First Aid 2008 Errata

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MadameLULU

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Okay, I figure we should go ahead and get a running list of errors going.

p.91 It says that the rate limiting enzyme for de novo pyrimidine synthesis is Aspartate transcarbamylase. RR Biochem and I think newer studies say that CPS II is the rate limiting enzyme.

P. 91 Fructose 1, 6 bisphosphatase is the rate limiting enzyme for gluconeogenesis, not pyruvate carboxylase

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Whats up docs? I am new to the site and here is my first post...I am not 100% about this being a mistake, so any thoughtful discussion about the topic is encouraged: FA 08 pg 397 states that local anesthetics "preferentially bind to ACTIVATED Na+ channels , so most effective in rapidly firing neurons" This seems similar to the action of lidocaine as an antiarrhythimic, but is not the way these drugs work as anesthetics from the research I have done. Na+ channel toxins like Tetrodotoxin, saxitoxin, ciguatoxin, and batrachotoxin all bind to ACTIVATED Na+ channels on the outside of cells and either decrease Na influx or cause inactivation. Conversely, local anesthetics cross the axonal membrane in their uncharged form and bind to INACTIVATED channels in their charged forms. This slows recovery and prevents propagation of AP's. Sources: Lippencott, and Kaplan Pharmacology 2008 pg 147. What do you guys think?
I think they're both right. Remember, there are three states for sodium channels: rested, activated, and inactivated. In a rapidly firing neuron, the sodium channels should be predominantly activated or inactivated, but not rested. That's why local anesthetics (and anti-arrhythmics) should predominantly affect rapidly firing neurons.
 
Y'all seem to have already identified most of the errors we received thus far, but as I promised, I wanted to give you a preview of the March errata sheet. This still needs to be reviewed by my editor, so I hope I didn't make any mistakes myself. I am still looking into a couple things and will add them as a separate post next week. Thanks for your patience.

91 - Fructose-1,6-bisphosphatase (FBP-1) is the rate-limiting step of gluconeogenesis.

95 - Not all glycolytic enzyme deficiencies lead to swelling of RBCs. Pyruvate kinase deficiency (PKD) disrupts glycolysis, leading to energy depletion in, and subsequent dehydration (crenation) of, RBCs. This process results in the production of echinocytes (burr cells), which are cleared by the spleen.

98 - The last sentence should say: "Bite cells result from the phagocytic removal of Heinz bodies by macrophages."

119 - Alpha-fetal protein (aFP) is decreased in a Downs pregnancy and human chorionic gonadotropin (hCG) is increased.

129 - The mandibular nerve (V3) is the only branch of the trigeminal nerve that carries both sensory and motor components.

160 - Rocky Mountain spotted fever (RMSF) is caused by R. rickettsii. Epidemic, endemic, and scrub typhus are caused by R. prowazekii, R. typhi, and R. tsutsugamushi, respectively.

163/167 - Hepatitis E (HEV), which was originally assigned to the Calicivirus family, is now uniquely classified to the Hepesvirus genus. It does not currently have a family.

168 - IgG anti-HAV indicates previous exposure - and subsequent immunity - to hepatitis A (HAV). A person can become immune to reinfection either by suffering through natural infection or by innoculation with the inactivated virus.

196 - The labels indicating the light and heavy chain hypervariable regions are reversed.

210 - Transudate is a consequence of increased capillary hydrostatic pressure (eg, fluid overload) or decreased plasma oncotic pressure (eg, hypoalbuminemia).

266 - Hyperglycemia is a possible adverse effect of diazoxide.

327 - The leftmost column should read: "transferrin/TIBC (inversely proportional to transferrin saturation)."

375 - The second sentence describing Asperger disorder should read: "Children are of normal intelligence and lack cognitive deficits."

386 - Acutely (as from a stroke), a unilateral lesion of the PPRF causes the eyes to look to the contralateral side. Chronically, the eyes may move back to midline, but have difficulty looking towards the ipsilateral side. Conversely, the type of lesion in the FEF dictates to which side the eyes look: hyperactivity (eg, a seizure) results in contralateral gaze, and hypoactivity (eg, a stroke) results in ipsilateral gaze.

428 - Type IV rental tubular acidosis (RTA) ultimately causes hyperkalemia.

431 - The correct spelling is "Curschmann's spirals."

447 - The definition of adenomyosis should read: "Endometriosis within the myometrium."

And 3 clarifications (ie, not errors)...

151/152 - Previously classified as somewhere between bacteria and viruses, members of the Rickettsiae genus cannot survive without a eukaryotic host cell. This parasitic relationship does not necessarily qualify them as "parasites," though many texts refer to them alternately as bacteria or parasites. Perhaps the best designation is "obligate intracellular organisms." The same is true for Chlamydiae.

262 - Though they are not specific for endocarditis, petechiae are a more common finding than other peripheral phenomena. The mnemonic could be revised to "FROM JANE P" or "MAP FOR JEN."

446 - Though hCG is elevated in an ectopic pregnancy, it is lower than in a comparatively uncomplicated pregnancy.
 
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Hey, that's great. We appreciate it. Is there a chance First Aid will put out a correct index? The things are a few pages from where they are said to be in the index, so it's not THAT hard to find, but it would be nice if it was spot on.
 
No problem. Just let me know if you disagree with anything on the list.

If you can tell me which subjects from the index are off, that would help me fix and/or republish them. If it's more than just a couple topics (eg, altitude sickness is the only one that's been reported as wrong thus far), then let me know that, too, and I'll report it back to the editors.
 
the correction listed as "pg. 431 the correct spelling is Curschmann's spirals":
My pg. 431 is about kidney stones & renal cell carcinoma (don't see anything about Curschmann's spirals). I found Curschmann's spirals mentioned on pg. 464, but it is spelled correctly.... I believe (Curschmann's spirals).

Also, on pg. 447, I don't see the mistake. My edition (2008) reads adenomyosis: endometriosis within the myometrium (just as you state it should read)

Thanks!
 
Thanks, Amy. Perhaps the people who reported them were actually using an older edition. I'll strike them from the 2008 list.
 
No problem. Just let me know if you disagree with anything on the list.

If you can tell me which subjects from the index are off, that would help me fix and/or republish them. If it's more than just a couple topics (eg, altitude sickness is the only one that's been reported as wrong thus far), then let me know that, too, and I'll report it back to the editors.

I just ran into them randomly while looking stuff up. Most are right, but some are off. ex:

abdominal layers = wrong, 297 is about pectinate line and abdominal layers is on 291

I'll post more as I run into them.
 
On page 393 of the 2008 edition under Facial lesions: Bell's palsy it says you get ipsilateral paralysis w/ inability to close eye on involved side (RIGHT). Then it says you get only lower face is affected, since upper face has contralateral and ipsilateral innervation by CN VII (WRONG). In the case of facial paralysis a LMN lesion (Bell's palsy) is actually worse because it produces upper and lower ipsilateral facial paralysis as opposed to an UMN lesion which only produces contralateral lower face paralysis sparing the contralateral upper face. I think this statement was meant to be put under the description of UMN lesions. Even the diagram to the right of the paragraph has this concept right although it is a pretty confusing/busy diagram anyway. Hope this helps
 
As a clarification on pg. 397 of the 2008 First Aid it has Nitrous Oxide (N2O) listed under the anesthetics category, while it does have anesthetic properties the MAC (minimum alveolar concentration-concentration of inhaled gas that produces anesthesia in 50% of patients) for N2O is 105%. This means that in order to induce anesthesia in 50% of patients you would have to give them air that's 105% N2O. Seeing the problem here that if you give this much you don't have any O2 in the air to survive on (so you're dead). Nitrous oxide therefore probably is better suited to go under analgesics (analgesic at 20-70% concentrations). The reason it is listed under here (I'm guessing) is becasue it is frequently used in combination with other inhaled anesthetics as it decreases the MAC needed for other anesthetics (ie decreases the dose needed to produce anesthesia in 50% of patients from Isoflurane/Sevoflurane/Desflurane etc). When you combo inhaled anesthetics with N2O you get this beneficial side effect, with less of the adverse S/E's (respirartory depression, decreased cardiac output/blood pressure).
 
On page 302, the "Notes" section on "Secretin" says "increase HCO3 neutralizes gastric acid in duodenum, allowing.....".

They ended with the word allowing. Not sure what they wanted to say here.
 
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Is there ne way we can directly email you w/ the errors bc I have emailed 1st aid many times w/ no reponse.

1. pg 243 (08), stating the coronary AT of the CFX LAD abd PD were incorrect/ missining info.

2. pg 407 (08) Psychiatry-
I believe that the subtypes for mood disorders are as follows.
a. unipolar disorder ( major depression)
b. Bipolar Disorder (manic-depression):
Subtypes- Bipolar 1 and Bipolar 2

3. Facial Lesions pg 393- is so messed up, I dont even know where to begin.
 
On a slightly more general note...

Am I missing something or does FA'08 utterly lack any material on myeloproliferative disorders (myelofibrosis, polycythemia vera, essential thrombocythemia). I can't find said topic(s) in/near relevant sections in hematology or in the, er, faulty index.

If I'm right on the omissions, this would constitute some serious errata, no?
 
Most of the errors in the Official First Aid 2007 Errata (http://firstaidteam.com/updates-and-corrections/usmle-step-1/step-1-archives/) were corrected in the 2008 edition. However, many were corrected improperly, either by simply removing wrong material or omitting important information mentioned in the correction. Based on that, here is a list of errors that remain:

The Correction # refers to the correction in the Official FA 2007 errata above.

p. 111 Porphyrias (Correction #22) – add "(hydroxymethylbilane synthase)" after porphobilinogen deaminase

p. 122 Embryologic derivatives (Correction #26) – add "some cranial nerves" to list of neural crest derivatives

p. 169 HIV (Correction #37) – add "1% of U.S. Caucasians" for homozygous CCR5 mutation, "20% of U.S. Caucasians" for heterozygous CCR5 mutation

p. 177 Cephalosporins (Correction #38) – add "cefpiramide" to list of third generation cephalosporins

p. 199 Complement (Correction #40) – add "(overactive bradykinin)" after "Deficiency of C1 esterase inhibitor leads to hereditary angioedema"

p. 235 P-450 interactions (Correction #50) – add "Isoniazid is generally considered a P-450 inhibitor but has also been shown to activate the isozyme CYP2E1."

p. 258 Infarcts: red vs. pale (Correction #56) – add "Both pale and red infarcts can occur in the brain depending on the location."

p. 314 Hemochromatosis (Correction #78) – add "Pancreatic fibrosis" to disease characteristics

p. 330 Hemorrhagic disorders (Correction #82) – add "Results in mild thrombocytopenia secondary to "giant" platelet formations." for Bernard-Soulier disease

p. 344 Brachial plexus (Correction #88) – label the unlabeled hand "Pope's blessing"

p. 453 Antiandrogens (Correction #102) – add "binds and blocks the androgen receptor, thereby preventing the binding of dihydrotestosterone" for spironolactone
 
rhetoric, as mentioned before, there are no errors on p. 431 and p. 447. So please remove these from your unofficial march errata list.

Also, concerning the p. 386 correction, I think it could be phrased better.

Frontal eye field (FEF) lesion:
Destruction (e.g., stroke)—ipsilateral gaze deviation (eyes look toward side of lesion)
Stimulation (e.g., irritative lesion like seizure)—contralateral gaze deviation (eyes look away from lesion)
(Source: HY neuroanatomy)

Paramedian pontine reticular formation (PPRF) lesion:

Paralysis of conjugate gaze to side of lesion. May be accompanied by contralateral gaze deviation, which often occurs in acute lesions (e.g., early stroke).
(Sources: Adams and Victor's Neurology, Lange Clinical Neurology, Principles of Critical Care, Wikipedia on PPRF)


Thanks for your effort!
 
Just picked this error up:
p 396 - Phenytoin - phenytoin does NOT cause malignant hyperthermia under ANY circumstances, please remove this side effect.
Sources: Goodman & Gilman's Pharmacology, Lange Basic & Clinical pharmacology, Drug Monograph on accessmedicine.com
 
p316: pancreatic adenocarcinoma

The associated image is not 134 as mentioned in the middle, but 141 which is mentioned at the end
 
Not sure if anyone's posted this yet.
But on page 304 the first line reads "Product of heme metabolism; actively taken up by hepatocytes."

According to USMLE World, the liver takes up indirect bilirubin through a passive process, and secretes the direct bilirubin through an active process. Let me know if you find anything that says otherwise...
 
Not sure if anyone's posted this yet.
But on page 304 the first line reads "Product of heme metabolism; actively taken up by hepatocytes."

According to USMLE World, the liver takes up indirect bilirubin through a passive process, and secretes the direct bilirubin through an active process. Let me know if you find anything that says otherwise...

I believe that First Aid is correct. I think bilirubin is taken up in the liver by an active process as well.
 
On page 302, the "Notes" section on "Secretin" says "increase HCO3 neutralizes gastric acid in duodenum, allowing.....".

They ended with the word allowing. Not sure what they wanted to say here.

it should read "pancreatic enzymes to function" after the word "allowing"...this was missplaced in the regulation column after the word "duodenum" for secretin.

(I have 2007 & 2008 versions and 2007 had the correct placement)

Hope that helps!
 
In Schizophrenia there is and increase of Dopamine (DA) in the mesolimbic tract which accounts for the positive symptoms (delusions, auditory hallucinations, etc). There is also a DECREASE in dopamine in the mesocortical tract which account for the negative symptoms (flat affect, alogia, avolition, adhedonia, etc). It is the action of atypical psychotics as compared to the typical psychotics at the mesocortical tract that accounts for the lack of or even reversal of negative symptoms seen in schizophrenia. Given this I don't think schizophrenia can be justly classified as solely a decrease in DA.
 
that is strange that they dont give out a complete errata list. i mean the representative seems to be here at times. i didnt like the short errata list on the website
 
As of 31/3/2008

p.91, Rate-determining enzymes of metabolic processes
The rate-limiting step of gluconeogenesis is fructose-1,6-bisphosphatase (FBP-1), not pyruvate carboxylase.
p.98, Glucose-6-phosphate dehydrogenase deficiency
The sentence in the third column under Heinz bodies should read, "Bite cells result from the phagocytic removal of Heinz bodies by macrophages, not "from macrophages."
p.100, Amino acids
In the discussion of glucogenic/ketogenic essential amino acids, threonine (Thr) should be replaced with tryptophan (Trp).
p. 117, Autosomal-recessive diseases
"a1-antitrypsin deficiency" should be removed from the list of autosomal-recessive diseases, as it is considered to be codominantly inherited.
p.119, Autosomal trisomies
The "prenatal screening" row of the Down syndrome column should read, "[down arrow] a-fetoprotein, [up arrow] B-hCG" (i.e., the direction of both arrows should be reversed). The remainder of the entry, "[up arrow] nuchal translucency," should remain unchanged.
p.129, Branchial arch innervation
The maxillary branch (V2) of the trigeminal nerve does not have a motor component.
p.160, "Tricky T's"
Endemic typhus is caused by Rickettsia typhi, not R. rickettsii; the latter causes Rocky Mountain spotted fever.
p.163 and 167, RNA viruses, hepatitis viruses
Hepatitis E virus is now classified under the family Hepeviridae, so the virus type corresponding to HEV should be changed in both entries from calicivirus to hepevirus.
p.196, Antibody structure and function
The labels indicating the light-chain and heavy-chain hypervariable regions are reversed in the figure.
p.210, Transudate vs. exudate
Transudate is due to [down arrow] oncotic pressure, not [up arrow].
p. 258, Infarcts: red vs. pale
The first sentence of this entry should read, "Red (hemorrhagic) infarcts occur in loose tissues with collaterals, such as lungs, intestine, or liver, or following reperfusion." The duplicate word "liver" should be removed.
p.266, Antihypertensive drugs
An adverse effect of diazoxide is hyperglycemia, not hypoglycemia.
p. 277, Adrenal steroids
Label B in the key at the bottom of the page refers to 21-hydroxylase deficiency. The letter "a" should be removed.
p. 296, Digestive tract anatomy
In the figure for this entry, the "mucosa" callout should be changed to read "muscularis mucosa," and the existing callout for "muscularis mucosa" should be deleted along with its arrow.
p. 302, GI hormones
In the "secretin" row of this table, the last four words in the "regulation" column should be shifted to the "notes" column. The "regulation" column should thus read, "[up arrow] by acid, fatty acids in lumen of duodenum," and the "notes" column should read, "[up arrow] HCO3– neutralizes gastric acid in duodenum, allowing pancreatic enzymes to function."
p. 313, a1-antitrypsin deficiency
As mentioned in item 4 above, this disorder is autosomal codominant, not autosomal recessive. The last two words of this entry should be changed accordingly.
p. 316, Pancreatic adenocarcinoma
The image reference on the third line should be to Image 141, not Image 134.
p. 327, Lab values in anemia
TIBC is an indirect measurement of transferrin, rather than "indirectly proportional to transferrin" as written.
p. 344, Brachial plexus
The unlabeled black-and-white image in the third column should be labeled "Pope's blessing."
p. 386, Brain lesions
A lesion of the parapontine reticular formation (PPRF) causes the eyes to look away from the side of the lesion, not toward. In addition, the spelled-out version of the acronym PPRF should be changed to paramedian pontine reticular formation.
A lesion of the frontal eye fields would cause the eyes to look toward the lesion, not away from the lesion as written.
p. 393, Facial lesions
The sentence in Bell's palsy, "Only lower face is affected, since upper face has contralateral and ipsilateral innervations by CN VII," refers to the UMN lesion section and should be moved accordingly.
p. 428, Renal tubular acidosis
Type 4 renal tubular acidosis causes hyperkalemia rather than hypokalemia as written.
p. 430, Glomerular pathology
In the discussion of SLE, "membranous glomerulonephritis" should be replaced with "diffuse proliferative glomerulonephritis."
Color plates, Image 41
The first portion of the caption for this image should read as follows:
Color Image 41. Alzheimer's disease. Key histologic features include "senile plaques" (not pictured); a coronal section showing atrophy, especially of the temporal lobes (A); and focal masses of interwoven neuronal processes around an amyloid core (B); arrows mark neurofibrillary tangles).
The remainder of the caption describing panel C is correct and should be left as is.
25. p. 461, CO poisoning
a. For consistency with column three of the "hemoglobin modifications" entry on page 112, the first line of "CO poisoning" should read, "CO has 200´ greater affinity for hemoglobin than does O2," not 50´.
p. 509, Review resources
The correct 2008 rating for Rapid Review: Behavioral Science is "B." Therefore, the duplicative review on page 509 should be deleted in favor of the one on page 512.
 
It seems everyone is too busy studying to post their findings lately. Anyway here's some more errors I found.

p 236 - Sulfa drugs - Sulfonylureas is mispelled.

p 318 - Antacid use - Aluminum hydroxide does NOT causes seizures, it causes dementia.

p 435 - Mannitol - Mannitol is NOT indicated for shock under any circumstances.

p 416 - Atypical antipsychotics - Olanzapine is also used for acute mania in bipolar disorder (in addition to the schizophrenia indication of other atypical antipsychotics). It is NOT indicated for any of the other things mentioned.
 
page 281 - Signaling Pathways of endocrine hormones

GHRH uses a cAMP signal pathway so says my syllabus and other Internet sources (even though Wikipedia says otherwise). GHRH acts on G-Alpha-S to increase cAMP to cause GH release.

http://www.sigmaaldrich.com/Area_of...e/PathFinder/Pathway_Maps/GHRH_Signaling.html

I think there's different isoforms that use IP3 signaling, but from what I understand, this is the main pathway. Maybe I'm wrong -- someone verify.

This may seem nit-picky, but there were a bunch of these stupid what type of signaling pathway questions on my biochem shelf exam.
 
page 281 - Signaling Pathways of endocrine hormones

GHRH uses a cAMP signal pathway so says my syllabus and other Internet sources (even though Wikipedia says otherwise). GHRH acts on G-Alpha-S to increase cAMP to cause GH release.

Costanzo phys says IP3 mechanism, so it seems first aid is right.
 
p 230 - Sympathomimetics - Clonidine and α-methyldopa are listed under Sympathoplegics when they are clearly direct Sympathomimetics.
 
if you define sympathoplegic = decreased sympathetic outflow, then yea they are sympathoplegics. I was thinking Agonism vs. Antagonism, but this is not the case.

Ty
 
Correct me on this if Im wrong but:

p.430: SLE (already mentioned for some problems).
ALSO: Wire-loop lesions are subendothelial deposits. (page has listed as subepithelial).

From Lange Pathology:

"Electron microscopy shows large immune complexes in the subendothelial, mesangial, and subepithelial regions. Wire loop lesions correspond with the presence of large subendothelial deposition of immune complexes and can be distinguished from membranous glomerulonephritis of SLE, in which there are subepithelial deposits."

So basically, SLE can present with many different layers of deposits but if its the WIRELOOP it is subendothelial. The diagram on the next page has SLE deposits listed as subendothelial. Am I missing anything here?
 
Correct me on this if Im wrong but:

p.430: SLE (already mentioned for some problems).
ALSO: Wire-loop lesions are subendothelial deposits. (page has listed as subepithelial).

From Lange Pathology:

"Electron microscopy shows large immune complexes in the subendothelial, mesangial, and subepithelial regions. Wire loop lesions correspond with the presence of large subendothelial deposition of immune complexes and can be distinguished from membranous glomerulonephritis of SLE, in which there are subepithelial deposits."

So basically, SLE can present with many different layers of deposits but if its the WIRELOOP it is subendothelial. The diagram on the next page has SLE deposits listed as subendothelial. Am I missing anything here?

They addressed this particular error in the new update list on their website.
 
I know this is nit-picking, but:

pg. 316: shouldn't there be a circle with a minus sign in it for H2 blockers?

Can someone confirm this?
 
As of 31/3/2008


p.100, Amino acids
In the discussion of glucogenic/ketogenic essential amino acids, threonine (Thr) should be replaced with tryptophan (Trp).

I'm a bit confused about this correction. Isn't Threonine essential and tyrosine non-essential? Tyrosine can be derived from phenylalanine.
 
p.100, Amino acids
In the discussion of glucogenic/ketogenic essential amino acids, threonine (Thr) should be replaced with tryptophan (Trp).


I'm a bit confused about this correction. Isn't Threonine essential and tyrosine non-essential? Tyrosine can be derived from phenylalanine.

Yeah. Tyr is a non-essential amino acid that is glucogenic and ketogenic. They should take it out since it is non-essential.

And Thr is an essential amino acid but it is only glucogenic NOT both.

Very confusing...:confused:
 
Another error?

pg. 267 says that labetalol is a partial beta agonist, so its contraindicated in angina.

pg. 232 states that labetalol is a non-selective (beta1=beta2) antagonist.

My dilemna, how can something be both a partial agonist and nonselective antagonist.

Am I missing something?
 
Another error?

pg. 267 says that labetalol is a partial beta agonist, so its contraindicated in angina.

pg. 232 states that labetalol is a non-selective (beta1=beta2) antagonist.

My dilemna, how can something be both a partial agonist and nonselective antagonist.

Am I missing something?

A partial agonist is the same thing as an antagonist because a partial agonist decreases the efficacy of the drug. I forgot to mention potency of a partial agonist so I'll edit my post. The potency of a partial agonist can either be the same, increased or decreased than the agonist.

So the potency of a partial agonist is INDEPENDENT whereas the efficacy of the partial agonist is ALWAYS DECREASED.
 
Pg. 461
"A decrease in PaO2 causes hypoxic vasoconstriction that....."


The accepted mechansim of hypoxic vasoconstriction is a decrease PAO2 (alveolar oxygen) not pulmonary arterial oxygen.

This has been confirmed by studies in which perfusion a lung with high PaO2,while keeping the Alveolar O2 low, still induced hypoxic vasoconstriction.

Recent research shows that the O2 sensing mechanism might be mitochodria-dependent.
 
Pg. 461
"A decrease in PaO2 causes hypoxic vasoconstriction that....."


The accepted mechansim of hypoxic vasoconstriction is a decrease PAO2 (alveolar oxygen) not pulmonary arterial oxygen.

This has been confirmed by studies in which perfusion a lung with high PaO2,while keeping the Alveolar O2 low, still induced hypoxic vasoconstriction.

Recent research shows that the O2 sensing mechanism might be mitochodria-dependent.

So in physiologic dead space where PAO2 is 100% but Pa02 = 0 due to no pulmonary blood blow, there is no vasoconstriction?
 
So in physiologic dead space where PAO2 is 100% but Pa02 = 0 due to no pulmonary blood blow, there is no vasoconstriction?

No, there shouldn't be any "hypoxic vasoconstriction". Hypoxic vasoconstriction is the effect of a low alveolar oxygen content inducing a change (some suggest an increase in cytosolic ca) in the smooth muscle of the vasculature, which leads to a constricted state. This is a compensatory mechanism which strives to maintain v/q matching. However, states of generalized hypoxia, such as high alt, can also induce hypoxic vasoconstriction.

Now, in your scenario, there is no blood flowing. The vessel caliber is narrow because of the lack of blood, not due to hypoxic vasoconstriction. Easy way to remember is that it is hypoxic vasoconstriction, not hypoxemic vasoconstriction.

The case of the fetus explemplifies both of these situations. Fetal pulmonary vasculature is of high resistance, which allows only minimal amounts of blood to flow. They are "vasoconstricted". This is acheived by 1) hypoxic vasoconstriction due to lack of fetal alveolar ventilation and 2)Re-routing of blood flow via the ductus arteriosus.

Hope this helps.
 
pg. 415.

FA only has SSRI's listed as treatment for OCD. I believe TCA's such as CLOMIPRAMINE (listed on the next page) can be used to treat OCD as well.
 
p 199 --

In the classic/lectin pathway of the complement system diagram, First Aid gives the incorrect components for the C3 and C5 convertases.

It should be corrected to:
C3 convertase = C4b,2b.
C5 convertase = C4b,2b,3b.

The source of the diagram (Levinson, 2004) does not make this mistake.
 
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