First Aid 2016 Rapid Review – Key Associations

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Actinic (solar) keratosis
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Precursor to squamous cell carcinoma
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Acute gastric ulcer associated with CNS injury
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Cushing ulcer (increased intracranial pressure stimulates vagal gastric H+ secretion)
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Acute gastric ulcer associated with severe burns
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Curling ulcer (greatly reduced plasma volume results in sloughing of gastric mucosa)
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Age ranges for patient with ALL/CLL/AML/CML
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ALL: child, CLL: adult > 60, AML: adult ~ 65, CML: adult 45-85
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Alternating areas of transmural inflammation and normal colon
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Skip lesions (Crohn disease)
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Aortic aneurysm, abdominal
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Atherosclerosis
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Aortic aneurysm, ascending or arch
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3° syphilis (syphilitic aortitis), vasa vasorum destruction
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Aortic aneurysm, thoracic
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Marfan syndrome (idiopathic cystic medial degeneration)
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Aortic dissection
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Hypertension
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Atrophy of the mammillary bodies
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Wernicke encephalopathy (thiamine deficiency causing ataxia, ophthalmoplegia, and confusion)
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Autosplenectomy (fibrosis and shrinkage)
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Sickle cell disease (hemoglobin S)
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Bacteria associated with gastritis, peptic ulcer disease, and gastric malignancies (e.g. adenocarcinoma, MALToma)
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H. pylori
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Bacterial meningitis (adults and elderly)
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S. pneumoniae
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Bacterial meningitis (newborns and kids)
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Group B streptococcus/E.coli (newborns), S. pneumoniae/N. meningitidis (kids/teens)
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Bilateral ovarian metastases from gastric carcinoma
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Krukenberg tumor (mucin-secreting signet ring cells)
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Bleeding disorder with GpIb deficiency
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Bernard-Soulier syndrome (defect in platelet adhesion to von Willebrand factor)
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Brain tumor (adults)
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Supratentorial: metastasis, astrocytoma (including glioblastoma multiforme), meningioma, schwannoma
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Brain tumor (kids)
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Infratentorial: medulloblastoma (cerebellum) or supratentorial: craniopharyngioma
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Breast cancer
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Invasive ductal carcinoma
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Breast mass
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Fibrocystic change, carcinoma (in postmenopausal women)
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Breast tumor (benign, young woman)
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Fibroadenoma
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Cardiac 1° tumor (kids)
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Rhabdomyoma, often seen in tuberous sclerosis
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Cardiac manifestation of lupus
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Marantic/thrombotic endocarditis (nonbacterial)
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Cardiac tumor (adults)
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Metastasis, myxoma (90% in left atrium; “ball and valve”)
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Cerebellar tonsillar herniation
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Chiari II malformation
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Chronic arrhythmia
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Atrial fibrillation (associated with high risk of emboli)
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Chronic atrophic gastritis (autoimmune)
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Predisposition to gastric carcinoma (can also cause pernicious anemia)
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Clear cell adenocarcinoma of the vagina
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DES exposure in utero
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Congenital adrenal hyperplasia, hypotension
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21-hydroxylase deficiency
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Congenital cardiac anomaly
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VSD
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Congenital conjugated hyperbilirubinemia (black liver)
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Dubin-Johnson syndrome (inability of hepatocytes to secrete conjugated bilirubin into bile)
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Constrictive pericarditis
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TB (developing world); idiopathic, viral illness (developed world)
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Coronary artery involved in thrombosis
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LAD > RCA > circumflex
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Cretinism
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Iodine deficit/congenital hypothyroidism
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Cushing syndrome
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– 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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Cyanosis (early; less common)
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Tetralogy of Fallot, transposition of great vessels, truncus arteriosus
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Death in CML
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Blast crisis
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Death in SLE
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Lupus nephropathy
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Dementia
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Alzheimer disease, multiple infarcts (vascular dementia)
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Demyelinating disease in young women
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Multiple sclerosis
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DIC
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Severe sepsis, obstetric complications, cancer, burns, trauma, major surgery, acute pancreatitis, APL
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Diverticulum in pharynx
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Zenker diverticulum (diagnosed by barium swallow)
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Ejection click
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Aortic stenosis
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Esophageal cancer
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Squamous cell carcinoma (worldwide); adenocarcinoma (U.S.)
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Food poisoning (exotoxin mediated)
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S. aureus, B. cereus
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Gastric cancer
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Adenocarcinoma
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Glomerulonephritis (adults)
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Berger disease (IgA nephropathy)
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Gynecologic malignancy
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Endometrial carcinoma (most common in U.S.); cervical carcinoma (most common worldwide)
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Heart murmur, congenital
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Mitral valve prolapse
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Heart valve in bacterial endocarditis
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Mitral > aortic (rheumatic fever), tricuspid (IV drug abuse)
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Helminth infection (U.S.)
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Enterobius vermicularis, Ascaris lumbricoides
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Hematoma—epidural
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Rupture of middle meningeal artery (trauma; lentiform shaped)
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Hematoma—subdural
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Rupture of bridging veins (crescent shaped)
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Hemochromatosis
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Multiple blood transfusions or hereditary HFE mutation (can result in heart failure, “bronze diabetes,” and increased risk of hepatocellular carcinoma)
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Hepatocellular carcinoma
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Cirrhotic liver (associated with hepatitis B and C and with alcoholism)
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Hereditary bleeding disorder
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von Willebrand disease
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Hereditary harmless jaundice
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Gilbert syndrome (benign congenital unconjugated hyperbilirubinemia)
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HLA-B27
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Psoriatic arthritis, ankylosing spondylitis, IBD-associated arthritis, reactive arthritis (formerly Reiter syndrome)
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HLA-DR3
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Diabetes mellitus type 1, SLE, Graves disease, Hashimoto thyroiditis, Addison disease
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HLA-DR4
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Diabetes mellitus type 1, rheumatoid arthritis, Addison disease
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Holosystolic murmur
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VSD, tricuspid regurgitation, mitral regurgitation
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Hypercoagulability, endothelial damage, blood stasis
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Virchow triad (increased risk of thrombosis)
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Hypertension, 2°
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Renal artery stenosis, chronic kidney disease (e.g. polycystic kidney disease, diabetic nephropathy), hyperaldosteronism
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Hypoparathyroidism
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Accidental excision during thyroidectomy
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Hypopituitarism
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Pituitary adenoma (usually benign tumor)
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Infection 2° to blood transfusion
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Hepatitis C
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Infections in chronic granulomatous disease
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S. aureus, E. coli, Aspergillus (catalase ⊕ )
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Intellectual disability
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Down syndrome, fragile X syndrome
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Kidney stones
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– Calcium = radiopaque – Struvite (ammonium) = radiopaque (formed by urease ⊕ organisms such as Klebsiella, Proteus species, and S. saprophyticus ) – Uric acid = radiolucent – Cystine = radiolucent
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Late cyanotic shunt (uncorrected left to right becomes right to left)
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Eisenmenger syndrome (caused by ASD, VSD, PDA; results in pulmonary hypertension/polycythemia)
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Liver disease
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Alcoholic cirrhosis
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Lysosomal storage disease
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Gaucher disease
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Male cancer
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Prostatic carcinoma
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Malignancy associated with noninfectious fever
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Hodgkin lymphoma
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Malignancy (kids)
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ALL, medulloblastoma (cerebellum)
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Metastases to bone
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Prostate, breast > lung > thyroid
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Metastases to brain
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Lung > breast > genitourinary > melanoma > GI
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Metastases to liver
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Colon >> stomach, pancreas
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Microcytic anemia
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Iron deficiency
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Mitochondrial inheritance
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Disease occurs in both males and females, inherited through females only
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Mitral valve stenosis
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Rheumatic heart disease
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Mixed (UMN and LMN) motor neuron disease
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Amyotrophic lateral sclerosis
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Myocarditis
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Coxsackie B
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Nephrotic syndrome (adults)
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Focal segmental glomerulosclerosis
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Nephrotic syndrome (kids)
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Minimal change disease
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Neuron migration failure
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Kallmann syndrome (hypogonadotropic hypogonadism and anosmia)
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Nosocomial pneumonia
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S. aureus, Pseudomonas, other enteric gram-negative rods
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Obstruction of male urinary tract
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BPH
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Opening snap
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Mitral stenosis
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Opportunistic infection in AIDS
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Pneumocystis jirovecii pneumonia
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Osteomyelitis
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S. aureus (most common overall)
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Osteomyelitis in sickle cell disease
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Salmonella
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Osteomyelitis with IV drug use
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Pseudomonas, Candida, S. aureus
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Ovarian tumor (benign, bilateral)
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Serous cystadenoma
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Ovarian tumor (malignant)
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Serous cystadenocarcinoma
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Pancreatitis (acute)
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Gallstones, alcohol
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Pancreatitis (chronic)
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Alcohol (adults), cystic fibrosis (kids)
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Pelvic inflammatory disease
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C. trachomatis, N. gonorrhoeae
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Philadelphia chromosome t(9;22) (BCR-ABL)
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CML (may sometimes be associated with ALL/AML)
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Pituitary tumor
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Prolactinoma, somatotropic adenoma
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1° amenorrhea
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Turner syndrome (45,XO or 45,XO/46XX mosaic)
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1° bone tumor (adults)
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Multiple myeloma
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1° hyperaldosteronism
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Adenoma of adrenal cortex
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1° hyperparathyroidism
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Adenomas, hyperplasia, carcinoma
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1° liver cancer
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Hepatocellular carcinoma (chronic hepatitis, cirrhosis, hemochromatosis, α1-antitrypsin deficiency, Wilson disease)
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Pulmonary hypertension
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Idiopathic, heritable, left heart disease (e.g. HF), lung disease (e.g. COPD), hypoxemic vasoconstriction (e.g. OSA), thromboembolic (e.g. PE)
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Recurrent inflammation/thrombosis of small/medium vessels in extremities
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Buerger disease (strongly associated with tobacco)
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Renal tumor
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Renal cell carcinoma: associated with von Hippel-Lindau and cigarette smoking; paraneoplastic syndromes (EPO, renin, PTHrP, ACTH)
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Right heart failure due to a pulmonary cause
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Cor pulmonale
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S3 heart sound
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Increased ventricular filling pressure (e.g., mitral regurgitation, HF), common in dilated ventricles
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S4 heart sound
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Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)
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2° hyperparathyroidism
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Hypocalcemia of chronic kidney disease
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Sexually transmitted disease
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C. trachomatis (usually coinfected with N. gonorrhoeae)
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SIADH
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Small cell carcinoma of the lung
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Site of diverticula
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Sigmoid colon
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Sites of atherosclerosis
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Abdominal aorta > coronary artery > popliteal artery > carotid artery
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t(14;18)
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Follicular lymphomas (BCL-2 activation, anti-apoptotic oncogene)
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t(8;14)
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Burkitt lymphoma (c-myc fusion, transcription factor oncogene)
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t(9;22)
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Philadelphia chromosome, CML (BCR-ABL activation, tyrosine kinase oncogene)
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Temporal arteritis
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Risk of ipsilateral blindness due to occlusion of ophthalmic artery; polymyalgia rheumatica
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Testicular tumor
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Seminoma (malignant, radiosensitive), increased placental ALP
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Thyroid cancer
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Papillary carcinoma (childhood irradiation)
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Tumor in women
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Leiomyoma (estrogen dependent, not precancerous)
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Tumor of infancy
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Strawberry hemangioma (grows rapidly and regresses spontaneously by childhood)
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Tumor of the adrenal medulla (adults)
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Pheochromocytoma (usually benign)
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Tumor of the adrenal medulla (kids)
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Neuroblastoma (malignant)
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Type of Hodgkin lymphoma
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Nodular sclerosing (vs. mixed cellularity, lymphocytic predominance, lymphocytic depletion)
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Type of non-Hodgkin lymphoma
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Diffuse large B-cell lymphoma
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UTI
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E. coli, Staphylococcus saprophyticus (young women)
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Vertebral compression fracture
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Osteoporosis (type I: postmenopausal woman; type II: elderly man or woman)
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Viral encephalitis affecting temporal lobe
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HSV-1
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Vitamin deficiency (U.S.)
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Folate (pregnant women are at high risk; body stores only 3- to 4-month supply; prevents neural tube defects)

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