sickle cell diseaseSalmonella
Osteomyelitis w/ IV drug usePseudomonas, S. aureus
Otitis extermaPseudomonas aeruginosa