LIST UPDATED TO QofQuimica post on 07-29-2009, 10:14 PM. Feel free to update with remaining posts. I'm going to bed.
-p. 12: Found by TSisk23, with comments from BiologyBY, QofQ and schistocyte. Section: MI, E. Complications of acute MI, point 5. Acute pericarditis. Reads: "a. Treatment consists of aspirin. b. NSAIDs and corticosteroids are contraindicated... " Correction: a. Treatment consists of aspirin or NSAIDs. b. Corticosteroids are second line treatment. c. Avoid indomethicin in post MI acute pericarditis PLEASE NOTE THERE HAS BEEN A FAIR AMOUNT OF DISCUSSION ABOUT THIS ITEM
-p. 38: This is the first typo that BiologyBY found. Under Aortic Regurgitation, part A (General characteristics), point #1, it should read that regurgitant blood flow increases left ventricular end diastolic volume, not and diastolic volume.
-p. 60: Found by jsong812. Under Septic Shock, A. General characteristics, point 3. Change "see Box 1-14" to "see Box 1-15".
Under Septic Shock, B. Clinical features, point 2. Change "see Box 1-14" to "see Box 1-15".
-p. 69: Table 2-3 at the bottom of the page has two problems: First, it blurs mild persistent asthma with intermittent asthma. Mild intermittent asthma should have symptoms 2 or fewer times per week, not two or more times. Second, it leaves out mild persistent asthma as a category. Mild persistent asthma has symptoms more than 2x/week but not every day (which would be moderate persistent asthma). Treat mild persistent asthma w/ a low dose inhaled steroid. The chart is correct that mild intermittent asthma does not require any control medication.
-p. 73: This is another omission. Under section C (Diagnosis), add a point #7 for PET/SPECT as a method of detecting lung cancer. PET scanning uses fluorodeoxyglucose; this is effective b/c tumor cells take up and metabolize more glucose than normal parenchyma does. SPECT is a related technique that uses a radioactive isotope (technetium-99), which again is selectively taken up by the tumor cells and allows visualization of the tumor.
-p. 83: By Tommy1496. Under Interstitial Lung Diseases Associated with Granulomas, A. Sarcoidosis, 3. Diagnosis, point g. reads: "...decreased FEV1/FEC ratio". Change to: "...increased FEV1/FEC ratio."
-p. 105: This is another omission. Under part b ("other causes include") at the top of the page, "Bleeding disorder (ex. hemophilia)" should be added to the differential for hemoptysis.
-p. 115: Typo at the bottom of the page. It should say, "Diet: limit protein to 30 to 40 grams per day", not milligrams!
-p. 137: Under point 2 (Lower GI bleeding), point a should say that diverticulosis is the most common source of GI bleeding in patients over age 60, not under. Point b underneath that one should say that angiodysplasia is the second most common source of bleeding in patients over age 60.
-p. 162: Typo under the section Thyroid Nodules, part A (General Characteristics). The second sentence in point 2 should say that multinodular conditions may be misleading, not leading.
-p. 163: Typo in box 4-5 at the bottom of the page. Under the heading Cold Nodules, the first point should read Decreased iodine uptake = hypofunctioning nodule, not increased.
-p. 170: Typo in the last sentence under Diagnosis, point #2 (Water Load Test). It should say that if a large amount of water is excreted in the urine (>65% in four hours), consider SIADH an unlikely diagnosis, not a likely one. A normal person should excrete >65% of a water load within four hours (or >80% in 5 hours). One source I checked stated that SIADH pts often only excrete <40% of the water load after five hours.
-p. 175: This is the error that Ashers found. Under Section D (Treatment), point 2 should say that medical treatment consists of alpha blockers (phenoxybenzamine), not beta blockers. (Just FYI, beta blockers can be added afterward if needed, but they should not be used first to avoid precipitating a hypertensive crisis due to unopposed stimulation of alpha receptors.)
-p. 177: This error was found by BiologyBY. Section B (Clinical Features), point 1 (lack of cortisol), letter d should read hypotension (especially orthostatic), not HTN. Make the same correction in the quick hit in the margin that is entitled "most common clinical findings of adrenal insufficiency." The sixth symptom is postural hypotension, not postural HTN. While you're making this correction, I would add an eighth clinical finding for adrenal insufficiency that I got pimped about, which is eosinophilia. (Just put another point for "eosinophilia" under "abdominal pain.")
-p. 181: Typo at the bottom under point b (Regimens), second point. The part in parentheses at the end should say that "one-half to two-thirds of this dose will be NPH and one-third to one-half regular", not one-third to one-third.
-p. 183: This is the mistake that JeffLebowski found. In Figure 4-6 at the bottom of the page, the third line of the flowchart is mislabeled. Under the left side (24 units heading), the two divisions should be "70% NPH" and "30% regular, not 30% NPH. The same mistake occurs on the right side of the flowchart under the 12 units heading. Again, it should read "70% NPH" and "30% regular, not 30% NPH.
-p. 185: Typo in the margin under "definition of microalbuminuria." The second line should read, "20 to 200 micrograms per minute", not grams. (I did the conversion, and 20-200 ug/min does come out to be about 30-300 mg/day.)
-p. 185: The chart of diabetes drugs at the bottom of the page omits two new and important classes of drugs: DPP-IV inhibitors (sitagliptin), and incretin mimetics (exenatide). The DPP-IV inhibitors inhibit the enzyme dipeptidyl peptidase IV, which breaks down the incretins (GLP-1 and GIP). Incretin mimetics stimulate insulin secretion in a glucose-dependent fashion and also inhibit glucagon secretion.
-p. 189: By bonnielass13. Under Acute Complications of Diabetes Mellitus, B. Hyperosmolar hyperglycemic nonketotic syndrome, 2. Clinical features, point a. change to "Thirst, polyuria
-p. 191: By jsong812. Under Hypoglycemia, B. Causes, 4. Ethanol ingestion, b. reads: Metabolism of alcohol that lowers nicotinamide adenine dinucleotide levels and decreases gluconeogenesis." Change to "Metabolism of alcohol that increases the NADH/NAD+ ratio and decreases gluconeogenesis."
-p. 203: By QofQuimica. Quick Hit reads: "There is no known association between essential tremor and Parkinson's disease." Change to "There may be some association between essential tremor and Parkinson's disease."
-p. 207: The section on therapies for Alzheimer's disease is pretty out of date. There are basically two classes of drugs in current use: acetylcholinesterase inhibitors, and NMDA receptor antagonists. Two AChE inhibitors, tacrine and donepezil, are mentioned under section D (Treatment). The book notes under point 2 that tacrine is not used very much b/c of the dosing regimen, but the main reason is actually because tacrine is so hepatotoxic. Currently, donepezil, galantamine, and rivastigmine are the most commonly used AChE inhibitors in Alzheimer's disease. The NMDA receptor antagonist in use is memantine. (Just add a point 5 for "NMDA receptor antagonists" under section D, because this class of drugs is not even mentioned.)
-p. 207: The Quick Hit note has an error. It's not true that tacrine and donepezil are the only FDA-approved agents; the other three drugs I listed are approved for treating Alzheimer's disease as well. Just cross out that phrase in the margin ("donepezil and tacrine are the only FDA-approved agents...").
-p. 210: Found by jsong812 with added comment by stochastic. Under Brain Herniation, A. General characteristics, 2. Sites of herniation, a. uncal herniation
bullet number 2 reads: "...results in ipsilateral anisocoria..." Change to "...results in ipsilateral mydriasis"
bullet number three reads: "Contralateral hemiparesis due to compression of cerebral peduncle against bone" Change to "May result in ipsilateral hemiparesis due to compression of the contralateral cerebral peduncle against the tentorial notch/."
-p. 222: This change was contributed by BiologyBY. Under Von Hippel-Lindau Disease, add a fourth point that states, "Associated with pheochromocytomas."
-p. 225: Found by QofQuimica. Table 5-5 Central Versus Peripheral Vertigo. Bottom entry under Peripheral Vertigo, change to "Direction of nystagmus: unilateral horizontal with torsional component; peripheral nystagmus is never vertical."
-p. 264: This typo was found by BiologyBY. In the Quick Hit entitled "Pre-renal failure vs ATN", the entry in the first row (Urine Osmolarity) under ATN should say <350, not >350.
-p. 272 under Dialysis, C. Hemodialysis, point 6 a. reads "hypotension due to rapid removal of extravascular volume" Change extravascular to intravascular
-p. 275 under Hematuria, A. General Characteristics, point 4, it should read "if large clots form in the lower GU tract", not GI tract.
-p. 278: This typo was found by BiologyBY. In the third section of Table 7-5(Laboratory findings), in the right hand column under Nephrotic Syndrome, the first line should read "Urine protein excretion rate >3.5g/24h", not <3.5
-p. 283: First Quick Hit on page reads: "ACE Inhibitors are contraindicated in patients with renovascular HTN" You could just cross that out, or add: "First line medical therapy for renovascular HTN is an ACE inhibitor or ARB. Don't freak out about the dip in GFR, just watch it carefully. It's reversible, so if you get into trouble you can just stop the drug."
-p. 293: Found by QofQuimica. Under Approach to Volume Disorders, A. Normal body fluid compartments, 4. Distribution of water, b. Extracellular fluid, first bullet should read "Plasma is one-fourth of ECF..."
-p. 296: This typo was found by BiologyBY. The first sentence in the section on Hyponatremia, section A, point 3 should read that "Symptoms usually begin when the Na+ level falls to <120 mEq/L", not >120.
-p. 296, the quick hit on the bottom of the page, 2nd point should read hypovolemia and hypervolemia are caused by too little and too much sodium, as opposed to the contrary.
-p. 300: Found by PenguinHead. Under Calcium, calcium metabolism, B. Hormonal control, point 2. Calcitonin, b. should be: "Kidney - decreased Ca++ reabsorption and decreased PO4 reabsorptoin"
Also, point 3. Vitamin D, b. should be "Kidney: increased Ca++ and increased PO4 reabsorption"
-p. 303: Found by Twitch. Under Hyperkalemia, C. Treatment, 2. Shift potassium into the intracellular compartment. Add c. Beta2 Agonist--shifts K+ into cells
-p. 311: This typo was found by BiologyBY. The second sentence of the caption to Part C of Figure 8-7 should read "The change in AG is greater than the change in HCO3-" not less than the change. The second sentence of the caption to Part B, which also reads "The change in AG is less than the change in HCO3-" is correct as written.
-p. 318: This is the mistake that laxman found. At the very bottom of the page under Section C (Diagnosis), cross out the part in parentheses that says, "See color figure 9-1". This figure is correctly cited at the bottom of p. 321 as a picture of a hypersegmented neutrophil.
-p. 332: Found by QofQuimica. Under Disorders of Coagulation, Hemophilia A, A. General characteristics, point 1 "...(approximately 1 in 10,000 male patients)"
-p. 344: This addition was contributed by WayChanger. The book comes up woefully short in its discussion of acute leukemias, and acute promyelocytic leukemia is not even mentioned at all. I think the best way to handle this is to add a Quick Hit in the margin on this page below the two that are already there. The new Quick Hit should say that "The t(15,17) APL subset of AML is treatable with ATRA (all trans retinoic acid) + chemo, which appears to cure ~90% of APL patients. Treatment with ATRA induces maturation of the immature neoplastic cells (which had a maturation block), and the subsequent chemo kills off these cells."
-p. 345: Another change contributed by WayChanger. The discussion of CML treatments is out of date. First, under CML, Section A (General Characteristics), Point 5, the sentence should be changed to read "....but the average is 3 years without modern treatments." Then, under CML, Section D (Treatment), point 2 should be changed to read that an alkylating agent or antimetabolite was formerly used to treat the chronic phase, not that either is used currently. Finally, in the margin next to Section D, include another Quick Hit: "Imatinib (Gleevec) is the current standard of care for CML. It is is a selective tyrosine kinase inhibitor that targets the dysfunctional chimeric protein bcr-abl formed by the t(9,22) Philadelphia chromosome." (Note: I am taking out the part WayChanger wrote about imatinib being curative, since the drug has not been around long enough for us to know for sure whether these pts will indeed live out normal lifespans. But it does appear to be curative in most cases, at least so far.)
-p. 354, 1st quick hit. Gohn's focus is a calcified primary focus, as opposed to Gohn's complex. Ranke's complex is also known as Gohn's complex, but this is not an error. Also change the corresponding text in the 2nd point under C. Diagnosis -> 2. CXR -> b. Other possible findings.
-p. 385, table 10-10 under Q fever, clinical findings, the text reading "Chronic: rifampin" should be switched over to the treatment column.
-p. 392 table 10-13, under meningitis it should read "See Table 10-3," not 10-6
-p. 392, under "Neutropenic Fever," the fourth point says that you should obtain the following for any neutropenic patient with a fever: CXR, PAN culture.... In parentheses, it then lists a bunch of different places to culture. I think they just mean pan-culture as in, culture everything in general, because I don't know of anything that PAN could be besides polyarteritis nodosa, which makes no sense. If they mean pan-culture, then capitalizing the word so that it looks like an acronym is confusing. It should be lower-cased.
-p. 409 under Prehypertension, it should say 120-139 or 80-89, not "and"
-p. 411: The authors seem to have a real issue with confusing alpha and beta blockers! Point b at the top of the page is labeled beta blockers, and that is correct. Point f, on the other hand, should be labeled alpha blockers, not beta blockers. While you're correcting this page anyway, I would also add that beta blockers are thought to decrease sympathetic outflow (in addition to decreasing HR and CO). Alpha blockers also relax vascular smooth muscle (as well as decreasing arteriolar resistance).
-p. 413 6 c third bullet HDL value should be <40 (rather than <35). At least according to AHA/ATPIII criteria
-p. 430: Found by bonnielass13. Under Gastrointestinal Diseases, Irritable Bowel Syndrome, D. Treatment. Add note: both cisapride and tegaserod (zelnorm) have been taken off the market in the US
-p. 449: Found by Deferoxamine. First Quick Hit. Spelling. Should read "Tympanic Membrane Perforation"
-p. 463: Found by PenguinHead. Under ELectrocardiogram Interpretation, ECG Pearls, B. Determine rate, end of point 1 "... this is the same as the 300-150-100-75-60-50 rule.)"
