First Aid 2009 errata

[apps-suck]

i havent found anything yet, anyone else?

yea i realize its early, but im sure theres someone out there whos been through the whole thing already

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[Knicks]

It's just ridiculous.

Do we, as students, have to expend energy on looking for these "shouldn't exist anymore at this stage" errors, or on studying for the USMLE?

 

[JHDMD11]

I don't see the clinical vignette's in FA 2009. FA 2008 had a page or so of high yield vignettes at the start of each chapter.

Did they move these somewhere else for 2009???

 

[swtiepie711]

Good catch! I didn't notice that but you're right - couldn't find them anywhere!

 

[Monica Lewinsky]

I don't see the clinical vignette's in FA 2009. FA 2008 had a page or so of high yield vignettes at the start of each chapter.

Did they move these somewhere else for 2009???

maybe they actually aren't so high yield...

 

[g6pddfishnc]

.

 

[Diegokikn]

Or maybe they just decided to take them out altogether.

I think they did... I do hope they have at least corrected the mistakes in the 2008's.
In any case, I'll have the 2008 errata in my hand when I go through the 2009's... I might as well have the 2008's .pdf version to check the vignettes... I do find them useful
I'll let you know if I got any mistakes!

 

[summit595]

All errata will be found at firstaidteam.com.

It's too early to have anything for the 2009 version just yet but if you find an error you get a gift card!

Also if you look at the actual errata most of the errors are pretty trivial. I'm pretty sure the 2008 errors won't be repeated in 2009 though.

 

[glsknl]

All errata will be found at firstaidteam.com.

It's too early to have anything for the 2009 version just yet but if you find an error you get a gift card!

Also if you look at the actual errata most of the errors are pretty trivial. I'm pretty sure the 2008 errors won't be repeated in 2009 though.

dude, this is not about "trivial" or not. the book comes out almost identical EVERY single year. there are like 10 new pages that were not in the previous edition. at most. and 100 new errors that too, were not in the old edition. that's the problem. if the editors work the same way in the hospital, they would be the delight of all the lawyers out there.

 

[ScootDoc]

I did find one error. Nephron Physiology. The part on Proximal Convoluted Tubule (PCT) It states that AngII --> increased Na & H20 excretion. Last time I checked AngII activates aldosterone secretion from the adrenal gland which acts to increase Na & H20 reabsorption.

 

[Diegokikn]

Page 353:
In the "Median Nerve" row they list "Pope's Blessing" as the sign its lesion causes.
Pope's Blessing should be listed as sign of distal "Ulnar Nerve" injuries.
It should be clarified under the sign for Median Nerve that the Claw hand involves 2nd and 3rd fingers.
Stupid Mistake since they got it right on a drawing in the next page 354.

Page 91:
Fragile-X syndrome is listed as X-linked recessive, when actually it's one of the few X-Linked Dominant disorders.
This error is in the 2008 too, and I don't see it in the Errata...

 

[nlax30]

Page 353:
In the "Median Nerve" row they list "Pope's Blessing" as the sign its lesion causes.
Pope's Blessing should be listed as sign of distal "Ulnar Nerve" injuries.
It should be clarified under the sign for Median Nerve that the Claw hand involves 2nd and 3rd fingers.
Stupid Mistake since they got it right on a drawing in the next page 354.

Funny, few of us were just talking about that same thing last night.

Came across this link: http://scrubnotes.blogspot.com/2008/02/popes-blessing-vs-claw-hand.html

While I don't think whoever wrote that blog post really clarified much, there quite a bit of discussion in the comments below that may help.

 

[Diegokikn]

Funny, few of us were just talking about that same thing last night.

Came across this link: http://scrubnotes.blogspot.com/2008/02/popes-blessing-vs-claw-hand.html

While I don't think whoever wrote that blog post really clarified much, there quite a bit of discussion in the comments below that may help.

Well, it's rather an stupid mistake anybody could have noticed... aparently there was no such an explanation on these lesions in the 2008 version, but there's this mistake in this "improved" version, lol.

I just noticed they also have it wrong in the diagram of the brachial plexus in the page 352... actually the only one right is in page's 354 drawing.

Bean's post in the link is the best explanation... I also found useful the russian's mnemonics of "gynecologist hand", it's better than pope's blessing

 

[sd1984]

Well, it's rather an stupid mistake anybody could have noticed... aparently there was no such an explanation on these lesions in the 2008 version, but there's this mistake in this "improved" version, lol.

I just noticed they also have it wrong in the diagram of the brachial plexus in the page 352... actually the only one right is in page's 354 drawing.

Bean's post in the link is the best explanation... I also found useful the russian's mnemonics of "gynecologist hand", it's better than pope's blessing

can u explain the mnemonic of gyno hand? also links to the link for beans post

 

[Diegokikn]

can u explain the mnemonic of gyno hand? also links to the link for beans post

Sure!
http://scrubnotes.blogspot.com/2008/02/popes-blessing-vs-claw-hand.html
Bean's Post is in the comments part of the blog, scroll down and you should find it.
And Gyno hand: When you perform an ob/gyn digital examination, you use (extend) 2nd and 3rd fingers while flexing 4th and 5th, which corresponds to a distal Ulnar nerve lesion a.k.a. Pope's Blessing.

 

[hmm...]

If you compare the 2008 errata with the 2009 FA, you can eliminate many of the errors that still exist in the book. Many have been fixed.

 

[scrubnotes]

Funny, few of us were just talking about that same thing last night.

Came across this link: http://scrubnotes.blogspot.com/2008/02/popes-blessing-vs-claw-hand.html

While I don't think whoever wrote that blog post really clarified much, there quite a bit of discussion in the comments below that may help.

Heh, well I tried! But yea, looking back on the post now, it's not really that clear. I wish I had a good ortho hand surgeon buddy to talk it over with, but alas, I don't, and there is surprisingly very little out there that goes into the hand lesions in great detail, beyond the superficial level we all learn in med school / read in first aid. Anyway, the discussion has been quite helpful, even for me, so hopefully you read through it all and can come away with a more comprehensive understanding of the lesions.

-Scrub

 

[DrKuroneko]

I was thinking about getting the 2009 FA but decided against it as many of the Qbanks use FA 2008 for reference and because I've been using it all year. Question to the masses. Has anyone gone through the trouble of comparing the two versions?

 

[nlax30]

Heh, well I tried! But yea, looking back on the post now, it's not really that clear. I wish I had a good ortho hand surgeon buddy to talk it over with, but alas, I don't, and there is surprisingly very little out there that goes into the hand lesions in great detail, beyond the superficial level we all learn in med school / read in first aid. Anyway, the discussion has been quite helpful, even for me, so hopefully you read through it all and can come away with a more comprehensive understanding of the lesions.

-Scrub
Scrub Notes USMLE Step 1 Posts

Ha, no problem. Actually just going back through and discussing it with others and trying to work it through the lesions is a great review in and of itself. But yeah, I was surprised as well at the lack of definite answers I could find. Found an orthopod text that talked about the hand of benediction in reference to ulnar lesions due to clawing of the 4th and 5th digits.

I think some of the confusion comes from some sources talk about what happens to the hand when you try and have the patient make a fist and/or extend their fingers. With a median n. lesion the 2nd/3rd fingers are clawed, but if you had the pt make a fist then they would make something similar to a hand of benediction, pope's blessing, or whatever you want to call it.

 

[FutureChiDoc]

FYI, there are errors from the 2008 Errata sheet that were NOT fixed in the 2009 version.

 

[Knicks]

The following are errors from the 2008 Errata sheet that were NOT fixed in the 2009 version:.................

Pathetic.

I really don't know what else to say. There is NO logical, common sense justification for that.


....

Pathetic.

 

[FutureChiDoc]

Pathetic.

I really don't know what else to say. There is NO logical, common sense justification for that.


....

Pathetic.

I agree man--it was quite disheartening to see that. I just assumed they were all fixed until I just happened to see one that I knew about. After that, i went through the WHOLE list to find them all. I think my list has them all--that is, at least the ones that carried over from last year. No idea what the NEW problems will be.

 

[SnowTown]

So far I only look through a very few things in the 2009 edition pictures and the endocrine section...

The 2009 edition have 20 less pictures than 2008 (124 vs 144)

There seems to be some small sections in 2008 that is not in 2009

???

EDIT: After going through a good portion of the 2009 version... I don't think the 2009 have less pictures, they just integrated some pictures in the back straight into corresponding text section. Some sections were also moved around to different pages/subjects.

Pathetic.

I really don't know what else to say. There is NO logical, common sense justification for that.


....

Pathetic.

well of course there is... $$$!!! and there will always be good demand for the book as long as step 1 is around

 

[FutureChiDoc]

well of course there is... $$$!!! and there will always be good demand for the book as long as step 1 is around

The part he's talking about is the fact that there are errors from the 2008 version still not fixed in the 2009, even though the First Aid Team PUT OUT THE ERRATA.

It's borderline unacceptable to release the list of errors from a previous version, and then not fix them in the new one.

 

[DizzyNT]

heads up everyone: the first errata sheet for 2009 edition has been put out @firstaidteam.com... to bad there's only a handful or errors on there

also can't seem to find it now, but someone on this forum wrote out the error list of 08 errors with corresponding 09 pg's that are still present, thought it was in this thread but cant find it now (maybe someone edited it out?), anyone saved this by chance?

 

[nlax30]

heads up everyone: the first errata sheet for 2009 edition has been put out @firstaidteam.com... to bad there's only a handful or errors on there

also can't seem to find it now, but someone on this forum wrote out the error list of 08 errors with corresponding 09 pg's that are still present, thought it was in this thread but cant find it now (maybe someone edited it out?), anyone saved this by chance?

That's weird..... the list WAS on one of the posts above but not seeing it now, wonder why it was edited out? *conspiracy theory on*

 

[Diegokikn]

That's weird..... the list WAS on one of the posts above but not seeing it now, wonder why it was edited out? *conspiracy theory on*

Maybe he just realized he should have first emailed FA to get $10 gift certificates and deleted the post...lol
anyway, I happened to save the email update with the post, here it is:

Posted by: FutureChiDoc
On: 01-31-2009 12:02 PM
The following are errors from the 2008 Errata sheet that were NOT fixed in the 2009 version:

p. 89 Cytoskeletal elements The correct spelling of the fourth
cytoskeletal element to the right of "Actin and myosin" is "adherens
junctions," not "adhering junctions." (NEW PAGE = 83)

p. 117 *, 313 * Autosomal-recessive diseases,
@1-antitrypsin deficiency "@1-antitrypsin deficiency" should be
removed from the list of autosomal-recessive diseases, as it is
considered to be codominantly inherited. (NEW PAGE = 91. The second
page listed already had the correction)
p. 277 * Adrenal steroids Label B in the key at the bottom of the page
refers to 21-hydroxylase deficiency. The letter "" should be removed.
(NEW PAGE = 282)

p. 332 Non-Hodgkin's lymphoma The phrase "most common (adult)" in the
"Comments" column should be moved from Follicular lymphoma to Diffuse
large cell lymphoma. (NEW PAGE = 339)
p. 344 * Brachial plexus The unlabeled black-and-white image in the
third column should be labeled "Pope's blessing." (NEW PAGE = 352)
p. 357 Skin disorders (continued), Miscellaneous disorders Acanthosis
nigricans is "associated with hyperinsulinemia," not "hyperlipidemia."
(NEW PAGE = 367)
p. 379 Extraocular muscles and nerves CN IV damage causes diplopia
with a defective downward gaze. Please edit the penultimate line
accordingly. (NEW PAGE = 399)
p. 433 Electrolyte disturbances The suprascript for the phosphate ion
should be 3-, not 2-. (NEW PAGE = 449)
Color plates * Image 41 (NOW = Image 44) 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.

Color plates * Image 56 (NOW = 59) In the figure caption for this
image, replace the term "swan-neck" with "boutonnière".

 

[Diegokikn]

Well, after reposting the old 2008 to 2009 errata message that was misteriously deleted I went to get the official errata and realized it was pretty much the same...
Is the User "futurechidoc" Tao Lee or Vikas Bhushan?
Coincidence? Conspiracy?
hehe

 

[davosPlatz]

Page 353:
In the "Median Nerve" row they list "Pope's Blessing" as the sign its lesion causes.
Pope's Blessing should be listed as sign of distal "Ulnar Nerve" injuries.
It should be clarified under the sign for Median Nerve that the Claw hand involves 2nd and 3rd fingers.
Stupid Mistake since they got it right on a drawing in the next page 354.

Page 91:
Fragile-X syndrome is listed as X-linked recessive, when actually it's one of the few X-Linked Dominant disorders.
This error is in the 2008 too, and I don't see it in the Errata...

Diego, Fragile-X is caused by repetition of the CGG segment of the FMR-1 gene on the X chromosome. It is not considered X-linked dominant. In FA 2009 it is listed as an "X-linked defect," not as recessive.

 

[nlax30]

Diego, Fragile-X is caused by repetition of the CGG segment of the FMR-1 gene on the X chromosome. It is not considered X-linked dominant. In FA 2009 it is listed as an "X-linked defect," not as recessive.

Further up on that page, 91, it's listed in that list of X-linked recessive disorders. He might have been referring to that.

 

[nlax30]

From the 2009 errata pdf:

p. 399
Extraocular muscles and nerves
CN IV damage causes diplopia with a defective downward gaze. Please insert the word “defective.”

I guess I was reading a little too much into what the book originally said, "diplopia with downward gaze".... BUT according to Neuroanatomy by Blumenfeld (p538) the "vertical diplopia worsens with downgaze"

Just another little bit to throw in there.

 

[davosPlatz]

Further up on that page, 91, it's listed in that list of X-linked recessive disorders. He might have been referring to that.

Good point. Interestingly the Fragile X Society in the UK says it is X-linked recessive:

Who's affected?
Fragile X affects about one in 3,600 men and one in 4,000 to 6,000 women of all races and ethnic groups. It shows an X-linked recessive pattern of inheritance and changes in the gene can become more serious as it's passed from parent to child.

What is the definitive answer on this? UpToDate lists it as neither recessive nor dominant. When a disorder is clinically manifested according to CGG repeats and variable inactivation of a gene, can it be classified as dominant or recessive?

 

[nlax30]

Good point. Interestingly the Fragile X Society in the UK says it is X-linked recessive:

Who's affected?
Fragile X affects about one in 3,600 men and one in 4,000 to 6,000 women of all races and ethnic groups. It shows an X-linked recessive pattern of inheritance and changes in the gene can become more serious as it's passed from parent to child.

What is the definitive answer on this? UpToDate lists it as neither recessive nor dominant. When a disorder is clinically manifested according to CGG repeats and variable inactivation of a gene, can it be classified as dominant or recessive?

Looks like there's not total agreement on this... Just looked in Harrisons (16th ed, p. 370) and the chart there lists it as X-linked recessive.

 

[davosPlatz]

Looks like there's not total agreement on this... Just looked in Harrisons (16th ed, p. 370) and the chart there lists it as X-linked recessive.

Nice find. I see it on page 400 of the 17th edition as well. Actually, there are two forms of Fragile X, it seems: FMR1 and FMR2-associated genetic abnormalities.

Anyhow, here is the link from the NIH Genetics page that says.. dun dun dun .. X-linked dominant.

http://ghr.nlm.nih.gov/condition=fragilexsyndrome

"Fragile X syndrome is inherited in an X-linked dominant pattern. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes. (The Y chromosome is the other sex chromosome.) The inheritance is dominant if one copy of the altered gene in each cell is sufficient to cause the condition."

 

[Diegokikn]

Nice find. I see it on page 400 of the 17th edition as well. Actually, there are two forms of Fragile X, it seems: FMR1 and FMR2-associated genetic abnormalities.

Anyhow, here is the link from the NIH Genetics page that says.. dun dun dun .. X-linked dominant.

http://ghr.nlm.nih.gov/condition=fragilexsyndrome

"Fragile X syndrome is inherited in an X-linked dominant pattern. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes. (The Y chromosome is the other sex chromosome.) The inheritance is dominant if one copy of the altered gene in each cell is sufficient to cause the condition."

Yeah, I did the same research when I was trying to find out whether it was X-dominant or recessive... I found out that in most genetics articles and NIH genetics page said it technically is "an X-Linked dominant disease with reduced penetrance", that's why I decided to post what I considered was the best answer... but obviously there's still controversy out there.

In any case... if there's still controversy regarding the pattern of inheritance, I don't really think they will ask about it in the Step 1

 

[pohma]

p. 79 says that alternative splicing is the reason for beta-thal mutations.

then p. 334 says beta-thal is due to mutations in splicing sites.

according to Lippincott's Biochem 4th ed (p. 427), it says mutations in RNA splicing are the cause of beta-thal. and that alternative splicing means multiple variations of mRNA can be produced from one gene.

any thoughts? or am i looking too much into this?

 

[pseudoknot]

p. 79 says that alternative splicing is the reason for beta-thal mutations.

then p. 334 says beta-thal is due to mutations in splicing sites.

according to Lippincott's Biochem 4th ed (p. 427), it says mutations in RNA splicing are the cause of beta-thal. and that alternative splicing means multiple variations of mRNA can be produced from one gene.

any thoughts? or am i looking too much into this?

It sounds like you need to review molecular biology a little bit.

A "mutation" would only be something that occurs in the genomic DNA.

Alternative splicing does not cause mutation in DNA.

If you have a transcript that is alternatively spliced (i.e., different splice sites can be chosen within the same pre-mRNA leading to different final mRNA transcripts) then you could imagine that mutations either at the different splice sites or regulatory sequences nearby could cause changes in the final transcripts, leading to altered function and disease.

Anyway, I think that's what they are referring to. "Mutations in RNA splicing" is bad writing and doesn't strictly make sense, but in general everything you quoted is talking about the same mechanism.

 

[pohma]

I appreciate your reply pseudoknot. and yes, that is why I have decided to review my molecular biology now before I start my intense board prep.

I thought they were the same mechanism as well but the wording threw me off a bit and I wanted to make sure I wasn't missing something. perfectly clear now. thanks

 

[DizzyNT]

can someone explain this to me?

FA (p412 in '09) for phase II block from succinylcholine (depolarizing, non comp) it's repolarized but blocked and antidote consists of cholinesterase inhibitors

Kaplan Pharm says AChE inhibitors cannot reverse phase 2 block

not sure i understand the whole phase 1/2 block and stuff but
can you or can't you reverse block with AChE inhibitors?

edit-
another Q? on p 411 says under local anesthetics
preferentially bind to 'Activated' Na+ Channels
Kaplan says binds preferentially to inactivated channels (makes sense as that's what Lidocaine does in heart as Class IB i thinks)

 

[jackbauer]

p63 on BIAS:

According to wikipedia the Pygmalion and Hawthorne effects seem to be wrong. The description of the Hawthorne effect is actually the Pygmalion effect, the Hawthorne effect is actually changing simply because someone is in a study, and I'm not sure what the name of the bias described in#8 would be. What's going on? Is FA right, or wiki, or neither? Any epi experts out there?

Happy studying

 

[DizzyNT]

how about whats most common cause of Liver Cancer,
mets is, but goljan says Lung is Most common, FA (in basic path section) says its Colon, and FA lists lung as last

 

[future_dr_house]

how about whats most common cause of Liver Cancer,
mets is, but goljan says Lung is Most common, FA (in basic path section) says its Colon, and FA lists lung as last

Harrison's agrees w/ FA's assessment.

 

[CHIRON11]

What is this the 4 or 5th edition of FA? And still we have errors...this is the best book for Step1 but this is ridiculous! Is it Le or Yale kids that have no clue....man if I saw one of them in the street I would punch'em in the mouth and take back my 45$. Heck, I pretty much wrote the book my self. This thread just makes me angry!

Thank you all for posting the corrected info. You are the ones that should get your names in FA!

 

[pseudoknot]

can someone explain this to me?

FA (p412 in '09) for phase II block from succinylcholine (depolarizing, non comp) it's repolarized but blocked and antidote consists of cholinesterase inhibitors

Kaplan Pharm says AChE inhibitors cannot reverse phase 2 block

not sure i understand the whole phase 1/2 block and stuff but
can you or can't you reverse block with AChE inhibitors?

edit-
another Q? on p 411 says under local anesthetics
preferentially bind to 'Activated' Na+ Channels
Kaplan says binds preferentially to inactivated channels (makes sense as that's what Lidocaine does in heart as Class IB i thinks)

As far as phase II block, this occurs after extended exposure to sux and I think FA is correct that it can be reversed by anticholinesterases. See the following:
http://www.cja-jca.org/cgi/reprint/30/6/569.pdf

 

[DizzyNT]

As far as phase II block, this occurs after extended exposure to sux and I think FA is correct that it can be reversed by anticholinesterases. See the following:
http://www.cja-jca.org/cgi/reprint/30/6/569.pdf

thanks, and for the IB i think its activated and inactivated, just not resting??

on page 318 under Jaundice, if viral hepatitis is considered hepatocellular than i think urine urobilinogen would be increased

and FA says p 331 anti AB antibodies are IgM, so cant cross placenta, Goljan says there IgG and can (and thus have ABO Hemolytic Dz of Newborn)

 

[jackbauer]

What is this the 4 or 5th edition of FA? And still we have errors...this is the best book for Step1 but this is ridiculous! Is it Le or Yale kids that have no clue....man if I saw one of them in the street I would punch'em in the mouth and take back my 45$. Heck, I pretty much wrote the book my self. This thread just makes me angry!

Thank you all for posting the corrected info. You are the ones that should get your names in FA!

No one is forcing you to use First Aid - if you don't like it, read something else. Since you "pretty much wrote" it yourself that shouldn't be much of a problem. It sucks that there are errors and I've submitted plenty to the publisher to get fixed, but guess what, there are errors in a lot of books! Like Robbins, B&B, Golan pharm etc. - legit professional textbooks! There are errors in published articles. Of course it should be better, but you don't need to get yourself worked up or punch anyone in the mouth over it. Give me a break

Also to update my previous post: I saw a UWorld question that confirms the Pygmalion effect as described in FA, but the definition for Hawthorne effect is different: "tendency of a study population to affect an outcome due to the knowledge of being studied." This definition agrees with Wikipedia, and none of the epi books I looked at in the library had anything much better.

 

[ZonaRidicularis]

.

 

[CHIRON11]

Thank you for your kind response. I hope you get named an editor in the 2010 FA...it will most likely be a major accomplishment in your life.

Give me a break

 

[lantus99]

Thanks for the updates guys & gals. At least your going through the stuff! I ended up ordering the latest one on the account of an additional 50-60 pages. I'll get it on Monday. The font hasn't changed right? Any new pharm drugs or molecular topics? The next "official errata" list is coming on the 1st of May. How long does a submission take to get approved for these corrections? I hope that will be the last one!

 

[DizzyNT]

not sure on this one but on p 261, for smooth muscle cell migration in atherosclerosis... its PDGF for sure, but it lists FGF-beta too, should this be TGF-beta instead of FGF-beta??