2019 FA Step 1 Proposed Errata & Su...
Page #ChapterIncluded in Published ErrataSectionFact NameNeeds Illustration Team ReviewSupporting Reference(s)Main CommentSubmission typeIllustration Author CommentSubmission type triaged by staffFirst author commentSecond author commentEditor commentEditor determination based on Prelim feedbackFirst Expert Reviewer1st Expert Reviewer Feedback2nd Expert Reviewer2nd Expert Reviewer FeedbackEditor determination based on Expert feedbackFinal wording on ErrataAdded to AnnotateGC amountGC paidDate SubmittedFirst NameLast NameEmailNull
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134BiochemistryMolecularChromatin structureN/AHeterochromatin --> column 2 --> Barr bodies (INACTIVATED X chromosomes) - Not inactivate X chromosomesSpelling/formattingReject, test states "Barr bodies (inactive X chromosomes) may be visible..." spelling is correct. - Victor MartinezVerifiedAgree with rejection.-AnupReject.

- Vivek		Agree with authors.Reject by 2 authors + 1 editor01/01/19 12:34 PMBehnamNabavizadehbehnam.nabavi@yahoo.com
234BiochemistryMolecularChromatin structureNot needed, mnemonicHistone Deacetylation Deactivates DNAMnemonicVerified06/10/19 8:10 PMEstefaníaHenríquez Luthjeehenriquezluthje@gmail.com
335BiochemistryMolecularNucleotidesFA 2019 Page 35Why (-1 ring ) is colored in red?Spelling/formattingAgree. It is a minor formatting issue. It should be in black font color. - Victor MartinezVerifiedWe can correct in 2020. -AnupAgree with both Anup and Victor. We can fix it in 2020.

- Vivek		Agree - JAtrue01/06/19 6:33 AMMoatasemAl-Janabiassoomi88@yahoo.com
435BiochemistryMolecularNucleotidesaaaPurines (A, G); 2 rings -- PURe As Gold; Exchange 2 gold Rings in a weddingMnemonicVerifiedReject.
Not a fan of this one.
MA		Would be easy to think of one ring, agree this is not helpful.
-Kaitlyn		03/01/19 6:26 AMElanaMolchoelana.molcho@gmail.com
535BiochemistryMolecularNucleotidesSelf-created.I have created a helping mneumonic for the major deamination reactions. C U At Home Get Xtra 5 Toppings. It allows one to remember the order of the deamination reactions and which reactions are paired.MnemonicVerifiedLY imo. Not an easy mnemonic to remember or understand either.

- Huzaifa		Agree with rejection. -Anup05/21/19 9:09 AMBriannaOlamijubrianna.olamiju@yale.edu
636BiochemistryMolecularDe novo pyrimidine and purine synthesishttp://tmedweb.tulane.edu/pharmwiki/doku.php/proguanil https://www.uptodate.com/contents/antimalarial-drugs-an-overview#H14Add proguanil (anti-malarial) to list list of medications that inhibit dihydrofolate reductase.High-yield addition to next yearAgree we should consider adding proguanil to the next edition, the prodrug that produces an active metabolite, cycloguanil that inhibits DHFR. - Victor MartinezVerifiedAgree with addition. -AnupReject

I don't think this is a HY drug to know for the USMLE Step1. We only mention it as a prophylaxis in several other places of the text but we don't discuss its pharmacology in any detail anywhere else.

-MA		02/18/19 1:52 AMBasimAlibasim.ajafri@gmail.com
736BiochemistryMolecularDe novo pyrimidine and purine synthesisFA 2019 page 416 Orotic aciduriaIn main pyrimidine base production diagram i think it would be better if you add (UMP synthase) enzyme on arrow from Orotic acid to UMP as it's clinically high yield.Clarification to current textI agree with the student and Vasily. It would reduce cognitive load - Victor MMakes sense. Let's migrate to Annotate and discuss with the illustration team.

-Vasily		Reasonable to consider this for 2020.

-Matt		Prelim accept but NOT publishable erratatrue04/18/19 3:43 AMMuhanadShaibmohanad.shaib@gmail.com
837BiochemistryMolecularGenetic code featureshttps://www.ugg.com/men-footwear/Add mnemonic "when you wear your UGG, you Tryp (trip; for Tryptophan)" to remember that UGG codes for tryptophan and that it is an exception to the Degenerate/Redundant feature of the genetic codeMnemonicIt is good. We should consider this mnemonic for the next edition. -Victor MartinezVerifiedCould be considered for addition, but not sure if this is HY. -AnupI don't think this is HY. Vote to reject.

-MA		02/08/19 11:45 AMRalphZeitounriz07@mail.aub.edu
937BiochemistryMolecularGenetic code featuresPersonal MnemonicThe 4 genetic code features are: Unambiguous, Degenerate, Commaless, and Universal. Take the first letters of these 4 features and you can spell "CUUD." The mnemonic would be: Genetic "CUUD" features.MnemonicVerifiedLY, IMO.

-Vasily		Agree, unnecessary. - Huzaifa04/28/19 12:58 PMMilanTerzicmilanterzic1996@gmail.com
1037BiochemistryMolecularPurine salvage deficiencieshttps://reference.medscape.com/drug/elitek-rasburicase-342255#90Rasburicase is colored as an enzyme with green. Please color it like a drug so as we don't get confused.Clarification to current textIt should be changed to keep consistency - Victor MAgree, a change is needed here. Suggest adding an arrow from uric acid to a new item "allantoin". This conversion is stimulated (arrow with a plus sign) by rasburicase (drug). One more arrow should be added from allantoin to urine.

-Vasily		Agree with editing this info. -AnupMinor but not unreasonable to edit this so it is not as confusing, agree with consideration of change as per Vasily.

-Matt		Prelim accept but NOT publishable erratatrue04/27/19 2:33 PMCharilaosChourpiliadisharishourp92@gmail.com
1137BiochemistryMolecularPurine salvage deficiencieshttps://reference.medscape.com/drug/elitek-rasburicase-342255#10 link2: https://www.researchgate.net/figure/Mechanism-of-action-rasburicase-and-allopurinol-Depicted-is-the-pathway-of-purine_fig1_11995629uric acid is the normal end of metabolism in human body. If rasburicase(urate oxidase) is taken as MEDICATION then it transform uric acid to allantoinMajor erratumI believe it is the same comment about the color of rasburicase, which should be black (drug) instead of green (enzyme). - Victor M.Agree with user. Humans do not have much activity of uricase and ASA and probencid do not have any effect on uricase or conversion of uric acid to allantoin. ASA and probencid affect the secretion of uric acid. The illustration needs to be changed to reflect this.
Ref: https://www.uptodate.com/contents/urate-balance?search=metabolism%20of%20uric%20acid&sectionRank=1&usage_type=default&anchor=H3&source=machineLearning&selectedTitle=1~150&display_rank=1#H3
Majed		Agree. We have already proposed a suggestion in annotate. -ACProposal already in place to remove both aspirin and probenecid from this diagram. This is therefore a duplicate.

-Matt		Reject by 2 authors + 1 editor05/13/19 11:33 AMElafMohamedElafmohamed38@gmail.com
1238BiochemistryMolecularDNA replicationMnemonic"2 'sides' to every 1 coin ['can']" hint for Etoposide/teniposide inhibit TOP II and irinotecan/topotecan inhibit TOP I. This can also be placed on page 434MnemonicReject. I agree with Anup. It is a complicated mnemonic to remember. -Victor MartinezVerifiedComplicated mnemonic for an already busy page. -AnupReject.

Agree with Anup and Victor.

-MA		Reject, I agree with Anup & Victor - JA01/09/19 7:30 AMNathanielBorochovnateboro8@gmail.com
1338BiochemistryMolecularDNA replicationMnemonicFlUORoquinolones inhibit TOP IV(4).MnemonicThe mnemonic is not bad. However, I feel that it is incomplete since TOP II is not included. - Victor MartinezVerifiedAgree with Victor. I think this page is already too busy as is. -AnupReject.

Agree with other authors.

-MA		01/12/19 8:15 AMMoatasemAl-Janabiassoomi88@yahoo.com
1438BiochemistryMolecularDNA replicationMnemonicTo remember that DNA Polymerase reads DNA 3’ to 5’ and DNA is synthesized 5’ to 3’ write out the words “reads” and “synthesized” but replace every letter “E” with the number “3” and every “S” with the number “5”. This works both for prokaryotic and eukaryotic DNA replication and synthesis. Clarifying image attached.MnemonicI don't like this suggestion. This mnemonic is not easy to remember. -Victor Martinez.VerifiedDefer to 2020. A suggestion, not errata. -AnupReject.

Not very good.

-MA		02/06/19 9:28 PMMatthew J.Christensenmattchristensen607@gmail.com
1538BiochemistryMolecularDNA replicationMneumonicDNA polymerase III (III, red color) proofreads with 3' (3, red color) --> 5' exonuclease. DNA I (I, red color) degrades RNA primer (prime, red color)MnemonicI don't feel that these numbers on red font will add extra value to the current information. -Victor Martinez.VerifiedReject.

Agree with Victor.

-MA		Not in favor of addition. -AC02/19/19 1:51 AMHeewonChoihxc326@case.edu
1638BiochemistryMolecularDNA replicationhttps://www.ncbi.nlm.nih.gov/pubmed/15137905Regarding Bloom Syndrome it would be better if add more information about it like it's autosomal recessive. clinical manifestations include : growth retardation, facial anomalies, photosensitive skin rash, and immunodeficiency.High-yield addition to next yearNot sure if this is HY for the Step exam. -AnupBloom is LY. Majed04/18/19 4:46 AMMuhanadShaibmohanad.shaib@gmail.com
1739BiochemistryMolecularMutations in DNAN/AIn the image provided for "Mutations in DNA", the silent mutation coding DNA (GAA) is the same as the mRNA codon (GAA). This would be a correct translation... not a silent mutation.Minor erratumReject. A silent mutation happens when there is a substitution of a single nucleotide. But, it codes for the same or original amino acid. GAG is the original sequence coding for Glu, GAA is the mutated sequence (G substituted for A) which also codes for Glu. So, the mutation is silent since the protein will have the same amino acid at the same position as if the nucleotide substitution never happened. - Victor MartinezVerifiedText is correct as is. No changes recommended. -VVReject by 2 authors + 1 editor02/16/19 3:53 PMDouglasMossdouglas.moss@my.rfums.org
1840BiochemistryMolecularDNA repairhttps://www.ncbi.nlm.nih.gov/pubmed/16238440Fanconi Anemia is given as example under "homologous recombination", it is actually an example of "Non-Homologous End Joining" repair mechanism.Minor erratumVerifiedThis was changed per faculty recommendation last year. Also, A quick pubmed search returns many results linking FA mostly to HR.
Example this recent review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5904331/


- MA		Agree, no changes to the text, as we have changed per faculty recs. -VVReject by 2 authors + 1 editor01/16/19 10:09 AMSaraKhandr.sarakhan7@gmail.com
1940BiochemistryMolecularDNA repairhttps://en.wikipedia.org/wiki/Non-homologous_end_joiningNHEJ is also defective in many forms of SCID.High-yield addition to next yearAgree. We could consider adding SCID as an example of NHEJ. "NHEJ deficiency confers (severe) combined immunodeficiency - (S)CID - due to a failure to carry out V(D)J recombination efficiently" https://www.ncbi.nlm.nih.gov/pubmed/24629483 -Victor MartinezVerifiedNot sure if this is HY. May need X-ref. -AnupReject.

There are more "classical" and more testable mechanisms of SCID that we cover elsewhere in the book.

-MA		01/20/19 7:06 PMCharlesde Leeuwdeleeuw.c@gmail.com
2041BiochemistryMolecularDNA replicationhttps://www.genscript.com/molecular-biology-glossary/12074/ATG-or-AUGThis submission is referring to a video associated with page 41 -- not an errata in the text. The title of the video / section is "Functional organization of a eukaryotic gene." I believe the error is spoken starting at time 1:09 -- "Also recall, the start codon is AUG when referring to DNA, and ATG when referring to RNA."Minor erratumWill be forwarded to Rx videos team.

-Matt		05/29/19 9:53 PMJessicaLijessicagli72@gmail.com
2141BiochemistryMolecularFunctional organization of a eukaryotic geneUworld Question #2033Poly-A tail is NOT AAAAAA its AAUAAAMinor erratumMay need faculty input. And would be HY info replacing current text. -ACThe tail depends on the type of signal. For DNA, it is AATAAA. For pre-mRNA, it is AAUAAA. For mature mRNA, it is AAAAAA as we show.

In short, we could add AAUAAA to the pre-mRNA line, but this is not critical. Moreover, there is already work in progress to modify this section that that the poly-A tail is not shown being the entire 3' end (as opposed to what our diagram shows now). All in all, based on this submission, no change is needed.

-Matt		Reject by 2 authors + 1 editor07/25/19 9:46 PMgevorggrigoryangevorgrigoryan@gmail.com
2241BiochemistryMolecularFunctional organization of a eukaryotic genehttps://easylifescienceworld.com/addition-of-3′-poly-a-tail-mrna-processing-in-eukaryotes/The graphic is inaccurate and highly confusing with its depiction of the addition of a poly-A tail. The way it is currently drawn makes it seem as if the polyadenylation signal – drawn as AATAAA on the coding strand – is itself transcribed into the poly-A tail, drawn on the mature mRNA as “AAAAAA.” Again, this is highly misleading and confusing. 1) On the graphic, clarify that pre-mRNA is the same as hnRNA, which is the term that you use everywhere else. 2) Draw the polyadenylation signal on the pre-mRNA strand as ‘AAUAAA’. The polyadenylation signal is specifically designed as being the 5’-AAUAAA-3’ sequence in the 3’UTR of the pre-mRNA which signals specific proteins to come and add the poly-A tail. The way it is currently drawn as being on the DNA is misleading, because the signal’s function is on the pre-mRNA. 3) The ‘mature RNA’ should show AAUAAA – since the signal is not excised – followed by a stretch of ~200 A’s. This is the biggest inaccuracy here – it really makes it seem like the poly A tail is just 7 adenine residues that were somehow directly transcribed from ‘AAUAAA’. Additionally, I think the graphic could be improved by drawing the 5’ cap as being more than just a blue terminal piece of the transcript. It would be much better to show it visually as a “7Me-G” linked by 3 “P”s to the 5’ end. Also, I think you should label “start codon” and “stop codon” on RNA, not the DNA. I’ve attached a really bad picture I drew to show how you could make the graphic better (with an artist more talented than me I hope).Major erratum11/24/19 9:28 PMRobShvartsrob.shvarts@gmail.com
2341BiochemistryMolecularProtein synthesisMnemonicThe directionality of protein synthesis proceeds from the amino (N) terminus to the carboxy (C) terminus. This can be remembered by “proteiNs are Created N → C terminus"MnemonicVerifiedThis seems familiar, maybe because it is mentioned in Kaplan videos? -AnupNot a fan to be honest. I don't think that this is important enough to have its own mnemonic.

-MA		03/01/19 8:43 AMMatthew J.Christensenmattchristensen607@gmail.com
2441BiochemistryMolecularRNA polymeraseshttps://www.ncbi.nlm.nih.gov/books/NBK22085/RNA polymerase 2 synthesizes 5' to 3'; it does not read 5' to 3'Major erratumReject. As I understand, this submission refers to "Functional organization of eukaryotic gene" fact. Confusion arises from the fact that we provide image of the coding strand, while it is the template strand that is actually transcribed.
-Vasily		Agree with Vasily. There is no erratum here. Just a slight misinterpretation on the part of the student in terms of what is being shown/actually influenced by the enzyme.

-Matt		Reject by 2 authors + 1 editor05/12/19 2:50 PMKinzaSultankinza.sultan@westernu.edu
2542BiochemistryMolecularRNA polymerasesIt's MnemonicActinomycin *D* (also known as *D*actinomycin) inhibits RNA polymerase in *D*ual (both) prokaryotes and eukaryotes.MnemonicI agree with Anup. It may be considered for the next edition. -Victor MartinezVerifiedCould be considered for 2020. -AnupReject.

What is the significance of knowing that it inhibits both enzymes?

-MA		01/12/19 9:13 AMMoatasemAl-Janabiassoomi88@yahoo.com
2642BiochemistryGeneticsSplicing of pre-mRNAmnemonic for existing material in bookGULAG - A mnemonic for the sequences at either end of an intron: FU at 3' end and AG at 5' end. The L stands for Lariat/Loop.MnemonicI am not inclined to agree or reject. However, according to google GULAG means "A system of labor camps maintained in the Soviet Union from 1930 to 1955 in which many people died". -Victor Martinez.VerifiedI would reject. Too many mnemonics. -AnupReject.

Agree with Anup.
MA		02/07/19 9:25 AMJoshuaMoranmoranjosh@live.com
2744BiochemistryMoleculartRNAhttps://www.ncbi.nlm.nih.gov/books/NBK6236/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848691/ ;and also UWorldIn the diagram explaining the structure of a tRNA, the acceptor stem is incorrectly labeled; it should include the whole length of the vertical 3' end attached to the T arm (so basically the CCA end is only part of the acceptor stem)Minor erratumThere are many diagrams and illustrations about this topic showing the stem in different ways. We need faculty input. - Victor M.VerifiedCould ask illustration team to look into it. -AnupAgree with Anup, reasonable to consider this year.

-Matt		Prelim accept but NOT publishable erratatrue03/08/19 6:45 PMHasanAlarourihassan.arouri@hotmail.com
2844BiochemistryMoleculartRNAhttps://en.wikipedia.org/wiki/D_arm#cite_note-hardt1993-1The D-arm is a portion of the tRNA molecule that acts as a recognition site for aminoacyl-tRNA synthetase; wording is unclear "D-arm detects the tRNA by aminoacyl-tRNA synthetase."Clarification to current textWe could change the text to read: "D-arm allows detection of the tRNA by aminoacyl-tRNA synthase."

-Vasily		OK to migrate over clarification for consideration in 2020.

-Matt		Prelim accept but NOT publishable erratatrue03/29/19 6:49 AMElanaMolchoelana.molcho@gmail.com
2945BiochemistryMoleculartRNATyping errorPage37says wobble codons differ in 3rd position.But in page44,in the figure below wobble is indicated in 1st position as tRNA is read from 5 to 3Minor erratum11/26/19 1:42 AMJavohirNazarovjavohir.nazarov.17@mail.ru
3046BiochemistryCellularCell cycle phaseshttps://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2443.1996.d01-234.xEPO is Non-receptor tyrosine kinase, while insulin, PDGF, EGF are receptor tyrosine kinase of the family tyrosine kinases.Minor erratumMany types of research and literature show EPO as a Janus Tyrosine kinase receptor (JAK). However, I agree with Anup, I think we need faculty input to be sure about this fact. -Victor Martinez.VerifiedThis article tends to suggest otherwise: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC49475/ . Needs expert review to determine if the user is correct or not. I found a bit of controversial info in these articles, so please kindly review. -AnupReject. The article mentions Tec, a non-receptor tyrosine kinase. However, there is no mention of EPO in the student's cited article. As pointed out by Anup, there are several articles that clearly establish that EPO is a receptor tyrosine kinase. No changes to the text. -VVReject by 2 authors + 1 editor02/06/19 7:26 AMahamdObeidatobeidat.amd@hotmail.com
3146BiochemistryCellularCell cycle phasesmnemonic, FA 19 p. 46*P*hosphorylated Rb allows cell cycle to *P*roceedMnemonicVerified05/07/19 6:00 PMElanBaskirebask003@fiu.edu
3246BiochemistryCellularCell cycle phaseshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC23451/hypophosphorylation (activation) of Rb should be hyperphosphorylation (activation) of RbMinor erratumReject. Hypophosphorylation induces the activation of Rb. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC137861/ - Victor MReject suggestion per Victor. -ACReject, Victor is correct, HYPOphosphorylation is the activating signal here. Text is correct as is, no change needed.

-Matt		Reject by 2 authors + 1 editor05/30/19 10:17 PMMohammed Sakil AhmedShahsakilshah1992@gmail.com
3346BiochemistryCellularCell cycle phasesnot neededCyclin-dependent kinases is Constitutive and inactive (in absence of cyclin)High-yield addition to next year08/06/19 2:02 PMRa'edAbabnehraedababneh@gmail.com
3446BiochemistryCellularCell cycle phasesSelf-writtenCDK's phosphorylate proteins like RB. When RB is phosphorylated is means it takes a phosphate, so it becomes heavy and can't do its normal function of stopping G1->S as it's now lazy and lets G1->S occur instead of stopping it.Mnemonic10/30/19 10:03 AMKhalidAlattarkhalid_alattar@hotmail.com
3546BiochemistryCellularRough endoplasmic reticulumaaaN-glycosylation occurs in the eNdoplasmic reticulum; O-glycosylation occurs in the gOlgi apparatusMnemonicVerifiedI like this mnemonic. I think we should add it.

-Vasily		03/02/19 3:34 AMElanaMolchoelana.molcho@gmail.com
3646BiochemistryCellularSmooth endoplasmic reticulumSelf-writtenSmooth Endoplasmic Reticulum (SER) - want's body to run SMOOTH so removes poisons and drugs. Makes Steroids for us to run smooth + has SMOOTH surfaces without ribosomes on it.Mnemonic10/30/19 10:06 AMKhalidAlattarkhalid_alattar@hotmail.com
3747BiochemistryCellularCell traffickinghttps://www.uniprot.org/locations/SL-0075COPI transports from Golgi -> Endoplasmic Reticulum (currently says from Golgi -> Golgi)Minor erratumAgree with Vivek and Vasily. The text states Golgi to Golgi since it is the retrograde type of transport. - Victor MartinezVerifiedReject. Agree with Vivek.

"The coat protein I (COPI) complex manages traffic from the Golgi back to the ER (retrograde transport), or between different compartments of the Golgi (intra-Golgi transport)."

https://www.sciencedirect.com/science/article/pii/S0960982215015055

-Vasily		I feel current text is correct as is as quoted below:

"vesicles with a COP I coat mainly transport proteins in the retrograde direction BETWEEN Golgi cisternae and from the cis-Golgi BACK to the rough ER."

Reference: https://www.ncbi.nlm.nih.gov/books/NBK21749/

- Vivek		Text correct as is. No change needed. -VVReject by 2 authors + 1 editor01/11/19 12:19 PMLaurenAllenlaurenallen76@gmail.com
3847BiochemistryCellularCell traffickingN/AI-cell disease: “I” is a part of the alphabet, so we start there. Ignoring A through E, we start with F to recall the clinical features of I-cell disease: Facial features coarse/ Gingival hyperplasia/ Hand deformity “claw”/ “I’s” (eyes) corneal clouding/ Joints/ Kyphoscoliosis/ Lysosomal enzymes ↑↑MnemonicVerified08/15/19 3:38 PMAndreiAllicockandreiallicock@gmail.com
3947BiochemistryCellularPeroxisomenot neededZellweger syndrome: Renee Zellweger has WEAK PEX (hypotonia; PEX gene mutation) and SEIZES (seizures) big livers (hepatomegaly); Refsum disease: ALPHA (alpha-oxidation disorder) males are PHYTAN A LOT (buildup of phytanic acid) because the REF's SON (Refsum) made the team but is CLUMSY (ataxia) and CAN'T SEE (cataracts/night blindness); Adrenoleukodystrophy: ß-A-L-D for ß-oxidationMnemonicI find this mnemonic a bit long. But, if the rest feels is useful, then it would be perfect for me. -Victor Martinez.VerifiedCould be considered for 2020. -AnupNot very good IMHO.

MA		01/02/19 2:06 PMNicholasYeisleynwygz4@mail.umkc.edu
4047BiochemistryCellularPeroxisomehttps://www.uptodate.com/contents/peroxisomal-disorders ,,,https://www.ncbi.nlm.nih.gov/books/NBK22240/we can use VLCFAS as mnemonic for zellweger syndrome , V--> vision problem , L --> liver enlargement, C --> copper high , F --> fe high , A --> abnormal muscle tone, S--> seizure,,,,,, we can also use PEX in PEroXisome for PEX geneMnemonicVerified08/31/19 8:23 AMMohamedMenofymohamed.a.menofy@gmail.com
4147BiochemistryCellularPeroxisome-ABCD gene ---> (A)drenoluekodystrophy, (B)-oxidation, (C)o long/so long chain fatty acid, DefectMnemonicVerified09/06/19 2:01 PMAhmad Y.Obeidatobeidat.amd@hotmail.com
4247BiochemistryCellularPeroxisomeMnemonicThe “βALD BOYS” are wearing VERY LONG CHAINS. With *A*DDED [Adrenals] *B*RAINS [Brain] and *B*RAWN [Testicles], [*C*omma/Coma] they’re *D*EADLIER [Death] than *1* I think this is a very good mnemonic because it’s short but written out it contains every single detail from the fact. It produces a good mental image, and it rhymes (sort of). I capitalized and put astericks around the parts that represent facts. “βALD” reminds us of the name of the disease and the deficient process (Adrenaleukodystrophy, β-oxidation). I took this part from another submission. “BOYS” reminds us that this is an X-linked disease. The bald boys wearing “VERY LONG CHAINS” reminds us that there’s a buildup of very long chain fatty acids (VLCFAs). “ADDED BRAINS and BRAWN” represents the adrenals, the brain, and the testicles – the affected organs. “,” is a COMMA and reminds us that COMA is a complication “DEADLIER” reminds us that death is a complication Finally, you’ll notice that I placed the astericks around the first letter of some of the clues to help remember the affected gene: ABCD1Mnemonic12/04/19 11:46 PMRobShvartsrob.shvarts@emory.edu
4348BiochemistryCellularCytoskeletal elementshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2064177/In 2006 a new systematic nomenclature for mammalian keratins was created, and the proteins previously called "cytokeratins" are simply called keratinsMinor erratum08/07/19 8:17 AMRa'edAbabnehraedababneh@gmail.com
4448BiochemistryCellularMicrotubulenature.com/subjects/dyneinTie-Dye is retro: Tie-Dye (dynein) in Retro(grade)MnemonicVerifiedI am personally not a big fan of this mnemonic, but I think we can migrate it, and see if the crowd likes it.

-Vasily		I like it better than what we have currently. Agree to migrate
-Kaitlyn		02/24/19 4:41 PMMyannaOlsenmyannaolsen@gmail.com
4548BiochemistryCellularMicrotubule inhibitorshttps://www.ncbi.nlm.nih.gov/pubmed/17986648"(Vin)cristine gets her tubes tied"Mnemonic11/24/19 3:49 PMKevinRiveraKevin.Rivera@tcu.edu
4649BiochemistryCellularSodium-potassium pumphttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2949520/The cardiac glycosides activate the Na+/Ca2+ exchanger which results in the exit of 3 Na+ ions and the entry of 1 Ca2+ ionMinor erratumVerifiedDigoxin MoA from UTD:

"Heart failure: Inhibition of the sodium/potassium ATPase pump in myocardial cells results in a transient increase of intracellular sodium, which in turn promotes calcium influx via the sodium-calcium exchange pump leading to increased contractility."

The wording really depends on the function of the Na/Ca exchanger.

If it can only move Ca outside of the cell and Na inside, then it is inhibited by high Na in the cell.

If it can move Ca inside the cell and Na outside of the cell, then it is activated by high Na in the cell.

I am pretty sure I saw it expained either way in a variety of qbanks. Whatever the exact function of the Na/Ca exchanger is, the end result is increased Ca inside the cell.

IMHO, UTD is a reliable enough resource, so it is worth migrating this suggestion to Annotate to continue the discussion.

-Vasily		Reject.


The cited article is discussing the mitochondrial Na-Ca exchanger. The Na-Ca exchanger present on the plasma membrane is inhibited by the increased intracellullar sodium. Our currect text is correct and accurate.

Ref: https://www.uptodate.com/contents/use-of-digoxin-in-heart-failure-with-reduced-ejection-fraction?sectionName=MECHANISM%20OF%20ACTION&search=digoxin&topicRef=1051&anchor=H2&source=see_link#H2

-MA		Seems controversial. Given the disagreement and nuance of this submission, will propose a migration with a high probability of expert review to ensure that we get things 100% right before making any changes to the text.

-Matt		Disagreement/need experttrue03/09/19 6:26 PMJeffreySackeysackeyjeff38@gmail.com
4749BiochemistryCellularSodium-potassium pumphttps://www.medscape.com/viewarticle/7858183 Na out(3 letters) , 2 K in (2 letters)MnemonicVerified08/31/19 8:29 AMMohamedMenofymohamed.a.menofy@gmail.com
4850BiochemistryCellularCollagenhttps://www.ncbi.nlm.nih.gov/pubmed/360747As Type 1 collagen is important for late wound repair, Type 3 collagen is also important for EARLY WOUND HEALINGClarification to current textAgree - Victor M.I think it is HY to contrast the roles of type III and type I collagen in wound repair.

It might be a good idea to change "granulation tissue" to "early wound repair".

We could also use bold font for words "early" and "late".

-Vasily		OK to migrate over to consider this for further debate.

-Matt		Prelim accept but NOT publishable erratatrue04/20/19 1:58 PMMuhanadShaibmohanad.shaib@gmail.com
4950BiochemistryCellularCollagen synthesis and structurenone neededHosts Give Partygoers Champagne at their SOIREE. Each of the four first words corresponds with the step in collagen synthesis that has an associated deficiency/syndrome. SOIREE corresponds with the first letter in the associated problem. Hosts (hydroxylation) Give (glycosylation) Partygoers (proteolytic processing) Champagne (cross-linking) at their SOIREE (scurvy, osteogenesis imperfecta, SKIP step 4 (R), Ehlers-Danlos, Ehlers-Danlos and Menkes)MnemonicIt is difficult to remember. - Victor M.VerifiedI personally do not like this suggestion. -AnupI don't get this at all. Agree it is not helpful
-Kaitlyn		03/10/19 6:23 PMNatalieJansenjansen7@uic.edu
5050BiochemistryCellularCollagen synthesis and structurehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093059/Clarify on the sentence: Glycine content best reflects collagen synthesis. For example, If i have two tissue samples, one of which is primarily made up of collagen (i.e, Bone or cartilage) and another one is devoid of collagen or containg negligible amount of collagen (i.e, synovial fluid). In this case, using glycine content reflects the amount of collagen present in these tissues. However, if i have two tissue samples, both made up of more or less collagen (let's say skin and ligaments). In this case, I can not use glycine to reflect the collagen amount present in these tissues as glycine though not abundant as much as in collagen, is still present in various other protiens such as elastin. Therefore, measuring glycine content could give me false results. In these cases, measuring hydroxylated proline (i.e, hydroxyproline) would be the best choice since it is very specific for collagen only.Clarification to current textI think this might be a valid clarification.

Currently we use the following wording: "Glycine content best reflects collagen synthesis (collagen is 1/3 glycine)".

It would be probably more accurate to say that "glycine's content in collagen (1/3) is less variable than that of lysine and proline".

And indeed, it seems that hydroxyproline, not glycine, is used by labs for collagen quantification, and we can mention this as well if deemed HY by the crowd.

-Vasily		Seems like a reasonable clarification, appreciate the detailed submission and critique. We can migrate over for 2020 consideration.

-Matt		Prelim accept but NOT publishable erratatrue03/17/19 8:21 AMKetanDaymaketandayma77@gmail.com
5150BiochemistryCellularCollagen synthesis and structureNAVitamin C deficiency leads to a problem with Hydrox"C"lation.MnemonicVerifiedNot a big fan of this mnemonic, but let's discuss with the crowd.

-Vasily		Not a fan either. Wouldn't be helpful IMO. -AC03/17/19 4:52 PMMazalHaglermbrakha72@gmail.com
5250BiochemistryCellularCollagen synthesis and structureself-madeI have created a helpful mnemonic for memorizing that lysine is involved in the collagen cross-linking process. "Do not lie or you will be cross-examined."MnemonicVerified05/21/19 9:13 AMBriannaOlamijubrianna.olamiju@yale.edu
5350BiochemistryCellularCollagen synthesis and structurenot needed"formation of procollagen to hydrogen and disulfide bonds " is better to be mentioned as independent stepClarification to current text08/07/19 2:34 PMRaedAbabehraedababneh@gmail.com
5450BiochemistryCellularCollagen synthesis and structurehttps://www.ncbi.nlm.nih.gov/books/NBK21582/I think the steps describing collagen synthesis are a little bit oversimplified, and it would actually be more clear to elaborate a bit. Firstly, it should be clear that "preprocollagen" refers to the alpha chains while they are undergoing translation in the cytosol but before they are translocated to the RER. Once in the RER, they are called "pro alpha chains." Second, "glycosylation of proline residues" should be its own step, and should not include the addition of disulfide bonds to form the triple helix. You should add a new step between step 3 and 4 that clarifies the stabilization of the triple helix with disulfide bridges. Each helical pro alpha chain is flanked at both ends (termini) by a globular “propeptide” – the disulfide bonds between the propeptides of 3 chains is what forms the triple helix. It would be a helpful addition to the graphic to draw these propeptides as circles at the termini of the chains and procollagen. In Step 5, it would be helpful to clarify that the “disulfide-rich terminal regions” are the same propeptides that were added in step 3. Now in the extracellular space, removing the propeptides causes the tropocollagen to be far less soluble, allowing the molecules to self assemble into fibrils for cross linking by lysyl oxidase in step 6. In step 5 for the graphic, add little circles representing the propeptides to the cleaved C- and N- terminals. Lastly, in step 6 of the graphic it is more accurate to call the final product a “fibril” than a “fiber.” A fiber is the collection of thousands of fibrils, each 50nm in diameter.High-yield addition to next year11/24/19 8:32 PMRobShvartsrob.shvarts@emory.edu
5551BiochemistryCellularEhlers-Danlos syndromehttps://www.ncbi.nlm.nih.gov/books/NBK21582/In describing the various types of Ehlers-Danlos Syndrome, the current text reads: "Hypermobility type (joint instability): most common type." It then starts a new line (as if introducing a completely distinct fact) and says "Classical type (joint and skin symptoms)". The next new line IS a distinct fact, describing a distinct type. The way that it's currently written really makes it seem like "Hypermobility type" and "Classical type" are different, but I believe they are exactly the same.Clarification to current text11/24/19 8:35 PMRobShvartsrob.shvarts@emory.edu
5651BiochemistryCellularMenkes diseaseIt's MnemonicMenkes protein (ATP7A ,vs ATP7B in Wilson) --->M precedes W and A precedes B alphabetically ,so " Menkes =ATP7A ,,Wilson =ATP7B".MnemonicThe mnemonic should reduce the cognitive load and this particular one is a bit difficult to remember. -Victor MartinezVerifiedToo complex for a mnemonic. Would be wasting time learning the mnemonic. -AnupAgree this is not helpful
-Kaitlyn		01/12/19 9:36 AMMoatasemAl-Janabiassoomi88@yahoo.com
5751BiochemistryCellularMenkes diseasenot requiredPlease see attachment: W=copper goes up, M=copper goes downMnemonicAgree, I think it is a good mnemonic. We should add it to the next edition. -Victor Martinez.VerifiedLet's consider for 2020. I think the mnemonic is quite good.
-Vasily		Agree with addition. -Anup02/04/19 10:06 PMJoshuaLadellajosh.ladella@gmail.com
5851BiochemistryCellularMenkes diseaseDoesn't need one (just a mnemonic)Tip for remembering ATP7A (Menkes Disease) v. ATP7B (Wilson's Disease): The B stands for Bronze, whose main ingredient is CopperMnemonicVerified07/10/19 4:08 PMJohnMitchelljohnpmit@uab.edu
5951BiochemistryCellularMenkes diseaseN/AATP7A --> A for absorption. Contrast with Wilson disease, ATP7B --> B for bile.MnemonicVerified09/06/19 9:13 PMChristopherYangchristopher.yang@northwestern.edu
6051BiochemistryCellularMenkes diseaseSelf-producedATP7A & ATP7B are both defects in copper processing with Menkes Disease and Wilsons Disease. 'M' in 'Menkes' comes before 'W' of 'Wilsons' in alphabet, therefore ATP7'A' Defect is due to Menkes, later 'B' is for Wilsons. Also, Menkes is due to defective copper 'A'bsorption and Wilsons due to defect excretion into 'B'ile.Mnemonic10/27/19 5:20 AMKhalidAlattarkhalid_alattar@hotmail.com
6152BiochemistryCellularElastinMneuomnicPeople with Marfans are so tall you have to look up to see them. Thus the subluxation of the lens is upward (and temporal)MnemonicVerified05/10/19 5:07 PMSofiaChinchillachinchsa@mail.uc.edu
6252BiochemistryCellularElastinmnemonicMarfan syndrome lens subluxation is upward: look up to see Mars vs homocysteinuria lens subluxation which is downward: look down to see urineMnemonicVerified07/23/19 6:30 AMMohammedKamareddineMohammed.kamareddine@gmail.com
6355BiochemistryLaboratory TechniquesFluorescence in situ hybridizationN/ASecond to last line states "(two blue arrows...)" but the arrows are not blue. Irrelevant wording.Spelling/formattingReject. There are two blue arrows on top of chromosome 8 showing duplication of the stated chromosome in the image. Therefore, the wording is correct. -Victor MartinezVerifiedReject. Agree with Victor.
-Vasily		Agree with rejection. -Anup01/22/19 9:22 PMAudreyHuntahunt01@nyit.edu
6455BiochemistryGeneticsMolecular cloningWebster-Miriam DictionaryStep two should say Add "reverse" transcriptase, not Add "reserve" transcriptaseSpelling/formattingReject, the current wording is appropriate " Add REVERSE transcriptase..." There is not "reserve" on step 2 (molecular cloning). - Victor MartinezVerifiedAgree with rejection. -AnupAgree with rejection.

-Vasily		02/14/19 3:06 AMZevAllisonzev.allison@gmail.com
6556BiochemistryGeneticsGenetic termshttps://www.uptodate.com/contents/li-fraumeni-syndrome?search=li%20fraumeni&source=search_result&selectedTitle=1~40&usage_type=default&display_rank=1Li-Fraumenia syndrome is listed as an example of loss of heterozygosity but more often functions as a dominant negative mutation as having one mutant allele creates 1/16th functional proteins in the final tetramer.Minor erratumReject. Li Fraumeni syndrome is linked to loss of heterozygosity and dominant negative mutations of p53. Therefore, current entry is accurate. -Victor MartinezVerifiedReject.

Cancer development in LFS can be due to both functional (dominant-negative mutations) or strcutural (loss of heterozygosity) loss of wild-type p53. Even the linked UTD article supports this.

Additional ref:
https://www.ncbi.nlm.nih.gov/pubmed/9047394
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135649/

- MA		Agree, the text is fine as is per MA. Additionally LFS is just listed as an example. -VVReject by 2 authors + 1 editor01/08/19 10:02 AMBrianBlankenshipb_blank@icloud.com
6657BiochemistryGeneticsGenetic termswww.Uworld.comHeteroplasmy definition: It says ".....resulting in variable expression in mitochondrially inherited disease"............. UWorld says "Variable Expression is not a feature of Mitochondrial diseases" in QID: 596 Choice D, last line.Major erratumReject. I agree with Vasily, the concentration of mutated mitochondrial DNA in the cell determines the variability of expression of clinical manifestation or the phenotype. "...Most mtDNA mutations are found in heteroplasmy, in which the proportion of mutant vs. wild-type species is believed to explain some of the observed high phenotypic heterogeneity..." https://www.ncbi.nlm.nih.gov/pubmed/17999439 If it is a matter of confusion we could add a small illustration of 3 cells showing different mutated Mt-DNA concentrations with variable phenotypes similar to the one provided in the following link. https://www.nature.com/articles/nrdp201680 - Victor MartinezVerifiedThank you for your comment and supporting image. I am inclined to reject.

Unfortunately, at present I have no access to UW to check the reference and better understand the context of the quote from UW. However, after some Internet search I have found the following.

1. "The expression of mitochondrial diseases is variable; a single cell may receive a uniform collection of mtDNA (homoplasmy) or a mixture of mutant and wild-type mtDNA (heteroplasmy). The proportion of mutant mtDNA molecules determines the penetrance and severity of expression."
Source: https://www.researchgate.net/figure/Mitochondrial-homoplasmy-and-heteroplasmy-The-expression-of-mitochondrial-diseases-is_fig3_328639320

2. "For individuals born with partial mitochondrial dysfunction, the accumulation of mtDNA mutations and mitochondrial damage could account for the delayed onset and progressive course of their diseases. The stochastic nature of this process could also explain variable expressivity and/or penetrance of disease."
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809581/

3. While the nuclear genome is diploid, harboring only two homologous copies of each chromosome (one from the father and one from the mother), the mitochondrial genome is polyploid, containing 1 to 10 identical molecules of mitochondrial DNA within its matrix. This variable copy number, combined with the variable number of mitochondria in each cell, has important implications for the phenotypic expression of a mutation. (See 'Heteroplasmy' below.)"
Source: https://www.uptodate.com/contents/mitochondrial-structure-function-and-genetics?search=heteroplasmy&sectionRank=1&usage_type=default&anchor=H8&source=machineLearning&selectedTitle=1~9&display_rank=1#H9

Three different sources suggest that variable expression (expressivity) is a feature of mitochondrial diseases. Therefore, I am strongly inclined to reject.

Here is my take on why UW says that variable expressivity is not characteristic of mitochondrial diseases. According to the image attached by the reader, variable expressivity is all about the same disease having different clinical manifestations in different people (i.e. different organ systems involved). However, other sources (UTD, see link below) define variable expressivity as variable disease severity. It is probably this difference in defining variable expression that might cause the confusion.
https://www.uptodate.com/contents/inheritance-patterns-of-monogenic-disorders-mendelian-and-non-mendelian?search=variable%20expression&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H3091344985

-Vasily		I suggest changing "variable expression" to "variation in disease severity". This applies to pages 57 (heteroplasmy) and 59 (mitochondiral inheritance).

- MA		I would really appreciate faculty input as to whether our current wording is correct. As far as I understand based on my reading, mitochondrial disease is associated with variable expressivity and penetrance depending upon the percentage of affected mitochondria. -VVDisagreement/need expertJeff HofmannThe authors and editors are correct and the student is wrong. No change is needed. UWorld is not a real source.Howard SteinmanI'm not clear about what's being debated. I've not seen the terms "incomplete penetrance" and "variable expressivity" used in reference to inheritance of mitochondrial-encoded genes. Yes, they are used routinely in reference to autosomal dominant inheritance of nuclear-encoded genes. The relevant terms for mitochondrial-encoded genes are: "heteroplasmy", "polyplasmy" and "threshold effect". "Variable expression" where, e.g. environmental factors influence the degree of expression of a gene, isn't applied to mitochondrial-encoded genes. You get different levels of expression in different cells because (as noted above) you have -1- different numbers of mitochondrial genomes in each cell and -2- different percentages of wild type and mutant genome in each cell. My bottom line is: don't use variable expression when referring to genes encoded by mitochondrial DNA.Reject01/12/19 9:06 PMSaraKhandr.sarakhan7@gmail.com
6757BiochemistryGeneticsMutations in DNAN/AMcCune-Albright Syndrome =3 "P"s: "P" recocious puberty, "P"igmentation, "P"olyostotic fibrous dysplasiaMnemonicThis mnemonic is great. McCune-Albright syndrome is commonly tested, we should consider it for the next edition. -Victor Martinez.VerifiedDefer to 2020. -AnupThis is great if you can remember the letter P. We need to tie that in to the eponym somehow?
-Kaitlyn		01/28/19 4:50 PMYoseliVenturayoseli.ventura14@gmail.com
6858BiochemistryGeneticsDisorders of imprintingMneumonicAngelMan has no Mama. The M in AngelMan helps think of deletion in the allele of the Mother VMnemonicIt is a good idea because since the mnemonic is similar to the one use for Prader-Willi syndrome, "Prader has no Papa (Paternal deletion)." -Victor Martinez.VerifiedDefer to 2020. -AnupI always remembered it as angleMAN because only the MANs DNA is present. I prefer my way
-Kaitlyn		01/24/19 12:13 PMHanaAslamdr.hanaaslam@gmail.com
6958BiochemistryGeneticsTypes of errors in morphogenesisFA2019Mnemonic for AngelMan syndrome: "Mom’s little Angel (Maternal deletion)". The M's are red/boldMnemonicVerified05/22/19 8:53 AMEirikKragereirik.krager@outlook.com
7059BiochemistryGeneticsFragile X syndromeFact Sheet 54| FRAGILE X SYNDROME This fact sheet ... PDFwww.genetics.edu.au › fact-sheet-54-frag...According to Harrison'' Principles of Internal Medicine -20th edition page 3363, Fragile X syndrome is classified as X linked Recessive, Robbins Pathology latest edition also says it as X linked Recessive. Wikipedia says XD but both these books says XR. I am not sure about the errorMinor erratumVerifiedI think we had a discussion on this matter. There are 2 links to support First Aid: https://ghr.nlm.nih.gov/condition/fragile-x-syndrome#inheritance https://rarediseases.info.nih.gov/diseases/6464/fragile-x-syndrome -AnupPer OMIM, Fragile X is x-linked dominant. OMIM is a very reputable site where most geneticists reference. No recommendations to change the text. -VV https://www.omim.org/entry/300624?search=fragile%20x-associated&highlight=x%20fragile%20associated%20xassociatedReject by 2 authors + 1 editor02/07/19 7:15 AMAnkurBhootbhootankur@gmail.com
7159BiochemistryGeneticsModes of inheritancehttps://www.uptodate.com/contents/mitochondrial-myopathies-clinical-features-and-diagnosis?search=gomori&source=search_result&selectedTitle=2~20&usage_type=default&display_rank=2Better classification of Mitocondrial diseases: add Kearns-Sayre syndrome (KSS) and Leigh syndrome, and also the stain often used for diagnosis : GOMORI THRICOME STAINHigh-yield addition to next yearI wouldn't add Kearns-Sayre syndrome and Leigh syndrome to the next edition. I don't believe these are HY. -Victor Martinez.VerifiedCan have X-ref opinion for HY/LY. -AnupI think these are HY but we don't have much room to include them. Also agree that Gomori is HY but again we don't have much room. I guess we could add the stain to the middle column of the table and just add the syndromes under the list for mitochondrial myopathies.
-Kaitlyn		02/18/19 10:50 PMLissetteOrozcolissetteorozco_004@hotmail.com
7259BiochemistryGeneticsModes of inheritancehttps://www.uptodate.com/contents/inheritance-patterns-of-monogenic-disorders-mendelian-and-non-mendelian?search=autosomal%20recessive&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Both autosomal recessive and x-linked recessive inheritance skips generations: ''RECEssive (autosomal and x-linked) inheritance takes a RECEss from family (no past family history of the disease)''.MnemonicVerified07/29/19 4:05 PMFranciscoDuenasfrancisco.duenasmd@gmail.com
7359BiochemistryGeneticsModes of inheritancehttps://emedicine.medscape.com/article/922305-overviewX-Linked Dominant diseases: A-mericas F-unniest X V-ideos (A: Alport , F: Fragile X , V: Vitamin D resistant rickets)MnemonicVerified09/01/19 8:37 PMAngeloPiazzaangelopiazzaortiz@gmail.com
7460BiochemistryGeneticsCystic fibrosishttps://www.drugbank.ca/drugs/DB08820Indication for Ivacaftor - not approved for patients with a Phe508 deletion UNLESS it's given in combination with lumacaftor. Indicated as monotherapy for other CF mutations, most notably, G551D, where the number of CFTRs is fine, but they just don't open enough.Clarification to current textReject, the text states that it must be used in combination with lumacaftor. Current edition " In patients with Phe508 deletion: a combination of lumacaftor (corrects misfolded proteins and improves their transport to the surface) and ivacaftor..." - Victor MartinezVerifiedNot clear from the student's comment, but as far I understand we had correctly and clearly stated that in patients with Phe508 deletions ivacaftor is given in combination with lumacaftor. We are nowhere metioning that ivacaftor should be used as a monotherapy with Phe508 deletions.

- Vivek		Agree with Vivek and Victor. Reject.

-MA		Agree with authors. No change to the text. -VVReject by 2 authors + 1 editor12/27/18 7:39 PMElizabethTsuielizabeth.tsui21@gmail.com
7560BiochemistryGeneticsCystic fibrosisFound on update here: https://www.uptodate.com/contents/cystic-fibrosis-assessment-and-management-of-pancreatic-insufficiency?search=cystic%20fibrosis%20treatment&source=search_result&selectedTitle=6~150&usage_type=default&display_rank=6#H9 and tested on in multiple UWorld questionsTreatment for Cystic Fibrosis includes pancreatic enzyme replacement therapy (PERT) to correct for pancreatic insufficiency.High-yield addition to next yearAgree, we should review this fact so we can include it in the next edition. It is highly tested on step 1 and step 2 CK. -Victor Martinez.VerifiedAgree that this is a HY topic. Can be added in 2020. Needs faculty/expert opinion and x-ref team review. -AnupAgree.
-Kaitlyn		true01/30/19 6:14 AMNathanielBorochovnateboro8@gmail.com
7660BiochemistryGeneticsCystic fibrosissimple illustration attached"defect in CFTR gene on chromosome 7"; Write CFTR as "C7TF" (where 7 is a laterally inverted image of F)MnemonicVerifiedToo confusing. Would opt to reject. -AnupToo difficult to explain in limited space. Reject.
-Kaitlyn		03/02/19 6:07 PMM MarwanDabbaghdr.dabbagh@outlook.com
7760BiochemistryGeneticsCystic fibrosishttps://www.fda.gov/news-events/press-announcements/fda-approves-new-breakthrough-therapy-cystic-fibrosisThere is a new breakthrough treatment for cystic fibrosis which was approved by the FDA. It is called Trikafta (elexacaftor/ivacaftor/tezacaftor) and its mechanism of action is by enhancing the function of the CFTR protein. It is approved for use in CF patients with a F508del mutation, which is present in 90% of CF patients. The previous iteration (presently in First Aid) named lumacaftor requires that the patient be homozygous for this mutation, while the current FDA guidelines say that the patient only needs some of their transport proteins to have this mutation.High-yield addition to next year10/21/19 8:01 PMJamesBlumlinejmblumli@oakland.edu
7861BiochemistryGeneticsMuscular dystrophieshttps://www.ncbi.nlm.nih.gov/pubmed/25348330book says that duchenne muscular dystrophy has truncated protein when in fact it should be beckersMajor erratumThe wording is correct. Duchenne displays truncated dystrophin. https://df6sxcketz7bb.cloudfront.net/manuscripts/95000/95918/jci.insight.95918.v1.pdf - Victor M.Both disorders can do this. We show the most common patterns. The student's link is for variants that produce truncated proteins. Long story short, no erratum, no change needed, because what we show is what we consider to be the most common/most high-yield.

-Matt		Reject by 2 authors + 1 editor05/16/19 10:08 AMManjilBasnetbasnetmanjil@gmail.com
7962BiochemistryGeneticsFragile X syndromeSelf-writtenFragile X Syndrome - patient/child with FRAGILE brain (intellectual disability), fragile large testes (macroorchidism), fragile large face, ears (long face, large ears)Mnemonic10/30/19 10:13 AMKhalidAlattarkhalid_alattar@hotmail.com
8062BiochemistryGeneticsRett syndromemnemonic from my brainStereotyped hand-wringing (Rett-ers cramp)MnemonicThis mnemonic does not help to decrease cognitive load. I wouldn't consider it for the next edition. -Victor Martinez.VerifiedNot sure if I would refer to this one. -AnupIgnores other key features of Rett syndrome. Reject.
-Kaitlyn		01/19/19 10:06 AMSabrinaSwogersabrina.swoger@gmail.com
8162BiochemistryGeneticsTrinucleotide repeat expansion diseaseshttps://emedicine.medscape.com/article/943776-overview#a1Fragile X is an X-linked recessive disorder according to Harrisons for Internal Medicine. In the 2019 version of first aid it states it is x linked dominant. If it was dominant you would not see carriers but there are carriers present.Major erratumReject.

The link provided by the reader says: "The pattern of inheritance most closely resembles X-linked dominance with variable penetrance". Other sources also say that Fragile X is X-linked dominant, eg:

https://rarediseases.org/rare-diseases/fragile-x-syndrome/

-Vasily		Agree with Vasily. This is an X-linked dominant disorder. The variable penetrance is accurate and may explain the "carrier" state. No change needed.

-Matt		Reject by 2 authors + 1 editor06/18/19 9:22 AMFarinaKhanfarinak08@gmail.com
8263BiochemistryGeneticsAutosomal trisomiesGenetics: Glossary of terms - UpToDateNondisjunction in meiosis illustration: Replacing the words "Trisomy" with "Heterodisomy" and "Isodisomy" as specified in the attachment.Minor erratumDespite heterodisomy and isodisomy are correct terms. We don't mention them in the text and I don't think these are HY enough to be clarified on current illustration. Reject. -Victor Martinez.VerifiedReject.

Current illustration is correct. They are All trisomies and the terms/distinction suggested by the user are LY for step1 and we don't discuss them in the text.

-MA		I agree with Victor and Majed.

Reject.

- Vivek		Agree, not in favor of adding heterodisomy or isodisomy, as they are pretty LY for purposes of Step 1. No changes. -VVReject by 2 authors + 1 editor01/02/19 12:41 PMBahaa' eddineSuccarBahaasuccar@gmail.com
8363BiochemistryGeneticsAutosomal trisomieshttps://www.ncbi.nlm.nih.gov/pubmed/25412855<2% of cases of Down Syndrome are due to mosaicism.High-yield addition to next yearI think we need faculty input regarding this comment since there are many available studies and sources showing different percentages of cases due to mosaicism. However, technically not an error. -Victor Martinez.VerifiedI think this is quite LY for Step 1, especially the percentages. However, this is not an errata and can be considered for 2020.. -Anup01/25/19 6:24 PMAriyaMobarakiariyamo@gmail.com
8463BiochemistryGeneticsAutosomal trisomieshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1684265/. Also UWorld question 8328please add that the majority of cases of Down syndrome result from nondisjunction in Meiosis I specificallyHigh-yield addition to next yearI agree we should add this. - Victor M.Agree. This fact is also emphasized in UW.

-Vasily		03/16/19 6:40 PMAnnaPriddypriddyanna@gmail.com
8563BiochemistryGeneticsAutosomal trisomiesUsmle World question ID 1824 , (choices C and E) explanationsMyelomeningocele is also associated with Edward Syndrome (Trisomy 18)Clarification to current textReject. I don't think this association is HY enough. -Victor M.Inclined to reject.

There is often a long list of conditions associated with inborn syndromes. How many symptoms should we list before we decide it is enough? I think in such cases it is better not to overload the text with detail and list only the most HY manifestations (especially those that are known to be tested and fit well into a mnemonic).

"In trisomy 18 the features may include agenesis of the corpus callosum, meningomyelocele, ventriculomegaly, chorioid plexus cysts, posterior fossa anomalies, cleft lip and palate, micrognathia, low-set ears, microphtalmia, hypertelorism, short radial ray, clenched hands with overriding index fingers, club or rocker bottom feet, omphalocele, diaphragmatic hernia, renal anomalies, cardiac defects, SUA, polyhydramnios, nuchal thickening or hygroma and cryptorchidism".

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286865/		Can migrate over for consideration of addition to the Edward syndrome entry.

-Matt		Prelim accept but NOT publishable erratatrue04/23/19 8:43 AMMuhanadShaibmohanad.shaib@gmail.com
8663BiochemistryGeneticsAutosomal trisomieshttps://emedicine.medscape.com/article/943463-clinical#b4In Trisomy 18, the image is not accurate since the patients have "clenched hands with the index finger overriding the middle finger and the fifth finger overriding the fourth finger "Minor erratum"Many infants with trisomy 18 syndrome also have characteristic malformations of the hands and feet. The hands are typically clenched, with overlapping of the index finger (second finger) over the third finger and the “pinky” (fifth finger) over the fourth." https://rarediseases.org/rare-diseases/trisomy-18-syndrome/ We should review this image - Victor M.I agree. Most questions I remember describe the clenched fists as suggested by the student.

-Vasily		Agree with authors. And thank you, Victor, for migrating. I will accept for credit. Due to time constraints and review with Jordan, it looks like this will be deferred to 2021.

I would not call this critical and in need of inclusion in the official errata, as knowing that the fists are clenched is likely most of what you need to know at the Step 1 level.

-Matt		Prelim accept but NOT publishable errata07/20/19 5:04 AMRa'edAbabnehraedababneh@gmail.com
8763BiochemistryGeneticsAutosomal trisomieshttps://www.mayoclinic.org/tests-procedures/quad-screen/about/pac-20394911mnemonic for quad screen test in down (see file attachment)MnemonicVerified08/31/19 8:47 AMMohamedMenofymohamed.a.menofy@gmail.com
8863BiochemistryGeneticsAutosomal trisomiesSelf-written1st & 2nd Trimester Screening - PRINCE Edward (trisomy 18) makes everyone KNEEL DOWN before him! (All screening levels are LOW/DOWN)Mnemonic10/30/19 10:18 AMKhalidAlattarkhalid_alattar@hotmail.com
8963BiochemistryPathologyGenetic termsUworld"DITCH" down syndrome for all the GI abnormalities listed in Uworld for trisomy 21 (D)Deuodenal atresia (most common) (I)Imperforate anus, (T)Transeophageal fistula ,(C)Celiacs Disease, (H)Hischsprungs diseaseMnemonicI like this mnemonic. Unfortunately, it does not list all the clinical manifestations or diseases related to Down syndrome. But, we could consider it for the next edition. -Victor Martinez.VerifiedDefer to 2020. A suggestion, not errata. -AnupWe don't discuss all of these and we discuss others. I don't think it is helpful since it does not include the cardiac and phenotypic signs.
-Kaitlyn		02/06/19 4:23 PMAshtonJacksongrace.v.gilbert@gmail.com
9064BiochemistryGeneticsCri-du-chat syndromeIt's Mnemonic*Cri du* - CHat =*5 letters * - CHromosome 5MnemonicI don't understand the mnemonic. CHat = 4 letters, not 5 letters. Therefore it does not correlate with chromosome 5 where the genetic disorder is present. -Victor Martinez.VerifiedAgree with Victor. Would reject suggestion. -AnupAgree to reject
-Kaitlyn		01/11/19 11:58 AMMoatasemAl-Janabiassoomi88@yahoo.com
9164BiochemistryGeneticsCri-du-chat syndromemnemonicCats are born with closed eyes (think epicanthal folds), have so cute paws like 5 fingers (think chromosome 5), your heart melts (VSD)MnemonicVerifiedThis mnemonic would not serve its purpose, and would just make the reader even more confused. Would prefer to reject suggestion. -AnupThis is "sketchy" style mnemonic that does not fit our style. Agree with anup to reject.
-Kaitlyn		03/02/19 6:17 PMM MarwanDabbaghdr.dabbagh@outlook.com
9264BiochemistryGeneticsGenetic disorders by chromosomeMnemonicChromosome 3: Von-Hippel-Lindau Gene, associated with Renal Cell Carcinoma -Both VHL and RCC have 3 letters Chromosome 5: Familial Adenomatous Polyposis (FAP) -APC gene mutation Read as: "Five-APC" or "FAPC" Chromosome 6: Hemochromatosis - associated w/ HLA A3 Read as: "HA3mochromatoSIX" Chromosome 11: Wilms tumor -Read as "W11ms tumor" Chromosome 13: Wilson Disease -Wilson Disease has 13 letters in total (same with Patau Syndrome, chromosome 13)MnemonicVerifiedVHL and RCC mnemonics are already mentioned in Neuro and Renal chapters.

FAPC is not bad, but pretty difficult explain concisely in writing.

Personally I am not a big fan of the HA3mochromatoSIX mnemonic, but we can ask GI team if they would like to use it.

Wilms tumor, Wilson disease and Patau - not a big fan.

-Vasily		03/15/19 4:53 PMChiaHsuchia.hsu@ttuhsc.edu
9364BiochemistryGeneticsWilliams syndromeIt’s just a movie quote mnemonic but helpful to remember the chromosome.Current mnemonic says “think Will Ferrell in Elf”. You can add the chromosome to the mnemonic by adding his famous line “First, I went through the 7 levels of the candy cane forrest.” For chromosome 7.MnemonicVerifiedThis mnemonic would not work for me, but I am okay with migrating to Annotate for further discussion if other authors feel like it.

Otherwise, reject.

-Vasily		05/02/19 11:51 AMGregoryMotzkusgregmotzkus@gmail.com
9465BiochemistryNutritionVitamins: water solubleMy brainProposed mnemonic for sorting B vitamins in order. TRN-PPB-FC "The RN - Placed Patient Bobs - Foley Catheter" Where there is a dash, the number skips. This covered B1-12 in order. I made this and have found it useful to keep the numbers straight with the names of the B vitamins.MnemonicI don't find this mnemonic easy to memorize. However, if other authors think it is useful we could consider it for the next edition. -Victor MartinezVerifiedAgree with Victor. Would reject suggestion. -AnupI like this for a biochem course but I don't think Step 1 commonly tests converting from a vitamins B# to its name so I agree to reject.
-Kaitlyn		01/05/19 12:56 PMChristopherTiptoncattk8@health.missouri.edu
9565BiochemistryNutritionVitamins: water solublehttps://reference.medscape.com/drugs/vitamins-water-solubleThierry (Thiamin) Robben (Riboflavin) aNd (Niacin) Petr (Pentothenic) Played (Pyridoxine) Ball (Biotin) For (Folate) Chelsea (Cobalamin)MnemonicVerified05/15/19 4:37 AMCharilaosChourpiliadisharishourp92@gmail.com
9666BiochemistryNutritionVitamin AMnemonicChronic toxicity from PHAAD diets: pseudotumor cerebri, hepatoxicity/megaly, alopecia, arthralgias, dry skinMnemonicVerifiedI think this mnemonic is worth migrating to discuss it with the crowd.

-Vasily		03/15/19 5:37 PMJasonTegethoffTegethoffjason@gmail.com
9766BiochemistryNutritionVitamin B1N/A"ATP BReakdown" for the four enzymes. Combination of 2018 and 2019 since Be APT is awkward. A=Alpha-ketoglutarate, T=Transketolase, P=Pyruvate, BR=BRanched-chain ketoacid (also reminds you of glucose BReakdown). All together reminds you that it is a loss of ATP due to impaired glucose breakdown.MnemonicI do like the mnemonic. I think we can take it into consideration for the next edition. -Victor MartinezVerifiedCan be put up for discussion in 1st pass. -AnupAgree. Easier to remember than what we have.
-Kaitlyn		01/23/19 5:36 PMAudreyHuntahunt01@nyit.edu
9866BiochemistryNutritionVitamin B1https://www.uptodate.com/contents/wernicke-encephalopathyif malnourishment is predispose, give thiamine before glucoseMnemonic12/04/19 1:25 PMObaidaSafiooobbbooo@outlook.sa
9967BiochemistryNutritionVitamin B3https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-gout?search=podagra&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2Podagra is not an excess of vitamin B3. Podagra is a manifestation of gout, literally meaning "painful toe." The book implies that an excess of B3 is called podagra, in parallel to how a deficiency of B3 causes pellagra. Rather, an excess of B3 can increase the risk of podagra (gout).Clarification to current textReject, we use arrows throughout the test to imply the consequence of a process or pathology. It does not mean synonym. Besides, the entry states that hyperuricemia is one of the clinical manifestations of vitamin B3 excess. Therefore, patients with this toxicity can display podagra. - Victor Martinez.VerifiedAgree with Victor's comment.
Reject

MA		Reject. Agree with Victor and MA.

-Vasily		No changes to the text. -VVReject by 2 authors + 1 editor12/24/18 1:41 PMDavidNwachukwudnjrocks@gmail.com
10067BiochemistryNutritionVitamin B3https://www-uptodate-com.library.iau.edu.sa/contents/overview-of-water-soluble-vitamins?search=vitamin%20b3%20b6%20and%20b2&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Vitamin B3 synthesis requires B6 and B2. 6 divided by 2 gives you 3MnemonicVerifiedDuplicated mnemonic. -AC05/08/19 6:02 PMAbdulrahmanAlghamdiAbdulrahmanalghamdi707@gmail.com
10167BiochemistryNutritionVitamin B3n/aRequires Vitamin B6 and Vitamin B2  [B6/B2 = B3]MnemonicVerifiedI think this was proposed a year or so ago and rejected. -AC07/10/19 9:44 PMAPandeyaranikopandey@gmail.com
10267BiochemistryNutritionVitamin B5noneI remember that Vitamin B5 is pantothenic acid because it sounds like "pento-thenic acid" and pento means 5MnemonicVerifiedSeems like a legitimate mnemonic. I am up for addition. -AnupSure. We have room to incorporate it. I think B5 in general is LY but if were keeping the vitamin we might as well keep this
-Kaitlyn		03/04/19 1:24 PMJessicaZimozimo.jessica@gmail.com
10368BiochemistryNutritionVitamin B7n/a"Please Always Put Biofuel in Car" First P is for Pyruvate, A is for Acetyl-CoA, second P is for Propionyl CoA, Bio=Biotin, Car=CarboxylaseMnemonicVerified05/28/19 9:12 AMCameronHansoncameron.g.hanson@gmail.com
10468BiochemistryNutritionVitamin B9https://www.ncbi.nlm.nih.gov/pubmed/23957651Small intestinal bacterial overgrowth is characterized by overproduction of *K9* (vitamins K, B9)... K9 to be highlighted in redMnemonicVerifiedFrom UTD: "folate and vitamin K levels are elevated in SIBO due to bacterial synthesis. Increased intestinal permeability also contributes to increased vitamin K levels".

I am not sure if this kind of info would fit in well in Biochem chapter, but it might fit in GI chaper. Bacterial overgrowth is mentioned a couple of times there, so why not consider creating a separate fact?

-Vasily		04/24/19 3:51 PMElanBaskirebask003@fiu.edu
10569BiochemistryNutritionVitamin Cn/aBold the 'C' in 'Vitamin C', and also bold/capitalize the 'C' in sCurvy.MnemonicIt is good. We should add it to the next edition. -Victor Martinez.VerifiedCan be considered for 2020. -AnupWe already have this.
-Kaitlyn		01/28/19 4:56 AMAdamKurnickadam@kurnick.net
10669BiochemistryNutritionVitamin CMnemonicTo remember which charged state of iron (Fe2+ or Fe3+) can and cannot be readily absorbed, use your fingers to represent each charge. Fe2+ = two fingers = peace sign = good; Fe2+ is readily absorbed. Fe3+ = three fingers = “read between the lines” = bad; Fe3+ cannot be absorbed.MnemonicI am not inclined to favor or reject. I think this mnemonic is quite large. If we consider to add it to the next edition, we should simplify it. -Victor Martinez.VerifiedCan be used as story mnemonic for 2020. -AnupThis takes a lot of space to explain for something not very HY. I am not a fan.
-Kaitlyn		02/06/19 11:29 PMMatthew J.Christensenmattchristensen607@gmail.com
10769BiochemistryNutritionVitamin CMnemonicFe3+ can be reduced by Vitamin C, the 3rd letter in the alphabet. Color coded image attached.MnemonicI would not include it in the next edition. It is not easy to remember. -Victor Martinez.VerifiedSeems a lot of things to remember for a small info. Would consider rejecting. -AnupThis takes more space to explain than it is worth.
-Kaitlyn		02/06/19 11:34 PMMatthew J.Christensenmattchristensen607@gmail.com
10870BiochemistryNutritionVitamin EIt's Mnemonic*E*xcess of Vitamin *E* increases risk of *E*nterocolitis in *E*nfants (infants).\ Highlight in red letter "E".MnemonicAgree. I like the mnemonic since it correlates vitamin E excess with enterocolitis. - Victor MartinezVerifiedCan be considered for 2020. -AnupAgree to incorporate. We could also use blEEding for the anticoagulant effect.
-Kaitlyn		01/11/19 8:50 AMMoatasemAl-Janabiassoomi88@yahoo.com
10970BiochemistryNutritionVitamin EIt's Mnemonicvitamin *E* ---> High-dose supplementation may alter metabolism of vitamin K : *E*nhanced anticoagulant effects of warfarin.MnemonicIf we use the mnemonics in the upper row, we could use this one too since is the same principle of using "E" as "E"ncreased or "E"nhanced. - Victor M.VerifiedCan be added for 2020. -AnupI prefer blEEding as I mentioned in line 38 above.
-Kaitlyn		01/11/19 8:58 AMMoatasemAl-Janabiassoomi88@yahoo.com
11070BiochemistryNutritionVitamin En/aExcess Vit E = Enterocolitis = Enfants “High dose Vit E goes into WAR with Vit K” = Enhances anticoagulant effect of WARfarin by altering the metabolism of Vit K.MnemonicVerified07/10/19 9:49 PMAPandeyaranikopandey@gmail.com
11172BiochemistryMetabolismEthanol metabolismhttps://step1.medbullets.com/biochemistry/102041/ethanol-metabolismIn ethanol metabolism under point number 2 it reads - “ 2) Fasting hypoglycaemia - decreases gluconeogenesis due to increased OAA—> malate. The correction is a decrease in OAA.Alcohol inhibits gluconeogenesis by depleting the pool of cytoplasmic NAD+. Depletion of cytoplasmic NAD+ by alcohol metabolism affects the re-oxidation of cytoplasmic malate to oxaloacetate by the cytoplasmic malate dehydrogenase, inhibiting gluconeogenesis. The inhibition of gluconeogenesis in response to alcohol ingestion results in alcohol-induced hypoglycemiaSpelling/formattingReject, ethanol metabolism increases NADH: NAD ratio (same info as per the student's link), this favors the reaction of OAA to Malate. The current text says decreased (downward arrow) gluconeogenesis due to increase (upward arrow) OAA to (horizontal arrow) malate. Therefore, the wording is appropriate. -Victor MartinezStaff acceptsAgree with Victor. Text is fine as is. No changes to the text recommended. -VVReject by 2 authors + 1 editor02/07/19 11:39 PMVyshnavyBalendravyshe11@hotmail.com
11272BiochemistryMetabolismEthanol metabolismOn the same page, next to the diagram, it says " Fasting hypoglycemia - decreased gluconeogenesis due to INCREASED OAA --> malate', which is correctThe DIAGRAM doesn't match with the caption. The diagram shows "decreased" OAA but it should be shown as "increased" OAAMinor erratumVerifiedI remember running across this errata in Flash Facts, and I think both the diagram and the text are correct. -AnupWe could make the caption clearer.

proposed changes:

"Fasting hypoglycemia—↓ gluconeogenesis due to↓ OAA → malate"
to

"Fasting hypoglycemia—↓ gluconeogenesis due to ↑ conversion of OAA → malate"
-MA		We can consider making the caption clearer, I agree. Otherwise, suspect no erratum here needing addressing.

-Matt		Prelim accept but NOT publishable erratatrue03/03/19 4:05 PMHeewonChoihxc326@case.edu
11372BiochemistryMetabolismEthanol metabolismhttps://www.khanacademy.org/science/biology/cellular-respiration-and-fermentation/glycolysis/a/glycolysisIn the glycolysis pathway, it shows DHAP -> Glycerol-3-P using an NAD+ to make NADH. The pathway rather uses up an NAD+ to make NADH. There fore someone with lactic dehydrogenase deficiency will use up all NAD+ inhibiting glycolysis. In the current printing, these patients will stimulate glycolysis.Minor erratum10/25/19 1:05 PMPaulKarroumPaul.karroum@me.com
11473BiochemistryMetabolismEnzyme terminologyMarks' Basic Medical Biochemistry: A Clinical Approach Fifth, North American EditionSynthase does not use ATP while synthetase requires ATP.Minor erratumI agree with the student we should change current wording. According to Lippincot's illustrated review: biochemistry, fifth edition, page 55. Synthase (does not require ATP). - Victor M.So we used to state this (synthetase uses ATP, synthase does not use ATP), but on further review, it turned out to be somewhat controversial. Moreover, both required sources of energy that could vary. Thus, we "generalized" it to what we have now, showing that both enzymes facilitate a reaction using some form of energy such as ATP of nucleotide sugar.

Not to use Wikipedia as a primary reference, but it actually does summarize well why the synthase/synthetase ATP/no ATP nomenclature is out of date:

https://en.wikipedia.org/wiki/Synthase

I would say not to go back and revert as it will just introduce the same controversy next year. I propose leaving as is, for in the current form it is not at all inaccurate.

-Matt		Reject by 2 authors + 1 editor06/11/19 3:43 PMMinjiBaebae.minji@yahoo.com
11573BiochemistryMetabolismRate-determining enzymes of metabolic processesLippinicott Illustrated Reviews Biochemistry 6th ed, page 121 "Regulation by intracellular energy levels".Fructose-1,6-bisphosphatase is also stimulated by high ATP levels. It should say "+Citrate +ATP".Minor erratumAgree, this makes sense. I think we can add "ATP (+)".

This is the citation from the supporting reference: "Fructose 1,6-bisphosphatase is inhibited by elevated levels of adenosine monophosphate (AMP), which signal an "energy poor" state in the cell. Conversely, high levels of ATP and low concentrations of AMP stimulate gluconeogenesis, an energy requiring pathway."

Although it does not bluntly say that "ATP stimulates fructose-1,6-bisphosphatase", I think this is exactly what is implied. Especially considering that it is written under "Dephosphorylation of fructose 1,6-bisphosphate" heading.

-Vasily		Agree with Vasily. Would migrate this over to allow for consideration in the 2020 edition since it appears that it is likely accurate.

-Matt		Prelim accept but NOT publishable erratatrue03/21/19 3:04 AMNicolasCuri Gawlinskinicolascurii@gmail.com
11674BiochemistryMetabolismSummary of pathwayshttps://www.uptodate.com/contents/overview-of-maple-syrup-urine-disease#H3Metabolism of "Odd-chain Fatty acids, branched-chain amino acids, methionine, and threonine" to Propionyl-CoA is incorrect. NOT all branched-chain amino acids can be catabolized to propionyl-CoA;Major erratumMaybe LY for Step 1, as it may not specifically test which BCAA aren't catabolized to propionyl-CoA. -ACDid some digging and have to agree with Anup, there are obviously some exceptions, but in the vast majority of cases and at the level of the Step 1, knowing that most odd chain fatty acids yield propionyl-CoA when metabolized is fine. We do not say "all" or "only" to avoid any absolute statements that open us up for errata.

For these reasons, I propose no change.

Some good reading on the subject: https://www.ncbi.nlm.nih.gov/books/NBK22387/#_A3064_

-Matt		Reject by 2 authors + 1 editor07/02/19 2:37 PMWillPikecwp31@georgetown.edu
11774BiochemistryMetabolismSummary of pathwaysFirst Aid Page 77To complete the list of all enzyme deficients, pyruvate dehydrogenase deficiency should be added in the parentheses next to the PDH enzyme name (#10 in the list), similar to how other enzyme deficiencies/conditions are listed. This can also be repeated for OTC deficiency.Minor erratumI don't understand this suggestion. PDH is number 14 on the list. -VMReject. The idea is to add "(PDH deficiency)" after "14 Pyruvate dehydrogenase", and to do the same for all other enzyme names in the list. IMO, this would clutter the page. There is no erratum. No change needed here.
-Vasily		Agree with authors. We state the enzyme clearly and adding extra text to discuss a deficiency would be too much text. And we would need to do it for other deficiencies to be consistent.

No change.

-Matt		Reject by 2 authors + 1 editor07/11/19 7:49 PMAbhishekGamiagami@jhmi.edu
11874BiochemistryMetabolismSummary of pathwayshttps://www.ncbi.nlm.nih.gov/pubmed/25037503Enzyme No. 6 Transketolase should have a bidirectional arrow as it is also possible to to yield Ribulose-5-Phosphate from Fructose-6-Phosphate.Minor erratum08/11/19 5:35 AMNoamDegnernoam.degner@me.com
11974BiochemistryMetabolismSummary of pathwayshttps://en.wikipedia.org/wiki/3-hydroxy-3-methylglutaryl-CoA_lyaseI suggest to add 24th enzyme "HMG-CoA lyase" , which is needed for ketogenesis, to the list and to the scheme.Clarification to current text09/04/19 12:50 PMAlsuZagorulkoalsu.zagorulko@gmail.com
12075BiochemistryMetabolismHexokinase vs glucokinaseN/AIn the chart, when it is reported the Km of the enzymes, while the arrows are correctly directionated, it is written the opposite: lower with upward arrow for hexokinase and higher with downward arrow for glucokinase.Minor erratum09/11/19 11:12 AMValentinaMilanimilanivlnt@gmail.com
12176BiochemistryMetabolismPyruvate dehydrogenase complexYou know thisI have a better way for remembering the 5 cofactors (please see the attached picture). “The FAmous Nerds Like CoenzymeA” goes in order (B1 thiamine pyrophosphate, B2 FAD riboflavin, B3 NAD niacin, Lipoic acid (and the L can be seen in part of the strokes for the number “4”), B5 CoA pantothenic acidMnemonicI am in favor of keeping the current text mnemonic since it is not adding extra value. - Victor MartinezVerifiedAgree that the current mnemonic is well recognized and used more often than the proposed one. But we can have a crowd debate on this! -AnupI prefer our current mnemonic.

-Vasily		01/12/19 2:27 PMJuliaGaoJgao@gwu.edu
12276BiochemistryMetabolismPyruvate dehydrogenase complexN/ARecommend red-bolding of "Ar"senic and G"ar"lic breath. This clinical finding is often mentioned in question stems and could help us quickly differentiate from Cyanide poisoning with Almond breath.MnemonicVerifiedI do not think this is a good one.

Reject.

-Vasily		03/15/19 2:23 PMJasonTegethofftegethoffjason@gmail.com
12376BiochemistryMetabolismPyruvate dehydrogenase complexUp to Date: Arsenic exposure and poisoning Author:Rose H Goldman, MD, MPH Section Editor:Michele M Burns, MD, MPH Deputy Editor:Lisa Kunins, MD Contributor Disclosures All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Apr 2019. | This topic last updated: Jan 07, 2019.Please consider adding "peripheral neuropathy" to the list of symptoms of arsenic poisoning. It is a symptom NBME expects students to recognize in identifying arsenic poisoning and is mentioned in UWorld and Amboss.High-yield addition to next yearCan be considered for addition. -AC05/20/19 1:05 PMWenzhengYuwenzheng_yu@brown.edu
12476BiochemistryMetabolismPyruvate dehydrogenase complexn/aAnother way to remember the cofactors: There are 5 things, in order B1, B2, B3, Lipoic Acid, B5. In addition to the current mnemonicMnemonic09/25/19 1:06 PMTriciaScalestscales@sgu.edu
12576BiochemistryMetabolismRegulation by fructose-2,6-bisphosphateUW QID 1031FBPase 2 it's same as fructose 2,6-bisphosphatase and it's written on the text fructose bisphosphotase 2 without 6 number on it. and FBPase 1 it's same thing as fructose 1,6-bisphosphatase , So it would be better for good understanding..Clarification to current textI agree with Vasily. It will be simplified by using a bold font. -VictorThis is a good point! But it might be challenging to demonstrate what the reader is refering to without being too wordy. We can try using bold font for "2" and "1" both for enzyme and substance names in the figure.

-Vasily		Can migrate over and see what others, such as the crowd, think.

-Matt		Prelim accept but NOT publishable erratatrue04/26/19 12:38 PMMuhanadShaibmohanad,shaib@gmail.com
12676BiochemistryMetabolismRegulation by fructose-2,6-bisphosphaten/auctose bisPHOSPHATASE-2 removes phosphate when FASTING  GLUCONEOGENESIS. PhosphofructoKINASE-2 adds phosphate while FED  GLYCOLYSIS.MnemonicVerified07/10/19 9:50 PMAPandeyaranikopandey@gmail.com
12777BiochemistryMetabolismAmino acidsI dont have oneThis is mnemonic for differentiation between keto a gluco essential amino acid : I saw (isoleucine) phen (phenylalanine) fixing three(threonine) tires(tyrosine) with kit glue ( ketogenic and glucogenicMnemonicVerified05/13/19 11:10 AMElafMohamedElafmohamed38@gmail.com
12877BiochemistryMetabolismTCA cyclehttps://www.sciencedirect.com/topics/medicine-and-dentistry/citric-acid-cycleOn page 77 of the 2019 edition, it is noted that "[T]he TCA cycle produces 3 NADH, 1 FADH2, 2 CO2, 1 GTP per acetyl-CoA = 10 ATP/acetyl-CoA (2x everything per glucose)." This is, in fact, incorrect. The TCA cycle amounts to 12* ATP/acetyl-CoA. The "10" should be changed to "12."Clarification to current textWe used to say 12, however, after adjusting for rounding, we edited this down to 10. I would not edit this as the original value of 12 was associated with several errata submissions!

-Matt		Reject by 2 authors + 1 editor06/03/19 4:33 PMMarcoLawandymlawandy@student.touro.edu
12978BiochemistryMetabolismATP productionnot indicated or refer to wikiThere is disaggrement in the net ATP production in page 74 and page 78, on Page 78, NADH produces 2.5ATP and FADH2 produces 1.5 ATP, but the calculation here is based on the newer estimates that NADH produces 3 ATP and FADH2 produces 2ATP. So in order to avoid confusion, I suggest either page 74 or page 78 be corrected. If we correct page 74, then it should be 27 net ATP via malate aspartate shuttle or 25 ATP via glycerol -3 P shuttleMajor erratumMay need faculty input. -AnupAccording to my calculations, there is no diagreement.

Per 1 glucose molecule, glycolysis produces 2+2*1.5 = 5 or 2+2*2.5 = 7 ATP molecules.

Per 1 glucose molecule, pyruvate dehydrogenase complex produces 2*2.5 = 5 ATP molecules.

Per 1 glucose molecule, TCA cycle produces 6*2.5 + 2*1.5 + 2 = 20 ATP molecules.

This adds up to 30 or 32 ATP molecules per 1 glucose molecule, depending on the shuttle by which NADH electrons reach mitochondria.

Recommend no changes to current text.

-Vasily		Expert input.

-Matt		Disagreement/need expert04/09/19 5:17 AMHangSongsonghangpku@163.com
13078BiochemistryMetabolismATP productionhttps://www.sciencedirect.com/topics/neuroscience/atp-synthaseATP synthase inhibitors decrease proton gradientMajor erratumReject. Oligomycin inhibits ATP synthase leading to accumulation of protons and increasing the gradient (difference). - Victor M.Agree with Victor. Text is correct that these inhibitors increase the gradient, not decrease it.

-Matt		Reject by 2 authors + 1 editor05/10/19 10:27 AMAbdulrahmanAlghamdiAbdulrahmanalghamdi707@gmail.com
13178BiochemistryMetabolismElectron transport chain and oxidative phosphorylationIt's Mnemonicthermogenin in b*r*own fat (has mo*r*e mitochondria than white fat).MnemonicThe mnemonic is not bad. However, I don't know if HY enough to be added. -Victor Martinez.VerifiedThe suggested mnemonic seems to be built around the fact that words "brown" and "more" both contain letter "r". IMO, this does not seem like a strong enough basis for a good mnemonic.

Reject.

-Vasily		Agree with Vasily, this is not easy to remember because the relevant letter is in the middle of the word. A student could think it is brOwn fat and nO mitochondria just as easily. Reject.
-Kaitlyn		01/11/19 9:09 AMMoatasemAl-Janabiassoomi88@yahoo.com
13278BiochemistryMetabolismElectron transport chain and oxidative phosphorylationIt's MnemonicN*O* ATP is produced because electron transport st*O*ps ----> *O*ligomycinMnemonicReject. I think students could find this mnemonic misleading. The use of the arrow implies that the consequence of the inhibition is oligomycin when it is actually the cause. I prefer the DRACCO mnemonic since it shows the order of inhibition and the first letter of the inhibitor. -Victor Martinez.VerifiedAgree with rejection. -Anup01/11/19 9:15 AMMoatasemAl-Janabiassoomi88@yahoo.com
13378BiochemistryMetabolismElectron transport chain and oxidative phosphorylationhttps://www.ncbi.nlm.nih.gov/pubmed/16676004Cytochrome c is found in the intermembrane space. But on page 78, cytochromc c is illutrated as overlaping with the inner mitochondrial membrane which causes confusion. Please consider moving cytochome c to the intermembrane space in the next edition of FA.Minor erratumAgree. Cyt C should be placed in the intermembrane space. -Victor MWe already show it by the intermembrane space! It is on the membrane surface. Yes, it "overlaps" but that's more of a diagram nuance than a reflection of where it is found and what it does. Almost every diagram I can find has placement similar to what we currently depict.

I suppose in many cases, the membranes are flipped vertically, which may explain the confusion.

See: https://www.nature.com/articles/nrm2434

No change.

-Matt		Reject by 2 authors + 1 editor06/12/19 9:41 PMI-ChunHungnzets@hotmail.com
13478BiochemistryMetabolismUrea cycleIt is a mneomonicOrnithine went by the car (carbomyl phosphate) to the city (citrulin) she met aspartae (added aspartate )they spended money (added ATP) they argued successively (arginine succinate)fume went out (fumerate product) the arguing (arginine) ended by drinking water (added water)and passing urine (urea product) and ornithine went back home (cycle completion)MnemonicVerified05/13/19 11:04 AMElafMohamedElafmohamed38@gmail.com
13580BiochemistryMetabolismDisorders of galactose metabolismhttp://www.jbc.org/content/280/7/5510.fullThe metabolic pathway for galactose has an incorrect abbreviation for UDP-Glu when referencing glucose bound to UDP. The abbreviation for glucose is Glc, not Glu (glutamate), so the correct term to use is UDP-Glc.Minor erratumVerifiedI do not think we have a mistake here. Btw, the cited reference uses Glu-6-P (not Glc-6-P) for glucose-6-phosphate.

The article below uses "UDP-glu".
https://www.ncbi.nlm.nih.gov/pubmed/19652996

Recommend no change.

-Vasily		Agree with Vasily. Appears to be no erratum here, no change.

-Matt		Reject by 2 authors + 1 editor03/03/19 10:15 AMMaxYudovichmax.yudovich@osumc.edu
13681BiochemistryMetabolismAmino acidshttps://en.wikipedia.org/wiki/Ketogenic_amino_acidThere are 5 Glucogenic/ketogenic amino acid: Isoleucine, Phenylalanine, Tyrosine, Tryptophan, Threonine (some don't recognize it as ketogenic)Major erratumI agree we should include tyrosine as part of the Glucogenic/ketogenic group in the next edition. However, not as part of the errata. "Tyrosine upon metabolism produces one molecule of fumarate and one molecule of acetoacetate. Fumarate is a glucogenic component because it is a TCA intermediate and gets converted to oxaloacetate which is channeled toward the path of gluconeogenesis. Acetoacetate is cleaved to form Acetyl CoA a precursor of ketone bodies. Hence, tyrosine is both glucogenic as well as ketogenic" http://usmle.biochemistryformedics.com/which-amino-acid-is-both-glucogenic-as-well-as-ketogenic/ - Victor MartinezVerifiedReject. This change was made last year based on well-sourced resources. Would not recommend any changes -VVReject by 2 authors + 1 editor02/14/19 2:49 AMSHICHENGSONGnicksong66@gmail.com
13781BiochemistryMetabolismAmino acidshttps://en.wikipedia.org/wiki/Tyrosine, https://en.wikipedia.org/wiki/TryptophanEssential Amino acids PVT TIM HaLL Phenylalanine Valine Tyrosine Threonine Isoleucine Methionine Histidine Leucine Lysine.Tyrosine is not an essential amino acid, it has to be replaced with TryptophanMajor erratumTyrosine was not mentioned in this fact in FA19.
Currently no change is needed.

-Vasily		Must be from a pre-2019 version. Current text is correct and shows tryptophan. No change needed.

-Matt		Reject by 2 authors + 1 editor03/28/19 2:22 PMChrisRobertdrchrisandrea@gmail.com
13881BiochemistryMetabolismAmino acidshttps://en.wikipedia.org/wiki/Glucogenic_amino_acidTyrosine is also both glucogenic and ketogenic; change mnemonic to "PITTT"High-yield addition to next yearI faced this errata in Flash Facts as well, and I think I may have already added it to the FA page. -Anup04/01/19 2:07 AMElanaMolchoelana.molcho@gmail.com
13981BiochemistryMetabolismAmino acidshttps://medlineplus.gov/ency/article/002222.htmAn addition to PV TIM HaLL: Van Halen says MILK FTW. Glucogenic AAs are V, H and M. Ketogenic AAs are L and K. I was thinking the letters could be highlighted in a different color. I have provided an image for student's enjoyment.MnemonicVerifiedHa! Thank you for sharing this. It looks like a creative take on essential amino acid mnemonic. However, there are a couple of issues preventing me from accepting this suggestion.

1. As I see it, there two main ways in which our current mnemonic (PVT TIM HaLL) can be imroved. Firstly, it would be nice to arrange the mnemonic in such a way that the essential amino acids be split accordingly into ketogenic, glucogenic and glucogenic/ketogenic. Secondly, it would be nice to get rid of extra letters ("a" in "HaLL"). Unfortunately, the suggested mnemonic does not address these two issues.

2. The suggested mnemonic uses one-letter abbreviations for amino acids which are conventional, but which are not obligatory to know for Step 1 and are not used anywhere in the book.

3. I am not sure if we will be able to get the copyright holder's permission to use the picture.

Thanks for the creativity. Please keep it up.

Reject.

-Vasily		04/30/19 4:07 PMArmandoGallegos, Jr.armando.gallegos2@gmail.com
14081BiochemistryMetabolismAmino acidshttps://www.diapedia.org/metabolism-and-hormones/5105758814/amino-acid-metabolismTRY (tryptophan) ISOLating (isoleucine) KGs (ketogenic/glucogenic) THRough (threonin) funnels (phenylalenin)..MnemonicVerified07/19/19 7:20 PMMohammedKamareddinemohammed.kamareddine@gmail.com
14181BiochemistryMetabolismAmino acidshttps://www.ncbi.nlm.nih.gov/books/NBK11035/Maybe add the following as they are often tested and referred to in question stems: 1) Excitatory AAs/Neurotransmitters - GLUTAMATE. 2) Biogenic AA's (3 catecholamines/tyrosine derivates + others) - Dopamine, Norepinephrine, Epinephrine, Histamine, Serotonin.High-yield addition to next year10/30/19 10:31 AMKhalidAlattarkhalid_alattar@hotmail.com
14281BiochemistryMetabolismSorbitolMnemonicUpdate mnemonic to "Sorbitol LuRKS around" --> adding "around" makes mnemonic make more sense/be more applicable/easy to remember. "Sorbitol LuRKS around" means sorbitol stays around/accumulates since LuRKS lack Sorbitol Dehydrogenase and/or have low levels of Sorbitol Dehydrogenase (Lens).MnemonicVerified05/03/19 6:50 PMShadiaSalehsal.shadia@gmail.com
14382BiochemistryMetabolismUrea cyclehttps://en.wikipedia.org/wiki/Allosteric_regulation#Essential_activatorsN-acetylglutamate is an OBLIGATE/ ESSENTIAL allosteric activator of carbamoyl phosphate synthetase I. Unlike allosteric activators, which induce enzymatic activity, obligate activators are required for enzymatic activity.Clarification to current textReject. Current fact is correct - Victor M.VerifiedFrom the supporting reference, it seems that obligate activators are a subset of allosteric activators. There is no mistake in current text. Recommend no change here.

-Vasily		Agree with Vasily, no change.

-Matt		Reject by 2 authors + 1 editor03/11/19 3:51 AMElanaMolchoelana.molcho@gmail.com
14482BiochemistryMetabolismUrea cyclehttps://www.ncbi.nlm.nih.gov/books/NBK513323/N-acetylglutamate is an OBLIGATE allosteric activator. Currently, it is written that it is an allosteric activator which implies that the enzyme can still work without N-acetylglutamate (just works better in the presence of it), however this is not the case. The enzyme cannot work without N-acetylglutamate, which makes it an obligate activator.Major erratumThis is a duplicate submission.

IMO, this level of detail seems LY, unless there is evidence that it is tested in qbanks or nbmes.

-Vasily		Duplicate, and still agree that it is low yield and not reflective of an erratum. Vasily's reasoning from prior submission still applies. No change here.

-Matt		Reject by 2 authors + 1 editor04/29/19 7:36 AMOpalSekleropalsekler@gmail.com
14582BiochemistryMetabolismUrea cycleMnemonic FA2019 (p. 82)"NAG ("nag" as in bother/pester) CPS-1 to start the urea cycle." (N-acetylglutamate is the allosteric activator of CPS-I, which is the rate-limiting enzyme in urea cycle.)MnemonicVerified05/03/19 6:55 PMShadiaSalehsal.shadia@gmail.com
14682BiochemistryMetabolismUrea cycleN/AUrea cycle, Carbamoyl phosphate synthetase ONE, think "I have to use number 1(pee)"MnemonicVerified05/28/19 5:16 PMDannyIbrahimdsi00199@yahoo.com
14783BiochemistryMetabolismAmino acid derivativeshttps://www.ncbi.nlm.nih.gov/pubmed/9326301a small bidirectional arrow next to tyrosine hydroxylase would be really nice, especially because this reaction is what let's us use certain dopaminergic drugsSpelling/formattingMaybe I am missing something, but it seems that the article says something along the following lines: "Tyrosine hydroxylase posesses DOPA oxidase activity. The products of DOPA oxidase activity are thioether derivatives of DOPA" (not tyrosine).

In other words, I do not see it explicitly written that tyrosine hydroxylase can turn DOPA into tyrosine. Even if it was the case, this is likely LY for Step 1.

Inclined to reject.

-Vasily		03/30/19 8:17 PMTrevaughnBaptistetbapt001@fiu.edu
14883BiochemistryMetabolismCatecholamine synthesis/tyrosine catabolismN/AA mnemonic for remembering the order of catecholamine synthesis I use is "tldr". Tyrosine --> L-dopa --> Dopamine --> noRepinephrine. You can also expand it if you want: "Please TLDR Ever" = Phenylalanine --> Tyrosine --> L-dopa --> Dopamine --> noRepinephrine --> EpinephrineMnemonicVerifiedThank you for the suggestion. Inclined to reject, as "d" can be misinterepreted as "dopa" and because "r" does not fit in the mnemonic that nicely.

-Vasily		03/04/19 1:58 PMJustinWinklerjmwink04@louisville.edu
14984BiochemistryMetabolismAlkaptonuriahttps://emedicine.medscape.com/article/941530-overview#a5first aid says: "Congenital deficiency of homogentisate oxidase in the degradative pathway of tyrosine to fumarate".Major erratumReject. Tyrosine deviates from catecholamine synthesis to produce a final product, fumarate which is part of the TCA cycle. Homogentisate and homogentisate oxidase belong to one of the steps of this process. Consequently, the wording is appropriate "Congenital deficiency of homogentisate oxidase in the degradative pathway of tyrosine pathway to fumarate..." -Victor MartinezVerifiedReject. Do not see any mistake here. There are several consecutive reactions that degrade tyrosine to fumarate. One of these reactions is catalyzed by homogentisate oxidase. If this enzyme is broken, alkaptonuria occurs.

-Vasily		Reject. -VVReject by 2 authors + 1 editor01/25/19 7:02 AMMohammad ALWahadnehALWahadnehwizerulz@gmail.com
15084BiochemistryMetabolismAlkaptonuriaNot neededUse "All Caps" (Alkaptonuria) when Typing (tyrosine) Furiously (fumarate) -- to remember that problem converting tyrosine to fumarate in alkaptonuriaMnemonicVerified05/17/19 1:05 PMOpalSekleropalsekler@gmail.com
15184BiochemistryMetabolismHomocystinuriaPage 84 of First Aid 2019 - In homocystinuria, lens sublexes "down and in."You look "down and in" (lens sublexes) when you PEE (homocystinURIA); vs MarFAN Syndrome ("FANS up and out").MnemonicGreat mnemonic!VerifiedNice mnemonic. Up for addition from my side. -Anup04/16/19 12:05 PMOrrShaulyshauly@usc.edu
15284BiochemistryMetabolismMaple syrup urine diseaseI just thought of this on my own"MSUD patients can't LIVe with these amino acids" (Leuicine, Isoleucine, Valine)Mnemonic10/25/19 9:32 PMsinamoridzadehsina.moridzadeh@gmail.com
15385BiochemistryMetabolismGlycogen regulation by insulin and glucagon/epinephrinehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5195864/, https://en.wikipedia.org/wiki/Phosphorylase_kinaseGlycogen phosphorylase kinase has calmodulin as one of its subunits. Therefore calcium binds directly to the enzyme and activates it. Furthermore, calcium is released from the endoplasmic reticulum in both muscle contraction and a1 receptor stimulation. This relationship can be summarized with the following arrows: Muscle contraction or a1 receptor stimulation -> Ca2+ (from endoplasmic reticulum) -> glycogen phosphorylase kinase (has calmodulin subunit). In the current graph in the book, the following sequence of arrows “calcium released from the endoplasmic reticulum -> Ca2+-calmodulin complex -> glycogen phosphorylase kinase” is conceptually wrong and unnecessary, as it is already shown with an arrow that calcium directly activates glycogen phosphorylase kinase.Major erratumAgree. The student is correct, calmodulin is the delta subunit of glycogen phosphorylase kinase (GPK). The illustration shows "Calcium-calmodulin in muscle during contraction" activates the GPK. However, We don't show that calmodulin is the subunit of this enzyme. It seems that Ca-Calmodulin complex activates GPK when it is only by Calcium. - Victor Martinez.VerifiedText is correct as is. When epinephrine bines the a-receptor, the PIP2-Ca2+ signal transduction system is activated, and calcium binds calmodulin. Would be beyond the scope of Step 1 to know that calmodulin is a binding receptor of glycogen phosphorylase kinase. Would recommend leaving text as is. -VV 1. Mark's BiochemistryReject by 2 authors + 1 editor01/07/19 2:45 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
15486BiochemistryMetabolismGlycogenhttps://www.uptodate.com/contents/glycogen-debrancher-deficiency-glycogen-storage-disease-iiiGlycogen debrancher is an enzyme with two catalytic activities (as already stated in the text). Cori disease is caused by congenital deficiency of glycogen debrancher, therefore none of these catalytic activities would occur. Thus, both steps 5 & 6 are inhibited (not only step 6).Major erratumAgree with the student. The enzyme has two catalytic sites and Glycogen storage disease has many subtypes including deficiency of both catalytic sites. We only mention n the table alpha-1,6-glycosidase. We need faculty input in this case. -Victor Martinez https://www.sciencedirect.com/topics/medicine-and-dentistry/glycogen-storage-disease-type-iiiVerifiedThis information is factually correct. Might need some expert review as well. Seems like a major errata to me. -AnupNot technically an error, so let's defer this to the main cycle. I'm reading that deficiency in glycogen debranching enzyme, amylo-1,6-glucosidase,4-α-glucanotransferase (AGL gene) is the cause of Cori disease. Please add a red box"III" to step 5 of Glycogen Storage Disease illustration. -VV https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2678930/ https://emedicine.medscape.com/article/119597-overview https://en.wikipedia.org/wiki/Glycogen_storage_disease_type_IIIPrelim accept but NOT publishable erratatrue01/07/19 2:51 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
15586BiochemistrytrueMetabolismGlycogen1. https://en.wikipedia.org/wiki/Dextrin. "Depolymerization of glycogen by phosphorylase halts when glycogen branches have been reduced to two to four linked glucose molecules (limit dextrins). Glycogen debrancher enzyme has two catalytic activities. One is the cleavage of a dextrin branch from the remaining glycogen molecule (amylo-1,6-glucosidase activity). The other is the transfer of the dextrin to the free end of a dextran polymer (oligo-1,4-1,4-glucanotransferase activity). The transferred dextrin may then be further depolymerized by phosphorylase." 2. https://www.uptodate.com/contents/glycogen-debrancher-deficiency-glycogen-storage-disease-iiiLimit dextrin refers to 2-4 residues, not 1-4. The smallest form of a dextrin is a disaccharide.Major erratumThe 4-alpha glucanotransferase enzyme is in charge of cleaving the outer branch of glycogen until it reaches the last glycosidic link which is 1,6. The last one is cleaved by alpha-1,6-glucosidase. Therefore, dextrins should have at least one residue in the branch. This student's comment sounds a bit nitpicky to me. But, it would help to have input from faculty for this one. "The 1,4-α-D-glucan 4-α-D-glycosyl transferase component transfers the terminal three glucose molecules to the parent chain and the amylo-1,6-glucosidase component cleaves the alpha 1,6 bond to release free glucose." https://www.ncbi.nlm.nih.gov/books/NBK26372/ -Victor Martinez.VerifiedMost of the sources I referenced define limit dextrin as "short" without specification of the number of sugars. There were no reference to the number of residues in the wiki article provided. However, UTD does define as two to four residues. Would appreciate faculty input for clarification. -VV https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/dextrin https://www.uptodate.com/contents/glycogen-debrancher-deficiency-glycogen-storage-disease-iiiDisagreement/need expertHoward SteinmanIs the debate about the number of sugar residues in the "limit dextrin". I agree that the smallest number of residues should NOT be 1. If you have 1, then the glycosidase acts to release free glucose. Our textbook says that the limit dextrin has 4 residues. If you want to say 2-4, I'd go for it. Main point: limit dextrin isn't 1 residue because that's not aceted on by the transferase activity of the debrancher enzyme. When it's just 1 residue, it's the glycosidase activity of the debrancher enzyme that acts. The figure shows it right. Bottom line: say that limit dextrin is 2-4 residues (or 4 residues)Accepttrue01/07/19 2:55 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
15687BiochemistryMetabolismGlycogen storage diseases1. Already mentioned in the book on page 86, 2. https://www.uptodate.com/contents/glycogen-debrancher-deficiency-glycogen-storage-disease-iiiCori disease is caused by glycogen debrancher deficiency, which has two catalytic activites (not only a-1,6-glucosidase).Minor erratumAgree with the student. The enzyme has two catalytic sites and Glycogen storage disease has many subtypes including deficiency of both catalytic sites. We only mention n the table alpha-1,6-glycosidase. We need faculty input in this case. -Victor Martinez https://www.sciencedirect.com/topics/medicine-and-dentistry/glycogen-storage-disease-type-iiiVerifiedAgree with the user. Please see the comment in the previous post for further workup. -AnupNot technically an error, so let's defer to main cycle. If faculty approves above, can replace "(a-1,6-glucosidase)" with "(1,6-glucosidase, 4-α-D-glucanotransferase)"Prelim accept but NOT publishable erratatrue01/07/19 2:59 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
15787BiochemistryMetabolismGlycogen storage diseases1. https://rarediseases.info.nih.gov/diseases/7864/glycogen-storage-disease-type-1a, 2. https://www.uptodate.com/contents/glucose-6-phosphatase-deficiency-glycogen-storage-disease-i-von-gierke-disease, 3. https://www.uptodate.com/contents/image?imageKey=PEDS%2F54417Von Gierke disease refers to the most common subtype of glycogen storage disease type 1, termed 1A, that is caused by glucose-6-phoshatase deficiency. Type 1B is caused by G6P transporter deficiency and is NOT termed Von Gierke disease.Minor erratumReject. It is correct that the disease has 2 types, type Ia, caused by the deficiency of glucose-6-phosphatase (G6Pase) catalytic activity, and GSD type Ib, caused by a defect in glucose-6-phosphate exchanger SLC37A4 (transporter). In spite of this, The two subtypes (GSDIa and GSDIb) are clinically indistinguishable. Historically, GSDI is also referred to as von Gierke disease after Dr. Edgar von Gierke, who first described the disease in 1929. https://www.ncbi.nlm.nih.gov/books/NBK1312/ https://myriadwomenshealth.com/diseases/glycogen-storage-disease-type-ib/ - Victor MartinezVerifiedAgree with Victor. No changes to the text. -VVReject by 2 authors + 1 editor01/07/19 3:01 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
15887BiochemistryMetabolismGlycogen storage diseaseshttps://www.uptodate.com/contents/glycogen-branching-enzyme-deficiency-glycogen-storage-disease-iv-andersen-diseaseDifferentiate Cori disease (GSD 3) from Andersen disease (GSD 4). A-B/C-D. Andersen- Branching enzyme/ Cori- Debranching enzymeMnemonicVerifiedAlthough I like the mnemonic (it would be helpful for a Biochem class), I think Andersen disease is LY for the exam. Hence, reject.

-Vasily		03/02/19 9:14 AMGrecia HaymeeAlvarez Fernandezgralvarez02@gmail.com
15987BiochemistryMetabolismGlycogen storage diseasesMade up.Mcardle disease: Myo/Muscle Pains, Pees and Palpitations (Pains=Muscle cramps, Pees=Myoglobinuria, Palpitations=Arrhythmia)MnemonicVerifiedI am borderline about addition. Waiting suggestions from other authors. -AnupI think it is an okay mnemonic. Suggest migrating to Annotate for further discussion.

-Vasily		03/29/19 11:57 PMAlecHastyalechasty2017@gmail.com
16087BiochemistryMetabolismGlycogen storage diseasesMy mind'There are 2 glycogen storage diseases that are always difficult to remember and often we use to forget it, so a easy way to remember (type III and IV glycogen storage disease) is with the next mnemonic: DCBA, (D) for debranching enzyme and the name of the disease is Cori/type III (C) and Branching enzyme with the name Andersen/type IV, so Debranching-Cori/Branching-Andersen so you only have to remember the leters DCBA.MnemonicVerified09/22/19 8:41 PMJorge AndresRios Duartejorgejejeje6@gmail.com
16187BiochemistryMetabolismGlycogen storage diseaseshttps://www.history.com/topics/ancient-history/pompeiiPOMPE Disease - Like POMPEII Volcano, heart is huge and pumping out may be affected (cardiomegaly, hypertrophic cardiomyopathy)Mnemonic10/30/19 10:38 AMKhalidAlattarkhalid_alattar@hotmail.com
16287BiochemistryMetabolismGlycogen storage diseasesAndersen Disease: https://rarediseases.org/rare-diseases/andersen-disease-gsd-iv/ Hers Disease: https://emedicine.medscape.com/article/119690-overview Tarui Disease: https://emedicine.medscape.com/article/949388-overviewThe main pneumonic I would like to contribute is: “ABCD” Andersen->Branching enzyme ; Cori ->Debranching enzyme. I noticed a similar one in the Errata table, but with letters switched around. I believe ABCD is a little easier to remember. In order for the pneumonic to make sense in the text, I added a section for Anderson's disease. I also added sections for Hers disease and Tarui disease because there is a lot of blank space on that page, and it helps complete knowledge about glycogen storage diseases. (see attached pdf, I also have .ai formats). Please feel free to send me an email with any additional questions! Thank you!Mnemonic11/21/19 7:21 PMForrestYehfyeh.ca@gmail.com
16388BiochemistryMiscellaneousLysosomal storage diseasesN/ATay-Sachs and Niemann-Pick both have 2 parts in their names just like Cherry-Red which is present in both of themMnemonicI don't find this correlation easy to remember. But, if others think it is useful, I wouldn't be opposed. - Victor Martinez.VerifiedReject suggestion. Too confusing. -AnupHa! This is actually the mnemonic I use. I think of the hyphen in the name of the diseases as of the cherry-red spot. It is challenging, however, to explain the mnemonic in writing.

I suggested this mnemonic previously but it did not make it into the book.

I still like this mnemonic. We could use a bold red dot in the name of the diseases (instead of the hyphen) and highlight with red the term "cherry-red spot" in the text.

-Vasily		01/04/19 4:26 AMFerasAl-Moussallyferas226@hotmail.com
16488BiochemistryMetabolismLysosomal storage diseasesFirst Aid 2019What is deficient and accumulated in Gaucher Disease? Gaucher = Groucher and needs sugar (glucose/glucocerebrosidase and glucocerebroside) What is deficient and accumulated in Krabbe disease? The krab is part of astrology/celestial galaxy signs, thus (galactocerebrosidae and galactocerebroside)MnemonicVerifiedThe table is already too crowded. Not sure if I would vote for or against this addition. -AnupI agree with Anup the page is really crowded with text already.

As for the mnemonic itself, it is not bad, but I am not a big fan of it either.

Reject.

-Vasily		03/12/19 1:37 PMWestonKlosterwkloster44@gmail.com
16588BiochemistryMetabolismLysosomal storage diseasesN/AFABry disease (F-fingers [episodic peripheral neuropathy]; A-angiokeratomas; you always look FABulous since you barely sweat)MnemonicVerified05/07/19 5:16 AMAdamKurnickadam@kurnick.net
16688BiochemistryMetabolismLysosomal storage diseasesAlana GhanimHow to remember the deficient enzyme in Hunter syndrome vs. Hurler syndrome. Hunter= iduronate which sounds like "I'd rather date" so think "I'd rather date a Hunter than a Hurler"MnemonicVerified06/27/19 11:05 PMAlanaGhanimalanaghanim@gmail.com
16788BiochemistryMetabolismLysosomal storage diseasesn/aA blind (destruction of oligodendrocytes - optic neuropathy) KRAB with regression is lost in the GALAXY (Galacto-).MnemonicVerified07/10/19 9:55 PMAPandeyaranikopandey@gmail.com
16888BiochemistryMetabolismLysosomal storage diseasesnot applicablehun(two)er deficient enzyme: iduronate 2;sulfatase, Hur(L)er: a-L-iduronidaseMnemonicVerified07/13/19 8:35 AMAwabElnaeemawab.kamal@gmail.com
16988BiochemistryMiscellaneousLysosomal storage diseaseshttps://www.uptodate.com/contents/fabry-disease-clinical-features-and-diagnosisFABRYS - F: Foam Cells in kidney, A: Alpha-galactosidase or Angiokeratoma, B: Burning pain in extremities (peripheral neuropathy or Boys of moms (X-linked recessive), R: renal failure, Y: Y is fine (because again its XLinked), S: Sphingolipidosis or S:Sweatless (hypohydrosis)Mnemonic10/03/19 4:16 PMMesudeRahmetimesudearahmeti@gmail.com
17088BiochemistryMetabolismLysosomal storage diseasesSelf-writtenTay-Sachs Disease - The general manager (GM) chose the wrong SAXophone GANG to play because their music but a HEX on the audience. (GM2 GANGlioside, HEXosamindase) /// Niemann-Pick Disease - Hey-MAN please PICK (NIEMAN-PICK) me to SING (SPHING). I think I sound great because i'm very drunk on FOAMY Beer (FOAMY LIPID-laden macrophages) with my big LIVER and SPLEEN. (Extreme alcohol use may lead to hepatosplenomegaly, these drunk people believe they/re great singers/SPHINGERS). /// Gaucher Disease - You go to the GAUCHER restaurant with your BRO's to eat GLUCOSE-containing food (GLUCO-cereBROside) where you use your TISSUE PAPER handkerchiefs and CRUMBLE it up when finished eating (Gaucher cells resemble crumpled paper).Mnemonic10/30/19 8:14 AMKhalidAlattarkhalid_alattar@hotmail.com
17189BiochemistryMetabolismFatty acid metabolismFirst Aid 2019 pg 73.The rate determining enzyme for Fatty acid synthesis is Acetyl-CoA Carboxylase (which is listed on pg 73). However it is not listed in the diagrams on page 89 and 74 despite its cofactor Biotin being listed.High-yield addition to next yearAgree. In spite of not being an error, I do think we should include acetyl carboxylase which is the limiting step of the fatty acid synthesis. That would include the integration of pathways on page 74 and the FA metabolism entry on page 89. This way we keep the same line of action by mentioning all the different rate determining enzymes. -Victor MartinezVerifiedHY addition for 2020. Suggest deferring for further workup. -Anup01/25/19 4:15 PMJosephCannizzojoseph.cannizzo@stonybrookmedicine.edu
17289BiochemistryMetabolismFatty acid metabolismhttps://ghr.nlm.nih.gov/condition/primary-carnitine-deficiency#genesSystemic carnitine deficiency is a defect in the transport of carnitine (not LCFA) into the mitochondriaMajor erratumWe do not have a major erratum here, but a clarification to the text might be considered: "Systemic primary carnitine deficiency -> no cellular uptake of carnitine -> no transport of LCFAs into mitochondria -> toxic accumulation of LCFAs in the cytosol -> weakness, hypotonia, hypoketotic hypoglycemia".

-Vasily		Agree that this is not an erratum. But I am not at all opposed to Vasily's proposed clarification which I do agree makes the text read much more clearly. We can consider this change for 2020 or 2021 depending on time.

-Matt		Prelim accept but NOT publishable erratatrue03/25/19 1:08 PMTammyHuatammy.hua95@gmail.com
17389BiochemistryMetabolismFatty acid metabolismhttps://ghr.nlm.nih.gov/condition/medium-chain-acyl-coa-dehydrogenase-deficiency#inheritanceMCAD deficiency has an autosomal recessive inheritance patternHigh-yield addition to next yearI don't think this is HY either. - Victor M.Provided reference supports the suggestion. I am not 100% sure that the suggestion is really HY.

-Vasily		03/30/19 6:14 PMLisa-QiaoMacDonaldllm012@jefferson.edu
17491BiochemistryMetabolismMetabolic fuel usepneumonic, link n/acarb/whey have 4 kcal (which is already there).... new submission: alcohol (how many letters in ALCOHOL=7; 7/kcal... fats how many kcal, 9/kcal (the FAT CAT has 9 lives)MnemonicVerifiedReject. Suggested mnemonic almost completely repeats our current mnemonic on page 91.

-Vasily		06/25/19 10:17 PMStanleyAbrahamszegedstan@hotmail.com
17592BiochemistryMetabolismFamilial dyslipidemiashttp://nlaresourcecenter.lipidjournal.com/Content/PDFs/Tables/1.pdfIn type III-- dysbetalipoproteinemia, if Apo E is defective, there should be increased chylomicrons and IDL, not VLDLMinor erratumMay need faculty input. -AnupOK to migrate over, but agree expert input would be helpful to ensure we address this accurately.

-Matt		Disagreement/need experttrue04/01/19 10:43 AMElanaMolchoelana.molcho@gmail.com
17693BiochemistryMetabolismKey enzymes in lipid transportper figure in page 92Hepatic lipase; degrades TGs remaining in IDL and "Chylomicron remnants"High-yield addition to next yearI don't think this is HY enough to be mentioned. Current text and illustration are consistent. Reject. -Victor M.VerifiedOn the one hand, I do not think that the provided reference supports the suggested change. As I see it, page 92 figure shows that chylomicron remnants are taken up via ApoE receptor - ApoE interaction. I do not see how the figure shows hepatic lipase's role in chylomicron degradation.

On the other hand, there are papers stating that hepatic lipase plays a role in chylomicron remnant metabolism. E.g.:

"HL, present in the basolateral surface of hepatocytes and the luminal and subluminal surfaces of endothelial cells or freely circulating in the bloodstream, hydrolyzes triglycerides and phospholipids present in circulating plasma lipoproteins, including IDL, chylomicron remnants..."

https://www.ahajournals.org/doi/10.1161/01.atv.0000140818.00570.2d

I do not think that this level of detail is HY for Step 1. I would leave the text as is unless other authors feel strongly otherwise. I do not think there is conflict between the figure and the text in terms of the role hepatic lipase.

I also do not remember seeing questions regarding the role of this enzyme in chylomicron metabolism in qbanks or nbme.

Reject.

-Vasily		03/01/19 7:36 PMAlaJamalala.aljamal@hotmail.com
17793BiochemistryMetabolismKey enzymes in lipid transporthttps://www.uptodate.com/contents/pcsk9-inhibitors-pharmacology-adverse-effects-and-use?search=pcsk9&source=search_result&selectedTitle=1~33&usage_type=default&display_rank=1#H3046621671 LINK 1 - First paragraph of Mechanism of Action section. LINK 2 - Genetic Considerations < Mutations in the PCSK9 Gene https://www.uptodate.com/contents/familial-hypercholesterolemia-in-adults-overview?search=ldl%20receptor&source=search_result&selectedTitle=1~47&usage_type=default&display_rank=1It is listed that the end result of PCSK9 is the decrease of serum LDL. This should say increase of serum LDL. The pathway in First Aid lists that the increase in LDL Receptor recycling is what leads to a decrease in serum LDL. In fact, when PCSK9 exerts its actions, the LDL Receptor is not recycled to the cell surface, but rather sent to lysosomes to be degraded. This would lead to less LDL uptake, and higher serum LDL levels. Therefore. PCSK9 does NOT lead to decreased serum LDL. I believe this may have been a mix up with the PCSK9 Inhibitor section, which would lead to decreased serum LDL. I've attached two different Uptodate links that state the MOA & effects. Thanks!Major erratum09/07/19 2:43 PMMichaelGarmomichaelgarmo@aol.com
17893ImmunologyLymphoid StructuresLymphatic drainage associationsFirst Aid 2017 MaterialPara-Aortic Lymph Nodes - "you have a PAIR OF(para) testes, ovaries, kidneys"MnemonicI don't find this mnemonic useful since it neglects the uterus. - Victor Martinez.VerifiedReject.
This is cute, but I agree with Victor, it leaves out the uterus which is important.
-Connie		Agree with authors, reject. -VVReject by 2 authors + 1 editor02/07/19 4:49 PMHaleyBasingerhaley.basinger@my.rfums.org
17993BiochemistryMetabolismMajor apolipoproteinshttps://www-uptodate-com.ezproxy.rosalindfranklin.edu/contents/image?imageKey=PC%2F112742&topicKey=PC%2F4560&search=hdl&source=outline_link&selectedTitle=1~150Currently, it is listed that the B-100 apolipoprotein is only on particles originating from the liver. However, HDL is synthesized in the liver and doesn’t contain B-100 which would contradict this statement.Clarification to current textReject. The table on page 93 "Major apolipoproteins" has a check sign only in VLDL, IDL and LDL columns in the B-100 row. HDL has not a check. The only apoliproteins checked are those produced in the liver with B-100 (LDL, IDL, and LDL.) - Victor MartinezVerifiedLikely a misunderstanding of the text. Would not recommend changes. -VVReject by 2 authors + 1 editor01/16/19 5:27 PMNakibMansurinakib.mansuri@my.rfums.org
18094BiochemistryMetabolismFamilial dyslipidemiasn/aType thrEE has defective ApoEMnemonicVerified08/21/19 4:37 PMJordanO'Steenjosteen441@gmail.com
18194BiochemistryMetabolismLipid-lowering agentshttps://www.uptodate.com/contents/effects-of-exercise-on-lipoproteins-and-hemostatic-factors?search=HDL%20exercise&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H472188367Effects of exercise on lipoproteins and hemostatic factors: Exercise training programs produce favorable changes in the lipoprotein profile in patients who already have CHD. Most studies have shown a significant increase in serum HDL-cholesterol and a decrease in serum triglycerides. Exercise training also may have a modest lowering effect on serum LDL-cholesterol. The mechanism of benefit may derive from positive changes in the proteins, and in particular the enzymes that regulate lipid metabolism. Exercise training may influence the functionality of lipoproteins as well as the levels of lipoproteins. Exercise may alter hemostatic risk factor by reducing the risk of acute thrombus formation, improving blood viscosity, and positively influencing rate of progression of atherosclerotic lesions.High-yield addition to next yearThis is overly specific and not HY for step 1in my opinion. I can't think of a question that could be written from this information that a student couldn't correctly guess the answer to. It may be worthwhile to devote a new fact/page to the benefits of exercise but this would be a huge undertaking to determine what is the more HY for step 1. We could consider for next year.
-Kaitlyn		07/31/19 9:24 PMPavelAksionavpavlusha_aksenov@mail.ru
18296ImmunologyLymphoid StructuresLymph nodeNot neededReplace the term "Postcapillary venule" with "High endothelial venule" in the lymph node schematic. High endothelial venules are mentioned in the text but not in the schematic. This can lead to confusion.Clarification to current textVerifiedReject.
HEVs are specialized post-capillary venous endothelial cells.This diagram is not at a high enough magnification to be able to visualize that. Also, the labeled item in our diagram is a post-capillary venule which is correct.
-Connie		Agree with Connie. No change to the text. -VVReject by 2 authors + 1 editor01/07/19 3:08 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
18396ImmunologyLymphoid StructuresLymph nodehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892634/Medulla consists of medullary cords (closely packed lymphocytes and plasma cells) must be changed to (closely packed B lymphocytes and plasma cells)Minor erratumVerifiedReject.
Looked at source, there is nothing that specifies "B" lymphocytes. Attaching another source from a higher impact journal (Cell) that says medullary cords "contains strings of lymphocytes." https://www.cell.com/immunity/image-resource-lymphnode
-Connie		No changes to the text. -VVReject by 2 authors + 1 editor01/07/19 2:56 PMNajatFadlallahnajat.fadlallah@lau.edu
18496ImmunologyLymphoid StructuresLymph nodehttps://www.uptodate.com/contents/evaluation-of-peripheral-lymphadenopathy-in-adults?csi=fe144795-2d9e-4501-a120-17fd294659e2&source=contentShareLymphadenopathy (LAD) : Painful LAD is seen with acute inflammation (e.g., Strep). Painless LAD is seen with chronic inflammation (e.g. autoimmune disease), metastatic carcinoma, or lymphoma . Abnormal lymph nodes if - firm/hard -immobile - >2cm -systemic symptoms (fever, night sweats, weight loss)High-yield addition to next year05/16/19 1:05 PMRayanEl Hajjarrayan.hajjar2@gmail.com
18597ImmunologyLymphoid StructuresLymphatic drainage associationsUpToDate, USMLE World.In the lymphatic drainage table, under "Area of body drained" column for Superficial Inguinal nodes, skin of "Glans Penis" (which drains into the deep inguinal nodes along with the popliteal nodes) can be added as another exception along with popliteal area.High-yield addition to next year08/14/19 9:12 AMAhmed AliKhanahmedalikhanjr@gmail.com
18698ImmunologyLymphoid StructuresSpleenMyself9 10 11, keep the spleen livinMnemonicVerifiedReject.
The rhyme is just slightly too much off for me. And it's not super intuitive that it's referring to the rib numbers.
-Connie		Agree with Connie, reject. -VVReject by 2 authors + 1 editor02/22/19 8:36 AMZaidR Najdawiznajdawi@hotmail.com
18798ImmunologyLymphoid StructuresThymushttps://www.ncbi.nlm.nih.gov/pubmed/16121185text says; Medulla is pale with Mature T cells and Hassall corpuscles. I recommend adding "Hassall Corpuscles have lymphopoietin important for maturing T cells". And to add mnemonic "Thymus Medulla goes through the hassle (Hassall) to "Mature T cells utilizing lymphopoietin"High-yield addition to next yearVerifiedReject.
The detail here is way beyond the scope of T cell maturation details needed for step 1.

Also, lymphopoietin is pretty upstream in the story of T cell maturation. Thymic stromal lymphopoietin expressed by Hassall's corpuscles actually activates CD11c+ DCs residing in the thymus, causing them to upregulate surface costimulatory molecules CD80/86, which enables them to induce the proliferation/differentiation of CD4+ T cells into Treg cells (CD25+FOXP3+). Treg induction by DCs can also be achieved by other pathways.

-Connie		Agree with Connie, lymphopoietin is a concept beyond the scope of Step 1 and is not the only pathway for T cell maturation. Would not recommend addition to the text. -VVReject by 2 authors + 1 editor03/01/19 8:11 PMAlaJamalala.aljamal@hotmail.com
18898ImmunologyLymphoid StructuresThymusN/AUnder "Thymoma", it says "Good syndrome" where it is likely mean "Goodpasture syndrome"Minor erratumNo, Good syndrome is correct. -VVReject by 2 authors + 1 editor07/05/19 10:38 PMJennaNickasjenna.nickas@gmail.com
18998ImmunologyLymphoid StructuresThymushttps://www.ncbi.nlm.nih.gov//articles/PMC4012878/RThymoma is associated with many autoimmune diseases including SLEClarification to current text11/19/19 8:41 PMElizabethAncionEancion@hotmail.com
190100ImmunologyCellularHLA subtypes associated with diseasesIt's MnemonicPsoriasis (there is a s*C*ale lession) --->HLA subtype *C* .MnemonicCurrently, we don't have mnemonic for psoriasis. The mnemonic is not bad since it correlates psoriatic lesion which is a scale with the HLA subtype (C). -Victor MartinezVerifiedReject -ScottOo I think we should consider this.

Maybe rephrase in a way that incorporates the "c" sound in psoriasis with the buzzwords "silver scale" in addition to HLA C.

Maybe pSoriasis presents with Silver Scale, HLA-C? This definitely needs some improving haha but just a thought?

-Connie		Agree, please add to annotate. -VVPrelim accept by 2 authors + 1 editortrue01/05/19 3:53 PMMoatasemAl-Janabiassoomi88@yahoo.com
191100ImmunologyCellularHLA subtypes associated with diseaseshttps://www.ncbi.nlm.nih.gov/pubmed/29072309In psoriasis, add the specific HLA-C allele that is strongly associated with the disease. All people have HLA-C in their genome. The specific allele that is associated with psoriasis is HLA-Cw6.High-yield addition to next yearReject, already specified on current edition. -Victor MartinezVerifiedWe already have this in the table titled HLA subtypes associated with diseases -ScottI think what the reader is suggesting is that we add that the specific allele associated with psoriasis is HLA-Cw6. The reader is technically correct, HLA-C is one of the three MHC class I genes we all have. Interestingly, I remember this being tested as just HLA-C, without going into detail about the specific allele. Interestingly, everything else on the list refers to a specific allele.

Maybe we can crosscheck to see if psoriasis is still being tested as just associated with a mutation in HLA-C, and that students don't have to know the specific allele?

Regardless, I'm on the fence, because this is the only tested disease related to HLA-C and I don't think step 1 will make student differentiate between different HLA-C alleles, so students should recognize HLA-C or HLA-Cw6. I feel like including it for completeness is not a bad thing, but this is already a confusing section so I don't want to include superfluous information if it's not needed.

-Connie

sources:
https://ghr.nlm.nih.gov/gene/HLA-C#conditions
https://www.ncbi.nlm.nih.gov/gene/3107		Reject. For the purposes of Step 1, it is more important to know that HLA-C can be associated with psoriasis rather than the specific allele. I recall having to memorize the association with the specific subtypes rather than the alleles associated with the subtypes. Honestly, HLA-B*5701 is one of the only mutations that are really needed to be memorized, and this is associated with hypersensitivity with abacavir than with a specific disease. Would not recommend addition. -VVReject by 2 authors + 1 editor01/07/19 3:13 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
192100ImmunologyCellularHLA subtypes associated with diseasesIt's MnemonicPsoriasis(Psoriati*C*) --->HLA subtype *C* .MnemonicI think that the mnemonic n first-row "Psoriasis (there is a sCale lesion) - HLA subtype C" is easier to remember and has a clinical correlation. -Victor MartinezVerifiedReject. -ScottReject, using letters at the end of a words is generally less intuitive for mnemonics.
-Connie		Agree, reject. -VVReject by 2 authors + 1 editor01/13/19 2:18 PMMoatasemAl-Janabiassoomi88@yahoo.com
193100ImmunologyImmune ResponsesHLA subtypes associated with diseasesToxicity of NRTIs - First Aid 2019 Pg-203; Its good to have this fact together with the other HLA associated disorders.HLA-B*5701 - Increased risk of Hypersensitivity with Abacavir (Anti RetroViral)High-yield addition to next yearReject. This fact is present in the HIV therapy entry, page 203. I don't think we should repeat it in the HLA subtypes table, page 100. -Victor MartinezVerifiedReject. This doesn't fit under neither the HLA Subtypes heading nor the MHC I and II headings. It fits best when we're discussing antiviral drugs though. -ScottWell this actually fits fine under the HLA subtypes. HLA-B*5701 is just a genetic variation of HLA-B, one of the 3 MHC class 1 genes (others are HLA-A, HLA-B). All this means is that people who have the 5701 variation of HLA-B are more susceptible to abacavir sensitivity.

We discuss this on page 203, I think that is the appropriate location. However, I would defer to the editor on whether it's worth a mention here. It is nice to have this grouped together with the other HLA allele-associated conditions, even though this is technically not a disease, but if I had to pick one location for this fact, I still think it fits better with the abacavir entry.

-Connie		Agree, this entry is more appropritae on page 203 related to abacavir. This is not technically an association with a disease, which is what the immunology table really focuses on. Therefore, would recommend leaving the text as is. -VVReject by 2 authors + 1 editor01/26/19 10:52 PMArpitJainarpitjaindr@gmail.com
194100ImmunologyCellularHLA subtypes associated with diseaseshttps://www.nejm.org/doi/full/10.1056/NEJMra0808284?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3DpubmedT1DM also has a strong association with HLA DQ2 and DQ8. This is the reason patient with T1DM are at high risk for developing celiac disease (which is also associated with HLA DQ2 and 8) and the ADA recommends screening all patients T1DM for celiac disease once.High-yield addition to next yearVerifiedAgree, but would want to verify how HY this is first.

American Diabetes Association currently says that the pts with the highest risk for TD1 are pts with DR3 or DR4+DQ8. UTD also mentions that TD1 is a risk factor for celiac, but doesn't mention the specific alleles.

We cover TD1 on page 346 and mention DR3 and DR4, but it might be worth adding in DQ8.
We cover celiac disease on page 375 and mention several associations, but not TD1. If we decide this is HY, may be worth adding TD1 to the list of associations.

-Connie

sources:
http://diabetes.diabetesjournals.org/content/62/6/2135
https://www.uptodate.com/contents/diagnosis-of-celiac-disease-in-adults?search=hladq2&source=search_result&selectedTitle=1~1&usage_type=default&display_rank=1		Celiac disease is more associated with DQ2/DQ8 for purposes of Step 1. Not convinced how HY association of Type 1 diabetes with DQ8 would be. Would not recommend any change to the text. -VVReject by 2 authors + 1 editor02/14/19 11:33 PMBasimAlibasim.ajafri@gmail.com
195100ImmunologyImmune ResponsesHLA subtypes associated with diseasesn/aA better Mnemonic for DR2 associated disease is "DRive 2 multiple hay pastures."MnemonicVerifiedYes!
This is definitely an improvement on the current mnemonic, which doesn't specify the DR number. Also this one flows a little better than the current one (multiple hay pastures are dirty).

-Connie		Love it! Please replace: "Multiple hay pastures are dirty" WITH "DRive 2 multiple hay pastures" with appropriate red mnemonic font. -VVPrelim accept by 2 authors + 1 editortrue03/01/19 8:45 AMChimaAmadica329@cornell.edu
196100ImmunologyCellularHLA subtypes associated with diseasesMnemonicHLA-C for Psoriasis hint: Pronounce "C-riasis"MnemonicVerifiedThere are several mnemonics proposed this year for psoriasis and HLA-C, this one is medium. We can compile and pick the best one once we migrate to annotate? Maybe we can compile the related smartsheet comments into one annotation so it's easy to see the options.

-Connie		Agree, please add to annotate and we can pick the best one -VVPrelim accept by 2 authors + 1 editor03/24/19 1:17 PMNathanielBorochovnateboro8@gmail.com
197100ImmunologyCellularHLA subtypes associated with diseasesMade up"C"oriasisMnemonicVerified05/13/19 3:24 PMMohamad OthmanEl Heloumohamadosman.helou@lau.edu
198100ImmunologyLymphocytesHLA subtypes associated with diseaseshttps://www.uptodate.com/contents/human-leukocyte-antigens-hla-a-roadmapmnemonic for DR2 ---> DRs get GOOD scores in 2nd year studying Histo MULTIPLE time SYSTEMatically( good--> good pasture, Histo-->Hay fever, MULTIPLE--> MULTIPLE sclerosis, SYSTEMatically--> SLE)MnemonicVerified08/31/19 9:05 AMMohamedMenofymohamed.a.menofy@gmail.com
199100ImmunologyCellularHLA subtypes associated with diseasesn/aDR5 is "pent"icious anemia.Mnemonic09/27/19 5:15 PMJordanO'Steenjosteen441@gmail.com
200100ImmunologyCellularHLA subtypes associated with diseaseshttps://www.uptodate.com/contents/prediction-of-type-1-diabetes-mellitus?search=type%20i%20diabetes%20dr3%2Fdr4&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1DR3/DR4 hurts beta cells to the core. (DM type I)Mnemonic09/27/19 6:36 PMJordanO'Steenjosteen441@gmail.com
201100ImmunologyCellularHLA subtypes associated with diseaseshttps://www.uptodate.com/contents/prediction-of-type-1-diabetes-mellitus?search=type%20i%20dDR3/DR4, Sugar no more (for DM1)Mnemonic10/14/19 10:47 AMDanielZhuDzhu5@pride.hofstra.edu
202100ImmunologyCellularHLA subtypes associated with diseasesN/APAIR of B-27 Bombers (fly undetected - seronegative arthropathies)Mnemonic10/17/19 5:56 PMAbhijitBattarabattar5@gmail.com
203100ImmunologyLymphocytesMajor histocompatibility complex I and IIhttps://www.uptodate.com/contents/major-histocompatibility-complex-mhc-structure-and-functionwe can use X in eXogenously as indicator for 2(ii) in MHC 2MnemonicVerified08/31/19 8:57 AMMohamedMenofymohamed.a.menofy@gmail.com
204101ImmunologyCellularDifferentiation of T cellsAs per information on p. 102Minor change to diagram. For Th17: add inhibited by IFN-gamma and IL-4. For Treg: add inhibited by IL-6.Spelling/formattingI agree we should add this to the next edition. However, it shouldn't be part of the errata. -Victor MartinezVerifiedAgree. We should be consistent -ScottYes, on annotate, it looks like there has been an effort to add in these cytokines, but there also seems to be some concern of over-population/over-crowding of the diagram.

I think it would be nice to have these for consistency, but maybe we can work with the illustration team to find a layout that works better. Maybe arrows coming from the helper T cell could all be parallel instead of coming out radially? It may be easier to read the cytokines that way.

-Connie		This would be something for the illustration team to address. Please add a note to annotate with Illustration team tagged. -VVPrelim accept by 2 authors + 1 editor01/20/19 6:57 PMCharlesde Leeuwdeleeuw.c@gmail.com
205101ImmunologyCellularDifferentiation of T cellsMnemonicTo remember which section of the thymus (cortex or medulla) is involved in positive vs negative T cell selection, think of the letter “t” as a plus sign (+) and the letter “l” as a minus sign (-). Clarifying image attached.MnemonicCould not understand the "t" as a (+) sign and "I" as a (-) sign- PriyeshVerifiedReject.

I think the "t" as "+" and "I" as "-" is clever, but I'm not sure where the letter I is coming from here?

-Connie		Agree, reject. -VVReject by 2 authors + 1 editor02/10/19 10:39 AMMatthew J.Christensenmattchristensen607@gmail.com
206101ImmunologyCellularDifferentiation of T cellsNone neededAdd in the down-regulators of Th17 cells and Treg cells as indicated on page 102. That is, add a red -IL4 and IFN-gamma for Th17 cells and a red -IL-6 for Tre cells onto the diagram.MnemonicVerified08/06/19 12:33 PMAbhishekGamiagami@jhmi.edu
207101ImmunologyLymphocytesDifferentiation of T cellsfirst aidwe can use O in pOsitive selection as indicator for cOrtex ,, and E in nEgative selection as indicator for mEdullaMnemonicVerified08/31/19 9:09 AMMohamedMenofymohamed.a.menofy@gmail.com
208101ImmunologyCellularImportant cytokinesFirst Aid Usmle Step 1 2019, page 102I suggest to add new column "Cytokines" into the table "Differentiation of T-cells" for visual perception of the information located on the next page (102).Clarification to current text09/04/19 12:09 PMAlsuZagorulkoalsu.zagorulko@gmail.com
209102ImmunologyCellularCytotoxic T cellshttps://www.hindawi.com/journals/bmri/2010/764542/They also fight against intracellular ListeriaHigh-yield addition to next yearVerifiedReject.

CTLs are important for immunity against intracellular pathogens in general. I don't think knowing listeria as a CTL target specifically is HY.

-Connie		Agree with Connie, reject. -VVReject by 2 authors + 1 editor03/01/19 8:13 PMAlaJamalala.aljamal@hotmail.com
210102ImmunologyLymphocytesMacrophage-lymphocyte interactionhttps://www.ncbi.nlm.nih.gov/pubmed/7751026Macrophages, dendritic cells, and other APCs release IL-12, which stimulates T cells to differentiate into Th1 subtype. Th1 cells secrete IFN-gamma, which enhances the ability of monocytes and macrophages to kill microbes they ingest. This function is also enhanced by interaction of T cell CD40L with CD40 on macrophage. (This also explains how macrophages favour differentiation into Th1)Clarification to current textIt is already covered on that section, however, we could consider adding this to the next edition for completeness. -Victor MartinezVerifiedOn the fence. We already state that Th1 cells are induced by IL-12 in the chart, so I'm not sure it is completely necessary to add that into the macrophage-lymphocyte interaction section. However, it does complete the story a little better, which I think could be helpful to include.

Would not consider this something to address urgently, but might be worth considering for 2020!

-Connie		I agree with Connie. This is already covered. We could include this information here again but risk unnecessary repetition.

However, this could consider for the 2020 edition as there is space on this page.

- Sarah		Agree, the chart does a great job of summarizing the function. Would not recommend addition again.Reject by 2 authors + 1 editor01/27/19 3:38 AMArpitJainarpitjaindr@gmail.com
211102ImmunologyCellularT cell subsetsUSMLE WORLD QBANK FOR STEP 1, QUESTION ID 762As TH1 cells secrets interferon gamma and interleukin 2 it also secretes Lymphotoxin BMinor erratumI don't think lymphotoxin B is HY at all, but I don't have access to UW and don't know if this is being presented as extraneous info or not.

Unless someone else can verify, I think it's too LY because it's not central to T cell function and also goes by several other names (TNFC)

-Connie		Agree with Connie, not convinced that it's HY enough for purposes of Step 1. Would not recommend addition to the text. -VVReject by 2 authors + 1 editor04/01/19 3:55 PMMuhanadShaibmohanad.shaib@gmail.com
212102ImmunologyCellularT cellsFA 2019 page 102 & 108Mnemonics to help keep straight the cytokines/interferons secreted by Th cellsMnemonicVerified05/06/19 10:28 PMEmilyTuttemilyktutt@gmail.com
213105ImmunologytrueImmune ResponsesImmunoglobulin isotypeshttps://www.uptodate.com/contents/the-humoral-immune-responseMaternal IgG starts to wane by birth and is almost completely gone by 6 months of age. It does not "start to wane after 6 months". As it is stated on page 110, the half-life of preformed antibodies is around 3 weeks.Major erratumVerifiedFaculty input needed.
The submitter is correct about the half-life of passively transferred IgG, and they are correct with the UTD reference, which says that "maternal IgG is largely cleared from an infant's circulation by 6 months of age." The reference given is an old paper from 1982.

However, more recent literature all states that passively acquired maternal Abs have distinct half-lives in infants, with pertussis-specific IgG waning by 4 mo, but measles remain protective at 6 mo and is still detectable by 1 year, dengue is still present in 82% of babies at 4 mo and 28% at 6 mo, but mean duration of rubella ab is 2.1 mo and varicella is 2.4 mo.

I want to say that our current text is fine given the large range of IgG half-lives, but UTD says otherwise, so faculty input might be nice!

-Connie

sources:
http://www.immunohorizons.org/content/2/1/14
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165321/
https://www.ncbi.nlm.nih.gov/pubmed/17629601
https://www.ncbi.nlm.nih.gov/pubmed/14604165
https://www.ncbi.nlm.nih.gov/pubmed/13677366
https://www.ncbi.nlm.nih.gov/pubmed/20558248		Would greatly appreciate faculty input per Connie's well-sourced comment. -VV EDIT: Please change "(provides infants with passive immunity that starts to wane after 6 months of age)" to "(provides infants with passive immunity that starts to wane after birth)"Prelim accept by 2 authors + 1 editorAnthony DeFrancosuggested change OK except change "starts to wane by birth" to "starts to wane after birth" (maternal IgG in the infant wanes because no longer supplied via placenta). This is the boards level concept for students, reality is slightly more complicated (as indicated by the additional research, probably as some antibody, mostly IgA is present I'm mother's milk and can provide some protection), but impossible/undesirable in a book of this kind to include minor qualifications of this typeAccepttrue01/07/19 3:17 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
214105ImmunologyImmune ResponsesImmunoglobulin isotypesNADMature, naive B-cells express only IgM and IgD prior to activation. Mature, naive B-cells are "Mature" and "Dumb" (M and D)MnemonicVerified06/08/19 2:50 AMMehreenAlidr.mehreenali@gmail.com
215106ImmunologyImmune ResponsesComplement-C5b activates MAC mnemonic: Big-MAC; B from Big is to remember it's C5b not C5aMnemonicIt is catchy since almost everyone knows McDonald's. We should add this to the next edition. -Victor Martinez.VerifiedI like this one,Suggest consideration for 2020. -ScottYes, but is this HY? C5b-9 as MAC is definitely HY, but I feel like it's always presented as C5-9 or C5b-9, and we don't really have to identify the individual components, and I haven't seen anything requiring differentiation of C5b-9 from C5a-9.

Maybe editor input? It's a cute mnemonic, but I wouldn't include it unless it's HY bc of crowding.

-Connie		Inclined to reject. We have a really nice mnemonic for C5a to help remember it's use. Additionally, questions usually present with C5-9 rather than identifying the specific component. Recommend no changes. -VVReject by 2 authors + 1 editor01/20/19 5:47 PMHasanAlarourihassan.arouri@hotmail.com
216106ImmunologyImmune ResponsesComplementhttps://www-ncbi-nlm-nih-gov.www.libproxy.wvu.edu/pubmed/11257302C1-Like Complex should be clarified in the image to be "MBL Complex". This is important, because MBL deficiencies have been described and are testable items for STEP (see next errata)Minor erratum08/18/19 9:25 PMJosephMcGuirejosephmcguirewv@gmail.com
217107ImmunologyPhysiologyComplement disordershttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC15187/"decay-acclerating factor" should be replaced with "decay-accelerating factor"Spelling/formattingAgree, minor spelling error -Victor MartinezVerifiedAgree - spelling error. Change to decay-accelerating factor as suggested. - SarahAgree with Sarah, change typo.

-Connie		Haha, good catch! But doesn't really need to be on published errata, defer to 2020. Please replace "decay-acclerating factor" with "decay-accelerating factor" -VVPrelim accept by 2 authors + 1 editortrue12/23/18 11:07 PMJoshuaTaylorjbtaylor@email.arizona.edu
218107ImmunologyPharmacologyComplement disordershttps://www.uptodate.com/contents/ace-inhibitor-induced-angioedema?search=kallikrein%20inhibitor&source=search_result&selectedTitle=4~22&usage_type=default&display_rank=4 - https://www.uptodate.com/contents/ace-inhibitor-induced-angioedema?search=kallikrein%20inhibitor&source=search_result&selectedTitle=4~22&usage_type=default&display_rank=4Benefit in the treatment of ACE inhibitor-induced angioedema: ECALLANTIDE : recombinant protein that inhibits plasma kallikrein.High-yield addition to next yearVerifiedUTD even says that available studies on this drug are conflicting. Ecallantide is literally under the section labeled, "therapies of unproven efficacy." I don't think this is HY, and the conflicting studies means that this won't be tested.

-Connie		Agree, reject. No changes.Reject by 2 authors + 1 editor02/19/19 12:06 AMLissetteOrozcolissetteorozco_004@hotmail.com
219107ImmunologyImmune ResponsesComplement disorderswas in a Uworld answer explanation but can also be read here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952982/early complement disorders: add that it's not any recurrent infection but it's again especially the "encapsulated" bacteria!High-yield addition to next year06/07/19 10:54 AMNoam LeanderDegnernoam.degner@me.com
220107ImmunologyImmune ResponsesComplement disordershttps://www-ncbi-nlm-nih-gov.www.libproxy.wvu.edu/pmc/articles/PMC2952982/ or https://www.uptodate.com/contents/inherited-disorders-of-the-complement-system?search=Complement%20system%20disorders&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1There are several complement disorders not listed here that have been described in the literature, but the high-yield ones not included in the book (according to Boards and Beyond as well as Pathoma) are MBL deficiencies (MBL gene affected; susceptible to meningitis caused by Neiserria meningitidis), C3 deficiencies (susceptible to recurrent infection with encapsulated bacteria & type III hypersensitivity syndromes), C3 Nephritic Factor (autoantibody), and hypocomplementemia. Others have been described in the attached article, but aren't considered high-yield to other STEP resources yet.Major erratum08/18/19 9:42 PMJosephMcGuirejosephmcguirewv@gmail.com
221108ImmunologyImmune ResponsesImportant cytokineshttps://www-ncbi-nlm-nih-gov.www.libproxy.wvu.edu/gene/3576IL-8 is now commonly referred to as CXCL8. Questions sometimes refer to IL-8 as CXCL8 without acknowledgement that it was formerly called IL-8.Minor erratum08/18/19 9:14 PMJosephMcGuirejosephmcguirewv@gmail.com
222109ImmunologyImmune ResponsesRespiratory burst (oxidative burst)https://www.uptodate.com/contents/chronic-granulomatous-disease-pathogenesis-clinical-manifestations-and-diagnosis?search=chronic%20granulomatous%20disease&source=search_result&selectedTitle=1~117&usage_type=default&display_rank=1Under respiratory burst diagram it states that "phagocytes of patients with CGD can utilize H2O2" when it should be cannot utilize H2O2.Minor erratumReject, the wording is correct GCD patients can utilize H2O2 generated by organisms, ultimately change this H2O2 into reactive oxygen species. -Victor MartinezVerifiedReject.
Text as is is correct. Patients with CGD cannot make their own H2O2, but they CAN utilize H2O2 generated by invading organisms.

-Connie		Agree with Connie and Victor. No changes. -VVReject by 2 authors + 1 editor01/25/19 5:28 PMNidhiShahshahnidhi420@gmail.com
223110ImmunologyImmune ResponsesCell surface proteinsn/aNK cells are KILLER at 16 yrs (CD 16) and caught at 56 yrs (CD 56 - suggestive marker)MnemonicVerified07/10/19 10:00 PMAPandeyaranikopandey@gmail.com
224111ImmunologyImmune ResponsesVaccinationIt's Mnemonic*in*activated vaccine = typhoid (V*i* polysaccharide, *in*tramuscular).MnemonicReject. I agree with Scott. It is not HY. -Victor MartinezVerifiedReject. Not HY. -ScottReject, not HY.

-Connie		Reject. -VVReject by 2 authors + 1 editor01/05/19 4:28 PMMoatasemAl-Janabiassoomi88@yahoo.com
225111ImmunologyImmune ResponsesVaccinationPlotkin SA, Cam NB. A New Typhoid Vaccine Composed of the Vi Capsular Polysaccharide. Arch Intern Med. 1995;155(21):2293–2299. doi:10.1001/archinte.1995.00430210041007The Vi typhoid vaccine is a subunit vaccine NOT an inactivated vaccine. Since it is composed of a capsular polysaccharide antigen and not the whole inactivated bacterium, it is by definition a subunit vaccine (similar to strep pneumo and H. influenza).Minor erratumAgree with the student. Typhoid Vi vaccine is made of the polysaccharide capsule from the bacteria. Therefore, it should be under the subunit classification. -Victor MartinezVerifiedCDC defines as an inactivated vaccine. Would not recommend any changes to the text. -VV https://www.cdc.gov/vaccines/hcp/vis/vis-statements/typhoid.htmlReject by 2 authors + 1 editor02/07/19 11:52 AMDanielBadindaniel.badin434@hotmail.com
226111ImmunologyImmune ResponsesVaccinationhttps://www.vaccines.gov/basics/typesI’ve always had a hard time remembering the live versus killed vaccines. I came up with two “stories” to help remember them. Live attenuated vaccine Mnemonic – The small, type A, yellow chicken named Sabin received his flu mist and MMR before rotating at BCG. Meaning – small (smallpox), type (typhoid oral) A (adenovirus), yellow (yellow fever) chicken (varicella – chicken pox), Sabin (Polio oral), flu mist (influenza), MMR (MMR), rotating (rotavirus), BCG (BCG) Killed or inactivated vaccine Mnemonic – A hippo named Salk contracted rabies from the flu shot. Meaning – A hippo (hepatitis A), Salk (Polio IM), rabies (rabies), flu shot (influenza IM) *The only one missing from this is typhoid Vi, but assuming one understands there is a typhoid oral and IM (Vi polysaccharide) vaccine, it should be fine.MnemonicVerified06/04/19 2:29 PMBlakeWalljblakewall@gmail.com
227111ImmunologyImmune ResponsesVaccinationhttps://www.uptodate.com/contents/treatment-and-prevention-of-enteric-typhoid-and-paratyphoid-fever#H14On page 111, the Vi polysaccharide typhoid vaccine is given as an example of a killed/inactivated vaccine. It is actually a subunit vaccineMajor erratum09/24/19 12:30 PMMuhammad ShariqUsmanshariqusman@outlook.com
228112ImmunologyImmune ResponsesHypersensitivity typesn/aUnder hypersensitivity type II I would match the formatting of type I. In the first part just say "Antibodies bind to cell surface antigens causing:" Keep the part with Cellular destruction, Inflammation and cellular dysfunction, but add on the square bullet point as seen in the HS type I.Spelling/formatting10/01/19 11:18 AMTriciaScalestscales@sgu.edu
229113ImmunologyImmune ResponsesHypersensitivity typeshttps://www.uptodate.com/contents/overview-of-antiretroviral-agents-used-to-treat-hiv?search=HLAB57%20ABACAVIR&source=search_result&selectedTitle=1~70&usage_type=default&display_rank=1 AND UWORLDType IV hypersensitivity reaction EXAMPLES: 1- TOUCH Contact dermatitis (poison,ivy,sumac,latex,nickel) 2- TRANSPLANT: graft vs host disease 3- TESTS : PPD (tuberculosis infection) ; IGRAS (Interferon gamma release assay); Abacavir HLAB57 hypersensitivity (100%NPV); Patch test (cause of contact dermatitis),T CELL FUNCTION: Candida extract (T cell inmune function)High-yield addition to next yearVerifiedReject.
We already have all of these examples except abacavir hypersensitivity. The way the text is currently organized I think is a little better than the suggested organization.

While abacavir hypersensitivity is HY, I don't think the mechanism is HY.

HLA-B*57:01 molecules preferentially bind peptides with alanine, threonine or serine at position 2, peptide antigens with these residues are generated by cleavage of cytosolic proteins by the proteosome in the cytoplasm and imported into the ER where they bind to newly synthesised HLA-B*57:01 molecules that are exported via the Golgi body to the cell surface for presentation to CD8+ cytotoxic T cells. In most cases these peptides will be derived from “self” proteins and will therefore not be recognized by T cells, but in HIV-infected individuals who carry the HLA-B*57:01 gene and who are treated with abacavir, an autoimmune hypersensitivity reaction involving CD8+ cytotoxic T cells can develop.

Interesting but not HY

-Connie		Reject. Thanks Connie for your explanation of abacavir sensitivity! :) -VVReject by 2 authors + 1 editor02/19/19 12:41 AMLissetteOrozcolissetteorozco_004@hotmail.com
230113ImmunologyImmune ResponsesHypersensitivity typesnoneSuspect type IV hypersensitivity due to poison ivy when there's: 1. recent outdoor activity. 2. linear/ streaky pattern rash.Clarification to current textCan be deferred to next year.05/14/19 2:06 PMHaithamAlaithanhsaithan93@gmail.com
231113ImmunologyImmune ResponsesHypersensitivity typesSelf-writtenType 3 Hypersensitivity - Also 3 letters for main examples - S-L-E (lupus), 'P'oly'A'rteritis'N'odosa, 'P'ost'S'trep'G'lomerulonephritis, 'S'ee 'S'erum 'S'ickness.Mnemonic10/30/19 11:16 AMKhalidAlattarkhalid_alattar@hotmail.com
232114ImmunologytrueImmune ResponsesBlood transfusion reactionshttps://emedicine.medscape.com/article/206885-overview https://www.uptodate.com/contents/image?csi=e6afcaee-c28c-4e19-ab8d-320cbfd6a359&source=contentShare&imageKey=HEME%2F94399 https://www.uptodate.com/contents/immunologic-transfusion-reactions?csi=cf86246a-4478-4dfa-8128-e266eefc2666&source=contentShareAllergic/anaphylactic transfusion reactions do NOT present with fever, contrary to what the "clinical presentation" column says.Minor erratumAgree. Fever is notably absent in allergic/anaphylactic transfusion reactions. Other symptoms are present such as urticaria, wheezing, shock, nausea, and abdominal cramps. - Victor Martinez.VerifiedAgree, accept. Provided sources check out, and I can't find anything on fever being present in allergic/anaphylactic transfusion reactions.

Remove "fever" from clinical presentation column of allergic/anaphylactic transfusion reaction.

Additional source (2018): https://www.ncbi.nlm.nih.gov/books/NBK482202/

-Connie		Agree with Connie.

- Vivek		Please remove "fever" from clinical presentation column of allergic/anaphylactic transfusion reaction. -VVPrelim accept by 2 authors + 1 editorAnthony DeFrancothis is my understanding as well that allergic reactions generally are not associated with fever to a significant degree.Accepttrue01/10/19 5:42 PMLucasNelsonlucasnelson@oakland.edu
233114ImmunologyImmune ResponsesBlood transfusion reactionshttps://www.uptodate.com/contents/clinical-features-diagnosis-and-treatment-of-disseminated-intravascular-coagulation-in-adults?search=DIC%20causes&sectionRank=1&usage_type=default&anchor=H255175&source=machineLearning&selectedTitle=1~150&display_rank=1#H255175Acute hemolytic transfusion reaction often present as DIC; as intravascular hemolysis is one of the causes of DIC.High-yield addition to next yearVerifiedReject. This is already present on page 420 in Heme/Onc -ScottReject.
Agree with scott, this is included in the mnemonic on page 420.

-Connie		Reject. No changes. -VVReject by 2 authors + 1 editor01/16/19 3:27 PMNicolasCuri Gawlinskinicolascurii@gmail.com
234114ImmunologyImmune ResponsesBlood transfusion reactionshttps://www.ncbi.nlm.nih.gov/books/NBK2265/#ch3.1.3In the "clinical presentation" column of "Acute hemolytic transfusion reactions" it states: hemoglobinuria (intravascular), jaundice (extravascular). BUT: jaundice occurs mainly at the intravascular hemolysis and only rarely occurs for extravascular hemolysis. This makes sense as hemolysis occurs at a much faster rate if it happens intravascular.Minor erratumCorrect. However, both do take place. Therefore, both intravascular and extravascular takes place and are included in the text. No changes recommended.Reject by 2 authors + 1 editor05/08/19 8:43 AMNoam LeanderDegnernoam.degner@me.com
235115ImmunologyImmune ResponsesAutoantibodieshttps://www.uptodate.com/contents/pathogenesis-of-hashimotos-thyroiditis-chronic-autoimmune-thyroiditisIn Hashimoto thyroiditis, antimicrosomal & antithyroid peroxidase refer to the same antibody. Put one of them in a parenthesis next to the other one so this becomes clear. The way it is currently written can lead somebody to falsely believe that they are different antibodies.Clarification to current textAgree. We could add this to the next edition. -Victor Martinez.VerifiedYes, antithyroid peroxidase was historically known as antimicrosomal. UTD link supports this.
-Connie		Agree but not an erratum.

- Sarah		Can be deferred to main cycle. Replace: "Antimicrosomal, antithyroglobulin, antithyroid peroxidase" WITH "Antithyroglobulin, antithyroid peroxidase (antimicrosomal)"Prelim accept by 2 authors + 1 editortrue01/07/19 3:19 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
236115ImmunologyImmune ResponsesAutoantibodieshttps://www.uptodate.com/contents/diagnosis-of-celiac-disease-in-adultsIn celiac disease, anti-tissue transglutaminase could also be IgG. This is useful because the IgG autoantibodies are used for the diagnosis of celiac disease in selective IgA deficiency.High-yield addition to next yearI don't think this fact is high yield, but we could add this to the next edition if other authors believe it is important. -Victor Martinez.VerifiedAccept but defer to 2020
This is true, UTD supports it too. Suggest, "Anti-endomysial (IgA), anti-tissue transglutaminase (IgA and IgG), deamidated gliadin peptide (IgA and IgG)" or "IgA anti-endomysial, IgA and IgG anti-tissue transglutaminase, IgA and IgG deamidated gliadin peptide."
-Connie		Agree with Connie. It might not be super HY, but it's not much extra work to just add in an extra IgG in there. -ScottReject. This is true but not HY for the exam. For the purposes of Step 1, it is more important to know the association of IgA with celiac disease rather than any other type of immunoglobulin. Suggest no change. -VVReject by 2 authors + 1 editor01/07/19 3:21 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
237115ImmunologyImmune ResponsesAutoantibodiesUworld, Becker Q bank, USMLE First AidShould add to the list: Autoantibody: "Anti-myelin antibodies"; Associated Disorder: "Multiple Sclerosis"High-yield addition to next yearI think we need faculty regarding this comment, usually, autoantibodies are not part of the typical workup for MS. According to Up to date: "patients with a typical presentation who have insufficient clinical and MRI evidence to confirm the diagnosis of MS by the McDonald criteria, additional testing with lumbar puncture for cerebrospinal fluid-specific oligoclonal bands, visual evoked potentials, and/or optical coherence tomography can be used to support the diagnosis, though optical coherence tomography is not part of the formal diagnostic criteria [2]. Of importance, these studies cannot be used to support optic nerve lesions in the absence of clear symptoms related to a current or historical attack. For patients with an atypical history, examination, or MRI, additional testing with spine MRI, lumbar puncture, and/or autoantibody determination for aquaporin-4 (AQP4) and myelin-oligodendrocyte glycoprotein (MOG) antibodies is warranted to investigate alternatives in the differential diagnosis. The neurological examination may reveal findings consistent with previous or current demyelinating events in the central nervous system, including optic neuritis (eg, relative afferent pupillary defect, color desaturation, visual loss), eye movement abnormalities (eg, internuclear ophthalmoplegia, pendular nystagmus), upper motor neuron signs (eg, spasticity, hyperreflexia, Babinski sign), ataxia, gait disturbance, hemisensory loss, or bilateral sensory loss and/or paresthesia in extremities due to a spinal cord lesion," https://www.uptodate.com/contents/evaluation-and-diagnosis-of-multiple-sclerosis-in-adults?search=antimyelin%20antibodies&source=search_result&selectedTitle=1~7&usage_type=default&display_rank=1#H2682842451 -Victor Martinez.VerifiedReject. Antimyelin antibodies currently lack clinical significance. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077472/ - ScottReject.
Anti-MOG antibodies have been a topic of debate for a long time, there are some excellent reviews (I'll cite below) that cover the history of this Ab and its association with differing neurological diseases.

That said, due to the ongoing controversy, it shouldn't be tested on Step 1. Reader says that UW is one of his sources, so if we can verify that, I suppose we should get an expert opinion.

In summary, some of the controversy about the relevance of these Abs is because it took a while to figure out that the Abs that target epitopes of myelin in its conformational state are biologically relevant, but the Abs that target epitopes of myelin in a denatured or linearized state are biologically irrelevant. Part of the long-standing assumption that these Abs are clinically associated with MS is due to extensive literature validating its role in murine EAE, but the literature in the more recent years basically slams the translational value of EAE models. Right now, the international consensus is that these Abs are important in pediatric and adult demyelination, but not associated with MS in adults. In fact, there was a publication last year in JAMA Neuro about anti-MOG associated demyelination being a completely new disease entry!

Sources:
https://jamanetwork.com/journals/jamaneurology/article-abstract/2685098
https://www.sciencedirect.com/science/article/abs/pii/S156899721500261X

-Connie		Completely agree with Connie. Anti-MOG antibody has created waves in the neurology community. This antibody is not necessarily associated with MS, and can sometimes be associated with optic neuritis or ADEM. Even if this is showing up on UWorld, I doubt that this would be tested on Step 1, considering how controversial this topic is in the neurology community. Would not recommend addition to the text. -VVReject by 2 authors + 1 editor01/26/19 3:18 PMPhuongVophuongtkvo@yahoo.com
238115ImmunologyImmune ResponsesAutoantibodieshttps://emedicine.medscape.com/article/176036-overview, as well as FA 2019 page 373 (to be consistent throughout the text)The associated disorder listed for "antiparietal cell, anti-intrinsic factor" autoantibodies is currently "pernicious anemia". Consider clarifying it to "pernicious anemia (autoimmune gastritis)" or "pernicious anemia, autoimmune gastritis" since autoimmune gastritis is a separate entity/condition that is associated with the listed autoantibodies and does increase the risk of pernicious anemia.Clarification to current text05/04/19 4:47 PMChristineLinchristine15yr@gmail.com
239115ImmunologyImmune ResponsesAutoantibodiesN/ARule of 3: PR3-ANCA (number 3), C-ANCA (C is the 3rd letter of the alphabet) and Granulomatosis With Polyangiitis (has 3 words)Mnemonic10/26/19 1:53 PMNunoLupi Mansonunomglmanso@gmail.com
240116IndexIndex22q11 deletion syndromesN/ADiGeorge syndrome is not listed in the index. Thymic aplasia is there but many people will be looking for DiGeorge.Minor erratumVerifiedDefer to 2020.

- Vivek		02/19/19 3:14 PMAlisonLissalisonmliss@gmail.com
241116ImmunologyImmune ResponsesImmunodeficienciesUSMLE-Rx (QID: 3718.10); https://emedicine.medscape.com/article/1050956-treatmentTreatment: IVIG; bone marrow transplant is not curative (differentiation of B cells would still not occur).High-yield addition to next yearI don't know which is the immunodeficiency that the student is referring to. However, on page 117 we do speak about IVIG and bone marrow transplant for SCID. A bone marrow transplant is curative for this disease. Up to date states: "...allogeneic hematopoietic cell transplantation (HCT) is clearly indicated for treatment of typical SCID. It is the only potentially curative, nonexperimental therapy available for a condition that is almost always lethal in the first few years of life..." https://www.uptodate.com/contents/hematopoietic-cell-transplantation-for-severe-combined-immunodeficiencies?search=SCID%20bone%20marrow%20transplant&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 -Victor Martinez.VerifiedReject. We do not have a section for treatment of these disorders anywhere. I do not recall seeing a step 1 question on management of these patients. -ScottReject.
Treatment of Bruton's XLA is not HY at all. Also it varies a lot.

-Connie		Agree, reject. -VVReject by 2 authors + 1 editor01/01/19 6:32 PMSarahMcGriffscmcgriff@gmail.com
242116ImmunologyImmune ResponsesImmunodeficienciesnot neededHighlight 22 in "22q11" to match mnemonic "CATCH-22".Spelling/formattingIt is not an error, but we could add this to the next edition to reduce the cognitive load. -Victor Martinez.VerifiedNitpicky, but we should be consistent with our formatting. -ScottAgree.

- Sarah		Sure. Please highlight the "22" in "22q11" in Column 2 to match the mnemonic in Column 3. -VVPrelim accept by 2 authors + 1 editortrue01/05/19 4:34 PMMoatasemAl-Janabiassoomi88@yahoo.com
243116ImmunologyImmune ResponsesImmunodeficiencies1. https://www.uptodate.com/contents/mendelian-susceptibility-to-mycobacterial-diseases-specific-defects, 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357480/I suggest renaming the IL-12 deficiency entry to Mendelian susceptibility to mycobacterial diseases (MSMD, mentioned on page 102 as well). IL-12 is the most common cause of MSMD (>50% of cases). Also list some other defects, especially INF-gamma receptor deficiency (seen it MULTIPLE times on different NBMEs and in UWorld).High-yield addition to next yearI think we need faculty input. The student seems correct, however, it is not clear if IL-12 deficiency can present only as Mendelian susceptibility to mycobacterial diseases. -Victor Martinez.VerifiedI would advise not changing the name because this entry is not specific to only MSMD, but to any cause of an IL-12 receptor deficiency. I think that we could mention MSMD again somewhere in the first column though. -ScottPartial accept!
I agree with Scott in that I don't think we should change the name of the entry. Quick lit search reveals that there are about 9 MSMD genes, of which two are related to IL-12. I think this entry is specific to IL-12.

However, I think we should add MSMD to the 3rd column "Findings." We include susceptibility to specific pathogens in the IgA and the candidiasis entries, I don't think adding MSMD would be out of place here.

Summary of reasoning:
MSMD is caused by several mutations in gene products that either affect the production or the response to IFNg. IL-12B and IL-12Rb1 are two autosomal genes that can cause this.
Because this is an IL-12R entry, we should keep it that way. The IL-12R is expressed by NK and T cells, and a receptor deficiency results in an inability to respond to IFNg. Contrary to some types of IFNgR deficiencies, IL-12 and IL-12R deficiency results in a "complete" phenotype, meaning that it always results in MSMD. To address Victor's concern, it looks like IL-12R deficiency will always present as MSMD due to the completely inability to respond to IFNg. It looks like there has been only 1 association of IL-12R deficiency with another systemic disease (Sjogrens, published 2017), so I don't think IL-12R deficiency will be tested in any other way.

-Connie

Sources:
https://www.ncbi.nlm.nih.gov/pubmed/25453225
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905729/
https://www.frontiersin.org/articles/10.3389/fimmu.2017.00885/full		Agree that we can include this in as a "Finding" rather than changing the name of the entry, considering that this entry is IL-12 specific. In findings, please include in the next line "Most common cause of Mendelian susceptibility to mycobacterial infections (MSMD)." -VVPrelim accept by 2 authors + 1 editortrue01/07/19 3:24 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
244116ImmunologyImmune ResponsesImmunodeficiencies1. https://www21.ucsg.edu.ec:2065/contents/common-variable-immunodeficiency-in-children?search=common%20variable%20immunodeficiency&source=search_result&selectedTitle=4~102&usage_type=default&display_rank=4#H10572287 ''Most patients with CVID present after puberty, and the disorder is usually diagnosed in the second or third decade of life. However, about 25 percent of all CVID patients present in childhood or adolescence, and there is an earlier peak of diagnosis at approximately eight years of age'' 2. https://www21.ucsg.edu.ec:2065/contents/clinical-manifestations-epidemiology-and-diagnosis-of-common-variable-immunodeficiency-in-adults?search=common%20variable%20immunodeficiency&source=search_result&selectedTitle=1~102&usage_type=default&display_rank=1In the commom variable immunodeficiency column, the part: ''Usually presents after 2 years and may be considered delayed''; could be changed to: ''Mainly diagnosed after 20 years old, with 25% of all patients detected before puberty, peaking at age 8''. Even though there is not an unanimous consensus on the age on onset, the way it's presented in the current text could be misleading and not helpful for the diagnosis of the disease.Major erratum08/28/19 12:44 PMFranciscoDuenasfrancisco.duenasmd@gmail.com
245116ImmunologyImmune ResponsesImmunodeficienciesNot neccessary, it comes from the collumn adjacent to the mnemonic.Just a simple addition of elevated eosinophils to the Hyper IgE (Job syndrome) mnemonic: Cold (noninflamed) staphylococcal Abscesses, retained Baby teeth, Coarse facies, Dermatologic problems (eczema), Elevated IgE & Eosinophils, bone Fractures from minor trauma. Learn the ABCDEF’s to get a Job!Mnemonic12/14/19 11:42 AMEricWallaceericwallace@students.aucmed.edu
246117ImmunologyImmune ResponsesImmunodeficiencieshttps://emedicine.medscape.com/article/137015-overviewWiskott-Aldrich syndrome: Mutation in WAS gene - should be WASpSpelling/formattingReject. WAS is the gene and WASp (p stands for protein) is the product protein. Therefore, our wording is correct. - Victor MartinezVerifiedReject.

WAS is the gene, WASP is the protein.

-Connie		Reject

We have correctly mentioned the gene name. WASp is a gene product and its gene WAS, which is mutated in this syndrome. The reference provided by the student itself is suggestive of the fact.

- Vivek		Agree, reject. -VVReject by 2 authors + 1 editor02/12/19 3:32 PMDianeVasquezdivasque89@gmail.com
247117ImmunologyImmune ResponsesImmunodeficiencieshttps://www.uptodate.com/contents/ataxia-telangiectasia?search=radiation%20ataxia%20telangiectasia&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Hypersensitivity to radiation cause multiple Double strand DNA breaks . Instead of what is in the book , just to clarify .High-yield addition to next yearVerifiedReject.
It's not because they're just "sensitive" to sun and that results in more DNA breaks. The sensitivity to ionizing radiation is due to the defect in detecting DNA damage which leads to a an accumulation of mutations, as we explain.

-Connie		Agree with Connie, reject. -VVReject by 2 authors + 1 editor02/19/19 12:27 AMLissetteOrozcolissetteorozco_004@hotmail.com
248117ImmunologyImmune ResponsesImmunodeficiencieshttps://emedicine.medscape.com/article/137015-overviewThe mnemonic WATER is already used for the symptoms of Wiskott-Aldrich syndrome. It is useful to point out that the A and E in it can also be used to memorize that IgA and IgE are increased in this disease.MnemonicVerifiedI like this!
I think it would be helpful and easy to add the increased IgA and IgE to the mnemonic! It's also helpful that those are the only two letters in WATER that could be an Ig.

-Connie		Agree that we can incorporate into the entry, as long as this change does not go to the next page. Please transfer to the annotate with appropriate red formatting and modifying the mnemonic as "WAATEER" -VVPrelim accept by 2 authors + 1 editortrue03/03/19 7:01 AMDanielBadindaniel.badin434@hotmail.com
249117ImmunologyImmune ResponsesImmunodeficienciesi saw this mneomonic on a YouTube channelLeukocyte adhesion deficiency (type 1) there is a really good way to sum up the condition which is by the name of the condition itself: L A D L: Late separation of the cord. A: Absence of the pus. D: Dysfunctional Neutrophil.MnemonicVerifiedYAS I like this one a lot. It's easy to remember and helpful.

We already list these symptoms. Organizing it into LAD and highlighting the letters in leukocyte adhesion deficiency is also easy.

-Connie		Love it, please add to annotate with appropriate red formatting. -VVPrelim accept by 2 authors + 1 editortrue04/18/19 4:24 PMMohamedAlmahmodim.s.alhuthali@gmail.com
250117ImmunologyImmune ResponsesImmunodeficienciesNot applicableMnemonic for decreased TRECS in SCID: "SCIDDING (skidding) because there are no TRECS (tracks)!"MnemonicVerified06/10/19 8:24 PMMehreenAlidr.mehreenali@gmail.com
251119ImmunologyImmune ResponsesTransplant rejectionN/AGVHD row, last column, line 9, the word "transfusion" is miss-spelled.Spelling/formattingAgree. Minor spelling problem -Victor MartinezVerifiedAgree. Change "tranfusion" to "transfusion". - SarahAgree, but doesn't need to be on published errata, can defer to 2020

-Connie		Please replace "tranfusion" with "transfusion" in Row 4, Column 4 of the Transplant rejection table -VVPrelim accept by 2 authors + 1 editortrue12/22/18 9:12 AMBehnamNabavizadehbehnam.nabavi@yahoo.com
252119ImmunologyImmune ResponsesTransplant rejectionhttp://tpis.upmc.com/tpislibrary/kidney/KHAcuRej.html, also https://en.wikipedia.org/wiki/Fibrinoid_necrosisto add "Fibrinoid" necrosis under the hyperacute rejectionHigh-yield addition to next yearVerifiedNo, fibrinoid necrosis is not exclusive to transplant rejection, and is more commonly used in the context of vascular damage due to autoimmune disease, high bp, like literally anything else but transplant rejection.

-Connie

https://onlinelibrary.wiley.com/doi/full/10.1002/%28SICI%291096-9896%280000%299999%3A9999%3CN/A%3A%3AAID-PATH610%3E3.0.CO%3B2-I		Agree with Connie, reject. -VVReject by 2 authors + 1 editor03/01/19 6:54 PMAlaJamalala.aljamal@hotmail.com
253120ImmunologyPharmacologyImmunosuppressantsSelf-made mnemonicBasiliximab mnemonic: The basilisk is in the 2nd Harry Potter movie (IL-2), when it bites someone they get scared (hypertension), swell up (edema), and shake in fear (tremor).MnemonicI like this mnemonic. I think people can relate to this. We should consider it for the next edition. - Victor MartinezVerifiedThis is a nice story mnemonic! Most people know about harry potter, and even if they don't, a basilisk is also just a mythical giant reptile and that works with the mnemonic regardless.

-Connie		I love this mnemonic, but unfortunately we do not include references to popular culture. We unfortunately had to reject a really good Harry Potter reference two years ago for this same reason :'( -VVReject by 2 authors + 1 editor02/11/19 2:44 PMThomasPolveroni-EdwardsPolveroni-Edwards.Thomas@mayo.edu
254120ImmunologyImmunosuppressantsImmunosuppressantsminor missing detail in 2019 First Aid TextMissing Daclizumab on page/column with Basiliximab. It is in previous versions but was left out in 2019 version. Despite this it is still found in the Index and refers to page 120.Minor erratumVerifiedAgree to remove from index, not add back.

Daclizumab has been pulled from the market. Should just remove the mention in the index.

-Connie		It was not tabulated either in the FAS18 edition. But I agree with the student that it is still indexed and referred to page 120 which needs to be deleted from index chapter.

- No errata
- Change during 2020 revision.


- Vivek		Agree, I'll add a note to the index. We decided to take it out last year due to it being removed from the market and because it was lower yield compared to the other drugs in the table. -VVPrelim accept by 2 authors + 1 editor02/22/19 6:21 PMAidaRoshansky-Kokaaidakokamd@gmail.com
255121ImmunologyImmunosuppressantsRecombinant cytokines and clinical usesIt's MnemonicIFN-*β* --->Multiple sclerosis(demyelination of CNS (*B*rain and spinal cord)).\Highlight "β and letter B in Brain".MnemonicIf we add this mnemonic to the next edition, I think it would be a better fit in the interferons entry on page 109. -Victor Martinez.VerifiedNot a bad mnemonic! Suggest consideration for 2020. -ScottI actually would reject this.

"B" for "brain" doesn't intrinsically link IFNb with multiple sclerosis. Also, if this is supposed to help with remembering what is included in the CNS, I feel like that's unnecessary because I think students should already know this before starting FA.

-Connie		Agree with Connie, reject. -VVReject by 2 authors + 1 editor01/02/19 3:08 PMMoatasemAl-Janabiassoomi88@yahoo.com
256121ImmunologyImmunosuppressantsRecombinant cytokines and clinical useshttps://www.uptodate.com/contents/clinical-applications-of-thrombopoietic-growth-factors?search=oprelvekin&source=search_result&selectedTitle=2~38&usage_type=default&display_rank=1INTERLEUKIN - 11: AGENT: Oprelvekin MECANISM: stimulates megakaryocyte growth in vitro and increases platelet production in vivo CLINICAL USES: ly reduced the extent of chemotherapy-induced thrombocytopenia and the need for platelet transfusions ADVERSE EFFECTS: luid retention with dilutional anemia, peripheral edema, pleural effusions, and atrial arrhythmiasHigh-yield addition to next yearVerifiedReject.
The UTD literally says, "Given its many adverse effects, use of oprelvekin is rarely justified."

And it's listed under "other," so definitely won't be tested.

-Connie		Agree, reject LY. -VVReject by 2 authors + 1 editor02/19/19 12:57 AMLissetteOrozcolissetteorozco_004@hotmail.com
257122ImmunologyImmunosuppressantsBevacizumabhttps://www.uptodate.com/contents/search?search=Bevacizumab&submit=GoUnder the notes section it states, "Also used for neovascular age-related macular degeneration, proliferative diabetic retinopathy, and macular edema." I believe it is important to recognize that Bevacizumab is used off-label for this indication. Bevacizumab/Avastin has never been FDA approved for ocular indications or intravitreal administration. While bevacizumab and ranibizumab are created from the same parent mouse antibody, they are two distinct antibodies and approved for two different indications. While bevacizumab is widely used for the indications listed in the notes, I think it would be appropriate to clarify that those are "off-label" clinical uses of bevacizumab. This has generated a great deal of controversy in ophthalmology and students should be aware that this particular antibody, while used for ocular indications, is not actually approved for such indications.Clarification to current text10/03/19 3:50 PMWilliamBloomwilliam.bloom3993@gmail.com
258122EndocrinePharmacologyDiabetes mellitus managementhttps://resident360.nejm.org/content_items/degludec-versus-glargine-in-type-2-diabetes, https://www.nejm.org/doi/pdf/10.1056/NEJMoa1615692should probably include degludec under the injectables given the big splash it's made in the last year through NEJMHigh-yield addition to next yearIt always takes a few years for new drugs to make it onto standardized tests. Let's wait a little longer. -Scott04/16/19 12:13 PMJan AndreGraumanjgrauman@gmail.com
259122ImmunologyImmunosuppressantsImmunosuppressantshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5713267/ https://www.ncbi.nlm.nih.gov/pubmed/26649440Agent: Secukinumab, Ixekizumab. Target: IL-17A. Clinical Use: Psoriasis, Psoriatic ArthritisHigh-yield addition to next yearI think this is worth adding! We have the TNF and IL-23 drugs, but generally I think we're moving away from the TNFa drugs. IL-17 is a huge target for psoriasis biologics, but we don't mention any.

Suggest adding entry above Ustekinuma:
Ixekizumab, Secukinumab.
IL-17A
Psoriasis, psoriatic arthritis

If there's no room here, we could consider moving to MSK chapter!

-Connie

https://www.uptodate.com/contents/treatment-of-psoriasis-in-adults?search=ixekizumab&source=search_result&selectedTitle=2~21&usage_type=default&display_rank=1#H625584391		Agree. Please add in per Connie, if space permits. If not, we can think about incorporating in the MSK chapter. -VVPrelim accept by 2 authors + 1 editortrue03/27/19 12:14 AMSteffanieCamilo Tertuliensteffkmilo@hotmail.com
260122ImmunologyImmunosuppressantsTherapeutic antibodiesIt's MnemonicE is the 5th letter alphabetically -->Eculizumab Complement protein C*5* .MnemonicReject. I don't feel this can be easily remembered. -Victor Martinez.VerifiedYeah, this is fine. I'm not inclined to accept or reject for 2020. -ScottReject.

-Connie		Reject. -VVReject by 2 authors + 1 editor01/13/19 2:14 PMMoatasemAl-Janabiassoomi88@yahoo.com
261122ImmunologyPharmacologyTherapeutic antibodieshttps://www.ncbi.nlm.nih.gov/pubmed/25823918if you can add these drugs with targeted receptor to therapeutic antibodies table: anti programmed cell death protein 1 (PD-1) therapy ( eg, pembrolizumab,nivolumab) or programmed cell death ligand PD-L1 (eg,Atezolizumab) are currently used in advanced melanoma, certain types of lung cancer and renal cell carcinomaMajor erratumReject.
We cover all these in Heme/Onc and Path, and I think that's a much better place for these facts.

-Connie		Agree, reject. We even have a really nice diagram that was created by our illustration team last year :) -VVReject by 2 authors + 1 editor03/27/19 8:03 AMMuhanadShaibmohanad.shaib@gmail.com
262122Neurology and Special SensesImmunosuppressantsTherapeutic antibodieshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100258/aimovig-erenumab-aooe-certolizumab pegol is another clinically relevant TNF alpha antibodyHigh-yield addition to next yearBelongs in immunology section04/16/19 12:00 PMJan AndreGraumanjgrauman@gmail.com
263122Neurology and Special SensesImmunosuppressantsTherapeutic antibodieshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100325/cimzia-certolizumab-pegol-certolizumab pegol is another clinically relevant TNF alpha antibodyHigh-yield addition to next yearDuplicate04/16/19 12:00 PMJan AndreGraumanjgrauman@gmail.com
264122ImmunologyImmunosuppressantsTherapeutic antibodieshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100325/cimzia-certolizumab-pegol-certolizumab pegol is another clinically relevant TNF alpha antibodyHigh-yield addition to next yearReject.
Approved by FDA <1 yr ago won't be tested.

-Connie		Reject -VVReject by 2 authors + 1 editor04/16/19 12:04 PMJan AndreGraumanjgrauman@gmail.com
265122ImmunologyImmunosuppressantsTherapeutic antibodieshttps://alexion.com/products/Soliris/Soliris-Generalized-Myasthenia-GravisEculizumab approved for Myasthena Gravis, Oct 2017High-yield addition to next year05/15/19 12:09 PMAveryElifritzelifritz70@gmail.com
266122ImmunologyImmunosuppressantsTherapeutic antibodieshttps://www.cdc.gov/meningococcal/clinical/eculizumab.html https://alexion.com/products/Soliris/Soliris-Generalized-Myasthenia-GravisEculizumab has black box warning for meningococcemia - Link with "Terminal complement deficiency (C5-C9)" on pg 107High-yield addition to next year05/15/19 12:13 PMAveryElifritzelifritz70@gmail.com
267122ImmunologyImmunosuppressantsTherapeutic antibodiesN/AAbciximab GP IIb/IIIa mnemonic: AbSIXimab; II (2) x III (3) = 6MnemonicVerified06/06/19 10:11 PMHaleyD'SouzaDSouzaHS@evms.edu
268122ImmunologyImmunosuppressantsTherapeutic antibodiesSelf-writtenb'EV'acizumab - 'VE'gf /// TRASTuzumab - give a lot of TRUST-2-HER with BREAST cancer (HER2).Mnemonic10/30/19 11:21 AMKhalidAlattarkhalid_alattar@hotmail.com
269124MicrobiologyBasic BacteriologyBacterial structuresNot needed.Last sentence in the second column which reads ‘Lipoteichoic acid (gram positive) only extend from membrane to exterior.’ should read ‘’Lipoteichoic acids (gram positive only) extend from membrane to exterior.’Spelling/formattingStaff acceptsUser is correct. Grammar issue.

Revise text from
".. acids (gram positive) only extend from .."
to
".. acids (gram positive only) extend from .."

- Humood		Agree with Humood.


- Vivek		01/01/19 9:14 AMMuhammad FaizanAlifaizanali.93@hotmail.com
270124MicrobiologyBasic BacteriologyBacterial structureshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595480/Gram-positive bacteria also has periplasm (book says: gram-negative only). In gram-positive, periplasm between peptidoglycan and plasma membrane.Major erratum08/25/19 11:29 AMDalerKudratovKUDRATOVD@GMAIL.COM
271125MicrobiologyBasic BacteriologyPleomorphic bacteriaMy brainCREAM does not have a shapeMnemonicVerifiedAccept.

Reasonable mnemonic. Let's discuss on Annotate.

- Humood		Accept. But it is not true that pleomorphic bacterias have no shape.Will need to tweak it on annotate.


- Vivek		01/12/19 7:50 PMLeviMarshallLSMmt4@health.Missouri.edu
272125MicrobiologyBasic BacteriologyPleomorphic bacterian/a“Ana, Rick and Mike from US Climbed Everest and said: NO WALL!” Anaplasma, Rickettsiae, Mycoplasma, Ureaplasma, Chlamydia, Ehrlichia No Peptidoglycan CELL WALL.MnemonicVerifiedNot a big fan. Sorry.

- Humood		Reject.

It is a long mnemonic and fairly confusing even after reading it for the third time.

Ashten		07/10/19 9:31 PMAPandeyaranikopandey@gmail.com
273125MicrobiologyBasic BacteriologyStainsNAPrimarily Intracellular Organisms Mnemonic: REAL intra-Cellular Body i.e. Rickettsia, Ehrlichia, Anaplasma, Legionella, Chlamydia, BartonellaMnemonicVerifiedReject.
Not a big fan, sorry. If others find it helpful, feel free to accept it.

- Humood		Not very helpful. Reject.


- Vivek		01/22/19 3:25 AMMurliMishramm.murli@gmail.com
274125MicrobiologyClinical BacteriologyYersinia enterocoliticahttps://www.ncbi.nlm.nih.gov/books/NBK7798/My comment is regarding Yersinia pestis, on page 125 in microbiology section under clinical bacteriology on the gram negative lab algorithm it states that Yersinia pestis is a gram negative bacilli. Upon further research and studying it has come to my attention that it in fact is a coccobacilli rather then just bacilli. During a question on my uworld i had gotten the question wrong because of this misleading information. It kept describing in the vignette a gram negative coccobacilli but looking at first aid gram negative lab algorithm it was classified as bacilli. Hopefully this error could be fixed for the next edition. Also is attached a supporting reference stating on a medical journal it is in fact a coccobacilli.High-yield addition to next year08/20/19 4:23 PMsagarvinayaksagarvinayak@hotmail.ca
275126MicrobiologyBasic BacteriologySpecial culture requirementsmenmonic onlymnemonic for culture media: Charcoa*L* for *L*egione*ll*aMnemonicVerifiedReject.
Not a big fan, sorry. If others find it helpful, feel free to accept it.

- Humood		Not helpful. Reject.

- Vivek		01/04/19 9:39 AMStevenFlamerflamer@mail.einstein.yu.edu
276126MicrobiologyBasic BacteriologySpecial culture requirementsmnemonic onlymnemonic for culture media: Thayer-Marti*N*for *N*eisseria.MnemonicVerifiedReject.
Not a big fan, sorry. If others find it helpful, feel free to accept it.

- Humood		Not helpful. Reject.

- Vivek		01/04/19 9:40 AMStevenFlamerflamer@mail.einstein.yu.edu
277127MicrobiologyBasic BacteriologyBordetella pertussishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264864/Bordetella Pertussis has a capsule and should be added to the Encapsulated bacteriaClarification to current textVerifiedReject.

Vivek makes a good point: if the capsule has not been clearly identified as a virulence factors (i.e., promoting evasion of phagocytic destruction), then it is highly unlikely USMLE will go after it on Step 1. The fact is probably of little clinical relevance besides the fact that capsule stains could be used. But, my understanding is that culturing a sample suspected of containing B. pertussis on Bordet-Gengou or Regan-Lowe agar for high specificity or using PCR to detect target DNA is preferred anyway from a diagnostic standpoint. I would not include it because there are much higher-yield facts to remember about encapsulated bacteria.

- Ashten		Yes, the user is correct. There are some other bacterias also with capsule. Unless it has a good pathoimmulogic basis it is not going to be tested.

"the B. pertussis PS capsule is not involved in classical capsule-mediated defense mechanisms, including adherence to mammalian host cell, complement-mediated killing and antimicrobial attack [17]. Currently, it is not known whether the B. pertussis PS capsule plays any role in bacterial virulence within an infected host."


However, the study referred to by the user states that "their work provides the first experimental evidence of a role for a virulence-repressed gene in pertussis pathogenesis."

We can further weigh in on the annotate for inclusion.


- Vivek		Good discussion. I agree with the authors that this is a LY fact. The list of capsulated organisms is not inclusive or comprehensive.

- Sarah		Reject by 2 authors + 1 editor03/10/19 10:49 PMJorgeAvilajorgeavila@uees.edu.ec
278128MicrobiologyBasic BacteriologyCatalase-positive organismsI made this mnemonic.SHE PLANS BC (of her) Cat... that is a mnemonic that is more helpful for the catalase + organisms because all the letters (SHE PLANS BC) are bacteria. The current one is okay and relates to cats but everyone I know says it is hard to remember and this one is easier.MnemonicVerifiedReject.
Not a big fan, sorry. If others find it helpful, feel free to accept it.

- Humood		Reject. A crowd sourcing participant has suggested a good mnemonic which we have accepted already.

- Vivek		01/10/19 2:09 PMCharanpreetSahotacharanksahota@gmail.com
279128MicrobiologyBasic BacteriologyCatalase-positive organismshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC380547/Klebsiella is a catalase positive organismHigh-yield addition to next year08/29/19 2:20 PMJayShahjayshah0425@gmail.com
280128MicrobiologyBasic BacteriologyCatalase-positive organismshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC380547/KATs Need PLACESS to Belch their Hairballs. KATs here stands both for Klebsiella and Catalase. The rest is just like in the bookMnemonic11/11/19 1:36 PMStanislavGruzdevstas200910@yandex.ru
281129MicrobiologyBasic BacteriologyType III secretion systemBent, Z. W., Branda, S. S., & Young, G. M. (2013). The Yersinia enterocolitica Ysa type III secretion system is expressed during infections both in vitro and in vivo. MicrobiologyOpen, 2(6), 962–975. doi:10.1002/mbo3.136Mnemonic: Third borns are always PESSY (Third for Type III secretion system; PESSY for Pseudomonas, E. coli, Shigella, Salmonella and Yersinia enterocolitis.MnemonicVerifiedNot a big fan. Sorry.

- Humood		Reject.

The mnemonic feels pretty forced, and "PESSY" does not register immediately on an initial read. I would much prefer a mnemonic for this that is more integrative (e.g., Gram-negative pathogens, GI pathogens, etc.).

Ashten		06/08/19 2:21 PMKariukiMainamaina@mail.einstein.yu.edu
282129MicrobiologyBasic BacteriologyType III secretion systempersonalInitials of every bacteria can be found on the subject itself: ''Type III SEcrEtion SYStem'' (pSEudomona, E coli, Salmonella, Yersinia, Shigella).MnemonicVerified08/29/19 10:02 AMFranciscoDuenasfrancisco.duenasmd@gmail.com
283131MicrobiologyBasic BacteriologyMain features of exotoxins and endotoxinsN/Aunder "Chemistry" of "Exotoxins", edit it to become: "Polypeptide with A and B components. A (active) component produces toxic effects and B (binding) components binds to cell surfaces."High-yield addition to next yearVerifiedReject.

Unless I am mistaken, I think this a faulty generalization. If we changed the text to what is suggested, it would imply that all exotoxins have A and B moieties / components, which is not true. In fact, AB toxins fall within one class of exotoxins (i.e., type III). Take TSST-1 from S. aureus as an example: its mechanism of pathogenicity is via non-specific MHC II binding on the cell surface. So, the chart should not be changed to include this because it would give the wrong impression to readers.

Ashten		I think this is not high yield to be mentioned in the table.


- Vivek		02/27/19 1:47 PMRalphZeitounriz07@mail.aub.edu
284132MicrobiologytrueMolecularBacteria with exotoxinshttps://iai.asm.org/content/73/5/2698Text indicates "Pertussis Toxin Overactivates adenylate cyclase (t cAMP) by disabling C;, impairing phagocytosis to permit surviva l of microbe". However, it is misguiding as "Pertusis Toxin (PT) is an AB5 toxin that is uniquely produced by B. pertussis. It comprises an enzymatically active A subunit (S1) that ADP ribosylates the alpha subunit of heterotrimeric Gi proteins in mammalian cells, and a B heteropentamer that binds unidentified glycoconjugate receptors on cells. ADP ribosylation of G proteins by PT causes a wide range of effects on signaling pathways in mammalian cells and is responsible for the systemic symptoms of pertussis disease, such as lymphocytosis, insulinemia, and histamine sensitivity. PT is an important colonization factor for B. pertussis lower respiratory tract infection and that PT plays an early role in this host-pathogen interaction, including delaying the recruitment of neutrophils to the site of infection. PT acts as a soluble factor that can enhance B. pertussis respiratory tract colonization. PT also suppresses serum antibody responses to B. pertussis after respiratory tract infection and may play multiple immunosuppressive roles in the host-pathogen interaction. "Major erratumVerifiedDefer to expert opinion.

Ashten		Already addressed by faculty.

- Vivek		Defer to an expert, this is beyond me.Disagreement/need expertSheldon CampbellWhile I'd need to look at the original text (is it referenced here -- if so, how?), the confusion arises from the fact that B. pertussis has several significant toxins. The 'pertussis toxin' ADP-ribosylated G proteins, resulting in interference with multiple signaling pathways, including some associated with immune response. There's also an adenylate cyclase toxin that increases cAMP levels, with, again, multiple effects. It's clear that multple factors, toxin and non-toxin, are responsible for pertussis. See: Melvin JA, Scheller EV, Miller JF, Cotter PA. Bordetella pertussis pathogenesis: current and future challenges. Nat Rev Microbiol. 2014 Apr;12(4):274-88.Warren Levinson1. Delete second part starting wiih impairing phagocytosis…

2. The first part is correct but I would reword it to say:

Inactivates inhibitory G subunit (Gi) which activates adenylate cyclase and increases cAMP		AcceptDelete:
Impairing
phagocytosis to permit
survival of microbes		true01/21/19 4:07 PMMurliMishramm.murli@gmail.com
285132MicrobiologyBasic BacteriologyBacteria with exotoxinsN/Aunder mechanism of Diphteria toxin and Exotoxin A, edit it to: "Inactivates elongation factor (EF-2) by ADP-ribosylation"High-yield addition to next yearVerifiedAgree with Vivek's suggestion.

Ashten		Yes, both are ADP-ribosylating exotoxins. We can edit the text to "Inactivate elongation factor (EF-2) by ADP-ribosylation.

https://www.ncbi.nlm.nih.gov/pubmed/119972
https://en.wikipedia.org/wiki/ADP-ribosylation

- Vivek		02/27/19 1:48 PMRalphZeitounriz07@mail.aub.edu
286132MicrobiologyBasic BacteriologyBacteria with exotoxinshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041834/increased fluid secretion: B. anthracis it states that that toxin is edema factor, which is incorrect. The toxin is Edema toxin ( protective antigen plus Edema factor) (AB toxin) , in which Edema factor is the A component that causes the increase in cAMP, and the B component is protective antigen, which mediates the adhesion to host cells. Individually they are non toxic and must be in a pair to form a virulence factor.Major erratumVivek's comment is solid. The commenter does have a valid point. I favor the idea of using "anthrax toxin" for the sake of consistency.

Ashten		In 2018 FA, it was edema toxin. Not sure why was it changed to last year. The student is correct that "The three components of the anthrax exotoxins, PA, LF, and EF, are individually non-toxic, but they pair to form the two major virulence factors of B. anthracis: lethal toxin (LT, composed of LF + PA) and edema toxin (ET, composed of EF + PA)"

# I think we mentioned edema factor because this is what causes characteristic edematous borders of black eschar in cutaneous anthrax.

I suggest we change "edema factor" to "anthrax toxin" as we mention that on page 137 "B. anthracis produces anthrax toxin (an exotoxin consisting of protective antigen, lethal factor, and edema factor)?

- Vivek		I agree. Using "anthrax toxin" is more comprehensive and less prone to being misleading. And it adds consistency throughout the chapter.

Sarah		true06/13/19 8:27 PMahmedshakirashakir85@gmail.com
287132MicrobiologyBasic BacteriologyBacteria with exotoxinsfirst aidwe can use mnemonic: she has cold blood not eating protein but fake corn (she --> shigella, cold blood--> hemorrhagic E coli, not eating protein--> inhibit protein synthesis, fake--->pseudo in pseudomonas, corn--> corynebacterium)MnemonicVerified08/31/19 9:18 AMMohamedMenofymohamed.a.menofy@gmail.com
288132MicrobiologyBasic BacteriologyBacteria with exotoxinsfirst aidwe can use mnemonic: VIP in Rio 2020 pass the cold water( vip rio--> vibrio , pass--> bacillus, the cold--> toxigenic E coli , water --> fluid secretion)MnemonicVerified08/31/19 9:21 AMMohamedMenofymohamed.a.menofy@gmail.com
289132MicrobiologyBasic BacteriologyBacteria with exotoxins-Bacteria that causes diarrhea via increase in c(A)MP ---> (A)ctively secrets Cl into the lumen, While cGMP only prevents absorptionMnemonicVerified09/08/19 11:43 AMAhmad Y.ObeidatObeidat.amd@hotmail.com
290132MicrobiologyBasic BacteriologyBacteria with exotoxinsSelf-writtenPSEUDO's use LONG structures to cause disease. 1) PSEUDOmonas infection often due to mechanical ventilations LONG TUBE use. 2) PSEUDOmembranes in LONG THROAT with diptheria. Both these PSEUDO organisms inactivate eLONGation factor!Mnemonic10/31/19 5:28 AMKhalidAlattarkhalid_alattar@hotmail.com
291132MicrobiologyBasic BacteriologyBacteria with exotoxinshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356903/Heat-stable toxin in Enterotoxigenic E. Coli not only inhibits NaCl reabsorbtion but also enchances Cl- secretion ("Heat-stable enterotoxin STa binds to the guanylate cyclase C receptor and activates its intracellular catalytic domain, causing the hydrolysis of guanosine triphosphate (GTP) and accumulation of intracellular cyclic GMP (cGMP) levels. These increased cGMP levels activate cGMP-dependent protein kinase II (PKGII) [15,50,51]. In addition, cGMP was shown to inhibit phosphodiesterase 3 (PDE3), leading to the activation of cAMP-dependent protein kinase A (PKA) [52]. Activated PKGII and PKA phosphorylate and open the cystic fibrosis transmembrane conductance regulator (CFTR) Cl− channel, inducing Cl− and HCO3− release into the intestinal lumen [50,51,52,53]. Protein kinase A also phosphorylates the sodium/hydrogen exchanger 3 (NHE3) that inhibits Na+ reabsorption (Figure 2) [54].")Major erratum11/15/19 12:57 PMStanislavGruzdevstas200910@yandex.ru
292133MicrobiologyBasic BacteriologyEndotoxinn/aLipopolysaccharide is made of Lipid A + O antigen + polysaccharide. Lip + O + polysaccharide (lipopolysaccharide) --> Lipid A + O antigen + polysaccharideMnemonicVerifiedReject.
I find it complicated.
If others find it helpful, feel free to accept it.

- Humood		I think we don't need mnemonic to remember all the components. So, would reject this submission.

- Vivek		02/21/19 1:30 PMJosephHuntleyhuntleyjh@gmail.com
293133MicrobiologyBasic BacteriologyEndotoxinhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC187311/adding TLR4 to the abbreviations at the end. TLR4 stand for Toll-Like Receptor 4Spelling/formattingAgreed.

- Humood		05/13/19 10:29 PMMuhanadShaibmohanad.shaib@gmail.com
294134MicrobiologyClinical BacteriologyGram-positive lab algorithmhttps://www.ncbi.nlm.nih.gov/pubmed/24451174 https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-listeria-monocytogenes-infectionListeria is facultative anaerobic bacilliMinor erratumCurrently we are correct in saying Listeria is aerobic (As supported by the UTD link). I am not sure if we need to mention it being facultaive anaerobic.

- Vivek		I agree with Vivek in that it is more HY to be aware that listeria is an aerobic organism. The addition of it being a facultative anaerobic seems LY and unlikely to be tested.

- Sarah		Reject by 2 authors + 1 editor06/22/19 12:31 PMClaudiaLaborcl.claudiaflora@gmail.com
295134MicrobiologyClinical BacteriologyStaphylococcus saprophyticusnot applicableI think the mnemonic: no stress is confusing, one can easily confuse StRESs Saprophyticus Resistant Epidermidis Sensitive with: stRESS Resistant Epidermidis Sensitive Saprophyticus. I suggest changing it with: In the hospital staff (staphylococcus) none voted (novobiocin) for ESR (Epidermidis Sensitive Saprophyticus Resistant)MnemonicVerifiedAccept.

Reasonable mnemonic. Let's discuss on Annotate.

- Humood		Agree, this mnemonic makes more sense.

- Vivek		03/23/19 7:28 PMAwabElnaeemawab.kamal@gmail.com
296135MicrobiologyClinical Bacteriologyα-hemolytic bacteriahttps://www.uptodate.com/contents/approach-to-gram-stain-and-culture-results-in-the-microbiology-laboratoryAlpha hemolysis is a partial hemolysis where hemoglobin is oxidized (not reduced) to methemoglobin and turns green.Minor erratumAccept.
User is correct per resource provided. Errata.

- Humood		Accept.

This is true: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071541/. The iron in the heme is oxidized from the ferrous (Fe2+) to ferric (Fe3+) form.

Ashten		true05/05/19 11:45 AMNaylaMrouehnaylamroueh@gmail.com
297136MicrobiologyClinical BacteriologyStreptococcus pyogenes (group A streptococci)https://reference.medscape.com/calculator/jones-criteria-diagnosis-rheumaticMajor criteria for rheumatic fever: J-Joint involvement ♥-Carditis N-Nodules, subcutaneous E-Erythema marginatum S-Syndenham chorea Minor criteria for rheumatic fever: H-Heart block (↑PR interval) A-Arthralgia “L”-Elevated ESR/CRP, leukocytosis F-Fever Need 2 major criteria or 1 major and 2 minor criteria for diagnosis. (2 HALF make up for 1 J♥NES)MnemonicVerifiedDefer to Cardio team.

- Humood		The mnemonic is interesting. But it took me time to understand. So, I feel it will overcomplicate the memorization. It is better to remember as it is rather than to understand another mnemonic IMO.


- Vivek

[cardio team feel free to override my comment if you want to work up this]		01/01/19 6:56 PMSarahMcGriffscmcgriff@gmail.com
298136MicrobiologyClinical BacteriologyViridans group streptococciN/AStrep "M"utans and Strep "M"itis --> "M"outh --> dental cariesMnemonicVerifiedAccept.

Reasonable mnemonic. Let's discuss on Annotate.

- Humood		Yes, let's discuss this on annotate. It looks a good mnemonic.

- Vivek		03/01/19 10:05 AMRalphZeitounriz07@mail.aub.edu
299137MicrobiologyClinical BacteriologyBacillus anthracis1. https://www.uptodate.com/contents/microbiology-pathogenesis-and-epidemiology-of-anthrax, 2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041834/Multiple newer sources state that the anthrax toxin is not a single exotoxin composed of three molecules. Bacillus anthracis produces two anthrax toxins (exotoxins), edema toxin (ET) and lethal toxin (LT), each of which consists of two subunits. When the protective antigen (PA) combines with the edema factor (EF), it gives rise to the edema toxin. When the protective antigen (PA) combines with the lethal factor (LF) it gives rise to the lethal toxin. So to summarize: LT = LF + PA, ET = EF + PA. Please correct this on page 132 (footnote) as well.Minor erratumVerifiedReject. Fine as is.

Per UTD, "Virulent B. anthracis requires a poly-D-glutamic acid capsule and three proteins (edema factor [EF], lethal factor [LF], and protective antigen [PA]) [16]."
https://www.uptodate.com/contents/microbiology-pathogenesis-and-epidemiology-of-anthrax?search=anthrax&topicRef=5533&source=see_link#H4

- Humood		Agree, reject. For exam purposes this is correct.Reject by 2 authors + 1 editor01/07/19 3:39 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
300137MicrobiologyClinical BacteriologyStreptococcus agalactiae (group B streptococci)Self-writtenGroup B Strep. went to CAMP with staph aureus (group B strep gives CAMP factor to increase staph aureus hemolysis)Mnemonic10/31/19 5:19 AMKhalidAlattarkhalid_alattar@hotmail.com
301138MicrobiologytrueToxicities and Side EffectsClostridiahttps://www.annualreviews.org/doi/abs/10.1146/annurev-micro-090816-093458?casa_token=ga1wCncZq4UAAAAA:6rU4x_nmFz-dAJ9q_iqIZOS1Ka0ezH43uV1IczlQ2Rihc7gqh_9WTsxvAaNCzuukflE2qSqiQDxygpJ-Toxin A was initially considered Enterotoxin and Toxin B as cytotoxin. However, consensus has changed in last 2-3 years. Both Toxin A as well as Toxin B have enterotoxicity.Minor erratumVerifiedNo action needed. Already on annotate as published errata.

- Humood		Agree, defer to an expert. Can't find too many sources on this.Disagreement/need expertSheldon CampbellI believe the distinction is LY. Both A and B toxins seem able to contribute to C difficile disease, and they operate by similar mechanisms.Warren LevinsonI would replace the first 4 lines with:

Produces Toxins A and B that damage enterocytes.

Then continue with : Both toxins lead… etc		AcceptReplace: "Produces 2 toxins. Toxin A, an enterotoxin,
binds to brush border of gut and alters fluid
secretion. Toxin B, a cytotoxin, disrupts
cytoskeleton via actin depolymerization." with "Produces Toxins A and B that damage enterocytes."		true01/02/19 12:17 PMMurliMishramm.murli@gmail.com
302138MicrobiologyClinical BacteriologyClostridiahttps://www.hindawi.com/journals/criid/2015/694247/I think it would be better if you add Closttridum Septicum to clostridia table and the difference between C.perfringen in Gas gangren causes as C.septicum not preced by trauma(atrumatic myonecrosis). Moreover C.septicum is underlying by colonic malignancyHigh-yield addition to next yearReasonable suggestion. However, needs to be drafted.

- Humood		05/13/19 11:32 PMMuhanadShaibmohanad.shaib@gmail.com
303138MicrobiologyClinical BacteriologyClostridia--"spas" in "tetanospasmin" should be highlighted to correspond to the highlight in "spastic" paralysisSpelling/formattingMigrated to annotate.
- Humood		true05/14/19 5:26 AMTaliaKamdjoutaliakamdjou@mail.tau.ac.il
304138MicrobiologyClinical BacteriologyClostridiahttps://www.jwatch.org/na43536/2017/03/02/vancomycin-vs-metronidazole-clostridium-difficileI believe it should be highlighted that oral vancomycin is now the preferred treatment over metronidazole. This came up numerous times for me in question banks.Clarification to current textReject.
Already revised. Oral vanco is mentioned before metronidazole.

- Humood		Agree with Humood. Already changed during Pass 1

Sarah		Reject by 2 authors + 1 editor05/21/19 9:17 AMBriannaOlamijubrianna.olamiju@yale.edu
305138MicrobiologyClinical BacteriologyClostridiahttps://www.uptodate.com/contents/primary-focal-hyperhidrosis?search=hyperhidrosis%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1The text says "Local botox injections used to treat focal dystonia, achalasia, and muscle spasms. Also used for cosmetic reduction of facial wrinkles." It can be added it is also used to treat local hyperhidrosis, because in spite of sweat glands being activated by sympathetic system their post-sypnaptic neurons release Ach.Clarification to current textAccept.

This is a fair point and would be simple to add in to the current text.

Ashten		Reasonable addition and potentially HY due to pharmacology-physiology tie in.

- Sarah		Prelim accept but NOT publishable erratatrue07/27/19 5:12 PMJudithVásquezjudith.vasquez.11@gmail.com
306139MicrobiologyClinical BacteriologyListeria monocytogenesSelf-written'LIST'eria - You go to the supermarket with your KID and your GROCERY-LIST to buy COLD/refridgerated DAIRY MILK, CHEESES, DELI MEATS. Your kid gets distracted playing with his ROCKET toys and TUMBLING on the floor. (Listeria affects KIDS/NEWBORNS often, associated with COLD enrichment growth, DAIRY products, DELI MEATS, rocket tails)Mnemonic10/31/19 6:14 AMKhalidAlattarkhalid_alattar@hotmail.com
307139MicrobiologyClinical BacteriologyNocardia vs Actinomyceshttps://accessmedicine.mhmedical.com/content.aspx?bookid=1020&sectionid=56968770Nocardia lives in soil but longs for oxygen and looks for it infecting lung. Actinomyces is normal flora but hates oxygen hiding from it on an abscess.MnemonicVerifiedNot a big fan, sorry.

- Humood		05/23/19 4:24 PMAna LuizaMapurunga Goncalvesanaluizamapurunga@gmail.com
308140MicrobiologytrueClinical BacteriologyMycobacteriahttps://emedicine.medscape.com/article/230802-overviewMycobacterium tuberculosis DOES NOT stain with a gram stain. First Aid states that it is gram positive, this is falseMinor erratumVerifiedThis is indeed an area of controversy (see references below).In view of this I suggest removing Gram + from here. We could discuss this faculty but in my opinion it is a controversial and likely LY fact, therefore safer to delete.

- Sarah

https://www.ncbi.nlm.nih.gov/pubmed/12356459
http://textbookofbacteriology.net/tuberculosis.html		Agree, remove Gram (+) from text. Just have it say Acid fast rods.Prelim accept by 2 authors + 1 editorSheldon CampbellTaxonomically, the Mycobacteria are most closely related to Gram-positives; however, they do not Gram stain well. First Aid is taxonomically true but practically false. I would agree to refer to the Mycobacteria as 'acid-fast rods' and leave their Gram stain status undescribed, as it's LY and more trouble than it's worth on this level.Warren LevinsonI would delete the Garm positive rods.

Just say

Acid-fast rods		AcceptDelete Gram (+) rods.true01/09/19 3:35 AMOmarTayhmotayh@gmail.com
309140MicrobiologyClinical BacteriologyMycobacteriahttps://www.uptodate.com/contents/tuberculosis-transmission-and-control-in-health-care-settingsMode of transmission of Mycobacterium tuberculosis --> airborneHigh-yield addition to next yearVerifiedYes, we can include this in the table of mycobacteria.

- Vivek		03/02/19 10:49 AMRalphZeitounriz07@mail.aub.edu
310140MicrobiologyClinical BacteriologyMycobacterian/aCORD factor activates maCORDphageMnemonicThis mnemonic does not make sense really. - VivekVerifiedI don't feel it will be useful.


- Vivek		05/06/19 12:58 PMMichaelHagertymichaelhagerty1992@gmail.com
311140MicrobiologyParasitologyProtozoa—CNS infectionshttps://microbewiki.kenyon.edu/index.php/Toxoplasma_gondiiwhat if you add Crescent shape organism on the diagnosis section of Toxoplasma gondii.Clarification to current textReject. No need.
- Humood		Agree with Humood. LY addition.

- Sarah		Reject by 2 authors + 1 editor05/15/19 5:23 PMMuhanadShaibmohanad.shaib@gmail.com
312141MicrobiologyClinical BacteriologyGram-negative lab algorithmhttps://accessmedicine.mhmedical.com/content.aspx?bookid=1551&sectionid=94106931Enterobacteriaceae(E. coli, serrate, Klebsiella, Enterobacter, Citrobacter) are oxidate test negative. Of the bacilli given in table on page 141, only 'P'seudomonas is oxidase 'P'ositive.(both starting with P)High-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		Reject. It will be oversimplification, confusing and may attract more errata. For example- "The Gram-negative diplococci Neisseria and Moraxella are oxidase-positive. Many Gram-negative, spiral curved rods are also oxidase-positive, which includes Helicobacter pylori, Vibrio cholerae, and Campylobacter jejuni."

https://en.wikipedia.org/wiki/Oxidase_test

-Vivek		01/01/19 1:35 PMAnjali GaurishankarByaleanjalibyale6@gmail.com
313141MicrobiologyClinical BacteriologyGram-negative lab algorithmhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1829097/ & https://www.uptodate.com/contents/vibrio-vulnificus-infections?search=vibiro%20vulnificus&topicRef=7646&source=see_link#H11Vibrio Vulnificus - motile, comma-shaped, gram-negative bacillus, The organism is isolated in high concentrations from shellfish (especially oysters), High iron levels appear to be a marked predictor of the severity of infection with Vibrio vulnificus. Laboratory diagnosis of Vibrio vulnificus infection can be performed by using stool, blood, or lesion cultures. The Gram stain shows a mildly pleomorphic, slightly curved gram-negative bacillus. It grows well in peptone water enrichment broth and can then be subcultured on thiosulfate citrate bile salts sucrose (TCBS) agar, which exhibits green colonies. Causes Rapidly Spreading cellulitis which is difficult to treat.High-yield addition to next yearBorderline accept.

Vibrio vulnificus is an interesting (and potentially lethal) bug. It is popular on the Step 2 CK exam, but not so much on the Step 1. This may change as the Step 1 is becoming more clinically orientated over time. Anyway, I believe this is a reasonable addition for this year. I would condense it to 2-4 lines.

- Humood		We have discussed little bit about V vulnificus as a bug causing food-borne illness (p178). What I find useful to include in the same table (foot note) are: their concentrations are high in shellfish (especially oysters) and it can also causes rapidly spreading cellulitis.


Otherwise, characteristics, lab diagnosis of this bug is not HY IMO for step 1.


- Vivek		03/19/19 5:15 AMBasselHafezbasselhafez95@gmail.com
314141MicrobiologyClinical BacteriologyLeprosyhttps://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-015-1768-6The lepromin skin test is used to determine the type of leprosy. Tuberculoid leprosy the test is positive and lepromatous leprosy the test is negative.Clarification to current text07/19/19 11:10 PMLuisApolinario Rojasluisapolinario90@hotmail.com
315142MicrobiologyClinical BacteriologyHaemophilus influenzaeUWorld question id: 963 explanation; Koneman's Color Alas and Textbook of Diagnostic Microbiology 6th ed, pg 446Haemophilus Influenzae can also be grown with S aureus, which provides factor V DIRECTLY, and provides FACTOR X via RBC hemolysis.Major erratumVerifiedhttps://microbeonline.com/x-v-factor-test-haemophilus-principle-procedure-results/
"H. influenzae can be grown in a blood agar plate previously streaked with beta-hemmolytic Staphylococcus aureus. As hemolysis by S. aureus liberates V factor, there will growth of the H.influenzae around the streak line, a property known as satellitism. "		Reject by 2 authors + 1 editor01/16/19 8:58 AMZygy, ElanaRoe-Zurz, Molchotetradynamo@gmail.com, elana.molcho@gmail.com
316142MicrobiologyClinical BacteriologyHaemophilus influenzaehttps://www.cdc.gov/hi-disease/about/causes-transmission.htmlRespiratory droplet transmission, not aerosol.Clarification to current text09/03/19 10:01 AMShajethaIyathuraishajetha.iyathurai@gmail.com
317142MicrobiologyClinical BacteriologyNeisseriahttps://www.cdc.gov/std/gonorrhea/lab/nmen.htmNeisseria are oxdiase + yet it is not mentioned as important information in their classification or in the diagram made for Gram negative bacteria in the previous pageMinor erratumVerifiedReject.
I don't think this is necessary. The important info here is maltose acid detection/fermentation.

- Humood		I agree with Humood. The list of oxidase positive organisms is not meant to be inclusive either. We merely mention HY examples as well as HY features of each organism that will help students identify the correct microbe in a clinical vignette.

- Sarah		Reject by 2 authors + 1 editor02/25/19 12:23 AMSyed YShahsyed.shah415@gmail.com
318144MicrobiologytrueClinical BacteriologyLactose-fermenting enteric bacteriasee diagram on p.141Add that Citrobacter is also a weak fermenter.Clarification to current textVerifiedAgree.

- Humood		Ok.

- Sarah		Okay, after Citrobacter add (weak fermenter).Prelim accept by 2 authors + 1 editorSheldon CampbellYes, agree.Warren LevinsonThere is no sense in adding Citrobacter and Serratia just because they fit the mnemonic.

The only reason this topic is important is that, in the stool culture, E coli ferments lactose and but Shigella and Salmonella do not. Any other information dilutes the impact of this key fact.

So I would delete all the other bacteria.		AcceptAdd (weak fermenter) after Citrobacter.true01/20/19 6:53 PMCharlesde Leeuwdeleeuw.c@gmail.com
319144MicrobiologyClinical BacteriologySalmonella vs Shigellahttps://ard.bmj.com/content/64/4/594Shigella flexeri is associated with Reactive ArthritisClarification to current textAlready added annotate.

- Humood		true05/13/19 10:41 PMMuhanadShaibmohanad.shaib@gmail.com
320144MicrobiologyClinical BacteriologySalmonella vs Shigellaown mnemonicIn shigella order: you can write in order with mnemonic: Dye> Flexing> Biceps> soon:: Dysenteriae>flexneri>boydii>sonneiMnemonicVerified09/15/19 6:39 PMShobhitPiplanishobhitpiplani@aol.com
321144MicrobiologyClinical BacteriologySalmonella vs ShigellaSelf-writtenMnemonic I believe should be placed as a NEW SECTION/NEW FACT just before salmonella and shigella section. In order to remember the H2S producers use "Yo See! Salmons Poo!" / "Yersina Shigella Salmonella Proteus". Poo represents +ve H2S production as it is dark/black in colour. The second half "Salmons Poo" obviously contains SALMONella while the first S will be for shigella. Hence Salmonella and Proteus both 'poo' / make H2S.Mnemonic10/31/19 6:29 AMKhalidAlattarkhalid_alattar@hotmail.com
322144MicrobiologyClinical BacteriologyYersinia enterocoliticahttps://www.uptodate.com/contents/microbiology-and-pathogenesis-of-yersinia-infectionsI found this to be mentioned alot in USMLE stem questions ""Conditions associated with iron-overload such as chronic liver disease, hemochromatosis, and thalassemias have been associated with an increased risk of invasive yersiniosisHigh-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		This aspect can be an important tested area. Because most strains lack efficient intrinsic iron uptake mechanisms, and depend on the iron binding strategies of other bacteria to capture the iron that they need; therefore, responsible for the association described by the user. I would vote for including it.

Change can be:

Lack efficient uptake process. Iron-overloading conditions (eg, chronic liver disease, hemochromatosis, thalassemias) increase risk of invasive yersiniosis.

- Vivek		12/31/18 6:42 AMMohammed SaifAlnaqeepalnaqeep@gmail.com
323144MicrobiologyClinical BacteriologyYersinia enterocolitica1. https://www.uptodate.com/contents/microbiology-and-pathogenesis-of-yersinia-infections 2. Uworld ID 15407 choice B explanationYersinia is NOT a rod, it is coccobacillus.Minor erratumVerifiedIt is true that across the medical literature Yersinia is referred to as coccobacilli. However, in FA we have called it as gram negative rod both in the algorithm and in-text.

Please note-
"A Coccobacilli is a type of bacterium with a shape intermediate between cocci (spherical bacteria) and bacili (rod-shaped bacteria). Please also note: Coccobacilli are very short rods." [1] Coccobacilli has important examples including H. Influenza, B. Pertussis, Pasteurella,, Brucella, F. Tularensis.


So, I think this is not an errata, but we can clearly mention it as a coccobacilli during 2020 revision both in the algorithm and in-text.

1. https://en.wikipedia.org/wiki/Coccobacillus

- Vivek		02/23/19 12:53 AMHeewonChoihxc326@case.edu
324145MicrobiologyClinical BacteriologyCampylobacter jejuniSelf-writtenAddition to mnemonic - HOT CAMPfire with many ANIMALS around that need to be COOKED MORE! (associated with infected animal contact and undercooked meats)Mnemonic10/31/19 6:51 AMKhalidAlattarkhalid_alattar@hotmail.com
325145MicrobiologyClinical BacteriologyEscherichia colihttps://www.uptodate.com/contents/pathogenic-escherichia-coli-associated-with-diarrhea/printTo remember which strains of E. coli cause watery diarrhea, remember the mnemonic TAP water (eTec, eAec, and ePec)Mnemonic10/31/19 7:59 PMDanielZhuDzhu5@pride.hofstra.edu
326145MicrobiologyClinical BacteriologyEscherichia colihttps://www.uptodate.com/contents/shiga-toxin-producing-escherichia-coli-clinical-manifestations-diagnosis-and-treatmentUnder Enterohemorrhagic E. coli, it says shiga-like toxin causes HUS, it should be just shiga toxin. The term shiga-like is outdated in this context.Minor erratum12/02/19 12:25 AMAhmedNoorahmed.noor09@yahoo.com
327145MicrobiologyClinical BacteriologyKlebsiellahttps://www.ncbi.nlm.nih.gov/books/NBK8035/adding urease positive (+) to the Klebsiella paragraph.Clarification to current textNo need to add here.
Urease positive organisms are mentioned on page 127.

- Humood		Agree with Humood. No change needed

Sarah		Reject by 2 authors + 1 editor05/13/19 10:36 PMMuhanadShaibmohanad.shaib@gmail.com
328146MicrobiologyClinical BacteriologyBacterial taxonomyUWorldV vulnificus has some interesting properties that would be beneficial to have in First Aid: Vibrio vulnificus grows in brackish coastal water and marine environments. transmission primarily occurs due to consumption of raw seafood or wound contamination. Manifestations are often mild but individuals with liver disease or iron overload are at very high risk of severe, fulminant infection (eg sepsis, necrotizing faciitis). Free iron acts as an exponential growth catalyst for the bacteriumHigh-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		01/15/19 12:06 PMPrasannaPatelrinzal.jsn@gmail.com
329146MicrobiologyClinical BacteriologyHelicobacter pylorihttps://www.uptodate.com/contents/treatment-regimens-for-helicobacter-pylori?search=helicobacter%20pylori%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1; https://www.medscape.com/viewarticle/920803; https://www.reuters.com/article/us-redhill-biopharm-fda/u-s-fda-approves-redhills-bacterial-infection-treatment-idUSKBN1XE141; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284035/The newest Tx option for H. Pylori infections is a triple therapy of amoxicillin, rifabutin, and a PPI due to bacterial resistance.High-yield addition to next year11/05/19 10:04 AMDanielSchaeferdrs12d@med.fsu.edu
330146MicrobiologyClinical BacteriologyLyme diseasen/aChange the E for the FACE mnemonic to : Erythema migrans/EncephalopathyMnemonicVerifiedAccept.

Reasonable mnemonic. Let's discuss on Annotate.

- Humood		Accept. Also, add- Cardiac block/carditis


Now it looks more complete.

- Vivek		01/20/19 6:52 PMCharlesde Leeuwdeleeuw.c@gmail.com
331146ImmunologyImmunosuppressantsTherapeutic antibodieshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100362/rituxan-rituximabAlso for the treatment of pemphigusHigh-yield addition to next yearWe cover rituximab, but the approval for pemphigus just happened in June, won't be tested.

-Connie		Agree, reject -VVReject by 2 authors + 1 editor04/16/19 1:42 PMJan AndreGraumanjgrauman@gmail.com
332146ImmunologyImmunosuppressantsTherapeutic antibodieshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100362/rituxan-rituximabrituximab is also for the treatment of pemphigusHigh-yield addition to next yearWe cover rituximab, but the approval for pemphigus just happened in June, won't be tested.

-Connie		Agree, reject. -VVReject by 2 authors + 1 editor04/16/19 1:42 PMJan AndreGraumanjgrauman@gmail.com
333146ImmunologyImmunosuppressantsTherapeutic antibodieshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100253/ilumya-tildrakizumab-asmntildrakizumab also blocks IL23 and is also used to treat psoriasisHigh-yield addition to next yearThis one is also relatively new, the psoriasis biologics tested on step 1 tend to be older.

This author is literally linking to a page of recent FDA approvals which is not helpful.

-Connie		Reject. -VVReject by 2 authors + 1 editor04/16/19 1:44 PMJan AndreGraumanjgrauman@gmail.com
334147MicrobiologyMiscellaneousSyphilishttps://www.mountsinai.org/health-library/tests/vdrl-testVDRL False -ve possible in Syphilis less than 3 months. VDRL False +ve possible in Lyme disease, SLE, HIV, Malaria, Tuberculosis, certain types of pneumonia, and IV drug users.High-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		I think this has a diagnostic value which would be important for step 2ck.

- Vivek		01/22/19 3:46 AMMurliMishramm.murli@gmail.com
335147MicrobiologyClinical BacteriologySyphilisN/ATertiary syphilis mnemonic: PARESIS: P: Personality change A: affective personality R: reflexes are hyperactive E: eyes are Argyll Robertson S: sensorial defects I: intellect is low S: speech is decreasedMnemonicVerifiedNot a big fan, sorry.

- Humood		05/12/19 10:04 AMAmnaAlsaihatiamna.saihati@gmail.com
336147MicrobiologyClinical BacteriologySyphilishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3537782/ https://fmc-reg.onecount.net/onecount/login/loginlogout.cgi?gid=36971,36971&return=https%3A%2F%2Fwww.mdedge.com%2Fdermatology%2Farticle%2F67306%2Fhair-nails%2Falopecia-association-sexually-transmitted-disease-review&brand=edge3&sid=anbmbhn3jeed8qd0qjdqbgsld6it would be better if you add picture of patient had alopecia, as it is associated with secondary syphilis.High-yield addition to next yearNo need.

- Humood		05/14/19 6:22 PMMugtabaAldiwekhaldiwekhmugtaba@gmail.com
337147MicrobiologyClinical BacteriologySyphilisfirst aidwe can use mnemonic: sits on a table eating gum argylrobertson attack rome with strong stroke leaving the city as charcoal during 3rd world war( table--> tabes dorsalis, gum--> gummas, attack--> ataxia, rome-->romberg + , charcoal--> charcot joint, war--> aortitis)MnemonicVerified08/31/19 9:28 AMMohamedMenofymohamed.a.menofy@gmail.com
338148MicrobiologyAntimicrobialsMacrolidesownChlamydiae be treated with Azithromycin and Doxycycline: Azithromycin (taken All alone); Doxycycline (taken for Cycle of 7 days)Mnemonic11/10/19 12:34 PMUroosaMazharuroosam@auamed.net
339148MicrobiologyClinical BacteriologySyphilishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5239707/#targetText=Within%2024%20hours%20after%20antibiotic,resolving%20a%20few%20hours%20later.Jarisch–Herxheimer Reaction is mediated by tumor necrosis factor (TNF), interleukin (IL)-6, and IL-8. It has been asked in multiple Q-Banks.High-yield addition to next year09/28/19 6:34 AMJamilNomanJamel.h2o.101@gmail.com
340148MicrobiologyClinical BacteriologyVDRL false positiveshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312652/ and https://www.ama-assn.org/residents-students/usmle/heres-most-missed-usmle-test-prep-question-and-right-answer"Drugs" here is referring to specific types of drugs (e.g., chlorpromazine, procainamide) or to IV drug users? I've found reference to both of them, I just need some clarificationClarification to current textVerifiedI think we mean specific drugs (medication) in this context and could clarify by providing specific examples in parenthesis as the reviewer suggested.

- Sarah		Agree, add (eg, chlorpromazine, procainamide) after drugs.Prelim accept but NOT publishable erratatrue12/27/18 11:49 PMNicolasCuri Gawlinskinicolascurii@gmail.com
341148MicrobiologyClinical BacteriologyVDRL false positiveshttps://openurologyandnephrologyjournal.com/VOLUME/8/PAGE/2/FULLTEXT/antiphospholipid syndrome can present with a false-positive VDRL. Could keep same mnemonic, just add antiphospholid syndrome between parentheses after lupus. Has showed up multiple times in qbanks.High-yield addition to next year07/24/19 8:45 AMMohammedKamareddinemohammed.kamareddine@gmail.com
342149MicrobiologyClinical BacteriologyZoonotic bacterian/a“Lousy BORing RECURRing Fever” BORrelia RECURRentis – Relapsing Fever – Louse “Rickettsia tyFLEA” Rickettsia typhi – Endemic typhus – FLEAsMnemonicVerifiedNot a big fan, sorry.

- Humood		07/10/19 9:33 PMAPandeyaranikopandey@gmail.com
343149MicrobiologyClinical BacteriologyZoonotic bacteriaSelf-writtenBARTonella - BART Simpson's pointy hair may SCRATCH your skin (CAT SCRATCH Disease) /// PASTEURella = 'PASTOR'ella - I felt the 'PASTOR's words deep in my SKIN and BONES (cellulitis & osteomyelitis) like an ANIMAL BITE.Mnemonic10/31/19 6:38 AMKhalidAlattarkhalid_alattar@hotmail.com
344151MicrobiologyMycologySystemic mycosesmy own ideabecause Coccidioidomycosis is common in California what if you highlight the C letter in red color on both word.MnemonicVerifiedReject. A one letter mnemonic is not ideal.

- Humood		05/13/19 10:58 PMMuhanadShaibmohanad.shaib@gmail.com
345151MicrobiologyMycologySystemic mycosesn/aBLASTOMYCOSIS: “GRANd Beast from the EAST is Vicious” EASTern US Blastomycosis, Broad Based Buds Verrucous skin lesions GRANulomatous nodulesMnemonicVerifiedNot a big fan, sorry.

- Humood		07/10/19 9:35 PMAPandeyaranikopandey@gmail.com
346151MicrobiologyMycologySystemic mycosesSelf-writtenAddition to current mnemonic - 'HISTOE'plasmosis - HIS TOE often STICKS OUT like a LARGE spleen and a tongue (tongue ulcers + spleenomegaly) but sometimes HIDES with macrophages and in BIRD/BAT droppings. (I believe it's important to have mnemonic to remember the splenomegaly as a differentiating point to the other infections)Mnemonic10/31/19 6:56 AMKhalidAlattarkhalid_alattar@hotmail.com
347153MicrobiologytruePharmacologyOpportunistic fungal infectionshttps://www.uptodate.com/contents/treatment-of-oropharyngeal-and-esophageal-candidiasis?search=nystatin%20swish%20and%20swallow&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1In the Candida section, it makes the treatment of esophageal candida ambiguous. It implies that nystatin can be used to treat esophageal candida. systemic therapy with fluconazole is required for esophageal candidasis, not topical therapy with nystatin.Minor erratumVerifiedI agree with the suggestion (and the referenced UTD article confirms this). I suggest the following change to the text:
"...nystatin, azoles or, rarely, echinocandins for oral; fluconazole, echinocandins, or amphotericin B for esophageal/systemic."

- Sarah		Agree,change the text to: "...nystatin, azoles or, rarely, echinocandins for oral; fluconazole, echinocandins, or amphotericin B for esophageal/systemic."Prelim accept by 2 authors + 1 editorSheldon CampbellAgree with change.Warren LevinsonThe Medical Letter says the Drug of Choice for both oral and esophageal candidiasis is fluconazole.AcceptChange text to: "...nystatin, azoles or, rarely, echinocandins for oral; fluconazole, echinocandins, or amphotericin B for esophageal/systemic."true01/31/19 1:45 AMHasaanOmarkalimdor101@gmail.com
348156MicrobiologyParasitologyProtozoa—CNS infectionshttps://www.cdc.gov/parasites/sleepingsickness/health_professionals/index.htmlCDC recommends T. b. gambiense be treated with Pentamidine and Eflornithine. Only the treatments for T. b. rhodesiense are listed, and these are usually not used for the other subspecies.Major erratum09/11/19 7:16 PMJosephYasmehjyasmeh@gmail.com
349156MicrobiologyParasitologyProtozoa—CNS infectionsSelf-writtenTrypanosoma 'BRUISY' - PAINFUL bite, like a painful BRUISE which hurts you till it makes you passout/SLEEP into COMA!Mnemonic10/31/19 7:02 AMKhalidAlattarkhalid_alattar@hotmail.com
350156MicrobiologyParasitologyProtozoa—othershttps://www.uptodate.com/contents/african-trypanosomiasis-clinical-manifestations-diagnosis-and-treatment#H2334707Winterbottom's sign. Winterbottom's sign is seen in the early phase of African trypanosomiasis, a disease caused by the parasites Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense which is more commonly known as African sleeping sickness.Clarification to current text07/31/19 8:38 PMPavelAksionavpavlusha_aksenov@mail.ru
351157MicrobiologyParasitologyProtozoa—hematologic infectionsSelf-writtenBABESIA / 'BABY'sia - I have TICKED off 'having a BABY' from my life-achievement goals, with the help of the RING I gave my wife and the CROSS I wear protecting us. (BABYsiosis by ixodes TICK seen with RING and CROSS forms!)Mnemonic10/31/19 7:10 AMKhalidAlattarkhalid_alattar@hotmail.com
352158MicrobiologyParasitologyProtozoa—othersUWorld qid 15448Rod-shaped kinetoplasts can be found on biopsyHigh-yield addition to next yearVerifiedReject.
I doubt this is super HY. I don't recall coming across this one.

- Humood		03/11/19 11:45 PMManonmaniMurugappanmano96@gmail.com
353158MicrobiologyParasitologyProtozoa—othersmnemonicTRYPomastigote (flagellated) are found in TRYPanosoma cruzi and brucei (page 156)MnemonicVerified09/12/19 10:07 AMFranciscoDuenasfrancisco.duenasmd@gmail.com
354158MicrobiologyParasitologyProtozoa—othersSelf-producedTrypanosoma CRUZI - 'Tom CRUZ' helps people everywhere, including the mysterious 'CHAGAS' area. He has a BIG DIALATED HEART, big colon, big esophagus. He gets KISSES of gratitude from those he saves. (CHAGAS disease has many LARGE/dilated organs + caused by KISSING bug)Mnemonic10/31/19 7:17 AMKhalidAlattarkhalid_alattar@hotmail.com
355159MicrobiologytrueParasitologyNematodes (roundworms)1. https://www.uptodate.com/contents/toxocariasis-visceral-and-ocular-larva-migrans 2. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30331-6/fulltextMost pts w/ Visceral larva migrans (T. canis) are asymptomatic. MC occurs in children and results in hepatitis and pneumonitis (if symptomatic). Hepatic sx - hepatomegaly or nodular lesions. Lung sx - dyspnea, wheezing, and a chronic nonproductive cough in 20-80% of pts. Ocular larva migrans is common. CNS and cardiac involvement are rare but are potentially life-threatening complications. So the text should be corrected as "Most often asymptomatic. If symptoms arise (particularly in children), most commonly occur in lung (pneumonitis), eye (visual impairment, blindness - "Ocular larva migrans"), liver (hepatomegaly, nodular lesions). Disease can rarely affect heart (myocarditis) and CNS (seizures, coma)"Clarification to current textVerifiedI agree that the condition is often asymptomatic but for the purposes of Step 1 asymptomatic cutaneous larva migrans is not likely to be tested. In addition, I would not add too much detail here as it is already a busy page.
The current text as such is not incorrect but I agree we should change it from "Often affects..." to "Can affect...".
We can also change the order of affecting organs to liver, eyes, CNS and then heart.

More of a clarification than an erratum.

- Sarah		Agree, change "Often
affects heart (myocarditis), liver, eyes
(visual impairment, blindness), and
CNS (seizures, coma)" to "Can affect liver, eyes (visual impairment, blindness), CNS (seizures, coma), heart (myocarditis)."		Prelim accept by 2 authors + 1 editorSheldon CampbellAgree with change.Warren LevinsonCould add “ Most patients asymptomatic. Can affect lung, liver, eyes”.AcceptChange "Often affects heart (myocarditis), liver, eyes (visual impairment, blindness), and CNS (seizures, coma)" to "Can affect liver, eyes (visual impairment, blindness), CNS (seizures, coma), heart (myocarditis)."true01/04/19 5:21 AMCemTuramcemturam@gmail.com
356159MicrobiologyParasitologyNematodes (roundworms)https://www.cdc.gov/parasites/loiasis/treatment.htmlLoa loa infection refractory to diethylcarbamazine may be treated with albendazole.High-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		I don't feel treatment of refractory loa loa infection will be tested.

- Vivek		01/09/19 4:50 PMJasonTegethofftegethoffjason@gmail.com
357159MicrobiologyParasitologyNematodes (roundworms)First aid 2018, UpToDate strongyloidiasis pageRe-formatting from last years text has gotten rid of the symptoms associated with strongyloides infection (epigastrc pain, pulmonary symptoms, and cutaneous manifestations)High-yield addition to next yearRevision already on annotate.

- Humood		05/05/19 4:15 PMAlannaHickeyalanna.hickey@umassmed.edu
358159MicrobiologyParasitologyNematodes (roundworms)Self-written'ANKLE NECTOR' - ANKLEstoma and NECATOR are both HOOKworms that attach to you and suck blood out like NECTOR using its HOOK.Mnemonic10/31/19 7:29 AMKhalidAlattarkhalid_alattar@hotmail.com
359159MicrobiologyParasitologyNematodes (roundworms)Self-writtenWucherria banCROFTi - Lara 'CROFT' (tomb-raider movie) is a FEMALE (female mosquito spreads it) who would rides HUGE ELEPHANTS in the jungle (like huge elephantiasis!)Mnemonic10/31/19 7:33 AMKhalidAlattarkhalid_alattar@hotmail.com
360160MicrobiologyParasitologyParasite hintshttps://www.youtube.com/watch?v=q2Q3TMtg4r8Easy way to remember Shistosoma Haematobium is associated with the bladder, It looks like a bladder with a urethra as the terminal spine.MnemonicVerified09/08/19 10:04 AMNatalieHarfordnatalie.09.97@hotmail.com
361161MicrobiologyParasitologyEctoparasiteshttps://www.uptodate.com/contents/scabies-management?search=scabies%20treatment&source=search_result&selectedTitle=1~88&usage_type=default&display_rank=1Sarcoptes scabiei: Treatment: Topical permethrin and oral ivermectin are the most common first-line treatmentsHigh-yield addition to next yearVerifiedNot an erratum, merely a potentially HY addition.
I agree we could add "Treatment: permethrin cream, oral ivermectin, washing/drying all clothing..."

- Sarah		02/06/19 2:39 PMSheilaSerinserinsheila@yahoo.com
362163MicrobiologyVirologyNaked viral genome infectivitypage 167There are no naked -ssRNA, they all are enveloped according to table page 167Major erratumVerifiedThat is a misinterpretation of the table which shows Picornaviruses, Hepevirus, Caliciviruses have no envelope and they are SS RNA structure .

- Vivek		Agree with Vivek. Current text is fine as is.

- Sarah		Reject by 2 authors + 1 editor03/01/19 7:48 PMAlaJamalala.aljamal@hotmail.com
363163MicrobiologyVirologyRNA viral genomesn/aFor RNA viral genomes, change mnemonic to: "I went to a positively retro (retrovirus), toga (togavirus) party, where I drank flavored (flavivirus) Corona (coronavirus) and ate hippie (hepevirus) California (calicivirus) pickles (picornavirus), man."MnemonicVerifiedMnemonic. Defer to 2020.

- Humood		I am not sure if "positively retro" make sense. But adding it would help to remember that these are positive stranded.


- Vivek		01/20/19 6:49 PMCharlesde Leeuwdeleeuw.c@gmail.com
364163MicrobiologyVirologyViral envelopesBeats "CPR to a naked Hippie"Enveloped RNA viruses: RHCP (Red Hot Chili Peppers)MnemonicVerified09/06/19 10:02 PMRasimcanMeralrasimcanmeral@gmail.com
365164MicrobiologyVirologyDNA virusesMyselfAdenovirus medical importance mnemonic "FAM Gets Pneumonia with Conjunctivitis" i.e. Febrile pharyngitis, Acute hemorrhagic cystitis, Myocarditis, Gastroenteritis, Pneumonia, ConjunctivitisMnemonicVerifiedMnemonic. Defer to 2020.

- Humood		Looks like a helpful mnemonic. We can shift it on annotate and structure it appropriately.

- Vivek		01/31/19 5:46 PMMurliMishramm.murli@gmail.com
366164MicrobiologyVirologyHerpesvirusesSelf-writtenHSV 2 - more common for GENITAL Herpes (remember 2 testicles, 2 labia for genitals).Mnemonic10/31/19 7:37 AMKhalidAlattarkhalid_alattar@hotmail.com
367164MicrobiologySystemsRed rashes of childhoodNot needed.For Parvovirus B19, you slap with the five fingers of your hand (fifth disease - "slapped cheek" appearance)MnemonicVerifiedNot a big fan.

- Humood		05/12/19 7:05 AMNajatFadlallahnajat.fadlallah@lau.edu
368165MicrobiologyVirologyHerpesviruseshttps://pmj.bmj.com/content/postgradmedj/61/722/1089.full.pdfCytomegalovirus: Presence of both intranuclear and intracytoplasmic inclusion bodies within infected cells. Mnemonic: "C (M)ore (V)odies"High-yield addition to next yearNot a big fan.

- Humood		05/15/19 12:36 PMJessica M.Alonsojessica_alonso@icloud.com
369165MicrobiologyVirologyHerpesviruseshttps://emedicine.medscape.com/article/279269-overviewadd is associated with oral hairy leukoplakiaHigh-yield addition to next yearReject.
Already mentioned on page 177.

- Humood		05/31/19 12:43 PMMeenhajKabirmkabir04@nyit.edu
370166MicrobiologyVirologyViral structure—general featureshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC112152/It is stated that CMV interacts with integrins such as heparan sulfate, but I believe this should be RSV. It has been recognized that the RSV G protein attaches to heparan sulfate on host cells.Minor erratumVerifiedBoth CMV and RSV interact with integrins (heparan sulfate). So not an erratum but we could consider adding RSV to the table if deemed HY.

https://www.ncbi.nlm.nih.gov/pubmed/11562534
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3457392/

- Sarah		LY, would not add.Reject by 2 authors + 1 editor01/11/19 1:51 PMRivaDesaird978@georgetown.edu
371167MicrobiologyVirologyRNA virusesn/aAll (+) RNA viruses are icosahedral, except for Corona. All (-) RNA viruses are helical, except for Delta.High-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		The suggested general statement looks helpful, but I afraid this may not capture all the RNA viruses?

- Vivek		01/20/19 7:44 PMCharlesde Leeuwdeleeuw.c@gmail.com
372167MicrobiologyVirologyRNA viruseshttps://web.stanford.edu/group/virus/rhabdo/2004bischoffchang/Rhabdo.htmAccording to RNA viruse table p167 Rhabdovirus has capsid symmetry "Helical" but it's actually is Bullet shape "characteristic" to it which is mention correctly in p171Major erratumReject.

The virus is bullet-shaped. The capsid is helical.

- Humood


Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition, 165, 1984-1994.e2		Humood is correct. The user is confusing capsid symmetry with virus shape.

- Sarah		Reject by 2 authors + 1 editor04/02/19 5:17 PMAbdallahMohamed ElsaidDr.abdallah.elsaeed@gmail.com
373167MicrobiologyVirologyRNA virusesSelf-writtenPICORNaviruses - they 'PERCH' before PICking CORN ! (addition to present mnemonic) /// FLAVI/FLAVOURvirus - This person from the WEST-NILE has some serious FLAVOUR/style weairing their YELLOW ST.LOUS Vuitton DENGUE Hat!!! (Flaviviruses include yellow fever, dengue, st louis encephalitis and west nile amongst others)Mnemonic10/31/19 7:43 AMKhalidAlattarkhalid_alattar@hotmail.com
374167MicrobiologyVirologyRNA virusesN/AARENAvirus - you bring your LASSO into the ARENA to fight. (LASSA fever encephalitis)Mnemonic10/31/19 7:48 AMAfeefaKonchwallakhalid_alattar@hotmail.com
375167MicrobiologyVirologyRNA virusesSelf-writtenBUNYAviruses - Don't HUNT-A-BUNNY in CALIFORNIA or CONGO! It's mean! (California encephalitis, crimean-CONGO fever and HANTA virus all fall under BUNYA/BUNNYvirus)Mnemonic10/31/19 7:51 AMKhalidAlattarkhalid_alattar@hotmail.com
376168MicrobiologyVirologyRNA viruseshttps://www.cdc.gov/rotavirus/clinical.htmlPlease add that Rotaviruses are 'wheel-shaped' (this was a key feature in recognizing the virus in a NBME question). CDC also states that 'The name rotavirus is derived from the Latin word rota, meaning “wheel.”'High-yield addition to next yearVerifiedYes. We can take include.

- Vivek		02/15/19 6:19 PMPrasannaPatelrinzal.jsn@gmail.com
377169MicrobiologyVirologyInfluenza viruseswww2.usmle-rx.comGenetic "S"hift is more "S"erious than Genetic driftMnemonicVerifiedAccept.

Reasonable mnemonic. Let's discuss on Annotate.

- Humood		Accept, makes more sense to me.

- Vivek		02/18/19 7:45 PMRobertoGuerrerorobguerrero@uees.edu.ec
378169MicrobiologyVirologyParamyxoviruseshttps://www.ncbi.nlm.nih.gov/pubmed/21171875 https://www.ncbi.nlm.nih.gov/pubmed/20100768 https://www.ncbi.nlm.nih.gov/pubmed/24739493: I think because Respiratory Syncial Virus(RSV) is an important virus causing bronchiolitis in children less than 2 years, so it would be better if you write about it in details in a separate paragraph. Common guys you should give some respect to RSV.!Clarification to current textReject.
No need for a separate paragraph. RSV already mentioned elsewhere on this chapter multiple times. Most HY info is the association between RSV and bronchiolitis.

- Humood		I agree with Humood. RSV is covered in the microbiology chapter as a cause of respiratory infections in small children and premature babies.

- Sarah		Reject by 2 authors + 1 editor05/15/19 5:46 PMMuhanadShaibmohanad.shaib@gmail.com
379169MicrobiologyVirologyRubella virushttps://emedicine.medscape.com/article/966220-clinicalstates maculopapular rash that starts on face and spreads CENTRIFUALLY; however, it should state CENTRIPETAL spreadMajor erratumVerifiedDefer to expert.

This looks like a subtle difference especially when it related to the spread if the rash on the human body. I am not sure which one is politically correct.

Anyway, we could either defer to expert or just say "starts on face and then spread caudally"

- Humood
https://www.uptodate.com/contents/rubella?search=rubella&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1		Reject.

The suggestion is based on atypical measles (see reference), and the commenter is mistaking the description of spread for the type of exanthem distribution. My understanding of the terms "centripetal" (i.e., toward the center) and "centrifugal" (i.e., away from the center) in the context of rashes is that "centripetal" rashes have a primarily truncal/central distribution (which would apply to measles), whereas "centrifugal" rashes would have a mostly peripheral/distal distribution (e.g., Coxsackie A virus infections). Now, since the exanthem begins centrally with measles virus infection, the rash would SPREAD centrifugally because it moving from a central distribution to a diffuse one. Also, like I mentioned, the commenter is referring to an atypical presentation, which is probably very LY and not worth including.

Therefore, I would keep the original text.

- Ashten		03/29/19 12:00 PMNidaaRasheednidaa.rasheed@mail.utoronto.ca
380169MicrobiologyVirologyRubella virushttps://emedicine.medscape.com/article/968523-clinicalThe text for Rubella virus currently lists "postauricular and other lymphadenopathy" as symptoms. Possibly clarify/correct "other lymphadenopathy" to "occipital lymphadenopathy".Clarification to current textReject.
I believe the current narrative refers to any LAD other than postauricular, not necessarily occipital.

- Humood		Agree with Humood. The text states "other lymphadenopathy" not occipital. The user may have misread the text.

- Sarah		Reject by 2 authors + 1 editor05/08/19 3:20 PMChristineLinchristine15yr@gmail.com
381170MicrobiologyVirologyMeasles (rubeola) virushttps://www.uptodate.com/contents/measles-clinical-manifestations-diagnosis-treatment-and-prevention?search=koplik%20spots&source=search_result&selectedTitle=1~6&usage_type=default&display_rank=1Koplik spots are better described as white-blue spots with an erythematous base rather than red spots with a white centerMinor erratum08/08/19 5:47 AMJulianMaamarijulian.maamari@lau.edu
382170MicrobiologyVirologyMeasles (rubeola) virushttps://www.uptodate.com/contents/measles-clinical-manifestations-diagnosis-treatment-and-prevention5 C's of measles: Cough; Coryza; Conjunctivits; "C"oplik spots; Cutaneous rashMnemonicVerified09/19/19 5:52 AMYazanAlzu'biyoalzoubi@gmail.com
383170MicrobiologyVirologyMeasles (rubeola) virusFA19 p.170 & 1835 C's of measles: Cough; Coryza; Conjunctivitis; "C"oplik spots; Confluent rashMnemonicVerified09/24/19 10:32 AMYazanAlzu'biyazan_zo3bi@hotmail.com
384172MicrobiologyVirologyHepatitis viruseshttps://www.uptodate.com/contents/hepatitis-a-virus-infection-in-adults-epidemiology-clinical-manifestations-and-diagnosis?search=hepatitis%20A&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H3024115574Hepatitis A is NOT usually asymptomatic (only in children <6yo). In fact, 70% of cases in adults have symptoms that usually begin with abrupt onset of nausea, vomiting, anorexia, fever, malaise, and abdominal pain. Within a few days to a week, dark urine (bilirubinuria) appears; pale stools (lacking bilirubin pigment) may also be observed. These are followed by jaundice and pruritus (40 to 70 percent of cases). The early signs and symptoms usually diminish when jaundice appears, and jaundice typically peaks within two weeks. Physical findings include fever, jaundice, scleral icterus, hepatomegaly (80 percent of cases), and right upper quadrant tenderness to palpationMajor erratumAccept.

User is correct. HAV commonly present with acute, self-limiting, hepatitis.

Replace
"Asymptomatic (usually), Acute"
With
"Acute and self-limiting (adults), Asymptomatic (children)"

- Humood
https://www.uptodate.com/contents/hepatitis-a-virus-infection-in-adults-epidemiology-clinical-manifestations-and-diagnosis?search=hepatitis%20A&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H3024115574		Good point. Agree with Humood.

- Vivek		Good point!
I agree it would be more accurate to make the change that Humood suggested (per UTD reference).

- Sarah		true03/21/19 2:49 AMNicolasCuri Gawlinskinicolascurii@gmail.com
385172MicrobiologyVirologyHepatitis virusesRobbins Pathologic Basis of Disease 9th Ed, pg 839hepatitis E is Endemic in Equatorial regions and frequently Epidemic (highlight E’s)Clarification to current textVerifiedReject.

Epidemic, Endemic, and Equatorial.
I do not think this is super HY for a mnemonic.

- Humood		Reject. Helping students to remember it with a mnemonic will unlikely to help them.

- Vivek		Agree - this mnemonic is not particularly helpful/HY.

Sarah		Reject by 2 authors + 1 editor03/21/19 5:59 AMNicolasCurinicolascurii@gmail.com
386172MicrobiologyVirologyHepatitis virusesN/Afor Hep E, to remeber preganacy, I would say PregnancEEMnemonicVerifiedNot a big fan. Sorry.

- Humood		05/01/19 10:45 AMOmairChaudryochaudry19@gmail.com
387172MicrobiologyVirologyHepatitis virusesn/aABCDEFG of Hep B. A: Arthralgia, B: Blood/baby/B, C: Cytotoxic T Cells/Carrier, D: DNA/Duration long, E: Eosinophilic, F: Fever/Full resolution, G: Granular, H: HepadnavirusMnemonicVerifiedNot a big fan. Seems random.

- Humood		05/22/19 11:22 AMCameronHansoncameronglennhanson@kcumb.edu
388172MicrobiologyVirologyHepatitis virusesmyselfHAV and HEV are fEcAl (fecal - oral transmission)MnemonicVerified09/23/19 9:02 PMFranciscoDuenasfrancisco.duenasmd@gmail.com
389175MicrobiologyVirologyHIVpg 175 FAgp "(F)orty" for (F)usionMnemonicVerifiedAccept.

Reasonable mnemonic. Let's discuss on Annotate.

It has to be tweaked to say forty-one.
- Humood		Accept.

- Vivek		03/09/19 9:14 AMRaulOrozco Villalobosraul_ou_fan@yahoo.com
390175MicrobiologyVirologyHIVn/aHow to remember which receptor is used for early vs. late infection in HIV: ‘Early’ has 5 letters = CCR5 ; ‘Late’ has 4 letters = CXCR4MnemonicVerifiedAccept.

Reasonable mnemonic. Let's discuss it on Annotate.

- Humood		Accept. I find this mnemonic very helpful. Agree to discuss further on annotate.

- Vivek		03/24/19 5:27 PMMackenzieMadisonmadisonm@iu.edu
391175MicrobiologyVirologyHIVN/ABeing a 'HOMO'-sexual 'M'ale usually increases the risk of getting HIV compared to the general population. However, a 'HOMO'zygous 'M'utation in 'M'acrophages (CCR5) makes you immune to the infection!Mnemonic10/27/19 5:41 AMKhalidAlattarkhalid_alattar@hotmail.com
392175MicrobiologyVirologyHIV diagnosishttps://emedicine.medscape.com/article/211316-workup#c1in the diagram "intermediate" should be "indeterminate"Spelling/formattingAdded during 2020 final pass. Can be considered for acknowledgement in next edition.


Vivek		11/04/19 9:07 AMRanyaBaddourahranyabaddourah@hotmail.com
393177MicrobiologyVirologyCommon diseases of HIV-positive adultshttps://www.uptodate.com/contents/mycobacterium-avium-complex-mac-infections-in-persons-with-hivMycobacterium Avium Intracellulare/complex mostly occurs in HIV patients with CD4 count less than 50cells/mm3. as mention in the table for sure it is less than 100 but to be more specific it would be better if you classify both organisms under less than 50 cells/mm3.High-yield addition to next yearDiscussion already on annotate.

- Humood		05/20/19 7:02 PMMuhanadShaibmohanad.shaib@gmail.com
394177MicrobiologyVirologyCommon diseases of HIV-positive adultsn/aAssuming CD 4+ count as DOLLAR$$$.  CD4+ cell <500/mm3 (< 500 million $)  You CAN Buy 2-Houses CANdida albicans, EBV, HHV-8, HPV  CD4+ cell <200/mm3 (< 200 $)  CAP, Hat, JoCkey and PyJama CANdida albicans, EBV, HHV-8, HPV  CD4+ cell <100/mm3 (< 100 $)  You CAN Go To A BAR and Buy yourself a CRaft beer and C-Mo:Mo CANdida albicans, Toxoplasm Gondii, Aspergillus fumigatus, BARtonella spp, EBV, CRyptosporidium spp, CRytococcus neoformans, CMV, Mycobacterium avium-intracellulareMnemonicVerifiedNot a big fan.

- Humood		Reject.

This is too much for a mnemonic. I do not think it would be very useful to the readers and might be pretty overwhelming.

Ashten		07/10/19 9:39 PMAPandeyaranikopandey@gmail.com
395177MicrobiologyVirologyCommon diseases of HIV-positive adultsN/ACMV infections in AIDS = C.R.E.E.P.Mnemonic11/22/19 1:40 PMHaleeEinfeldraxorium@gmail.com
396178MicrobiologySystemsBugs causing food-borne illnesshttps://www.sciencedirect.com/topics/medicine-and-dentistry/vibrio-parahaemolyticusV parahaemolyticus and V vulnificus . source of infection contaminated or raw seafood. adding the word raw to the textClarification to current textOkay. Added to annotate.

- Humood
https://www.uptodate.com/contents/vibrio-vulnificus-infections?search=vibrio%20vulnificus&source=search_result&selectedTitle=1~35&usage_type=default&display_rank=1		true05/13/19 11:05 PMMuhanadShaibmohanad.shaib@gmail.com
397181MicrobiologySystemsCommon vaginal infectionshttps://www.uptodate.com/contents/image?imageKey=PC%2F68759&topicKey=OBGYN%2F5477&search=common%20vaginal%20infections&source=outline_link&selectedTitle=1~150 and https://www.uptodate.com/contents/image?imageKey=OBGYN%2F81449&topicKey=OBGYN%2F5477&search=common%20vaginal%20infections&source=outline_link&selectedTitle=1~150This might be an overkill for Step 1, but I've made this table with data from UpToDate that adds a lot of value in diagnostic and differentials between these common vaginal infections, looking at their Si/Sx.High-yield addition to next yearAccept.

Let's migrate this table to Annotate and discuss what needs to be included in the book.

- Humood		This table is interesting. But I feel most of it is already covered and. However, we can move this table on annotate and see how can we optimize our current table, particularly symptomatic and diagnostic differences.






- Vivek		03/21/19 3:31 AMNicolasCuri Gawlinskinicolascurii@gmail.com
398181MicrobiologySystemsCommon vaginal infectionshttps://www.ncbi.nlm.nih.gov/pubmed/26042815 https://www.ncbi.nlm.nih.gov/pubmed/16648432Bacterial vaginosis it is Off white discharge, lab findings: positive whiff test(amine odor with KOH). Trichomonas vaginitis is THIN foul smelling discharge. Candida Vulvovaginitis : ph normal (3.8-4.5) for the treatment Azoles (eg,Fluconazole)Clarification to current textReject.
I didn't get the proposal. We have a table that contrasts all types of vaginal infections.

- Humood		Reject.

Unnecessary. This information is covered sufficiently in the table.

Ashten		Agree with the authors. The table covers all HY information already.

- Sarah		Reject by 2 authors + 1 editor05/14/19 11:09 AMMuhanadShaibmohanad.shaib@gmail.com
399181MicrobiologySystemsUrinary tract infectionsMy brainUsual pathogens- KEEPS = Klebsiella, E.coli, Enterococcus, Enterobacteriaceae, Proteus, Pseudomonas, Staph. Saprophyticus, SerratiaMnemonicVerifiedMnemonic. Defer to 2020.

- Humood		I feel it is a helpful mnemonic and reasonable to consider for UTI.

- Vivek		02/01/19 1:24 PMMariahGoslinggoslingm@hawaii.edu
400182MicrobiologySystemsToRCHeS infectionsFA p. 182Go to IT to fix your PC (Intraventricular calcifications with Toxoplasmosis; Periventricular calcifications with Cytomegalovirus)MnemonicVerifiedMnemonic. Defer to 2020.

- Humood		Does't really make sense to me. Reject.

- Vivek		12/28/18 12:11 PMElanBaskirebask003@fiu.edu
401182MicrobiologySystemsToRCHeS infectionsFA19 p.182*CALL* *IT* to fix your *PC* (Intracranial *CALL*cifications with *T*oxoplasma, *P*eriventricular with *C*ytomegalovirus)MnemonicVerifiedReject.

Not a big fan, sorry.

- Humood		Reject.

The mnemonic is not very easy to remember on first read and may actually require more thought to keep straight than just remembering the specific facts.

- Ashten		03/28/19 5:59 PMElanBaskirebask003@fiu.edu
402182MicrobiologySystemsToRCHeS infectionsmnemonic, p. 182 FACALl IT for your PC. CALcifications: Intracranial/Toxo, Periventricular/CmvMnemonicVerifiedReject.
Sorry not a big fan.
- Humood		Reject.

Toxoplasmosis has a distinct presentation that probably does not need a mnemonic for students to remember.

In summary: not worth it.

- Ashten		04/16/19 3:12 PMElanBaskirebask003@fiu.edu
403182MicrobiologySystemsToRCHeS infectionshttps://www.ncbi.nlm.nih.gov/pubmed/19697432Pulmonary Artery stenosis is associated with congenital rubella syndrome.Clarification to current textReject.
Not super HY. PDA is more important association.

- Humood		Reject.

I think Humood makes a good point. While the evidence provided does uphold this suggestion, I do not think that it would be tested on Step 1 over PDA.

Ashten		I agree with the authors. The association with PDA is more HY.
Also, we mention congenital rubella as a cause of pulmonary artery stenosis in the cardiovascular chapter already. I don't think it is sufficiently HY to warrant repetition here.

- Sarah		Reject by 2 authors + 1 editor05/13/19 11:14 PMMuhanadShaibmohanad.shaib@gmail.com
404183MicrobiologySystemsRed rashes of childhoodi have no hyperlinks, i came up with thatafter a Rad Party, CHug Milk and Sleep Vell ( Rubella virus , Parvovirus B19, Coxsackievirus type A, HHV-8, Measles virus, Strep. pyogenes, Vzv)MnemonicVerifiedMnemonic. Defer to 2020.

- Humood		A complicated mnemonic. Suggest to reject it.

- Vivek		12/25/18 2:44 PMdeepikagudapatideepgudapati@gmail.com
405183MicrobiologySystemsRed rashes of childhoodhttps://en.wikipedia.org/wiki/Herpanginain Coxsackievirus type A ulcer in oral mucosa, what if you add (Herpangina) after oral mucosaClarification to current textAccept.
Added to annotate.

- Humood
https://www.uptodate.com/contents/hand-foot-and-mouth-disease-and-herpangina?search=coxsackie%20virus&source=search_result&selectedTitle=2~92&usage_type=default&display_rank=2		true05/14/19 11:15 AMMuhandShaibmohanad.shaib@gmail.com
406184MicrobiologySystemsSexually transmitted infectionsN/AGranuloma inguinale --> The character "A" which cites the picture, has a different font compared to elsewhere in the book.Spelling/formattingVerifiedUser is correct. Can implement in 2020.

Font seems smaller than the elsewhere.
- Humood		Agree.

- Vivek		12/29/18 4:32 AMBehnamNabavizadehbehnam.nabavi@yahoo.com
407187MicrobiologyAntimicrobialsAntimicrobial therapyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3457410/mecA gene originally identified in methicillin-resistant S. aureus (MRSA) encodes a PBP of 668 amino acid residues which is responsible for beta-lactam resistanceHigh-yield addition to next yearVerifiedReject.
The numbers do not seem super HY.

- Humood		Reject.

Polypeptide size probably does not matter because the point is that a PBP is encoded by the gene, which is the mechanism by which the resistance occurs.

Ashten		02/27/19 9:34 AMReemaPatelpatelr58@students.rowan.edu
408187PharmacologyPharmacologyAntimicrobial therapyhttps://www.uptodate.com/contents/nitrofurantoin-drug-information?search=nitrofurantoin&topicRef=8065&source=see_link#F201984Nitrofurantoin - first line therapy in Acute uncomplicated cystitis >or= 12 years of age and chronic recurrent UTIs. It is a High risk medication in Geriatric patients (>or = 65 years) as it is included in Beers criteria. Contraindications: Anuria, oliguria, or significant impairment of renal function (creatinine clearance [CrCl] <60 mL/minute or clinically significant elevated serum creatinine) or previous history of cholestatic jaundice or hepatic dysfunction associated with prior nitrofurantoinHigh-yield addition to next year03/19/19 4:46 AMBasselHafezbasselhafez95@gmail.com
409187MicrobiologyPharmacologyAntimicrobial therapyhttps://www.uptodate.com/contents/nitrofurantoin-drug-information?search=nitrofurantoin&topicRef=8065&source=see_link#F201984Nitrofurantoin - first line therapy in Acute uncomplicated cystitis >or= 12 years of age and chronic recurrent UTIs. It is a High risk medication in Geriatric patients (>or = 65 years) as it is included in Beers criteria. Contraindications: Anuria, oliguria, or significant impairment of renal function (creatinine clearance [CrCl] <60 mL/minute or clinically significant elevated serum creatinine) or previous history of cholestatic jaundice or hepatic dysfunction associated with prior nitrofurantoinHigh-yield addition to next yearAccept.

Agree to add new entry for nitrofurantoin.

- Humood		Agree, this would be a HY entry. We have no dedicated entry for nitrofurantoin.



- Vivek		03/19/19 4:53 AMBasselHafezbasselhafez95@gmail.com
410188MicrobiologyAntimicrobialsPenicillinase-resistant penicillinshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5517843/Kindly add methicillin to the list of penicillase-resistant penicillinsHigh-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		12/31/18 4:11 AMKamleshunRamphuladramphul@hotmail.com
411189MicrobiologyAntimicrobialsCephalosporinshttps://www.uptodate.com/contents/extended-spectrum-beta-lactamases?search=Ceftolozane&source=search_result&selectedTitle=4~12&usage_type=default&display_rank=3Add "Ceftolozane" in 3rd generation as it has enhanced activity against Pseudomonase and extended-spectrum β-lactamase-producing Enterobactericeae. Used with tazobactamHigh-yield addition to next yearVerifiedReject.
I don't recall coming across this info. Does not seem super HY.

- Humood		Reject.

I also did not come across this. It looks like the brand name for ceftolozane/tazobactam is Zerbaxa, which I have yet to encounter during third year.

Ashten		02/07/19 7:16 PMRodrigoCavalcanterodrigoccavalcante@hotmail.com
412189MicrobiologyAntimicrobialsCephalosporinshttps://www.uptodate.com/contents/cephalosporinsInside 2nd generation cephalosporins, add "Used in the prophylaxis and therapy of anaerobic contamination from the GI tract in the abdominal and pelvic cavities". Below the entry "2nd gen - HENS PEck" add ⇒ Anaerobic coverage (specifically Cefotetan and Cefoxitin)High-yield addition to next yearReject.

I don't think this is super HY. I haven't seen this being asked on the boards.

- Humood		Reject. Not HY.

- Vivek		03/21/19 2:57 AMNicolasCuri Gawlinskinicolascurii@gmail.com
413189MicrobiologyAntimicrobialsCephalosporinshttps://www.microbiologyresearch.org/content/journal/ijsem/10.1099/ijsem.0.001572#tab2Enterobacter Aerogenes is now known as Klebsiella Aerogenes. Also listed as 'E. Aerogenes' on page 190 under "Carbapenems: Mechanism of resistance"Major erratum11/13/19 2:34 AMRobShvartsrob.shvarts@emory.edu
414189MicrobiologyAntimicrobialsβ-lactamase inhibitorshttps://www.uptodate.com/contents/combination-beta-lactamase-inhibitors-carbapenems-and-monobactams?search=vaborbactam&source=search_result&selectedTitle=2~6&usage_type=default&display_rank=1Add "vaborbactam" to the list as used in Meropenem-vaborbactam for KPCHigh-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		Defer to 2020.

Looking at the UpToDate entry, it looks like the evidence is not super robust yet for the effectiveness of that drug combo vs. other antibiotics. It would be worth watching this, but I doubt it will be relevant for Step over the next year.

Ashten		01/25/19 8:36 PMRodrigoCavalcanterodrigoccavalcante@hotmail.com
415190MicrobiologyPharmacologyClostridiaUworldFidaxomicin is a macrocytic antibiotic that inhibits RNA polymerase and is bactericidal to C. difficile.High-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		12/30/18 2:09 PMGurnoorGrewalgurnoorgrewal92@yahoo.com
416190MicrobiologyAntimicrobialsVancomycinn/a“Red Man NOT wearing a DRESS singing DA-DA inside his VAN” Red Man Syndrome Nephrotoxicity, Ototoxicity, Thrombophlebitis DRESS syndrome Binds D-A-D-A portion of cell wall precursors VANcomycin.MnemonicVerifiedNot a big fan. Sorry.

- Humood		07/10/19 9:41 PMAPandeyaranikopandey@gmail.com
417190MicrobiologyAntimicrobialsVancomycinSelf-writtenVANcomycin - REDMAN is driving the VAN (redman syndrome with vancomycin) that you need a D-Ala/dollar to ride with (addition to pre-existing mnemonic). For clostridium difficile infection we send the VAN directly into GIT (ORAL DOSE) to look for pseudomembranes made by C. Difficile.Mnemonic10/30/19 11:32 AMKhalidAlattarkhalid_alattar@hotmail.com
418191MicrobiologyAntimicrobialsAminoglycosideshttps://www.uptodate.com/contents/aminoglycosides?search=aminoglycosides&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Add "Plazomicin" as a novel aminoglycoside used for KPC and ESBL-producing EnterobacteriaceaeHigh-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		I afraid this novel drug will be tested on step 1 exam. Reject.

- Vivek		01/25/19 8:42 PMRodrigoCavalcanterodrigoccavalcante@hotmail.com
419191MicrobiologyAntimicrobialsAminoglycosideshttps://www.uptodate.com/contents/aminoglycosidesThe figure shows that aminoglycosides inhibit initiation complex formation. The following is from Uptodate: "The aminoglycosides primarily act by binding to the aminoacyl site of 16S ribosomal RNA within the 30S ribosomal subunit, leading to misreading of the genetic code and inhibition of translocation [3,4]. The initial steps required for peptide synthesis, such as binding of mRNA and the association of the 50S ribosomal subunit, are uninterrupted, but elongation fails to occur due to disruption of the mechanisms for ensuring translational accuracy".Major erratumVerifiedI think we are correct in saying that it generally inhibits initiation complex formation through binding of the 3OS submit (therefore called 30S inhibitors; depicted in the illustration page 191 ) and thus it leads to elongation failure.


Though I agree the minute details on the molecular interaction is not highlighted (that's why the student is confused) which is not important to mention IMO.

https://www.sciencedirect.com/topics/neuroscience/aminoglycoside


- Vivek		03/13/19 5:34 AMXiangGuodrguox@126.com
420191MicrobiologyAntimicrobialsProtein synthesis inhibitorshttps://pubchem.ncbi.nlm.nih.gov/compound/lincomycinLincomycin drug it binds also to 50s sub unit.what if you added to the mnemonics CCEL at 50 to be CCELL. extra L for lincomycinClarification to current textReject.
Lincomycin is not super HY in my opinion.

- Humood		Reject.

Agree with Humood - LY.

Ashten		Agree with authors. This is a relatively LY drug.

- Sarah		Reject by 2 authors + 1 editor05/13/19 7:26 PMMuhanadShaibmohanad.shaib@gmail.com
421192MicrobiologyAntimicrobialsTetracyclinesNot needed.For mechanism of resistance: Tetracyclines are treated as Trash by bacteria. You dont want to bring Trash inside (reduced uptake) you want to throw it out (increased efflux)MnemonicVerifiedMnemonic. Defer to 2020.

- Humood		I feel it would be a big mnemonic which one may need to memorize further.


- Vivek		01/01/19 7:51 AMMuhammad FaizanAlifaizanali.93@hotmail.com
422192MicrobiologyAntimicrobialsTetracyclinesNoneTo remember that Tetracyclines are contraindicated in pregnancy you can use the mnemonic "tetrogen" or "tetragen" (teratogen)MnemonicVerifiedAccept.

This is appropriate. I prefer "TETRA-gen" for consistency.

Ashten		Interesting mnemonic. Both words look similar and may be helpful to remember this.


- Vivek		03/05/19 4:57 PMManyleAhmedManyleAhmed@Gmail.com
423192MicrobiologyAntimicrobialsTetracyclinesN/AAdverse effects of tetracyclines (some of them are found in different sections of FA, so this list is more comprehensive than the one in the FA tetracycline section): Tetracyclines Freeze Bone Growth In Prepubescent Patients = Teeth discoloration, Fanconi syndrome (expired tetracyclines), Bone growth inhibition, GI distress, Idiopathic intracranial hypertension, Pill-induced esophagitis, Photosensitivity.Mnemonic11/25/19 12:59 PMHaleeEinfeldraxorium@gmail.com
424193MicrobiologyAntimicrobialsMacrolideshttps://www.uptodate.com/contents/azithromycin-clarithromycin-and-telithromycin?search=macrolides&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H12On aminoglycosides, it is mentioned that they can cause neuromuscular blockade and are contraindicated in patients with myasthenia gravis. Telithromycin, a macrolide, can also cause exarcebation and it is contraindicated for MG patients.High-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		Reject. Telithromycin is now rarely used due to postmarketing reports of hepatotoxicity and exacerbations of myasthenia gravis which is not reported with other drugs in this class. We also don't mention this drug anywhere in the FA.

- Vivek		01/25/19 8:59 PMRodrigoCavalcanterodrigoccavalcante@hotmail.com
425195MicrobiologyPharmacologyAntimicrobial therapyNot neededWrite Daptomycin as "DaptomySKIN to remember that this antibiotic is used to treat skin infections.MnemonicVerifiedOkay. Sounds reasonable.
Added to annotate.

- Humood		true07/01/19 3:06 PMJackelinePortojcjp0704@gmail.com
426196MicrobiologyAntimicrobialsRifamycinshttps://www.uptodate.com/contents/rifamycins-rifampin-rifabutin-rifapentine/printCurrent text claims "Rifampin ramps up cytochrome P-450, but rifabutin does not." This is not true, as rifabutin is considered an inducer of CYP-450, although to a lesser extent than rifampin. I suggest the following rewrite: "Rifampin RAMPS up cytochrome P-450. So does Rifabutin, BUT less so."Minor erratumVerifiedI understand teh student's concern that the current mnemonic is reflecting as if Rifabutin does not induce CYP-450 at al.

However, that is already added in the second column of rifamycins which states-

"Rifabutin favored over rifampin in patients with lllV infection due to less cytochrome P-450 stimulation."

We can work on the mnemonic during next revision. Currently, it is fine as is.


- Vivek		Reject. Agree with Author.Reject by 2 authors + 1 editor01/10/19 2:38 PMEmilyCokerecoker@ucla.edu
427196MicrobiologyPharmacologyRifamycinshttps://www.uptodate.com/contents/rifaximin-drug-information?search=rifaximin&source=panel_search_result&selectedTitle=1~37&usage_type=panel&kp_tab=drug_general&display_rank=1Rifaximin, sold under the trade name Xifaxan among others, is an antibiotic used to treat traveler's diarrhea, irritable bowel syndrome, cl difficile infection (off label), and hepatic encephalopathy. It has poor absorption when taken by mouthHigh-yield addition to next year07/31/19 9:10 PMPavelAksionavpavlusha_aksenov@mail.ru
428197MicrobiologytrueAntimicrobialsEthambutolhttps://www.uptodate.com/contents/ethambutol-an-overviewReplace "may be reversible" with "usually reversible". Optic neuritis is reversible in most patients.Clarification to current textVerifiedAgree. User is correct.

- Humood		Ok. not an erratum but good clarification.

- Sarah		Change to "Usually reversible."Prelim accept by 2 authors + 1 editorSheldon CampbellAgree. That's more precise wording.Warren LevinsonNeither Katzung nor Mandell discuss reversibility of Optic Neuritis due to ethambutol, so I think I’ll pass on this one.AcceptChange to "Usually reversible."true01/07/19 3:43 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
429198MicrobiologyAntimicrobialsProphylaxis in HIV/AIDS patientshttps://emedicine.medscape.com/article/1529727-overview#a8Primary prophylaxis for Mycobacterium avium (MAC) in people living with HIV infection who immediately initiate ART is no longer recommended, regardless of CD4 count (AII recommendation).Major erratum10/15/19 7:16 AMMohamad HekmatSukkarihekmat_sukkari@hotmail.com
430198MicrobiologyAntimicrobialsTreatment of highly resistant bacteriahttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5204005/For drugs that treat MRSA: “There’s a line (linezolid) to dab (daptomycin) in the clean (clindamycin-according to Sketchy Pharm) van (vancomycin).” Also-“Tiger (tigecycline) and dog (doxycycline) covered in TonS (TMP-SMX according to Sketchy Pharm) of tar (ceftaroline).”MnemonicVerifiedNot a big fan. Sorry.

- Humood		06/07/19 2:34 PMCarlosSilvaCsilva@llu.edu
431199MicrobiologytrueAntimicrobialsAmphotericin B1. https://www.uptodate.com/contents/pharmacology-of-amphotericin-b, 2. https://www.uptodate.com/contents/treatment-of-cryptococcus-neoformans-meningoencephalitis-in-hiv-infected-patientsReplace "Intrathecally for fungal meningitis" with "Intrathecally for coccidioidal meningitis". Intrathecal administration is not used for cryptococcal meningitis.Clarification to current textVerifiedAgree. User is correct.

- Humood		Ok. not an erratum but good clarification.Ok. not an erratum but good clarification.

- Sarah		Replace "Intrathecally for fungal meningitis" with "Intrathecally for coccidioidal meningitis".Prelim accept by 2 authors + 1 editorSheldon CampbellAgree with change. I looked for other likely uses of intrathecal Ampho, didn't find any.Warren LevinsonI agree. Change “fungal” to “coccidioidal”AcceptReplace "Intrathecally for fungal meningitis" with "Intrathecally for coccidioidal meningitis".true01/07/19 3:45 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
432199MicrobiologyAntimicrobialsAntifungal therapyUWorld, UpToDateAzoles specifically blocks 14-alpha-demethylase (the cytochrome P450 enzyme that converts lanosterol to ergosterol)High-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		Already covered in the page 198 and 199; however, we should specifically mention within the illustration that the enzyme 14-alpha-demethylase is actually a cytochrome P450 enzyme.

[Because in the text (199) we mentioned that it blocks cyt450 but on illustration (198) we mentioned it inhibits demethylase]

- Vivek		01/15/19 7:33 PMPrasannaPatelrinzal.jsn@gmail.com
433199PharmacologyAntimicrobialsAntifungal therapyFirst Aid for the USMLE STEP 1 2019PHARMACOLOGY (ANTIFUNGALS): Fact (p.199): Nystatin for the treatment for oral Candidiasis Mneumonic: NY State Candidates I voted for (orally) Fact (p.199): Flucytosine for the treatment of meningitis by Cryptococcus Mneumonic: FLU got you feeling CRYPTO Fact (p.199): Azoles inhibit cytochrome P-450 Mneumonic: That azole is so inhibited Fact (p.199): Terbanafine for the treatment of fungal nail infections. Mneumonic: TER (her) FINE nails Fact (p.200): Echinocandins for cell wall inhibition includes caspofungin Mneumonic: CASPER the friendly ghost goes through WALLS PHARMACOLOGY (ANTIMICROBIALS): P.204: Antibiotics contraindicated during pregnancy: MCAT M- Metronidazole C- Chloramphenicol A- Aminoglycosides T- TetracyclinesMnemonicVerified05/15/19 3:22 AMMadihaKhanmadiha34m@gmail.com
434199MicrobiologyPharmacologyAntifungal therapy(my brain)For Flucytosine - "FU-cytosine" - since it involves 5-FUMnemonicVerifiedReject.
Seems like a stretch.

- Humood		Reject.

Not very intuitive.

Ashten		05/16/19 2:09 PMAndrewKoandrewko@hawaii.edu
435199MicrobiologyAntimicrobialsAzolesfirst aidsee attachmentMnemonicVerified08/31/19 9:50 AMMohamedMenofymohamed.a.menofy@gmail.com
436200MicrobiologytrueAntimicrobialsAnti-mite/louse therapyhttps://www.uptodate.com/contents/pediculosis-capitis?search=lice%20treatment&source=search_result&selectedTitle=1~86&usage_type=default&display_rank=1#H88337; https://www.uptodate.com/contents/lindane-drug-information?search=Lindane&source=panel_search_result&selectedTitle=1~13&usage_type=panel&kp_tab=drug_general&display_rank=1Include topical ivermectin as treatment. Remove Lindane or clarify Lindane neurotoxicity. Lindane lotion has been discontinued in the US for more than 1 year. Only use lindane in patients who cannot tolerate or have failed first-line treatment.Clarification to current textVerifiedI agree.

I suggest removing Lindane and adding topical +/- oral ivermectin (as oral ivermectin is used for scabies while the topical version is used for pediculosis).

- Sarah		Agree, remove Lindane, add "Topical +/- oral ivermectin"Prelim accept by 2 authors + 1 editorSheldon CampbellDoes the section include the cheapest, most widely used agents -- permethrins and benzoyl alcohol?Warren LevinsonYes add ivermectin to Permethrin

Delete Lindane.		AcceptAgree, remove Lindane, add "Topical +/- oral ivermectin"true02/06/19 2:51 PMSheilaSerinserinsheila@yahoo.com
437201MicrobiologyAntimicrobialsDrug namesUpToDate Docosanol: Drug informationDocosanol is a topical agent that prevents viral entry and replication at the cellular level. It is used for orolabial herpesHigh-yield addition to next yearVerifiedDefer to 2020.
? HY new content.

- Humood		Not high yield IMO. Reject.

- Vivek		01/15/19 7:00 PMPrasannaPatelrinzal.jsn@gmail.com
438202MicrobiologyAntimicrobialsGanciclovirhttps://www.uptodate.com/contents/ganciclovir-and-valganciclovir-an-overview#H2Ganciclovir monophosphate is formed by UL97 Kinase. It is called the UL97 kinase b/c The drug is converted intracellularly to ganciclovir 5'-monophosphate by a viral kinase, which is encoded by the cytomegalovirus (CMV) gene UL97 during infection. I would indicate that it is the triphosphate form that preferentially inhibits viral DNA polymerases more than cellular DNA polymerases. In addition, ganciclovir triphosphate serves as a poor substrate for chain elogation, thereby disrupting viral DNA synthesis by a second route :-)Minor erratum11/23/19 8:12 PMMarkPilarskimarkdp21@yahoo.com
439203MicrobiologyAntimicrobialsHIV therapynot neededFor abacavir association with HLA-B*57:01, highlight AB in abacavir red and highlight the A-B in HLA-B*57:01 red for memory aidMnemonicVerifiedMnemonic. Defer to 2020.

- Humood		Not helpful IMO. Reject.

- Vivek		12/22/18 2:52 PMNicholasYeisleynwygz4@mail.umkc.edu
440203MicrobiologyAntimicrobialsHIV therapynot needed"miraviroCXX"; (CXX is roman numerals for 120, gp120)MnemonicVerifiedMnemonic. Defer to 2020.

- Humood		Not helpful IMO. Reject.

- Vivek		12/28/18 9:48 AMNicholasYeisleynwygz4@mail.umkc.edu
441203MicrobiologytrueAntimicrobialsHIV therapyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773846/Maraviroc is not a fusion inhibitor. It is a co-receptor binding inhibitor. Both fusion inhibitors and co-receptor binding inhibitors are considered ENTRY inhibitors. I recommend changing "Fusion inhibitors" with "Entry inhibitors". This also applies to the chart on page 201.Minor erratumVerifiedI agree - it would be more appropriate to rename these "Entry inhibitors".

UTD (Overview of antiretroviral agents used to treat HIV) also uses this term.

I don't think it is a major erratum but should be addressed in the next edition.

- Sarah		i agree, entry inhibitor is more appropriate word ~ parthAgree, change to "Entry inhibitors"Prelim accept by 2 authors + 1 editorSheldon CampbellAgree; that's a sensible grouping.Warren Levinson203 HIV I agree. Change “Fusion” to “Entry”AcceptChange"Fusion inhibitors" to "Entry inhibitors"true01/07/19 3:47 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
442203MicrobiologyPharmacologyHIV therapymyselfNRTI mnemonic: TESLA DZ Tenofovir, Emtricitabine, Stavudine, Lamivudine, Didanosine, ZidovudineMnemonicVerifiedMnemonic. Defer to 2020.

- Humood		This mnemonic standalone is not intuitive and helpful IMO. Would reject it.


- Vivek		01/29/19 8:47 AMMurliMishramm.murli@gmail.com
443203MicrobiologyAntimicrobialsHIV therapyhttps://www.ncbi.nlm.nih.gov/pubmed/16302461Enfuvirtide is NOT effective against HIV-2, but at the top of the page it says only NNRTIs are not effective against HIV-2Minor erratum05/14/19 3:59 PMMatthewPavlicampavlica@nyit.edu
444203MicrobiologyPharmacologyHIV therapyFrom the DHHS: https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/21/52/when-to-start-antiretroviral-therapyART is now started for ALL HIV patients as soon as possible.High-yield addition to next yearAccept.

I think it would be prudent for us to update the text to reflect this practice:

"Antiretroviral therapy (ART): initiated at the time of HIV diagnosis."

Ashten		05/16/19 4:46 AMAndrewKoandrewko@hawaii.edu
445203MicrobiologyPharmacologyHIV therapy(my brain)Current mnemonic: "EnFUvirtude - FUsion inhibitor"; Suggestion: "EnFUvirtude - FUsion inhibitor - gp FUrty-one"MnemonicVerifiedReject.

Too much. I think it might be too overwhelming to remember.

Given Sarah's comment on Annotate about "Entry Inhibitors" vs "Fusion Inhibitors," I would recommend this:

ENfuvirtude inhibits ENtry.

Ashten		05/16/19 4:48 AMAndrewKoandrewko@hawaii.edu
446203MicrobiologyPharmacologyHIV therapyNo reference needed.Staph Aureus Dies Tomorrow as wELL. Staph-> stavudine. Aureus-> Abacavir. Dies-> Didanosine. Tomorrow-> Tenofovir. wELl-> Emtricitabine and LamivudineMnemonicVerifiedReject.

Too complicated.

Ashten		06/27/19 5:46 PMMohamedElashwalmelashwal@outloo.com
447203MicrobiologyPharmacologyHIV therapyNo reference needed. mnemonicNNRTIs Mnemonic: Elves Never Die. Elves-> Efavirenz. Never-> Nevirapine. Die-> Delavirdine.MnemonicVerifiedAccept.

This one's pretty good; it's simple and get to the point about the drugs in that class.

Ashten		06/27/19 5:49 PMMohamedElashwalmelashwal@outlook.com
448203MicrobiologyAntimicrobialsHIV therapyNone MnemonicNucleos(t)ides LimiT HIV DiAZESs (Diseases) Competitively DEN (than) Non-nucleosides.MnemonicVerifiedReject.

Too complicated and clunky.

Ashten		07/05/19 2:50 PMAkintundeGbadeboakintundegbadebo@gmail.com
449203MicrobiologyAntimicrobialsHIV therapyNone"DIDanosine can lead to PancreaDIDis". An easy way to remember this small and very testable fact.MnemonicVerified08/03/19 7:59 PMSumeetSalhotrasalhotra1991@yahoo.com
450203MicrobiologyAntimicrobialsHIV therapynot neededMnemonic for remembering the seven antiretrovirals in the NRTIsMnemonicVerified08/26/19 10:05 PMAlexaLawsonlexielawson19@gmail.com
451203MicrobiologyAntimicrobialsHIV therapySelf-writtenProTEASE Inhibitiors - NAVIR (never) TEASE (proTEASE) chubby/large people who have lipodystrophy/cushings and high blood sugar (these are complications of protease inhibitor use). They are at risk of complications!Mnemonic10/30/19 11:37 AMKhalidAlattarkhalid_alattar@hotmail.com
452203MicrobiologyAntimicrobialsHIV therapyhttps://www.uptodate.com/contents/treatment-of-hiv-2-infectionHIV-2 is resistant to NNRTIs and all fusion inhibitors (inc. enfuviritide and maraviroc). HIV-2 also has variable resistance against protease inhibitors (so PI regimens must be used with caution). Finally, a clarification on page 175 about when to suspect HIV-2 would be helpful (person from endemic area [West Africa]). Thanks!Major erratum11/08/19 5:50 PMBryceHwangbphwang@stanford.edu
453204MicrobiologyAntimicrobialsHepatitis C therapyhttps://www.uptodate.com/contents/simeprevir-drug-informationAdverse effects of Grazoprevir and Simeprevir are switchedMinor erratumYes, the user is correct. According to medscape and UTD, headache and fatigue has been reported in 10% of patients taking Grazoprevir. (1) In case of Simeprevir, photosensitivity reactions and rash have been most commonly reported. (2)

[Current text states the opposite]


1. https://reference.medscape.com/drug/zepatier-elbasvir-grazoprevir-1000055#4
2. https://reference.medscape.com/drug/olysio-simeprevir-999875#4


- Vivek		Well spotted. Minor erratum to be fixed during Pass 2.

- Sarah		Prelim accept by 2 authors + 1 editortrue05/06/19 11:20 AMNaylaMrouehnaylamroueh@gmail.com
454204MicrobiologyPharmacologyHepatitis C therapyhttps://www-uptodate-com.proxy.hsc.unt.edu/contents/treatment-regimens-for-chronic-hepatitis-c-virus-genotype-1-infection-in-adults?search=hepatitis%20c%20treatment&topicRef=3673&source=see_link#H16319566Mnemonic/"general rule" to help remember drug treatment combinations for Hep CMnemonicVerifiedReject.

I agree with Vivek: the suggestion seems to be lacking.

Ashten		This mnemonic suggestion is not clear to me.

- Vivek		05/06/19 10:33 PMEmilyTuttemilyktutt@gmail.com
455204MicrobiologyAntimicrobialsHepatitis C therapyhttps://www.uptodate.com/contents/treatment-regimens-for-chronic-hepatitis-c-virus-genotype-1-infection-in-adults?search=ledipasvir&source=search_result&selectedTitle=3~28&usage_type=default&display_rank=3#H253485860Capitalizing the letter A in ledipAsvir and ombitAsvir make it easier to remember they are ns5*A* inhibitors. Same thing for letter B in sofosBuvir and dasaBuvir as they are ns5*B* inhibitors. Additionally, some of the hepatitis C therapies are not in the index.MnemonicVerifiedThanks for the comment. That sounds a good idea and helpful to remember NS5A AND NS5B inhibitors. We can forward this suggestion to annotate. With regard to, hepatitis C therapies, this needs to be checked by the indexed time at a later time.


- Vivek		05/07/19 8:09 PMThoNguyentnguyen27@kumc.edu
456204MicrobiologyAntimicrobialsHepatitis C therapyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206157/On page 204 under NS3/4A inhibitors under toxicity; should read: Simeprevir: Photosensitivity reactions, rash, headache, fatigue, nausea. Grazoprevir: headache and fatigue. Here is a quote from this article 'The main side effects of Simeprevir include headache, fatigue, nausea, photosensitivity and skin rash’Minor erratum06/04/19 12:09 AMTriciaScalestscales@sgu.edu
457204MicrobiologyAntimicrobialsHepatitis C therapyhttps://emedicine.medscape.com/article/177792-treatment#d11Ribavirin is a guanosine nucleoSide inhibitor as it is a nucleoside analogue. The statement that it inhibits 'synthesis of guanine nucleotides' is true as well but I find it clearer to say that it is a nucleoside inhibitor rather than it 'inhibits the synthesis of nucleotides.'Clarification to current text06/30/19 2:43 PMIanMarkianmark926@gmail.com
458204MicrobiologyAntimicrobialsInterferonsn/a(2018 edition) In Clinical Use row, "Chronic HBV and HVC" should be changed to "Chronic HBV and HCV" (HCV has letters transposed)Spelling/formatting05/18/19 11:40 PMNehalyShahnehaly.shah@gmail.com
459206PathologyPathologyBarrett esophagushttps://www.ncbi.nlm.nih.gov/books/NBK459330/Barrett’s esophagus is the condition in which a specialized columnar epithelium replaces the normal stratified squamous epithelium of the esophagusHigh-yield addition to next year08/23/19 12:24 PMNilayPatelnlypatel@yahoo.com
460206PathologyPathologyCell injuryhttps://breast-cancer-research.biomedcentral.com/articles/10.1186/bcr287Desmoplasia:the proliferation of non-neoplastic fibrous tissueHigh-yield addition to next yearYes, this is true, but not as testable and may lead to some confusion. I think it is best left with metaplasia, dysplasia, and hyperplasia. -SM05/14/19 9:36 PMLincolnKavinskylincoln.kavinsky@gmail.com
461206PathologyPathologyCellular adaptationshttps://www-uptodate-com.ezproxy.aub.edu.lb/contents/epidemiology-and-pathogenesis-of-benign-prostatic-hyperplasia; https://www-uptodate-com.ezproxy.aub.edu.lb/contents/overview-of-benign-breast-diseaseAdd "BPH" as an exception to neoplastic potential of hyperplasia, and add "apocrine metaplasia of the breast" as an exception to neoplastic potential of metaplasia.High-yield addition to next yearVerifiedReject. I'm not entirely sure what this submiter wants us to do. This could have possibly been an errata for a previous version? -SM Agreed, Reject - AKBReject. It seems like the student is suggesting that the text states that all hyperplasia and metaplasia have neoplastic potential? -MK01/12/19 12:30 PMRalphZeitounriz07@mail.aub.edu
462206PathologyCellularCellular adaptationsn/aTo remember the difference between hypertrophy and hyperplasia: the LARGEST cells will win a TROPHY (larger cells in hyperTROPHY). A cell wants MORE cell friends to PLAY with (make more cells in hyperPLAYsia).MnemonicVerifiedNice mnemonic but not terribly useful. Can skip. - AKBI think this mnemonic is good but i'm not sure many readers would need a mnemonic for this. It may be a waste of space. - MK02/19/19 12:29 PMElizabethMurrayelizabeth.murray@downstate.edu
463209PathologyCellularNecrosishttps://journals.aace.com/doi/pdf/10.4158/EP15935.CRFat Necrosis as complication of Trauma on Obese Patient, also a complication in patient with extensive weight loss after adrenalectomy. Fat Necrosis could be a major complication in obese patients after a postsurgical treatment, so this can be published as a high yield example of Fat Necrosis Complication after surgery on obese patients.High-yield addition to next yearThis article is a case report - I'm not sure how "high yield" this material is. Reject. - MKReject. -SM04/29/19 12:22 PMMarie CarmenPadínmarie9735@gmail.com
464210PathologyCellularIschemiaNoticedIn the ischemia section, the subendocardium (LV) of the heart is labeled with "A" for the image, but this is already referred to below by red infarct "A" showing an image of the lung.Minor erratumReject. -ScottReject. There are several pictures on the page, each labeled individually and in different sections. It seems self-explanatory which A is referring to which picture. - MKAgree with rejection.

-Matt		Reject by 2 authors + 1 editor04/04/19 9:27 PMNankiHurananki.hura@gmail.com
465211PathologyPathologyTypes of calcificationmyself, FA2019Dystrophic calcification mnemonic: CCATTTS Liq Fat In Psam Room i.e. CREST syndrome, Congenital cmv, Atherosclerosis, Toxoplasmosis, Thrombi, TB, Schistosomiasis, Liquefactive necrosis of chronic abscess, Fat necrosis, Infarcts, Psammoma body, RubellaMnemonicVerifiedReject. -ScottI think this mnemonic is would be hard to remember. Reject? - MK03/26/19 7:32 AMMurliMishramm.murli@gmail.com
466212PathologyPathologyAmyloidosishttps://watermark.silverchair.com/ajcpath108-0289.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAk0wggJJBgkqhkiG9w0BBwagggI6MIICNgIBADCCAi8GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMtlki02qZntdM7fHhAgEQgIICAKb0OCRLIttoA307SWFQyMWGFQoZqVdeyp0SkLJU_bBGQ1LsNYjblQkqprShv4Anu-BVtNaDFDb0rEbYMNMZXBtWrQDaA4M7c8yJnnw4foUc-bvHtLPYWVSVIC2Qh3PfD5EnrmDoXIXvTfGPHMM_J4sveANlPRx7tbznKpmhJR5k8_DeWhB77aU5zJVYBMbfbAxb-pC0mvK8IE68J81KaqBL6sUdXVfkrA29G3hFdi2LSLFJnrBw9IJ5eXtkcohaY7iCO5_U6tHizycQ6nPjk8FJIf13nexfkb_HL1YQ-MnPcpsgf5gwegWZQC59iJ6v9c8IVGi7q1dM9OGG7ePZJ09fVPlmJksMiE9Bz-dShJMh7FyzmJhUMd7HSwfkoB9X2_t1QjxJUKldo25HIUJrGbUvOMuoex97_F-_ZbBnv2GODQUnm-5J3_QwlCZLvQVulEJx9KiqvZrMn3ekybkZS0o9nNG8FNmOP62QnYUKeDCI2FTbQ9AUgIDjBeT5fhkRG0khUNeZo14hhMQqJAFMxni6KhS-W_Go6faMIsX6q6BTpOQDjbb4NTuNCtHgPC9KHPiWxV2izvxCKogPXbgAfa1V4sHICtoOHFr3DXWutRT4GFi5hVMjVIC7KY24T88bnaokEKP4xwWuKkIuhsd2B9fR-UZfh3JKoIpcBqK_HmtqCalcitonin amyloid is known as 'ACal' (There should be no space between 'A' and 'Cal')Spelling/formattingVerifiedThank you for the comment. Agree, there should be no space.

https://www.ajkd.org/article/S0272-6386(16)30645-X/fulltext?rss=yes&mobileUi=0

- Vivek		Accept.

Agree with user and Vivek
-MA Agree as well - AKB		12/23/18 4:47 AMJerrinBawajerrin.bawa@gmail.com
467213ImmunologyInflammationAcute inflammationhttps://www.ncbi.nlm.nih.gov/pubmed/17625373Procalcitonin is one of the main diagnostic markers for infections.High-yield addition to next yearReject.
As of 2017, procalcitonin is still considered a "promising" marker for sepsis, which makes me think it's too novel to be tested. UTD entry on acute phase reactants says that "Further study is required to define its clinical utility."

Also the source provided by the proposer is from a 2007 article published in a journal of a Nippon med school.

Also this is the wrong chapter designation but page 213 is the correct page for acute phase reactants in the path chapter.

-Connie

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5543591/
https://www.uptodate.com/contents/acute-phase-reactants?search=procalcitonin&source=search_result&selectedTitle=3~62&usage_type=default&display_rank=3		Agree with Connie. While we often use it in the clinical setting, it has not been around long enough to be tested on Step 1. Would not recommend addition to the text. -VVReject by 2 authors + 1 editor03/26/19 12:47 PMJose CarlosFernandezjosecarlos1593@yahoo.com
468213PathologyInflammationAcute phase reactantshttps://www.uptodate.com/contents/acute-phase-reactantsNext to Fibrinogen, the addition of an "upwards" arrow before ESR would clarify the result of increased fibrinogen.Clarification to current textVerifiedWe explain the relationship between fibrinogen and ESR on the next page(p214).

-MA		Agree with MA-SM Same, - AKBAgree with addition of up arrow next to ESR since they do correlate. Clarification only, NOT published errata-worthy.

-Matt		Prelim accept but NOT publishable errata01/02/19 5:22 AMAdamKurnickadam@kurnick.net
469213PathologyInflammationAcute phase reactantshttps://www.uptodate.com/contents/acute-phase-reactantsThe addition of an arrow pointing upwards and ESR (*increases ESR*) would be helpful if placed next to "Positive (Upregulated)". Otherwise, it would be helpful if "*upwards arrow* Acute Phase Reactants" was placed on Page 214 next to Inflammation under "increased ESR".Clarification to current textVerifiedReject.

Not all reactants directly cause an increase in ESR. ESR is also covered in more detail on the very next page.

-MA		I think we could ACCEPT here and disagree with MA. I think that this could give additional benefit because the ESR is fairly SENSITIVE for inflammation, but ESR is also an insanely nonspecific finding and could be from any cause of inflammation. -SMAgree with addition of up arrow next to ESR since they do correlate. Clarification only, NOT published errata-worthy.

-Matt

NB: duplicate submission by same student, credit should be given only once if implemented		Prelim accept but NOT publishable errata01/02/19 5:25 AMAdamKurnickadam@kurnick.net
470213PathologyInflammationAcute phase reactantshttps://www.ncbi.nlm.nih.gov/pubmed/23172263adding procalcitonin to Acut pahse reactant but it is unique because it has positive and negative properties. it is level rise in bacterial toxins and fall in response to viral infections.High-yield addition to next yearReject. There is a huge boom in recent literature about the usability of PCT in Sepsis patients. It is not technically mentioned in any reerence that I am aware of as an acute phase reactant. -SM05/18/19 7:47 PMMuhanadShaibmohanad.shaib@gmail.com
471213PathologyInflammationInflammationhttps://emedicine.medscape.com/article/1048887-overview#a3 https://www.uptodate.com/contents/ace-inhibitor-induced-angioedema?search=bradykinin&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H4335305Cardinal signs of inflammation: Tumor (swelling): ADD bradykininHigh-yield addition to next yearVerifiedReject. Bradykinin is included under the cardinal signs of Dolor. -SMReject. Bradykinin mediates pain. - MK; reject - AKB01/21/19 7:21 AMHasanAlarourihassan.arouri@hotmail.com
472213PathologyInflammationInflammationhttps://www.uptodate.com/contents/approach-to-the-patient-with-neutrophilia?search=Leukemoid%20reaction&sectionRank=1&usage_type=default&anchor=H23&source=machineLearning&selectedTitle=1~48&display_rank=1#H23Leukemoid reaction refers to a white blood cell (WBC) count >50,000/microL from causes other than leukemia. The majority of cells are mature neutrophils, often accompanied by a prominent left shift.High-yield addition to next yearThis is something that could be tested, likely at the Step 3 level. Leukemoid reactions are not typically dealt with on Step 1 to my knowledge. -ScottI have seen leukemoid amongst Step 1 content and think it is a fair point to include - AKB03/21/19 3:15 AMNicolasCuri Gawlinskinicolascurii@gmail.com
473215PathologyPathologyAcute inflammationMyself, FA2019Leukocyte Extravasation step mnemonic: Leukocyte go to Margin Rolling And Transmitting Chemicals i.e. Margination, Rolling, Adhesion, Transmigration, ChemoattractionMnemonicVerifiedReject. -ScottReject-akb03/26/19 8:31 AMMurliMishramm.murli@gmail.com
474216PathologyInflammationLeukocyte extravasationhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037658/VLA-4 integrin. VLA stand for Very Late Antigen, i think it would be better if you add this to the abbreviations and symbols at the end of the book.Spelling/formattingunnecessary, not a testable fact; - AKBReject. - MK04/26/19 4:44 PMMuhanadShaibmohanad.shaib@gmail.com
475216PathologyInflammationLeukocyte extravasationself-madeTo remember the order: "MR. please ACT out the leukocyte extravasation" where M-margination, R-rolling, A-adhesion, C-crawling, T-transmigration.MnemonicVerifiedReject. I think the images work better and tell the same thing. -Scott05/15/19 8:01 AMTaliaKamdjoutkamdjou@hotmail.com
476216PathologyInflammationLeukocyte extravasationSelf CreatedTo remember that Sialyl Lewis X partners up with selectins for Leukocyte Extravasation. Si-Le-Xtins bind selectins during Leukocyte Extravasation. Si - Sialyl. Le - Lewis. Xtins - XMnemonicVerified09/08/19 2:21 PMBaoanhVubaoanhvu21@gmail.com
477221PathologyNeoplasiaTumor nomenclaturehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834696/Melanocytes are NOT derived from mesenchyme; they come from neural crest cells. (this has important implications considering metastasis of malignant melanocyte tumors, since the -misleading- association that mesenchymal-derived cells spread hematogenously).Major erratumReject. Sorry, melanocytes have a very strange developmental process as described here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834696/ Neural Crest Cells is a group of cells originating from the embryonic germ layer named ectoderm. Under inductive influence of the notochord, the middle area of the embryonic disc differentiates into neuroectoderm that is visible as a neural plate at 4-week-old human embryo (Figure 5A). This plate folds and changes into the neural tube, future central nervous system elements – brain, spinal cord. During this process named neurulation, a group of cells from edges of the neural plate (crests), separates, changes the phenotype from epithelial to mesenchyme and migrate out from neuroepithelium (Figures 5A and ​and5B).5B). These neuroectodermal cells migrating to many places of the forming embryo's body are neural crest cells – NCC (Figure 5C). Neural crest cells are initially multipotent cells but gradually become lineage-restricted in developmental potential. This potential is determined by anatomical localization along the cranial-caudal axis, e.g. cranial NCC can differentiate into neurons, glial cells but also chondrocytes, osteocytes, muscle cells, whereas trunk NCC form neurons and glial cells in the peripheral nervous system, endocrinal cells (Figure 6). These cells proliferate and start to express distinct molecular markers. -ScottAgree with Scott. Appears to be complex but the bottom line is that our current statement of melanocytes being derived from "mesenchyme" is correct. No change.

-Matt		Reject by 2 authors + 1 editor07/14/19 9:04 PMNicolasCuri Gawlinskinicolascurii@gmail.com
478222PathologyNeoplasiaHallmarks of canceruWorld and pathomaTissue invasion by metastatic cells is described in Uworld and Pathoma with cell attachment to the basement membrane happening before its degradation by metalloproteinases.Minor erratumReject. It's the same process, we just use different words, besides not all metastases happen because of metalloproteinases -ScottAgree with Scott. We don't really fixate on a single timeline, just the general process. There is no erratum here.

-Matt		Reject by 2 authors + 1 editor05/07/19 10:32 AMGeorge AmauryLara Colladoamaurylarac@gmail.com
479222PathologyNeoplasiaHallmarks of cancerhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179891/"Seed and Soil" hypothesis, certain tumor cells (the seeds) can only successfully colonize selective organs (the soil) that have suitable growth environments. The current text leads to a different meaning of Seed and Soil theory [ first encountered capillary bed is the often site of mets ] while the theory actually implies something elseMinor erratumthis is true and a great way to think of metastatic potential, however, the USMLE will likely never write a question about the "seed and soil hypothesis". ScottI agree with the submission. I think the way we have this written, it implies that tumor cells spread to the first capillary bed they encounter, when in fact it is better described by the sentence that follows about organ tropism. It is somewhat inaccurate.

My thoughts? Delete "seed and soil theory" text from the entry. It's not really covered in anywhere near enough detail and is likely LY as Scott points out, anyway.

Would not call publishable errata-worthy.

-Matt		Prelim accept but NOT publishable errata07/19/19 7:12 AMAhmadMashlaha7hmad@live.com
480224PathologyPathologyBone formationhttps://www.mayoclinic.org/diseases-conditions/bone-metastasis/symptoms-causes/syc-20370191the pneumonic painful bones kill the lungs should be painful breasts kill the lungs instead.MnemonicVerifiedReject, not necessary and awkward -AKBReject. I understand why the student would suggest this, but the point of the mnemonic is to remind you which cancers metastasize to bone. - MK02/16/19 6:33 AMMaryFahmymaryfahmy07@hotmail.com
481224PathologyNeoplasiaCommon metastasesFA 2019 Page 224remove highlight from these letters "ungs" in the word "Lungs" in the mnemonic(Painful Bones Kill The Lungs) , keep just "L" in red color.Spelling/formattingVerifiedAgree, as per the student (for the next 2020 edition).

- Vivek		Agree.

-MA ; same - akb'		01/05/19 2:17 PMMoatasemAl-Janabiassoomi88@yahoo.com
482224PathologyNeoplasiaCommon metastasesGojan RRShould say "most carcinomas INITIALLY spread via lymphatics" and can give example of colorectal carcinoma commonly metastasizing to liver.Clarification to current textReject. -ScottReject. Isn't this implied as the cancer spreads to the other sites via the lymphatics? - MKAgree with rejection.

-Matt		Reject by 2 authors + 1 editor04/03/19 9:54 AMJamshaidMirjmir@sgu.edu
483224PathologyNeoplasiaProstatic adenocarcinomaUWorld Question ID: 11747. https://www.ncbi.nlm.nih.gov/pubmed/16960456. https://www.ncbi.nlm.nih.gov/pubmed/16915183.Metastasis of carcinomas are via lymphatics with the exception of 4 carcinomas that spread hematogenously stated in the First Aid 2019: 1. Hepatocellular Carcinoma, 2. Renal Cell Carcinoma, 3. Choriocarcinoma, 4. Follicular Thyroid Carcinoma. However, as per UWorld question (ID: 11747), prostatic adenocarcinoma spreads to the vertebral column by the prostatic venous plexus, hence hematogenously and not by lymphatics, making prostatic adenocarcinoma spread to the vertebral column a hematogenous metastasis which should be added to the exceptions described anteriorly by the First Aid or should be stated on this page.Clarification to current textGreat question! However, I think that we reject. Because the most common route of metastasis is lymphatic, though hematogenous spread is possible, it is less likely. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459485/ -ScottScott is correct. Not to mention, that the venous plexus leading to these bones often contains associated lymphatics!

Reject.

-Matt		Reject by 2 authors + 1 editor06/01/19 4:18 PMJackelinePortojcjp0704@gmail.com
484225PathologyNeoplasiaImportant immunohistochemical stainshttps://www.nature.com/articles/nrc3893S-100: is stated to be a target of Neural Crest cells in the table even though they can be seen to target more general Mesodermal tissue. You even specified on page 426 under the Islet Langerhans cells of Histiocytosis- t being mesodermal in origin in brackets. My supporting evidence is it staining breast cancer tissue as well!Clarification to current textVerifiedYes, they may belong to the mesodermal line of tissue, however, we use them in anatomic pathology to identify neural cells. The practical application of this stain is the most important. -ScottNo need for change, as Scott said, practical application (i.e. the exam itself) most important; leave as is- AKBAgree with Scott's assessment, no change is needed.

-Matt		Reject by 2 authors + 1 editor02/26/19 12:40 PMAbdul SattarRaslananr06@mail.aub.edu
485225PathologyNeoplasiaNeoplasia and neoplastic progressionhttps://www.nature.com/articles/s41598-018-24310-5Neurofibromin (Ras GTPase activating protein) and in neurology section p 513 NF1 ((encodes neurofibromin, a negative RAS regulator )Clarification to current textVerifiedI think that this fits better on page 513. -ScottAgree with student. I see a similar comment on Annotate. Neurofibromin is an inhibitor of RAS/MAPK signaling. Robbins pathology, table 7-7. - MKAgree, reasonable addition, and placing on p513 is fine as an addition.

-Matt		Prelim accept but NOT publishable errata02/14/19 6:20 AMnehalkhalidnehalnasser55@gmail.com
486225PathologyNeoplasiaOncogeneshttps://www.ncbi.nlm.nih.gov/pubmed/19462461JAK2 is a "Non-receptor" tyrosine kinase. This is clarified in case of BCR-ABL - that it is a "non-receptor" tyrosine kinase. However, JAK2 does not have this clarificationClarification to current textVerifiedAgree, we can change this on non-urgent basis.

- Vivek		Agree with Vivek.

- MA		Agree with clarification for 2020 as per submission/authors. NOT published errata worthy.

-Matt		Prelim accept but NOT publishable errata12/23/18 4:29 AMJerrinBawajerrin.bawa@gmail.com
487225PathologyNeoplasiaOncogeneshttps://www.ncbi.nlm.nih.gov/m/pubmed/23059849/RET associated neoplasm is familial medullary carcinoma of the thyroid. Many students think medullary carcinoma alone which is excluded here but a clarification to familial would helpHigh-yield addition to next yearVerifiedReject. https://ghr.nlm.nih.gov/gene/RET#conditions "Additionally, a nonfamilial form of medullary thyroid carcinoma (a type of thyroid cancer that can also occur as part of multiple endocrine neoplasia) can be caused by somatic mutations in the RET gene." -SMReject, unnecessary detail -AKB01/10/19 10:51 PMEmilyLoweryEmilylowery94@gmail.com
488225PathologyPathologyOncogeneshttps://emedicine.medscape.com/article/1744824-overviewAssociated Neoplasm with RET oncogene says MEN2A, and 2B and papillary thyroid carcinoma. Should say Medullary thyroid carcinoma although Papillary thyroid carcinoma is also associated with RET/PTC proteins with constitutive RET kinase activation due to chromosomal rearrangements generating a fusion gene.Major erratumReject. We aren't able to make any definitive conclusions about RET and MTC. "Thus, despite the well-known molecular basis of fMTC, the genetic variants of the sporadic form are still poorly understood, and functional analyses are needed to better understand the consequence of such RET variants and to improve our knowledge on the disease." https://www.ncbi.nlm.nih.gov/pubmed/23059849 ScottAgree with Scott. From a syndrome versus a sporadic mutation perspective, what we list is accurate and would not make any changes.

-Matt		Reject by 2 authors + 1 editor07/24/19 3:23 AMAbhijitBattarabattar5@gmail.com
489225PathologyNeoplasiaOncogenesMy own brainHow to remember the proteins for TSC1 (hamartin) and TSC2 (tuberin) - which one codes which? TSC2 = "Two"berin!MnemonicVerified09/12/19 10:17 AMHaleeLiuraxorium@gmail.com
490225PathologyNeoplasiaOncogeneshttps://emedicine.medscape.com/article/123447-overviewDuring my study and cross referencing for Step 1, I noted that in FA2019, the RET oncogene is listed only in association with papillary thyroid carcinoma but I have encountered it being more associated with medullary thyroid carcinoma. Some of the sources I have referenced do not even mention papillary thyroid carcinoma in association with RET.High-yield addition to next year11/04/19 8:52 AMPaula DanikaBinsolpdbinsol@gmail.com
491225PathologyNeoplasiaTumor suppressor genesN/AFor Li Fraumeni syndrome, a better mnemonic than SBLA would be "Check your LABS: Leukemia, Adrenal gland, Breast, Sarcoma"MnemonicVerifiedI like LABS better than SBLA, but the problem with the other name may come up. I've personally never heart of SBLA syndrome before though. -ScottI agree that this mnemonic is probably an easier way to remember the 4 letters. However, SBLA cancer syndrome is another name for LiFraumeni syndrome. - MK02/22/19 9:56 AMSanamSolankisolankism@vcu.edu
492225PathologyNeoplasiaTumor suppressor genesInfo taken directly from table on p. 225 of FA 2019mnemonic for cancers arising from PTEN mutations: "PTEN" (P - prostate, T - teat [breast], EN - endometrial)MnemonicVerifiedAccept. ScottAccept. This mnemonic is easy to remember and helpful for the types of cancers that arise from PTEN mutations. -MK03/26/19 10:22 AMSaieeshRaoimsa.projects@gmail.com
493225PathologyNeoplasiaTumor suppressor genesFA 2019Loss of function of PTEN causes Prostate, breast, and endometrial cancer. “PTEN = Prostate, Tatas, and ENdometrium”MnemonicVerified05/05/19 2:21 PMJasminShahrestanijshahrestani@gmail.com
494225PathologyNeoplasiaTumor suppressor genesNo reference needed.TSC2 ; think "two"berinMnemonicVerified07/02/19 3:31 PMMohamedElashwalmelashwal@outlook.com
495225PathologyNeoplasiaTumor suppressor genesNoneTo learn easily gene product of tumor suppressor genes TSC1 and TSC2: TSC1-lamartin, TSC2berin.MnemonicVerifiedReject. -Scott07/20/19 8:55 PMStephanieDel Riostep.dt@outlook.es
496225PathologyNeoplasiaTumor suppressor genesnot neededPTEN Associated with (Prostate, Tits{breast}, ENdometrial cancer)MnemonicVerifiedReject. -Scott07/23/19 5:29 AMMamounSouleimanmamoon1995@hotmail.com
497226PathologyNeoplasiaCarcinogensN/A"Ionizing radiation" row --> please add "Blood" under organ column for "Leukemias"Clarification to current textVerifiedAgree with the student. We should add "blood" under organ column for leukemias. (We did the same for alkylating agents).


- Vivek		I don't feel that this is important enough to include in the published errata.

- MA		Technically bone marrow, not blood. Can consider this as an addition/clarification, I recharacterized as such. NOT published errata worthy.

-Matt		Prelim accept but NOT publishable errata01/09/19 9:07 AMBehnamNabavizadehbehnam.nabavi@yahoo.com
498226PathologyNeoplasiaOncogenic microbes1. https://www.cdc.gov/parasites/liver_flukes/index.html 2)https://www.publichealth.va.gov/exposures/infectious-diseases/cholangiocarcinoma.asp 3)https://en.wikipedia.org/wiki/Clonorchis_sinensis 4) https://www.uptodate.com/contents/liver-flukes-clonorchis-opisthorchis-and-metorchisExisting Information is Liver Fluke (Clonorchis sinesis) causes Cholangiocarcinoma. The "Liver Fluke" term should be replaced by "Chinese Liver Fluke" or simply remove the term liver fluke since 1)the current version delivers message that all liver flukes esp Clonorchis causes cholangiocarcinoma, whereas Opisthorchiidae liver flukes (Clonorchis and Opisthorchis) causes cholangiocarcinoma not the Facioliadiae liver flukes. 2. fasciola hepatica is commonly known as common liver fluke (just google liver fluke) and Clonorchis sinesis is a liver fluke, but commonly pronounced as Chinese Liver Fluke, you can check the uptodate weblink mentioned below.Minor erratum11/26/19 7:23 AMOm MurtiNikhildromnikhil@gmail.com
499227PathologyNeoplasiaSerum tumor markershttps://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-paget-disease-of-bone?search=Paget%27s%20disease%20of%20bone&source=search_result&selectedTitle=1~56&usage_type=default&display_rank=1 https://academic.oup.com/ajcp/article-abstract/83/5/594/1819719?redirectedFrom=PDFPaget Disease of Bone is listed as a cancer, but the disease itself isn't itself neoplastic. Perhaps it therefore doesn't belong on this list, just as other non-neoplastic causes of increased ALP are not on the list (even though they too have an increased risk for cancers, like primary sclerosing cholangitis)..Minor erratum08/12/19 9:43 PMJosephYasmehjyasmeh@gmail.com
500227PathologyNeoplasiaSerum tumor markersN/ACA 125 for Ovarian Cancer: “These ovaries are open for business from 1-to(2)-5.”MnemonicVerified08/13/19 11:54 AMJaredSharzajaredsharza@gmail.com
501228PathologyNeoplasiaImportant immunohistochemical stainsUWorld QID: 926, https://www.ncbi.nlm.nih.gov/pubmed/24893135, https://www.uptodate.com/contents/neuroendocrine-neoplasms-of-unknown-primary-site?search=pheochromocytoma%20synaptophysin&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2Chromogranin, synaptophysin, and neuron-specific enolase also identify pheochromocytomas, due to their neuroendocrine cell lineage. "Page 336 --> pheochromocytoma --> etiology/findings" should also be updated to include this.High-yield addition to next yearThis one has a caveat because pheochromocytomas are virtually 100% positive for CgA, they can lose synaptophysin, and NSE is used as a marker for detecting malignant pheochromocytoma, because it's normal in benign pheos. I say we reject this one because it is written above the level of a 2nd year medical student. -Scott https://www.ncbi.nlm.nih.gov/pubmed/16188147 https://www.ncbi.nlm.nih.gov/pubmed/334237305/24/19 11:37 AMEyalBenDavidbendavid.eyal@gmail.com
502228PathologyNeoplasiaP-glycoproteinUW ID: 1819; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762612/There should be clarification to the current text to explicitly state that P-glycoproteins are ATP-dependent efflux pumps with a specificity for hydrophobic compounds. UW states: "The human multidrug resistance (MDR1) gene codes for P-glycoprotein, a transmembrane ATP-dependent efflux pump protein that has a broad specificity for hydrophobic compounds. This protein can both reduce the influx of drugs into the cytosol and can increase efflux from the cytosol, thereby preventing the action of chemotherapeutic agents (eg, anthracyclines)."High-yield addition to next yearWe do mention that on page 228. Reject. ScottThis is basically to add non-urgent detail to the fact such as its ATP-dependence or the specificity for hydrophobic compounds. This can be deferred to 2021.

-Matt		06/17/19 5:33 PMYolandaZhangyolandazhang43@gmail.com
503229PathologyNeoplasiaHematopoiesishttps://www.ncbi.nlm.nih.gov/pubmed/20237866Approximately 95% of patients with polycythemia have a V617F mutation involving the JAK gene. This mutation replaces valine with phenylalanine at the 617 position, rendering hematopoietic cells more sensitive to growth factors such as EPO and TPO. So PV is not only about increased level of EPO, but about increased sensitivity to EPOHigh-yield addition to next yearVerifiedI don't think that students will need to get that specific with their knowledge. As long as they know that Paraneoplastic Polycythemia is associated with elevated erythropoietin levels, they will be golden. I can't imagine a question being asked that will differentiate between the increased sensitivity and the absolute elevation of EPO on the USMLE. -ScottI agree with Scott and think this suggestion is out of the scope of step 1. -MK02/01/19 6:35 PMSergiiSakhnosakhnomd@gmail.com
504229PathologyNeoplasiaParaneoplastic syndromesN/AThymomas are Pure and GoodMnemonicVerifiedReject. Scott05/16/19 7:45 PMMehreenAlidr.mehreenali@gmail.com
505229PathologyPathologyParaneoplastic syndromeshttps://www.uptodate.com/contents/nonislet-cell-tumor-hypoglycemiaNonislet cell tumor hypoglycemia: due to increased insulin like growth factor-2 with normal insulin and normal c-peptide, occurs more commonly in patients with mesenchymal tumors, fibromas, carcinoid, myelomas, lymphomas, hepatocellular, and colorectal carcinomasHigh-yield addition to next year10/25/19 2:17 PMMohamad HekmatSukkarihekmat_sukkari@hotmail.com
506232PharmacologyPharmacokinetics & PharmacodynamicsEnzyme kineticsnot neededunder the Lineweaver section I recommend modifying the text to " The closer to zero on Y axis, the higher the Vmax, the closer to zero on X axis the higher Km" and high Km means low affinity. More convenient to rememberClarification to current textVerifiedSounds like a good idea.

Current text is heterogeneous. We use some symbols (arrows) and few words for Vmax, but we use many words (but no symbols) for Km. Suggest using more parallel (homogeneous) wording. Something like:

"X-intercept closer to zero = higher Km = lower affinity
Y-intercept closer to zero = higher Vmax".

Hopefully, this will improve readability.

-Vasily		Agree w/ Vasily.

Seems like text about the y-intercept and x-intercept should be written in a similar format.

Both should be written using symbols (arrows) or text.


- Sarina		Reasonable to consider Vasily's proposal for FA2020, we can definitely migrate this over for consideration. Need not be official errata worthy.

-Matt		Prelim accept but NOT publishable erratatrue03/01/19 7:37 PMAlaJamalala.aljamal@hotmail.com
507232PharmacologyPharmacokinetics & PharmacodynamicsEnzyme kineticshttp://www.biology-pages.info/E/EnzymeKinetics.htmlMichaelis-Menten curve, the BLUE CURVE which express the effect of "Non-competitive inhibitor" is NOT ACCURATE at all, actually it shows that Km will increase....please replace the blue curve which represents, the addition of Noncompetitive inhebitor with an accurate and correct one.Major erratumIn summary, this erratum focuses on the shape of the blue curve. It should technically reach a plateau value (1/2 Vmax, for example) with a fixed Km (owing to unobstructed active binding site). I would say that while our curve could be better, this is not an urgent erratum that needs immediate addressing. The text and associated details are all accurate and a student can currently learn this correctly from the presented material. Owing to time concerns, I would flag this as an accepted clarification to be considered in 2021.

-Matt		Prelim accept but NOT publishable erratatrue05/05/19 12:34 AMMohammadJmasimohammad.jmasi2010@gmail.com
508234PharmacologyPharmacokinetics & PharmacodynamicsEfficacy vs potencyhttp://tmedweb.tulane.edu/pharmwiki/doku.php/basic_principles_of_pharmUnder noncompetitive antagonist, it says that potency is decreased. Potency should remain unchanged.Major erratumDuplicateDuplicateDuplicate01/30/19 10:43 PMJordanSchoutenjordan.schouten@health.slu.edu
509234PharmacologyPharmacokinetics & PharmacodynamicsPharmacokineticsany basic pharmacologyPage 3 of the errata for page 234 says to change efficacy to "no change" -- this is wrong!! It should be potency.Major erratumWe have been discussing this already on annotate with conflicting views.

Can't reject/accept.


- Vivek		Agree, duplicate submission that is already under debate on Annotate. Will reject for that reason alone.

-Matt		Reject by 2 authors + 1 editor05/04/19 3:05 PMAshrafPatelASHRAFXPATEL@GMAIL.COM
510234PharmacologytruePharmacokinetics & PharmacodynamicsReceptor bindingtruehttp://tmedweb.tulane.edu/pharmwiki/doku.php/basic_principles_of_pharmUnder agonist with noncompetitive antagonist it states that this would lead to a decrease in potency and efficacy. However, the ED50 would be equal for agonist alone or agonist with noncompetitive antagonist therefore the potency should be unchanged.Minor erratumVerifiedSounds like a valid comment. This cell should say: "No change".

-Vasily		Agreed. If ED50 is the same potency would be the same.

- Sarina		This is a bit above my level of comfort. The reference does support an unchanged EC50 (surrogate for ED50) which technically suggests unchanged potency if we go by its definition of amount of drug needed for effect (which per slopes doesn't change, it is efficacy that changes), although as with many things in pharmacology, it often goes beyond that level of simplicity. Let's flag this one for expert review.

-Matt

UPDATE: Based on expert feedback, this is a valid erratum. We can change the up arrow to "no change" as per expert reviewer feedback. Worthwhile to publish in the errata.

-Matt		Prelim accept by 2 authors + 1 editorRayudu GopalakrishnaA valid comment. The potency will not change with an addition of noncompetitive antagonist to agonist. In the table, in the row (noncompetitive antagonist), potency "downward arrow" must be replaced with "no change."Accepttrue01/05/19 2:32 PMRachelWatsonrcfh7@health.missouri.edu
511234PharmacologyPharmacokinetics & PharmacodynamicsReceptor bindingN/ANoncompetitive antagonist should not change potency.Major erratumDuplicateDuplicateDuplicate01/21/19 11:35 AMCharlesde Leeuwdeleeuw.c@gmail.com
512234PharmacologyPharmacokinetics & PharmacodynamicsReceptor bindingN/AI believe there is an error in the erratum: in the noncompetitive antagonist row, the potency column should be changed to "no change"; the efficacy column is correctMinor erratumVerifiedThank you for your input! I agree. In noncompetitive antagonist line, potency should be "No change" and efficacy should be "[downarrow]".

-Vasily		Same as above.

- Sarina		Erratum in the errata? Recommend expert review, since I had recommended that initially for the initial submision leading to the errata entry!

This content is complicated and should be addressed by a full pharmacist.

-Matt		Disagreement/need expert03/09/19 5:37 PMWenzhengYuwenzheng_yu@brown.edu
513234PharmacologyPharmacokinetics & PharmacodynamicsReceptor bindingNot needed. Suggested errata spreadsheet supports this point.Your recently posted official errata is incorrect. The proposed change to the text should be: “in the noncompetitive antagonist row, change potency from down arrow to no change”. The errata says to change efficacy to no change, but that would be incorrect.Major erratumVerifiedThank you for your input! I agree. In noncompetitive antagonist line, potency should be "No change" and efficacy should be "[downarrow]".

-Vasily		Same as above.

- Sarina		Duplicate of above.

-Matt		Reject by 2 authors + 1 editor03/10/19 1:54 PMSamanthaSavitchsls034@jefferson.edu
514234PharmacologyPharmacokinetics & PharmacodynamicsReceptor bindinghttps://firstaidteam.files.wordpress.com/2019/03/errata-2019-first-aid-for-the-usmle-step-1-pub-3_1_19.pdfError in errata: Newest errata (01/03/19) states that the Efficacy column for Noncompetitive antagonist should say no change; however, it is the potency that would remain unchanged, not the efficacyMinor erratumAddressed above.

- Sarina		Duplicate of above.

-Matt		Reject by 2 authors + 1 editor03/28/19 12:54 AMDhruvSarwaldhruvsarwal@gmail.com
515234PharmacologyPharmacokinetics & PharmacodynamicsReceptor bindinghttps://derangedphysiology.com/main/cicm-primary-exam/required-reading/pharmacodynamics/Chapter%20418/competitive-and-non-competitive-antagonistsThe book has an error in potency column of non competitive antagonist which should be changed from decrease to no change but the errata for 2019 edition for this correction also has an error...it says to change the decrease sign of efficacy column to no change in same rowMinor erratum09/17/19 1:26 AMAshishTripathiashishtripathi1245@gmail.com
516235PharmacologyPharmacologyDrug metabolismhttps://www.merckmanuals.com/professional/clinical-pharmacology/pharmacokinetics/drug-metabolismMost drugs are inactivated (not activated) by phase I metabolismMinor erratum08/31/19 8:23 PMNicoBivonanico.bivona@gmail.com
517235PharmacologyPharmacokinetics & PharmacodynamicsUrine pH and drug eliminationhttps://www.uptodate.com/contents/enhanced-elimination-of-poisons#H8Acidifying urine is abandoned and a/w acidemia. UTD — Urinary acidification (urine pH below 5.5) with ammonium chloride or ascorbic acid was historically used to treat intoxications with weak bases such as amphetamines, quinidine, or phencyclidine. However, this practice has been abandoned, as efficacy has not been established and iatrogenic toxicity (from severe acidemia) can occur.Major erratumYes, clinically, this is almost never done, but that is not the goal of this fact. The goal is to teach basic acid/base pharmacology concepts that are likely to be tested. For that reason, I would reject this proposal, which is essentially to not talk about it. The Step 1 often tests content that is not clinically relevant, but rather focused on teaching important concepts.

-Matt		Reject by 2 authors + 1 editor08/02/19 11:54 PMZonghao PanZonghao Pan763500885@qq.com
518235PharmacologyPharmacokinetics & PharmacodynamicsUrine pH and drug elimination763500885@qq.comAcidifying urine is abandoned and a/w acidemia. UTD — Urinary acidification (urine pH below 5.5) with ammonium chloride or ascorbic acid was historically used to treat intoxications with weak bases such as amphetamines, quinidine, or phencyclidine. However, this practice has been abandoned, as efficacy has not been established and iatrogenic toxicity (from severe acidemia) can occur.Major erratum08/10/19 8:18 AMZonghaoPan763500885@qq.com
519236PharmacologyPharmacokinetics & PharmacodynamicsEfficacy vs potencynone neededEfficacy: moves along the vErtical axis; pOtency: moves along the hOrizontal axisMnemonicVerified03/21/19 4:11 PMNatalieJansenjansen7@uic.edu
520236PharmacologyPharmacokinetics & PharmacodynamicsTherapeutic indexFA 2019 Page 251suggest making *The* in "Theophylline " and in the word "These" in mnemonic , in red color , like mnemonic in page 251.MnemonicVerifiedI think the only having the "T" in red is sufficient for this mnemonic.

- Sarina		Agree with Sarina. Reject.
-Kaitlyn		01/05/19 3:08 PMMoatasemAl-Janabiassoomi88@yahoo.com
521236PharmacologyPharmacokinetics & PharmacodynamicsTherapeutic indexBlumenthal DK. Pharmacodynamics: Molecular Mechanisms of Drug Action. In: Goodman and Gilman's The Pharmacological Basis of Therapeutics. 13th ed. McGraw-Hill Education / Medical; 2017:31-54.It is worth mentioning that this is a quantal dose-response curve (which differs from a graded dose-response) and then define quantal dose-response. ‘A quantal dose-respnse measures the proportion of the population which responds to a particular dose of a drug to produce a predefined/preset response (eg two fold increase in INR). The percentages of the responding population are plotted over progressively increasing doses of the drug as a cumulative frequency distribution (ogive). Quantal dose-response allows determining ED50, ET50 and the therapeutic index of the drug for a particular response’.High-yield addition to next yearAgree! I think we can clarify that this is a quantal dose response curve, which would add minimal text. The book does not really distinguish b/w graded vs. quantal dose response curves.

I think it is important to highlight the fact that the Y-axis refers to the number of patients that achieve a therapeutic effect vs. a graded dose-response curve, which emphasizes the measurable effect (eg, BP) instead of the number of patients that respond to a treatment.

- Sarina		03/27/19 2:49 PMVardanHambardzumyanhambvart@yahoo.com
522237PharmacologyAutonomic DrugsAcetylcholine receptorsUWorld Question ID 1360Nicotinic ACh receptors are ligand gated NA/K and "Ca" too. there was a question on that on UWorldHigh-yield addition to next yearVerifiedAgreed. We can consider adding Ca channels.

https://www.sciencedirect.com/topics/neuroscience/nicotinic-acetylcholine-receptor

- Sarina		03/01/19 7:52 PMAlaJamalala.aljamal@hotmail.com
523237PharmacologyAutonomic DrugsAutonomic receptorshttps://web.archive.org/web/20060907231522/http://sprojects.mmi.mcgill.ca/cns/histo/systems/cranialnerves/main.htmon Diagram it is marked as Parasympathetic cell body located/ leave from "Medulla". Instead some paraSym nuclei originate from Midbrain (Edinger–Westphal nucleus) or in Pons (Super, inferior salivatory Nuclei). Suggest changing "Medulla" on Diagram to "Brainstem" to prevent confusion.Clarification to current textVerifiedSounds like a valid suggestion! Agree, we would be more accurate if we said "Brainstem" instead of "Medulla". There are multiple parasympathetic nuclei outside of the medulla.

However, I would not classify this submission as a "Major erratum". I'd rather say it is a "Minor erratum" or "Clarification to current text".

-Vasily		Agree. This should be changed.
-Kaitlyn		Reworked as a clarification.

Agree with this proposal, reasonable to edit the text to better emphasize brainstem intstead of medulla.

-Matt		Prelim accept but NOT publishable erratatrue03/01/19 7:46 PMAlaJamalala.aljamal@hotmail.com
524237PharmacologyAutonomic DrugsAutonomic receptorsKatzung, Basic & Clinical Pharmacology, 14e, https://accessmedicine-mhmedical-com.arktos.nyit.edu/content.aspx?bookid=2249&sectionid=175216108#1148433103Skeletal muscle uses a nicotinic receptor (Nn) not a muscarinic receptor as indicated by the "M" subscript in the figure (bottom right)Minor erratumVerifiedThank you for your suggestion!

I do not believe there is a mistake in current text. Nm is expressed on skeletal muscles whereas Nn is expressed in autonomic ganglia. The "m" subscript stands for "muscle", not "muscarinic".

-Vasily		There is not an error in the current text. Nm receptors are expressed on skeletal muscle.

- Sarina		No erratum here per author.

-Matt		Reject by 2 authors + 1 editor03/03/19 10:35 AMAudreyHuntahunt01@nyit.edu
525238PharmacologyAutonomic DrugsG-protein–linked second messengershttps://www.uptodate.com/contents/pathogenesis-of-spontaneous-preterm-birthMention in the caption of the diagram in the bottom that Myosin light-chain kinase causes vascular smooth muscle contraction. Also in the diagram , next to myosin light-chain kinase(smooth muscle) , add an arrow that says "vasodilation of blood vessels".Clarification to current textVerifiedValid suggestion.
I think it should be more clear that MLCK causes vascular smooth muscle contraction, so inhibition of MLCK would cause smooth muscle relaxation (however this information is likely present in a different chapter)

I think it is acceptable to add vasodilation of BVs to the diagram at the bottom of the page.

So, it would read something like: Myosin light-chain kinase (smooth muscle) --> vasodilation of vascular SM (or BV dilation)

- Sarina		Agree with suggestion and appreciate input from authors and experts. Would definitely consider this in 2020.

-Matt		Prelim accept but NOT publishable errataRayudu GopalakrishnaThe schematic presentation is right. Myosin light chain kinase (MLCK) differentially regulated by calcium ions and cAMP. Calcium-calmodulin binding to MLCK activates it which in turn phosphorylates myosin and causes smooth muscle contraction.http://www.jbc.org/content/277/8/6550.full.html cAMP-dependent protein kinase phosphorylates MLCK which decreases the affinity of MLCK for calcium-calmodulin and decreases its activity and causes relaxation of smooth muscle. http://molpharm.aspetjournals.org/content/24/2/235.longtrue01/02/19 2:52 PMBahaa' eddineSuccarbahaasuccar@gmail.com
526238PharmacologyAutonomic DrugsG-protein–linked second messengersN/AFor H1 a1 V1 M1 M3: *HAV*e *1* *stiff* *M*&*M* boozy *smoothie* (emphasizes smooth muscle contraction). For M2 a2 D2: *I*’m (inhibit) *2 (too)* MAD and need to *relax* (emphasizes inhibition results in relaxation of smooth muscle).MnemonicVerifiedThe idea behind this is good but I think it could be better. The M&M needs to reference M1 and M3. also, to be less inappropriate, we could say its a frozen smoothy (as opposed to stiff and boozy)
-Kaitlyn		01/21/19 2:48 PMCharlesde Leeuwdeleeuw.c@gmail.com
527238PharmacologyAutonomic DrugsG-protein–linked second messengershttps://www.cvpharmacology.com/vasoconstrictor/alpha-agonistThe major function of a1 receptors in FA (this year and last) says increase vascular smooth muscle contraction. Until Sketchy, I did not understand that that includes BOTH (a) arteriole/precapillary sphincter contraction w/ incr. MAP and (b) venous vasoconstriction & decreased capacitance / increased venous return. I wasn't aware of the veno-constriction effect from FA.Clarification to current textVerifiedIn the interest of being concise, I think the current text is acceptable, as "vascular" implies both arterial and venous blood vessels.

Although I understand that the current text may seem unclear, I think it is sufficient for now.

- Sarina		No change needed, minor point.

-Matt		Reject by 2 authors + 1 editor01/23/19 9:00 PMEmanuelGrantewg4bd@virginia.edu
528238PharmacologyPharmacologyG-protein–linked second messengerslippincott pharmacologybladder relaxation is done by beta 2 not Beta 3Minor erratumReject. This is not correct. Haven't checked lippincott for it. But there are many studies saying bladder relaxation is mediated by beta 3 adrenaergic receptors (AR).

"The distribution of beta-AR subtypes mediating detrusor muscle relaxation is species dependent, the predominant subtype being the beta(3)-AR in humans." [1]

"beta3-AR, which is implicated in metabolic functions of endogenous catecholamines, mediates relaxation of human detrusor muscle." [2]

"The beta3-adrenergic receptor (beta3-AR) has been shown to mediate various pharmacological and physiological effects such as lipolysis, thermogenesis, and relaxation of the urinary bladder. "

1. https://www.ncbi.nlm.nih.gov/pubmed/17600372
2. https://www.ncbi.nlm.nih.gov/pubmed/12007519
3.https://www.ncbi.nlm.nih.gov/pubmed/16457637

- Vivek		Agree with Vivek. Beta-3 receptor agonism is strongly associated with bladder relaxation in numerous studies as demonstrated. This erratum is incorrect and will be rejectedf.

-Matt		Reject by 2 authors + 1 editor05/20/19 7:17 PMCHERYLFRANCIScherylann_francis@yahoo.com
529238PharmacologyAutonomic DrugsG-protein–linked second messengersn/aDAMiT – D2 , α2, M2 - Gi coupled – Two HAV 13 Mcq – H1, α1, V1, M1, M3 - Gq coupled letS All β Very Very Happy-2 Day – All β, V2, H2, D1 - Gs coupledMnemonicVerified07/10/19 1:21 PMAPandeyaranikopandey@gmail.com
530238PharmacologyAutonomic DrugsG-protein–linked second messengersn/aDAMiT – D2 , α2, M2 - Gi coupled – Two HAV 13 Mcq – H1, α1, V1, M1, M3 - Gq coupled letS All β Very Very Happy-2 Day – All β, V2, H2, D1 - Gs coupledMnemonicVerified07/10/19 9:17 PMAPandeyaranikopandey@gmail.com
531238PharmacologyAutonomic Drugsβ-blockersCannavo A, Koch WJ. Targeting β3-Adrenergic Receptors in the Heart: Selective Agonism and β-Blockade. J Cardiovasc Pharmacol. 2017;69(2):71–78. doi:10.1097/FJC.0000000000000444 Niu X, Watts VL, Cingolani OH, et al. Cardioprotective effect of beta-3 adrenergic receptor agonism: role of neuronal nitric oxide synthase [published correction appears in J Am Coll Cardiol. 2012 Jul 31;60(5):481]. J Am Coll Cardiol. 2012;59(22):1979–1987. doi:10.1016/j.jacc.2011.12.046B3 adrenergic receptors are present in the cardiovascular system, mainly in myocardium and endothelium, where they have a prominent role in modulating cardiac function and angiogenesis. B3 receptors are couple Gs primary in adipose tissue, otherwise in ventricular myocardium b3 receptors are coupled Gi proteins. Cause this property, b3 receptor in the heart are not subject to desensitization and downregulation, and in fact, their levels within human failing myocardium remain unchanged or become upregulated. Recommendation: Add Gi protein coupled in b3 receptors, and also add cardioprotective effect.High-yield addition to next yearI think this is overly specific for step 1. not HY. reject.
-Kaitlyn		05/28/19 7:00 PMLaura PatriciaAguilar Francolaura.aguilarfranco@gmail.com
532239PharmacologyAutonomic DrugsAnticholinesterase poisoningFA 2019 Index pg. 790 listed Vesamicol @ pg. 239.Vesamicol listed in index for page 239. It does not exist on this page. This must be from a previous edition and was not removed from the index.Minor erratumVerifiedAgree. Vesamicol should be removed from the Index.

-Vasily		Agree. Vesamicol is not written on p 239 although it does apply to this page since it inhibits VMAT.

- Sarina		Agree with removal of index item that no longer exists.

-Matt		Prelim accept but NOT publishable errata03/10/19 1:13 PMThuyNguyentn0193@my.unthsc.edu
533239PharmacologyAutonomic DrugsAntiarrhythmic Drug Classeshttp://tmedweb.tulane.edu/pharmwiki/doku.php/intro_to_antiarrhythmicsTo remember which class of Antiarrhythmic is associated with each specific Channel, use the mnemonic "Nah Brother, Keep Calm." Type I's are Na+ Channel Blockers, Type II are B-Blockers, Type III are K+ Blockers, and Type IV are Ca2+ blockers!MnemonicVerifiedI like this but I can't figure out where we talk about the anti arrhythmic types. Perhaps in the cardio chapter??
-Kaitlyn		04/18/19 3:55 PMJonathanCaggianoJCaggiano494@gmail.com
534240PharmacologyAutonomic DrugsAnticholinesterase poisoningN/AAnticholinesterase poisoning: BE LESS DUMB: B: bradycardia E: emesis L: lacrimation E: excitation of skeletal muscle S: salivation S: sweating D: diarrhea U: urination M: miosis B: bronchospasmMnemonicVerified05/12/19 10:07 AMAmnaAlsaihatiamna.saihati@gmail.com
535240PharmacologyAutonomic DrugsAnticholinesterase poisoningNot applicablewith regard to muacarinim side effects, to reduce confusing them with anticholinergic side effects and other side effects, it is possible to make the connection: DUMBBELLSS for Muscularity, Muscularity refering to muscarinicMnemonicVerified06/19/19 5:52 AMAwabElnaeemawab.kamal@gmail.com
536240PharmacologyAutonomic DrugsCholinomimetic agentsMade it upGrandma don't remember --> galantamine, donepezil, rivastigmineMnemonicVerifiedWay better than what we have. We should incorporate.
-Kaitlyn		04/01/19 7:42 AMAliJilania.jilani.77@gmail.com
537241PharmacologyAutonomic DrugsAtropinenot neededDUMBBELSS in p240 is changed to DUMBBeLSS, I wonder if there is some story behind and suggest making it more clear.MnemonicVerified01/10/19 4:56 AMHangSonghuwanheng.pku@gmail.com
538241PharmacologyAutonomic DrugsAtropinehttps://www.uptodate.com/contents/anticholinergic-poisoning?csi=5f1accf7-931f-49fb-a327-fe153c4efcf2&source=contentShareThe "e" in the DUMBBELLSS mnemonic should be capitalized. In the 2017 Edition the "E" was correctly left uncapitalized since it was for "Excitation of skeletal muscle and CNS" which is a nicotinic effect and is not blocked by Atropine. However in the 2019 edition the "E" is used for "Emesis" which is a muscarinic effect and is blocked by atropine.Minor erratumVerifiedAgree. It should be "DUMBBELLS" now, not "DUMBBeLLS".
-Vasily		Correct. The 'e' on p. 241 needs to be capitalized.

- Sarah		Agree with change. NOT published errata worthy, however.

-Matt		Prelim accept but NOT publishable errata01/29/19 6:38 AMNaylaMrouehnaylamroueh@gmail.com
539241PharmacologyAutonomic DrugsAtropineSketchyMedical - autonomic drugsunder atropine, add a "heart" subtitle and include the fact that it can reverse fatal bradycardia (increase HR)High-yield addition to next yearDisagree. The first sentence already states that Atropine is used to treat bradycardia.

- Sarina		I agree we already state this but the table is more eye catching and we don't want students to miss this key point. We have room to add to the table. I vote we do it.
-Kaitlyn		03/17/19 11:46 AMAnnaPriddypriddyanna@gmail.com
540241PharmacologyAutonomic DrugsAtropineFA 2019 page 241To the adverse effects section, add "Fast as a Fiddle" to represent tachycardiaMnemonicVerifiedWe should use this.
-Kaitlyn		04/09/19 1:57 PMJasminShahrestanijshahrestani@gmail.com
541241PharmacologyAutonomic DrugsAtropineUWORLD;Add to Side Effects "Fast as a Fiddle" as a mnemonic for increased HR due to the decreased vagal tone of the SA nodeMnemonicVerifiedWe should use this
-Kaitlyn		04/15/19 1:16 PMCheyennaEspinozacespinoza@oakland.edu
542241PharmacologyPharmacologyMuscarinic antagonistsIt would be better to say it treats bradycardia and ophthalmic on applications and mention mydriasis and cycloplegia on adverse effects.For atropine, putting the "Produce mydriasis and cycloplegia" on application side is somehow "misleading" since the applications for every other muscarinic antagonists are what the drugs are used for, but not what the elicit.Clarification to current textDisagree.

Cycloplegia is not an AE. Atropine eye drops are used to stimulate pupil dilation/cycloplegia for eye exams.

- Sarina		I guess at best this submission could be considered a request to clarify the text so it is clearer what the indications are, and it is clearer what the adverse events are? Will accept so that the team can review this year.

I agree with Sarina there is no erratum here, rather, my goal is for us to review the text and, if needed, optimize clarity.

-Matt		Prelim accept but NOT publishable erratatrue04/17/19 1:05 AMMatthew Yat HonChungmchung@mail.sjsm.org
543241PharmacologyAutonomic DrugsMuscarinic antagonists-Oxybutynin, Solifenacin, Tolterodine : decrease Sitting On ToiletMnemonic10/03/19 8:29 AMAhmadY. Obeidatobeidat.amd@hotmail.com
544242PharmacologyAutonomic DrugsSympathomimeticsMnemonicMiraB3gron - B3 stops your peeMnemonicVerifiedI think this mnemonic might give a wrong impression that Vitamin B3 "stops your pee". For this reason, not a big fan of this mnemonic.

Reject.

-Vasily		I agree with Vasily but as someone who could never remember the location of these receptors, I actually like this.
-Kaitlyn		02/27/19 4:47 AMNathanielBorochovnateboro8@gmail.com
545242PharmacologyAutonomic DrugsSympathomimeticshttps://www.sciencedirect.com/topics/neuroscience/phenylephrinePhenylephrine is a vasoconstrictor that causes increase in BP, not hypotension. It can cause reflexive bradycardia.Major erratumReject. the column is for application. Phenylephrine is indicated as the treatment of hypotension, vascular failure in shock being a vasocontrictor (we don't mean it will cause hypotension).

https://www.uptodate.com/contents/phenylephrine-systemic-drug-information?search=phenylephrine&source=panel_search_result&selectedTitle=1~139&usage_type=panel&display_rank=1

- Vivek		Agree with Vivek. The text clearly states that the vasopressor phenylepherine treats hypotension. Must've been a misreading on the part of the student. Reject erratum.

-Matt		Reject by 2 authors + 1 editor06/06/19 1:11 AMKinzaSultankinza.sultan@westernu.edu
546242PharmacologyAutonomic DrugsSympathomimeticsmeUnderline and put in red the T in "Tocolysis" so that it starts the same as TerbutalineMnemonic12/06/19 10:06 AMFranciscoDuenasfrancisco.duenasmd@gmail.com
547243PharmacologyAutonomic DrugsNorepinephrine vs isoproterenolrefer to page 242 and attached imagethe effects of epinephrine and isoprotenerol are mixed up at the top of the image. They should be Epinephrine (β > α) and Isoproterenol (α ≈ β)Minor erratumDisagree. Isoproterenol is highly beta-specific, whereas epinephrine has a reasonable amount of both, hence the "equal-ish" sign. No change.

-Matt		Reject by 2 authors + 1 editor08/05/19 8:47 AMMohammedKamareddineMohammed.kamareddine@gmail.com
548244PharmacologyPharmacologyα-blockershttps://www.ncbi.nlm.nih.gov/m/pubmed/2417047/Under ‘α2 selective’ please add Clonidine and Alpha Methyl dopa. These drugs cause a decrease in generalised sympathetic outflow and a decrease in blood pressure. Rebound hypertension is a concern with abrupt cessation. (The index of the book says these drugs can be found on page 240 and 244 but they are NOT there on these pages!)Clarification to current textVerifiedDisagree.

a-methyldopa and clonidine are selective a2 agonists, not a1/a2 antagonists.

On p. 243, the topic of rebound HTN is discussed.

- Sarina		This is an index erratum. Agree with review of the index and correction of the page numbers with incorrect references.

-Matt		Prelim accept but NOT publishable errataRayudu GopalakrishnaClonidine and alpha-methyldopa are alpha2-agonists. Therefore, they are discussed on page 243 as alpha2-agonists. Page 244 for alpha blockers. Therefore, clonidine and alpha-methyldopa are not discussed here. Student is right that index is listing clonidine on page 244. It is indeed present on page 243. (This correction is needed).true12/31/18 6:46 AMMuhammad FaizanAlifaizanali.93@hotmail.com
549244PharmacologyAutonomic Drugsα-blockersNo need itMirtazapine is an a2 selective blocker, in the FA 2019 edition you put the drug in the a blocker section as a sympatholytic. Mirtazapine is in effectum an a2 selective blocker, but due its mechanis of action, mirtazapine acts as an indirect symphatomimetic. You should move mirtazapine to indirect sympathomimetics drugs (page 242)Clarification to current textWe have appropriately listed it (as alpha-2 selective) under alpha blockers. I think the student misunderstood it being classified as sympatholytics.

Indirect-acting sympathomimetic drugs are those that act indirectly to increase the concentration of the endogenous neurotransmitter by causing its release (e.g., amphetamine derivatives) or inhibiting its reuptake (e.g., tricyclic antidepressants). While mirtazapine is technically increasing release, I could not find any valid resource that consider it as that.


- Reject


- Vivek		Agree with Vivek. Technically it may have some indirect sympathomimetic activity, but it is by and large best classified as an alpha blocker in most resources, including our text. For this reason, I would reject this erratum as well.

-Matt		Reject by 2 authors + 1 editor05/28/19 7:38 PMLaura PatriciaAguilar Francolaura.aguilarfranco@gmail.com
550245PharmacologyAutonomic DrugsHeart failureImprovisedWhen I survive (decr. mortality) HF, Buy Me a Car! (BIsoprolol = BUY / MEtopropolol = ME / CARvedilol = Car)MnemonicVerifiedThis is fine but our current mnemonic better encompasses the point. Reject.
-Kaitlyn		01/23/19 6:55 PMEmanuelGrantewg4bd@virginia.edu
551245PharmacologyAutonomic Drugsβ-blockershttps://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-management-of-the-cardiovascular-complications-of-cocaine-abuse?search=cocaine%20toxicity&sectionRank=2&usage_type=default&anchor=H9004423&source=machineLearning&selectedTitle=1~150&display_rank=1#H9004423Under adverse effects, it is stated that there is unsubstantiated concern for unopposed alpha stimulation after giving beta blockers for cocaine toxicity. Multiple other times in the book there are mentions of this affect. I do not believe unsubstantiated should be used, since there are studies showing the vasoconstriction seen in this setting.Minor erratumVerifiedThank you for your suggestion! I agree with reopening the discussion on the wording here.

UTD: "We recommend that beta-blockers not be used to treat cardiovascular complications, particularly myocardial ischemia, in patients with acute cocaine intoxication. This proscription in the acute setting is based principally upon theoretical concerns of coronary artery vasoconstriction and systemic hypertension, which can result from unopposed alpha-adrenergic stimulation."

https://www.uptodate.com/contents/cocaine-acute-intoxication

I remember there was a big discussion last year. But for the purposes of Step 1, I believe unopposed alpha-adrenergic stimulation with beta-blockers is a HY topic.

-Vasily		We should consider removing the word "unsubstantiated" from the text.

It seems redundant since the text already states that using B-blockers for cocaine-associated chest pain is "controversial".

I think the reader will understand that guidelines regarding the use of B-blockers in cocaine users may remain ambiguous, but it is still important to emphasize the effect of unopposed alpha stimulation in this context.

- Sarina		I think the rewording proposed is reasonable (eg, removing the word "unsubstantiated" to make it a bit less controversy-generating).

Agree with migrating over for consideration.

-Matt		Prelim accept but NOT publishable erratatrue03/01/19 1:20 PMDylanErwinderwin@smu.edu
552245PharmacologyAutonomic Drugsβ-blockersFirst aid 2019 p. 507Add "Essential tremor" to list of applications for beta blockers in the top section of the table, as referenced on p. 507Clarification to current textThis is worthwhile but I am not sure what we would say in the "actions" column because I'm not sure anyone knows how this works. I think mentioning it in the Neuro chapter is sufficient.
-Kaitlyn		We can consider adding it here (note we already mention tremor, but specifically for hyperthyroidism). Non-urgent and can be considered in 2021.

-Matt		Prelim accept but NOT publishable erratatrue05/11/19 4:57 PMAudreyHuntahunt01@nyit.edu
553245PharmacologyAutonomic Drugsβ-blockersFA Page 245Create a new mnemonic for the two partial agonists - "P"inodolol and "A"cebutolol are both "P"artial "A"gonists - the first letters in partial agonist will tell the student the drugs that are partial agonists!MnemonicVerified07/28/19 7:32 PMAbhishekGamiagami@jhmi.edu
554246PharmacologyAutonomic DrugsIngested seafood toxinsNot needed.Tetradotoxin Terminates sodium channel activity while ‘Siguatoxin’ Starts sodium channel activity.MnemonicVerifiedHa! Not bad! I think we should consider this mnemonic.

-Vasily		This is clever but siguatoxin is spelled with a C. Our current mnemonic is better. Reject.
-Kaitlyn		01/01/19 7:55 AMMuhammad FaizanAlifaizanali.93@hotmail.com
555246PharmacologytruePharmacologyIngested seafood toxinshttps://www.uptodate.com/contents/overview-of-shellfish-and-pufferfish-poisoning?csi=109e1dce-e711-45db-8f40-b18da1147c4b&source=contentShareIt’s stated in the text that tetrodotoxin effects sodium channels in cardiac/nerve tissue. Tetrodotoxin does not effect sodium channels in cardiac tissue. The Na v 1.5 channels in cardiac tissue are not effected by this toxin.Major erratumVerifiedGood point! There are some articles that specifically state that mammalian heart is resistant to TTX:
"Sodium current (I(Na)) of the mammalian heart is resistant to tetrodotoxin (TTX) due to low TTX affinity of the cardiac sodium channel (Na(v)) isoform Na(v)1.5"
https://www.ncbi.nlm.nih.gov/pubmed/17935523?dopt=Abstract

On the other hand, some sources mention that tetrodotoxin ingestion can lead to arrhythmias.
https://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750019.html

It would probably be safer just to remove "cardiac/" from current text to read: "Highly potent toxin; binds fast voltage-gated Na+ channels in nerve tissue preventing depolarization".

It would be great if an expert could double check this.

-Vasily		I agree with Vasily. It would be more accurate to remove "cardiac" from the text.
Here is a good review article on this topic https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212850/

- Sarah		Agree with authors. The literature does not overly support cardiac sodium channel blockade. Arrhythmias noted but that could certainly be a nerve-related process (eg, changes in vagus nerve activity) as opposed to direct cardiac. Thus, I will support the removal of "cardiac" from the text as per the author's proposal.

Reasonable to put this in the published errata.

-Matt		Prelim accept by 2 authors + 1 editorRayudu GopalakrishnaStudent comment is right. The authors’ and editor’s responses are appropriate. Tetrodotoxin does not affect the low affinity sodium channels in the heart. Therefore, removing the word “heart” and leaving the word “nerve” in the text is important as suggested. Older literature, there are some reports on the direct toxic effect of this toxin on the heart. These studies used higher doses or unhealthy heart (ischemia/reperfusion). Later studies have not shown such toxic effects on healthy adult heart at low doses of toxin. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2857368Accept01/30/19 2:37 PMBradyGunnSa198622@atsu.edu
556246PharmacologyAutonomic DrugsIngested seafood toxinsMy selfC in Ciguatoxin looks like an O for Open Na channels and the "do" in Tetrodotoxin can signify "No" depolarization (TetroNOtoxinMnemonicVerified06/08/19 3:21 PMDanny IbrahimDanny Ibrahimdsi00199@yahoo.com
557246PharmacologyPharmacologySeizuresFirst Aid, sketchyDrugs that induce/lower the threshold for seizures: FABRICATE: (F)Flumazenil, (A) Amphotericin B, (B) Bupropion, (R) Reye's syndrome (aspirin), (I) Isoniazid, (C) Cocaine, Carbepenams, (A) antipsychotics, (T) Tricyclic antidepressants, (E) EnfluraneMnemonicVerifiedWe need to address what drugs are highest yield. We mention others. I defer to an editor.
-Kaitlyn		02/06/19 4:29 PMAshtonJacksongrace.v.gilbert@gmail.com
558247PharmacologyPharmacologyCytochrome P-450 interactions (selected)It’s a mnemonic based on what’s already present in FA 2019P450 inducers can be remembered in an easier way; by classifying them as: * 3 anticonvulsants (Phenytoin, Phenobarbital, Carbamazepine ) * 2 Anti-microorganisms (Rifampin, Griseofulvin) * 1 Anti-HIV (Nevirapine) * And St John’s wort For inhibitors; Almost all of them have O in their names as shown in the attached photo; except for: - Cimetidine, can be put with Omeprazole as both are decrease HCL secretion - Grapefruit juice; can be put with Alcohol as both are things to drinkMnemonic11/01/19 8:02 PMHusseinAlsa’dihussein.alsadi22@hotmail.com
559247PharmacologyToxicities and Side EffectsSpecific toxicity treatmentshttps://www-uptodate-com.elibrary.einstein.yu.edu/contents/beta-blocker-poisoning?search=remedy%20for%20beta%20blocker%20toxicity&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5#H14Mnemonic: Better unblock the GAS line (Better for beta blockers; GAS for Glucagon, Atropine and Saline)MnemonicVerified06/08/19 3:25 PMKariukiMainamaina@mail.einstein.yu.edu
560248PharmacologyToxicities and Side EffectsDrug reactions—endocrine/reproductivehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860825/adding Gynecomastia to the table. and drugs that causing it: Spironolactone, THC (Marjiuana), Alcohol chronic , Cimetidine, Ketoconazole, Estrogen , Digoxin. the mnemonics will be " STACKED"MnemonicVerifiedThis is a good idea but the drugs chosen by the student are not comprehensive. The reference included mentions other drugs (almost too many). However, I think it is worthwhile and we have room on the page. Support incorporating.
-Kaitlyn		Reflagged as a mnemonic as this is certainly not a clarification. Can consider addition in 2021.

-Matt		05/13/19 7:53 PMMuhanadShaibmohanad.shaib@gmail.com
561248PharmacologyPharmacologyDrug reactions—gastrointestinalMyself, FA2019Drugs causing diarrhea mnemonic: MACroLiDeS causes diarrhea i.e. Macrolides (erythromycin), Acamprosate, Colchicine, Lipid-lowering agents (ezetimibe, orlistat), anti-Diabetes drugs (acarbose, metforming, pramlintide), SSRIsMnemonicVerifiedI like this but mnemonics that don't use every letter are always difficult to remember. I this STAY CALM is better - Ssris Trazodone (adding this one to work with mnemonic) Acamprosate acetYl cholinesterase inhibitors (this one is a stretch, I know) Colchicine Antidiabetes drugs Lipid lowering drugs Diabetes drugs.
-Kaitlyn		03/26/19 6:43 PMMurliMishramm.murli@gmail.com
562248PharmacologyPharmacologyDrug reactions—gastrointestinalMyself, FA2019Hepatitis causing drugs mnemonic: Fibrates RIPS the liver i.e. Fibrates, Rifampin, Isoniazid, Pyrazinamide, StatinsMnemonicVerifiedI like it.
-Kaitlyn		03/26/19 6:53 PMMurliMishramm.murli@gmail.com
563248PharmacologyToxicities and Side EffectsDrug reactions—gastrointestinalNoticedDoes not mention GLP-1 agonists as causal agents of pancreatitis (EX: Exenatide). Diuretics is listed as a cause of pancreatitis, but these effects are not mentioned in the Renal chapterClarification to current textAgreed! I think we can add GLP-1 agonists as a cause of pancreatitis here.

- Sarina		OK with consideration of GLP-1 inhibitors here.

-Matt		Prelim accept but NOT publishable erratatrue04/06/19 6:03 PMNankiHurananki.hura@gmail.com
564248PharmacologyToxicities and Side EffectsDrug reactions—gastrointestinalFirst Aid for the USMLE Step 1Should add GLP-1 analog as drug that can cause pancreatitisMinor erratum10/16/19 12:31 PMRayanEl Hajjarrayan.hajjar2@gmail.com
565249PharmacologyToxicities and Side EffectsDrug reactions—hematologicnot requiredDCP = Direct Coombs Positive = methylDopa Cephalosporins PenicillinMnemonicVerifiedI'm on the fence about if I like this or what we have currently better.
-Kaitlyn		02/07/19 8:00 PMJoshuaLadellajosh.ladella@gmail.com
566249PharmacologyToxicities and Side EffectsDrug reactions—hematologicFA 2019 Page 249Remove red color from the word "Coombs" , it's not needed.Spelling/formattingStaff rejectsReject.

I still find it useful.

- Vivek		02/15/19 7:13 AMMoatasemAl-Janabiassoomi88@yahoo.com
567249PharmacologyToxicities and Side EffectsDrug reactions—hematologichttps://www-uptodate-com.elibrary.einstein.yu.edu/contents/major-side-effects-of-class-i-antiarrhythmic-drugs?search=major%20side%20effects%20of%20class%20IA%20antiarrythmic%20drugs&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Mnemonic: Help! Very Low platelet glycoprotein 1a (H for Heparin, V for Vancomycin, L for Linezolid and 1A for class 1A antiarrythmics).MnemonicVerified06/08/19 2:35 PMKariukiMainamaina@mail.einstein.yu.edu
568249PharmacologyToxicities and Side EffectsDrug reactions—musculoskeletal/skin/connective tissuehttps://www.uptodate.com/contents/thiazolidinediones-in-the-treatment-of-diabetes-mellitus#H22Add thiazolidinedione drugs to list of medications that can increase risk of osteoporosis and fracture (albeit the risk is small and only proven in postmenopausal women). This risk is mentioned in Endocrine Drugs.High-yield addition to next yearVerifiedSure, I think we can add thiazolidinedione to the list of drugs that cause osteoporosis since it is mentioned that it increases risk of fractures on p. 371

- Sarina		02/18/19 2:53 AMBasimAlibasim.ajafri@gmail.com
569249PharmacologyToxicities and Side EffectsDrug reactions—musculoskeletal/skin/connective tissuehttps://www.uptodate.com/contents/drug-allergy-classification-and-clinical-features?search=drug%20hypersensitivity%20HLA&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2I've made a table with the high-yield associations of specific HLA subtypes and their respective drug reactionsHigh-yield addition to next yearThis is very interesting but I don't remember being tested on it... We do not have room on the page currently so I reject at this time.
-Kaitlyn		03/21/19 3:19 AMNicolasCuri Gawlinskinicolascurii@gmail.com
570249PharmacologyPharmacologyDrug reactions—musculoskeletal/skin/connective tissueMyself, FA2019Myopathy causing drugs mnemonic: ColD PenGuin FINS Had myopathy i.e. Colchicine, Daptomycin, Penicillamine, Glucocorticoids, Fibrates, Interferon alpha, Niacin, Statins, HydroxychloroquineMnemonicVerifiedI don't like this one but I can't come up with anything better. Would like to know what other people think.
-Kaitlyn		03/26/19 7:29 PMMurliMishramm.murli@gmail.com
571249PharmacologyToxicities and Side EffectsDrug reactions—musculoskeletal/skin/connective tissuehttps://www.hepatitisc.uw.edu/page/treatment/drugs/simeprevir-drugSimeprevir drug is Hepatits C virus protease inhibitor can cause photo sensitivity as well. So the New mnemonics would be SSAT For PhotoHigh-yield addition to next yearThis is a fairly new drug but I think it shows up on Step 1. Many sources do discuss the photosensitivity. An alternative to the mnemonic would be SAT For Some Photos.
-Kaitlyn		Reflagged as a high-yield addition for 2021, not a clarification as is currently tagged.

-Matt		05/13/19 8:04 PMMuhanadShaibmohanad.shaib@gmail.com
572249PharmacologyToxicities and Side EffectsDrug reactions—musculoskeletal/skin/connective tissuehttps://www.researchgate.net/publication/8474741_Drug-induced_lupus_erythematosusadding minocycline and quinidine for drug induced lupusHigh-yield addition to next yearReflagged as a high-yield addition for 2021, not a clarification as is currently tagged.

-Matt		05/15/19 7:28 PMMuhanadShaibmohanad.shaib@gmail.com
573249PharmacologyPharmacologyFluoroquinolonesmnemonicDrug reaction: tendon and cartilage damage with Fluoroquinolones; add mnemonic "FLOORoquinolone makes you drop to the floor without tendons and cartilage"MnemonicVerifiedI like this.
-Kaitlyn		03/06/19 4:51 PMM MarwanDabbaghdr.dabbagh@outlook.com
574250PharmacologyToxicities and Side EffectsDrug reactions—neurologichttps://www.ncbi.nlm.nih.gov/pubmed/16449853Under Visual Disturbances, Isoniazid does not cause "optic neuropathy/color vision changes." Only Ethambutol is known to do this.Clarification to current textVerifiedAccording to UTD, INH can cause optic atrophy and optic neuritis. So I do not think we are making a mistake by saying that optic neuropathy is an adverse effect. Not as HY as peripheral neuropathy due to B6 deficiency, but still a valid point.

As for color vision, I think it would be safer not to mention it in the context of INH.

Suggest changing "optic neuropathy/color vision changes" to "optic neuritis".

This will leave us with our current mnemonic and will probably be a little bit more accurate.

-Vasily		Definitely not an erratum as isoniazid-induced optic neuropathy (often retrobulbar neuritis) is a well described entity in the literature.

I agree with Vasily in that the ocular side effect of ethambutol is more HY and therefore we could remove this information from the chapter if deemed too LY.
However, it does not have to be mentioned in the published errata.


Personally I would leave it as is but should be discussed with the author team +/- crowdsourcers during the 2020 review process.

- Sarah		I am fine with tweaking the text to be clearer/more accurate as per the authors' feedback. I also would not lose sleep if we opted to keep the text as is. Will accept for discussion by the 2020 chapter team.

Definitely not published errata-worthy!

-Matt		Prelim accept but NOT publishable erratatrue01/06/19 1:05 AMJerrinBawajerrin.bawa@gmail.com
575250PharmacologyPharmacologyDrug reactions—neurologicmyself, FA2019Peripheral Neuropathy causing drugs mnemonic: VIPs in Platinum group have peripheral neuropathy i.e. Vincristine, Isoniazid, Phenytoin, Platinum agents (cisplatin)MnemonicVerifiedI like this one.
-Kaitlyn		03/26/19 7:53 PMMurliMishramm.murli@gmail.com
576250PharmacologyToxicities and Side EffectsDrug reactions—neurologichttps://emedicine.medscape.com/article/1179733-overview#a5Use of combined oral contraceptive pill is very common. Given how common its use is, it would be wise to note that it is known to be associated with idiopathic intracranial hypertension.High-yield addition to next year08/31/19 7:44 AMAnthony MartinLimanthony.m.lim@gmail.com
577251PharmacologyToxicities and Side EffectsCytochrome P-450 interactions (selected)My brain"GRAMPPS CaN" -> See attachment for mnemonic breakdown. Everyone in my study group loves this mnemonic... People like mnemonics where every word means something!!!MnemonicVerifiedI think this is easier to remember than what we have but I don't know what all the letters mean. Need to see the attachment.
-Kaitlyn		01/29/19 10:28 AMLeviMarshallLSMmt4@health.Missouri.edu
578252PharmacologyMiscellaneousDrug namesNot neededThe table is missing fluoroquinolones: -floxacin / fluoroquinolones/ ciprofloxacin, gemifloxacin.High-yield addition to next yearVerifiedNot an erratum.

As always it is difficult to decide which drug name endings/suffices should be included in this table and which are LY or self-explanatory/well known. Personally I don't feel it is necessary to add -floxacin for fluoroquinolones here but if others think it is HY, it could be added.

- Sarah		I agree with Sarah. I don't think it is too HY to add quinolones to this table since they are emphasized in the micro chapter.

- Sarina		01/07/19 3:54 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
579252PharmacologyMiscellaneousDrug namesmy brainput the AR of -sARtan in red because it stands for Angiotensin-2 Receptor blockerMnemonicVerifiedAgree, this is helpful
-Kaitlyn		02/14/19 5:20 AMBahaa' eddineSuccarbahaasuccar@gmail.com
580253PharmacologyMiscellaneousDrug namesNot neededFor drugs ending in "-limus", the category is listed as mTOR inhibitor (sirolimus, everolimus). However, tacrolimus, a calcineurin inhibitor, also ends in "-limus". A more accurate description of the category would be to say that drugs ending in "-limus" bind to FK binding proteins.Minor erratumsVerifiedThis is a valid point, but a note regarding this issue already exists on Annotate. It has been deferred till 2020.

-Vasily		Agreed, this is a good point!

- Sarina		Duplicate of submission last year.

-Matt		Reject by 2 authors + 1 editor03/10/19 2:00 PMSamanthaSavitchsls034@jefferson.edu
581256Public Health SciencesEpidemiology & BiostatisticsBias and study errorshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159210/A recently released NBME Form had a question testing the concept of Intention to Treat, which I could not find in First Aid. It is a means of reducing errors in Trials, by which you include all study participants into the analysis regardless of study compliance.High-yield addition to next yearI do not recall being tested on this for Step 1. Need further input -YKI agree it should be included. It's not a difficult calculation and is an important concept in research. -KDAgree, would not recommend addition to the text. -VVReject by 2 authors + 1 editor05/03/19 1:58 PMDouglasPetersdougpeters94@gmail.com
582256Public Health SciencesEpidemiology & BiostatisticsObservational studieshttps://www.nature.com/articles/6400454"Ecological studies" should be added to the list of observational studies. It came up in a UWorld question.High-yield addition to next yearI agree in adding this to the table. -YKNot sure this would be particularly HY, ecological studies are almost never used in any clinical setting due to the potential for "ecological fallacy". Would recommend rejecting
- FQ		Agree with Frank. Though this comes up on UWorld, ecological study is not necessarily a HY topic to add to the text that is frequently tested. Would not recommend addition. -VVReject by 2 authors + 1 editor03/28/19 4:12 PMHarpreetGillharpreetkgill.94@gmail.com
583256Public Health SciencesEpidemiology & BiostatisticsObservational studiesboard and beyond videosin case-control study you can write O letter in word control as capital and highlight with red as well and highlight first O in Odds ratio sentence with red color too.MnemonicVerifiedI would most definitely reject. Pretty much every type of study listed has at least one O. -KDAgree with Kristina -YKReject. -VVReject by 2 authors + 1 editor05/02/19 12:14 PMMuhanadShaibmohanad.shaib@gmail.com
584256Public Health SciencesEpidemiology & BiostatisticsObservational studiesnoneDon't be CoI = Cohort = Incidence of DiseaseMnemonicVerifiednot a fan, reject -YKYes, not a fan. -VVReject by 2 authors + 1 editor05/26/19 9:36 AMNicolaDuzaknhampel@mail.sjsm.org
585257Public Health SciencesEpidemiology & BiostatisticsLikelihood ratioMyself, FA2019Mnemonic to remember LR: LR = Disease/Healthy i.e. LR+ = Positve rate in Disease/Positive rate in Healthy; LR- = Negative rate in Disease/Negative rate in HealthyMnemonicVerifiedNot a great mnemonic, and is basically already covered in the text. No change. -YKAgreed, not useful
-FQ		Agree, reject. -VVReject by 2 authors + 1 editor03/27/19 6:37 AMMurliMishramm.murli@gmail.com
586257Public Health SciencesEpidemiology & BiostatisticsObservational studiesnoneCross your P's = Cross-sectional Study looks at Prevalence of diseaseMnemonicVerifiednot a fan, reject -YKYes, reject. -VVReject by 2 authors + 1 editor05/26/19 9:33 AMNicolaDuzaknhampel@mail.sjsm.org
587258Public Health SciencesEpidemiology & BiostatisticsQuantifying riskSainani KL, Schmajuk G, Liu V. A caution on interpreting odds ratios. Sleep. 2009;32(8):976.The example of Odds Ratio should be written as 'lung cancer patients have 8 times higher odds of having a history of smoking.' An OR is not directly interpreted as a change in likelihood, chance, risk, etc.Minor erratumI am inclined to reject. I think our wording is appropriate, in that case, likelihood and odds would be addressing the same concept. However, we could have faculty input about this issue. "Odds of an event happening is defined as the likelihood that an event will occur, expressed as a proportion of the likelihood that the event will not occur. Therefore, if A is the probability of subjects affected and B is the probability of subjects not affected, then odds = A /B." https://psychscenehub.com/psychpedia/odds-ratio-2/ - Victor MartinezVerifiedReject. Would rather not have "odds" in the definition itself. No changes to the text. -VVReject by 2 authors + 1 editor02/13/19 12:51 AMWesleyPlinkeplinke@ohsu.edu
588258Public Health SciencesEpidemiology & BiostatisticsQuantifying riskhttps://www.cdc.gov/training/SIC_CaseStudy/Interpreting_Odds_ptversion.pdfThe odd ratio is Odds of an exposure given a disease (i.e. a/c) Vs Odds of exposure in absence of disease (i.e. b/d). In Case control study, groups are divided based on disease presence or absence. Hence, disease odds are not calculated. We calculate the odds of exposure. (Current text says opposite) (Please check CDC reference)Major erratumThis user is incorrect. The text is clearly giving an example of an odds ratio in which we calculate the odds that the patients smoke (not the odds of disease, which he/she is suggesting here). No change necessary. -YKI think this user is correct. We are trying to ascertain the odds of exposure retrospectively once we have observed the cases and controls. I have added a clarifying statement in the text.
- FQ		Our statement is correct as written but could be clarified. Please delete the phrase "the odds of the outcome in the" so that the highlighted statement reads:

Depicts the odds of a certain outcome given an exposure (eg, disease [a/c]) vs absence of that exposure (eg, no disease [b/d]). -VV		Prelim accept by 2 authors + 1 editortrue03/27/19 6:49 AMMurliMishramm.murli@gmail.com
589258Public Health SciencesEpidemiology & BiostatisticsQuantifying riskhttps://www.ncbi.nlm.nih.gov/books/NBK431098/ ; Uworld ID 1205Odds ratio (OR) formula should be (a/b)/(c/d) = ad/bc, NOT (a/c)/(b/d) = ad/bcMinor erratumReject. both formulas are "correct", however the current representation is important to demonstrate exposure / not exposure. No change -YKReject. Text is fine as is. -VVReject by 2 authors + 1 editor05/17/19 2:21 AMHeewonChoihxc326@case.edu
590258Public Health SciencesEpidemiology & BiostatisticsQuantifying riskn/aNNH = 1/AR – hARmMnemonicVerifiedWe already have something similar. Also if this is meant to represent an equation, then it is incorrect. Reject. -YKReject, text is fine as is. -VVReject by 2 authors + 1 editor07/10/19 9:20 PMAPandeyaranikopandey@gmail.com
591258Public Health SciencesEpidemiology & BiostatisticsStatistical distributionhttps://www.uptodate.com/contents/glossary-of-common-biostatistical-and-epidemiological-terms?search=Odds%20ratio&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Error: "If in a case-control study, 20/30 lung cancer patients and 5/25 healthy individuals report smoking, the OR is 8; so the lung cancer patients are 8 times more likely to have a history of smoking." Correction [ "If in a case-control study, 20/10* lung cancer patients and 5/20* healthy individuals report smoking, the OR is 8; so the lung cancer patients are 8 times more likely to have a history of smoking.Spelling/formattingThis refers to fact "Quantifying Risk". The student appears to be incorrect. The text is saying that 20 out of a total of 30 patients and 5 out of a total of 25 patients. He/she is "correcting" this to present a ratio of those patients who smoke and who do not smoke, which would likely be very confusing if presented this way. Recommend no change. -YKAgree with Yumi, suggest no change. -VVReject by 2 authors + 1 editor03/15/19 1:11 PMJoel AdoquayeAlloteyjalloteya@gmail.com
592259Public Health SciencesEpidemiology & BiostatisticsIncidence vs prevalencehttps://dhsprogram.com/pubs/pdf/FR175/12Chapter12.pdfTherapy initiation may increase prevalence depending on what the disease is (eg, Cancer, Diabetes, HIV) as it prolongs survival time. Current text says it decreases prevalence.High-yield addition to next yearThis comment is nitpicky since curative therapy reduces (e.g bacterial infections/antibiotics) the prevalence. But, if therapy is not curative (HIV/antiretrovirals), it increases prevalence by reducing overall mortality. Technically, it is not an error, but we might specify these two types of therapies in the next edition. -Victor MartinezVerifiedValid point, especially since chronic illnesses make up a large portion of illnesses treated today. I think we can correct this by simply removing "therapy initiation" from the table. This information is already basically covered by the text above the table stating "prevalence ~ incidence for short duration disease; prevalence > incidence for chronic diseases" -YKYes, agree with your assessment, since prevalence could increase or decrease depending on if it's an infectious or chronic disease. Perhaps we could clarify this or just directly remove if that would be easier.
- FQ		Agree with Yumi. Please delete "Therapy initiation" row from the table. -VVPrelim accept by 2 authors + 1 editortrue01/29/19 4:32 AMJerrinBawajerrin.bawa@gmail.com
593259Public Health SciencesEpidemiology & BiostatisticsPrecision vs accuracyn/aRandom Error – Decrease Precision in a test Systematic Error – Decrease Accuracy in a test “REPtiles Deep in the SEA”.MnemonicVerifiedNot very good. Reject -YKNo changes. -VVReject by 2 authors + 1 editor07/10/19 9:22 PMAPandeyaranikopandey@gmail.com
594260Public Health SciencesEpidemiology & BiostatisticsBias and study errorshttps://www.uptodate.com/contents/evidence-based-approach-to-prevention?search=lead-time%20bias%20definition&source=search_result&selectedTitle=1~19&usage_type=default&display_rank=1#H20178015To differentiate between "lead-time bias" and "length-time bias," you can think "If a disease is detected early, you get a 'head start' on the treatment, and therefore take the 'lead.'" This draws comparison to a race.MnemonicVerifiedI don't see this as being helpful for differentiating between the two. Recommend no change. -YKAgreed, would also reject
- FQ		Agree, reject. -VVReject by 2 authors + 1 editor03/17/19 6:34 PMAmerMohiuddinamemohiu@iu.edu
595260Public Health SciencesEpidemiology & BiostatisticsBias and study errorsn/a"HAWK"thorne bias - subjects being watched like a HAWK; "B"erkson bias - subjects get "B"etter careMnemonicVerifiedthese are clever, but it does not look like we have enough room on this page for these mnemonics. -YKThe Hawk one is great; I'd include it if there's space. I don't like the second. Could be easily misremembered as the patients being better, i.e. LESS sick instead of more. -KD05/06/19 12:52 PMMichaelHagertymichaelhagerty1992@gmail.com
596261Public Health SciencesEpidemiology & BiostatisticsStatistical distributionhttps://en.wikipedia.org/wiki/Population_pyramidPopulation pyramids, their different kinds ( developing vs. developed countries) and calculating dependency ratio using the pyramids deserves a part in the book. developed countries show a "constrictive" and developing countries show an "expansive" pattern in the pyramids. The dependency ratio is calculated by adding the nonproductive population (less than 15 yrs and more than 65 yrs old) and dividing it by the productive workforce ( between 15 and 65 yrs of age).High-yield addition to next yearis this tested on Step 1? I don't recall being tested on this type of information. -YKI don't think this is a necessary inclusion. -KDWhile it can sometimes be included, it's more of a undergraduate stats process. Would not recommend addition. -VVReject by 2 authors + 1 editor05/12/19 8:48 AMAmirhosseinAkhavan Sigariamirsigari@yahoo.ca
597261Public Health SciencesEpidemiology & BiostatisticsStatistical distributionit"s a mnemonic"M"e"A"n= "M"ost "A"ffected by outliers ------ "M"o"D"e= "M"ost "D"efiant to outliersMnemonicVerifiedDon't like it. -YKNo changes. -VVReject by 2 authors + 1 editor05/18/19 9:30 AMMohamad OthmanEl Heloumohamadosman.helou@lau.edu
598261Public Health SciencesEpidemiology & BiostatisticsStatistical distributionn/aIt's POSITIVE to be RIGHT but don't be MEAN. (POSITIVEly skewed distribution has RIGHT tail and the MEAN is the higher value)MnemonicVerified08/25/19 4:38 PMSultanAljarbasultan6044@hotmail.com
599261Public Health SciencesEpidemiology & BiostatisticsStatistical distributionhave attached file for referencefor positive skew mean> median> mode (go alphabetically and to the direction of the skew) and same with negative skewMnemonicVerified09/10/19 9:19 AMshobhitpiplanishobhitpiplani@aol.com
600264Public Health SciencesEthicsInformed consentn/aFor the informed consent requirements of disclosure, understanding, capacity, and voluntariness, you can remember "Don't Underestimate Core Values"MnemonicVerifiedSomewhat good, but not really relevant to the text it represents. Suggest to reject -YKNot that great. -VVReject by 2 authors + 1 editor05/29/19 9:03 PMLexieGibsonlexiegibs@gmail.com
601266Public Health SciencesEthicsEthical situationshttps://www.deathwithdignity.org/terminology/The situation where a terminally ill patient requests physician assistance in ending his/her life is currently being referred to as "physician assisted suicide," which is widely viewed as a biased term, as "suicide" does not accurately describe a terminally ill patient wishing to hasten their death. It would be more appropriate to refer to it as "physician assisted death"High-yield addition to next yearI agree with Vivek, we definitely need faculty input for this one. Both terms are widely used, but I think we need to choose the one that is more ethically appropriate. -Victor MartinezVerifiedOn UpToDate, they refer to it as "physician-assisted dying (PAD)", so this user may have a good point here.The article also speaks about the various terminologies, and it seems there is no set term. I think we should consider changing the term in this edition, with faculty approval. -YK

Source: https://www.uptodate.com/contents/physician-assisted-dying-understanding-evaluating-and-responding-to-requests-for-medical-aid-in-dying?search=physician%20assisted%20suicide&source=search_result&selectedTitle=1~17&usage_type=default&display_rank=1		The student has argued an important point with a reference discussing it. However, it is still a popular term described in the code of medical ethics as seen in the article blow and the underlying concepts remain the same. I feel we need faculty input to shed more light on it in terms of appropriateness.

- https://www.ama-assn.org/delivering-care/ethics/physician-assisted-suicide

- Vivek		However, it may be okay to leave as is, considering that the AMA still uses the term "physician assisted suicide." Would appreciate input from faculty. -VVDisagreement/need experttrue01/15/19 10:19 AMKaylaSheehankaylaksheehan@gmail.com
602266Public Health SciencesEthicsEthical situationsNoticedAll of the examples are gender-neutral and describe the patient as him/her in the "appropriate response" (unless specified in stem/pregnant), except for the situation of the "family member asks you not to disclose the results of a test etc." For this one, the last sentence says, "[...] the patient might seriously harm himself"; it should read "himself/herself."Spelling/formattingI'm personally of the opinion this might be more due to lack of space, would be favor of keeping as is
- FQ		I'd actually be inclined to change it for consistency. -KDPretty nitpicky but sure. In the 5th row entry on page 266, please replace "himself" with "himself/herself" in the last sentence. -VVPrelim accept by 2 authors + 1 editortrue04/04/19 4:12 PMNankiHurananki.hura@gmail.com
603266Public Health SciencesEthicsEthical situationshttps://www.ama-assn.org/delivering-care/ethics/physician-assisted-suicideAdd The AMA Code of Ethics: "Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life."Clarification to current textIn the AMA code of ethics, this line is followed by 4 points which clarify its meaning by "aggressively respond". Out of context, this can be taken the wrong way (eg, be aggressive in medical treatment of a potentially terminal illness). That being said, I think we could clarify the current text. Instead of the current "Physicians may, however, prescribe medically appropriate analgesics even if they shorten the patient’s life", we can say "Physicians must provide emotional support, comfort care and adequate pain control when necessary." -YK07/10/19 10:45 PMTatianaSantostatisantosmd@gmail.com
604268Public Health SciencesThe Well PatientCar seats for childrenhttps://www.nhtsa.gov/equipment/car-seats-and-booster-seatsMissing text on page 268 regarding car seats for children, index reference still presentMajor erratumAcknowledged, should remove the index reference to this page.
- FQ		Agreed -YKGood catch. Will add a note to the index. -VVPrelim accept by 2 authors + 1 editor03/27/19 4:01 PMDhruvSarwaldhruvsarwal@gmail.com
605270Public Health SciencesHealthcare DeliveryCommon causes of death (US) by ageFirst aid 2019AIDSSpelling/formattingReject. AIDS stands for acquired immune deficiency syndrome and SIDS for sudden death infant syndrome which is the third leading cause of death in infants according to the CDC. https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2016-508.pdf -Victor MartinezStaff rejectsReject

SIDS stands for Sudden infant death syndrome which is the third leading cause of death among infants.

- Vivek		Text is fine as is. -VVReject by 2 authors + 1 editor01/11/19 2:24 PMHsinyuYinhsinyu94@hotmail.com
606270Public Health SciencesHealthcare DeliveryCommon causes of death (US) by agehttps://www.cdc.gov/injury/images/lc-charts/leading_causes_of_death_by_age_group_2017_1100w850h.jpgThe CDC reports maternal complications as the third leading cause of death for individuals under 1 years of age, SIDS is the fourth leading cause. In First Aid 2019, SIDS is listed as the third leading cause. I have attached CDC table showing this.Major erratumYes it appears the user is correct. This changed from the 2015 CDC chart, in which SIDS was still #3. Looks like there is enough support here to change the table. -YK

Source: 2015 data -- https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2015-a.pdf

2017 data -- https://www.cdc.gov/injury/images/lc-charts/leading_causes_of_death_by_age_group_2017_1100w850h.jpg		I'm not so sure we should change, as if you look through the past 6 years of CDC data from 2012-2017, SIDS outranks maternal complications on most years, though the difference is quite small. Perhaps we can list them as tied for number 3?
-FQ		Considering that CDC released a new table in 2017, it would be worth changing in the text. In the "Common causes of death" table, please replace "SIDS" with "Maternal complications" as the #3 cause in infants <1 year (Column 2). -VVPrelim accept by 2 authors + 1 editortrue03/23/19 3:00 PMAntaraAfrinafrinant@msu.edu
607270Public Health SciencesHealthcare DeliveryMedicare and MedicaidIt's MnemonicThe 4(fou*R*) parts of Medica*R*e ,not Medicaid.MnemonicI believe that the ABCD parts we use as mnemonic is enough. But, if the rest think that this proposal is adding extra value, then I am good with it. -Victor MartinezVerifiedI don't see this as necessary or helpful -YKAgreed, doesn't seem useful, would reject.
- FQ		Agree with authors. Would not recommend adding. -VVReject by 2 authors + 1 editor01/06/19 4:19 PMMoatasemAl-Janabiassoomi88@yahoo.com
608270Public Health SciencesHealthcare DeliveryMedicare and Medicaidhttps://www.hhs.gov/answers/medicare-and-medicaid/what-is-the-difference-between-medicare-medicaid/index.htmlYou CARE for the elderly and you give AID to the poor.MnemonicVerifiedNot necessary -YKOur mnemonic is better. -VVReject by 2 authors + 1 editor03/30/19 2:55 PMBrandonFlockbrandon.flock@my.rfums.org
609273IndexIndexOrientationFA2019The page numbers in FA 2019 are still representative of FA 2018 on page 597 and do not align with page numbers in current editionSpelling/formattingStaff accepts02/03/19 11:28 AMJoannaGeorgakasjoanna_georgakas@brown.edu
610277CardiovascularPhysiologyAuscultation of the hearthttps://www.uptodate.com/contents/physiologic-and-pharmacologic-maneuvers-in-the-differential-diagnosis-of-heart-murmurs-and-sounds?search=auscultation%20of%20heart%20sounds&sectionRank=1&usage_type=default&anchor=H2&source=machineLearning&selectedTitle=4~150&display_rank=4#H2*I*nspiration increases intensity of r*I*ght heart sounds; *E*xpiration increases intensity of l*E*ft heart soundsMnemonicI think we can take into account this mnemonic for the next edition since generally speaking murmurs increasing with expiration originate with left side valves. - Victor Martinez.VerifiedSince the first part is already included in the 2019 edition, perhaps a line with expiration can be added just below and the letters in the text can be capitalized to highlight the mnemonic. -LilitI think this could be included in the "Auscultation of the Heart" section - MK01/05/19 1:30 PMKelseyHarderkharder@kumc.edu
611278CardiovascularEmbryologyHeart embryologyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107421/The posterior CARDINAL vein, and not "posterior vein", gives rise to the IVC.High-yield addition to next yearI don't consider this needs to appear on errata since posterior (cardinal), subcardinal and supracardinal veins give rise to IVC. If this needs further clarification, we could add parentheses after posterior with the word (cardinal) in the next edition. - Victor Martinez.VerifiedCan change to posterior cardinal vein. Do not think this is MAJOR errata category - EPDon't think this is necessary. -MK01/07/19 3:56 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
612278CardiovasculartrueEmbryologyHeart morphogenesishttps://www-uptodate-com.webproxy2.ouhsc.edu/contents/prenatal-assessment-of-gestational-age-date-of-delivery-and-fetal-weight?search=gestational%20age&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H12019 version states cardiac looping begins in week 4 of "gestation", but this should instead be week 4 of "development" or week 6 of gestation since gestational age is calculated from the date of last menstrual period (see page 619 of the 2019 First Aid)Minor erratumI agree with the student. We should be consistent with our formatting, gestational age is calculated from the last menstrual period and embryonic age (developmental) from date of fertilization. We should say "week 4 of fertilization" or "week 4 of development."However, I don't know if this qualify to be on errata. - Victor Martinez.VerifiedAgree with using "development" - MKDefer to an expert.Disagreement/need expertjohn.r.butterly@dartmouth.eduI can not comment on this - no expertise in this area*CARDIO Anish Bhatti think development is the safest and most appropriate term, as it is both accurate and an umbrella term.Accepttrue01/25/19 12:14 PMChristinaJacobschristinacjacobs@outlook.com
613278CardiovascularEmbryologyHeart morphogenesisuworld question 202Cryptogenic stroke is evaluated by echoCG with "bubble study" to identify R->L heart shunt (PFO, ASD)High-yield addition to next yearThe study is described in the question stem and the student must make an inference to reach a diagnosis. Choosing a correct diagnostic study for a given condition is more so tested on Step 2/3. I recommend rejecting. -LilitAmbivalent about this suggestion but leaning towards recommending rejecting. While the student is correct, I think it is low yield for Step 1. The UWorld question the student references doesn't necessarily require the student to know that bubble studies are used in the evaluation of cryptogenic stroke; it merely describes the procedure of observing bubbles passing from RA to LA, and the student must infer this indicates the presence of PFO. -Mitchell Katona03/26/19 10:21 AMDmytroPavlenkopavlenko.md@gmail.com
614279CardiovascularEmbryologyHeart morphogenesishttps://emedicine.medscape.com/article/893798-overviewIn the figure showing the spiraling of the aorticopulmonary septum, the spiral is drawn in the wrong direction. The aorta should be spiraling over the pulmonary trunk, not under it.Minor erratumReject. The illustration depicts the rotation of the aorticopulmonary septum. It is a spiral so, at some point, the pulmonary would be over the aorta and then it would spin over, putting the aorta above the pulmonary trunk. Besides, the current illustration does not show which part corresponds to the aorta and pulmonary trunk. - Victor Martinez.VerifiedAgree, reject.Reject by 2 authors + 1 editor01/05/19 2:25 PMJoshuaLadellajosh.ladella@gmail.com
615280CardiovascularEmbryologyFetal circulationhttps://www.uptodate.com/contents/patent-ductus-arteriosus-in-preterm-infants-management?search=ibuprofen%20ductus%20arteriosus&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H230984984Ibuprofen is now used to close a PDA instead of indomethacin generallyHigh-yield addition to next yearI think we already are considering adding NSAIDs to the text instead of just Indomethacin. -LilitAgree with this suggestion. If we are changing to NSAIDs then should be ok, but I do not see any comment thread on this page about changing from indomethacin to NSAIDs. - Huzaifa05/09/19 4:53 AMJackHenryjack.henry@ucdconnect.ie
616281CardiovascularAnatomyAnatomy of the hearthttp://www.vhlab.umn.edu/atlas/coronary-arteries/lad-left-anterior-descending-artery/index.shtmlLAD supplies the anterior 2/3 of interventricular septum, anterior left ventricle, anterolateral papillary muscle, and provides collateral circulation to the Right ventricle. It is the most commonly occluded. The left circumflex (LCX) supplies anterior of interventricular septum, anterolateral papillary muscle, left atrium, and the posterior and lateral sides of the left ventricle.Major erratumDuplicate12/27/18 6:58 PMMollySchiebermolly2163@gmail.com
617281CardiovascularAnatomyAnatomy of the heartNot Needed. It's RepititiveLAD(arises from LCA) supplies anterior 2/3 of interventricular septum, anterolateral papillary muscle, and anterior surface of LV. Most commonly occluded.Clarification to current textIs the suggestion that we should fix the entry on coronary blood supply for LAD since the first line and second line are repetitive? If that is the comment, then yes, I agree. -AidaVerifiedAgreed with this suggestion. The information is repetitive and can be combined into a single sentence. Addressed in another comment and migrated to annotate already. -LilitAgree with student- this information is repeated in the next line. Needs to be combined. -MKtrue01/26/19 8:30 PMArpitJainarpitjaindr@gmail.com
618281CardiovascularAnatomyAnatomy of the heartuworldaccording to UWORLD; Rt dominance is in 70%, Lt dominance in 10% and co-dominance in 20%Minor erratumVerifiedThe article mentioned here is from the American Journal of Critical Care and was published in 2011. I haven't really come across any other resources that specify the percentages. -LilitInfo from student cited PMID: 21885462.- MKUnderstandably, there is some variation in the reported rates of coronary dominance. Most seem to quote 7-8% for left dominance (see https://www.sciencedirect.com/science/article/pii/S0002870307006242) but for Step 1 purposes it may be easier to simplify these percentages like the student suggested. The exact percentages are unlikely to be relevant or HY for Step 1 as long as students are aware of the general distribution of coronary dominance.

Either way the current text is not incorrect. It may be worthwhile discussing this further on Annotate to see whether simplification would be useful.

I will flag this for expert input first to ensure a change as the student suggested would not result in a factual erratum.

Sarah		Disagreement/need experttrue03/01/19 7:23 PMAlaJamalala.aljamal@hotmail.com
619281CardiovascularAnatomyAnatomy of the hearthttps://emedicine.medscape.com/article/158064-overviewSA node is supplied by SA Nodal Artery which is perfused by branches of the RCA in ~60% of cases whereas in ~40% it is perfused by the LCX. This is in great contrast to the printed statement of, "RCA supplies SA node" in FA 2019. The parenthetical that follows "(blood supply independent of dominance)" remains a true statement and should be kept. This fact is supported by the eMedicine link as a supporting reference with the relevant information in the Etiology subsection titled "Childhood and familial diseases," italicized heading "SA nodal artery disease." An additional journal article has been included corroborating the same anatomical fact.Major erratumVerifiedI wasn't aware of this until I looked this up on UTD. Here is the exact link of the content mentioned in this suggestion. I think expert input might be needed for this. -Lilit https://www.uptodate.com/contents/sinus-node-dysfunction-epidemiology-etiology-and-natural-history?search=sa%20node%20dysfunction&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H440351002The UTD is pretty clear. Here is another primary source that is in agreement with the student. https://journals.sagepub.com/doi/10.1177/147323000803600410 I agree with Lilit that it is probably best to include an expert. Otherwise, it must be clarified that ~40% of SANAs are LCX branches. -Mitchell Katonatrue03/18/19 3:36 PMSamir K.Shahsamirkshah93@gmail.com
620281CardiovascularAnatomyAnatomy of the heartpage 281 in first aid 2019. It seems to be just a minor typoUnder the "Coronary blood supply" section there are two mentions of LAD. The first one states "LAD and its branches supply anterior 2/3 of interventricular septum, anterolateral papillary muscle". I believe this is a duplication of the fact right below it. Could it be that the first LAD fact is actually supposed to say LCA? Because that would make more sense.Minor erratumAlready discussed here and on annotate. -LilitPer Lilit, has already been discussed. - Huzaifatrue05/09/19 11:34 PMAriaFariborziaafariborzi@gmail.com
621281CardiovascularAnatomyAnatomy of the hearthttps://www.ncbi.nlm.nih.gov/books/NBK534790/The posterior descending artery does not supply the AV node. The atrioventricular nodal branch supplies the AV node, which is usually a branch of the right coronary artery, but may in some cases be a branch of the left circumflex artery.Major erratum08/24/19 8:42 PMMatthewPavlicampavlica@nyit.edu
622281CardiovascularAnatomyCardiac and vascular function curveswww.usmle-rx.comIn Coronary Blood supply, there's a repeat on content regarding LAD supply.Clarification to current textAs suggested, in the first and second paragraph, second column, LAD supply is repeated. However, I don't consider that this should be part of the errata. We should change our wording in the next edition. - Victor Martinez.VerifiedSame as above. Agree with change in Editor comment. - MKChange "LAD and its branches supply anterior 2/3 of
interventricular septum, anterolateral papillary
muscle.
LAD supplies anterior of interventricular
septum, anterolateral papillary muscle, and
anterior surface of LV. Most commonly
occluded."

To:
LAD and it's branches supply anterior 2/3rd of interventricular septum, anterolateral papillary muscle, and anterior surface of LV. Most commonly occluded.		Prelim accept but NOT publishable erratajohn.r.butterly@dartmouth.eduthe recommendation is fine with menish7886@gmail.comi like the change as wellAccepttrue12/27/18 10:36 AMSaraKhandr.sarakhan7@gmail.com
623281CardiovascularAnatomyMyocardial infarction complicationsN/AUnder CORONARY BLOOD SUPPLY on page 281, Cardiovascular - Anatomy, there is a description of the structures supplied by the LAD, followed immediately by a second sentence repeating the same information. It would help save space in the 2020 edition if these two sentences were condensed.Clarification to current textDuplicate. -Victor Martinez.VerifiedAgreed with student. The revised sentence suggested by second author looks good. Nicely combined the important aspects of both sentences. -LilitNice catch. Agree with the student. It is repeating the same information.


I suggest combining first and second sentence in the second column as follow:

LAD and its branches supply anterior 2/3 of interventricular septum, anterolateral papillary muscle, and anterior surface of LV. Most commonly occluded.

- Vivek		true01/10/19 7:10 PMRichardFerroRichard.Ferro@quinnipiac.edu
624282CardiovasculartruePhysiologyCardiac output variableshttps://www.uptodate.com/contents/surgical-management-of-heart-failure?search=laplace%27s%20law%20hypertrophy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1LV compensates for ↑afterload by thickenin (hypertrophy) in order to ↓wall tension; wall tension should be changed into wall stressMinor erratum"Wall stress or wall tension is a conception derived from physics (Laplace's law) and represents the systolic force or work per surface unit. It is the systolic force made by myocardial tissues. Stress increase indicates enlargement of the left ventricle or increase of intracavitary pressure." https://www.ncbi.nlm.nih.gov/pubmed/12070929 Wall stress and tension are derived from Laplace's law, they are part of the same principle. I do agree, we should change from "decreased wall tension" to "decreased wall stress" since the formula we show on the book involving thickness (5th arrow, column 3) is wall stress= P x r/2wall thickness. Therefore, by increasing wall thickness (denominator), wall stress reduces. - Victor Martinez.VerifiedI agree with this - it is really the stress that is being reduced as t is the wall thickness that is changing. John ButterlyAgree, change wall tension to wall stress.Prelim accept by 2 authors + 1 editorjohn.r.butterly@dartmouth.eduI agree - change wall tension to wall stress*CARDIO Anish BhattagreeAccepttrue01/06/19 3:58 AMHangSongwh429@cornell.edu
625283CardiovascularPhysiologyCardiac output equationshttps://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12156COPD also causes arterial stiffness leading to increased pulse pressureHigh-yield addition to next yearVerifiedThis article discusses OSA, which is already mentioned in text. Reject. -LilitThe article the student provided is on OSA. OSA is already discussed in text underfed increased PP due to increased sympathetic tone.- MK03/01/19 7:25 PMAlaJamalala.aljamal@hotmail.com
626283RenalEmbryologyPotter sequence (syndrome)https://en.wikipedia.org/wiki/Potter_sequence#CausesI think the text should clarify that bilateral Renal agenesis leads to potter sequence, in the book it is stared under multi cystic dysplastic kidneyClarification to current textVerifiedReject.Potter Sequence typically refers to the appearance of the infant appearance of a fetus or neonate exposed to severely decreased or absent amniotic fluid secondary to renal disease. It is not necessarily associated with a specific in-utero renal condition, therefore although Potter sequence is seen in patients with renal agenesis, it is more commonly associated with Multi-cystic dysplastic kidney. (Source: UpToDate) Addition/change not required. -RohanReject, AKBGood analysis by Rohan. I agree that no further clarification is required.

- Sarah		Reject by 2 authors + 1 editor03/09/19 12:42 PMAmanKalraaman
627284CardiovascularPhysiologyPressure-volume loops and cardiac cycleUworld question 1625right bottom of page: (6) Exercise, [chronic] AV shuntMajor erratumVerifiedAgreed with second author comment. -LilitRecommend rejecting. Both acute and chronic AV shunts decrease TPR. The UWorld question the student references actually states as much. Other hemodynamic changes may vary with time but this is not the case for TPR. -Mitchell Katonaagree. no change needed.
Sarah		Reject by 2 authors + 1 editor03/26/19 10:16 AMDmytroPavlenkopavlenko.md@gmail.com
628285CardiovascularPhysiologyCardiac and vascular function curveseMedicine https://emedicine.medscape.com/article/1894036-overview, Lilly's Pathophysiology of the Heart (Chapter 2), UWorld QID 1557,(Unable to enter "NEW FACT" in the box, but I would file this under "HEART SOUNDS") - Both S3 and S4 are heard best in the left lateral decubitus position. As written in the text, it suggests that only the S4 is heard best in this position. This may confuse readers to associate S4 only with that position, when in fact either S3 or S4 are associated with the left lateral decubitus position.Clarification to current textVerifiedAgree with this. -LilitThis is technically correct. Consider adding that S3 is best heard at apex when patient is in left lateral decubitus position. - MKAgree. This can be migrated to Annotate.
Sarah		Prelim accept by 2 authors + 1 editortrue04/01/19 9:39 PMAndrewKoandrewko@hawaii.edu
629285CardiovascularPhysiologyCardiac and vascular function curvesn/a“Kick in the end (S4) if it’s stiff and noncompliant” S4 = “atrial kick” against a stiff LV hypertrophy.MnemonicVerifiedNot a very useful mnemonic. Reject. - HuzaifaAgreed with Huzaifa. Not very useful. Reject. -Lilit07/08/19 2:12 PMAranikoPandeyaranikopandey@gmail.com
630285CardiovascularPhysiologyCardiac and vascular function curvesn/a“a Curved aXe in the Vine Yard”MnemonicVerifiedOh I like this mnemonic for jvp curve! "A Curved aXe in the Vine Yard." Helps remind me of the order, and isn't a random mnemonic that would be difficult to remember. Accept. - HuzaifaI like this a lot too. Definitely helps with the order. Would have been better if we could somehow stress that X and Y are descents and the rest are waves, but this is still pretty good. Accept. -Lilit07/08/19 2:14 PMAPandeyaranikopandey@gmail.com
631285CardiovascularPhysiologyFlow-volume loopsNone needed.During isovolumetric relaxation, the line representing ventricular volume should be completely flat. In the current text, it is slightly curved, however, this is a isovolumetric process with no volume changes occuring.Minor erratum11/25/19 10:57 PMAbhishekGamiagami@jhu.edu
632285CardiovascularPathologyHeart failurehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3305384/S3 is associated with systolic heart failure. 3 syllables in sys-tol-ic. S4 is associated with diastolic heart failure. 4 syllables in di-a-stol-icMnemonicVerifiedAddressed in another comment. Reject. -LilitReject. S3 can also be heard in diastolic HF. https://www.uptodate.com/contents/auscultation-of-heart-sounds?search=s3%20s4&source=search_result&selectedTitle=1~104&usage_type=default&display_rank=1#H24 -MK04/20/19 11:20 AMRyanBenderrbender49@gmail.com
633285CardiovascularPhysiologyPressure-volume loops and cardiac cyclehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253755/In the ventricular volume curve of the second graph, it is shown that during the atrial systole the ventricular volume increases gradually and then decreases to the level that it was prior to the atrial systole. This is wrong. The ventricular volume increases and remains at that volume (isovolumetric contraction) until the aortic valve opens.Major erratumReject, as per the student's link, The cardiac cycle shown on the research is similar to the current FA illustration. Both illustrations depict the same volume (straight horizontal line) during the isovolumetric contraction until the aortic valve opens, this is followed by ejection. -Victor MartinezVerifiedAgree with author, reject.Reject by 2 authors + 1 editor01/07/19 4:01 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
634285CardiovascularPhysiologyPressure-volume loops and cardiac cyclehttps://www.uptodate.com/contents/auscultation-of-heart-soundsIt states that S4 should be considered abnormal, regardless of patient age. According to uptodate and UWorld, S4 is normal in healthy older adults.Major erratumVerifiedYes agreed. According to the link provided, S4 can be normal in older healthy individuals due to decreased ventricular compliance with age. S4 is always abnormal when it is palpable, regardless of age. -LilitAgree. S4 can be found in healthy older adults without any other cardiac abnormality, due to decreased ventricular compliance with age. This could, however, be changed to "S4 is always abnormal when it is palpable, regardless of patient age." - MKOk, this could be clarified further as Mitchell recommended. Won't take up too much additional space.

- Sarah		Prelim accept but NOT publishable erratatrue03/17/19 2:05 AMNidaBajwanab016@jefferson.edu
635285CardiovascularPhysiologyPressure-volume loops and cardiac cyclefa2019x descent - atrial relaXationMnemonicVerifiedIm not inclined to accepting this mnemonic, as it seems to suggest that x descent is due to atrial relaxation. The illustration is very clear and the text explains the concept really well. -LilitRecommend rejecting. Although atrial relaxation occurs during the x descent, this is incidental to the process that causes the x descent (TV displacement during rapid ejection). It is not likely to help the student understand the significance of the x descent to know that it occurs during atrial relaxation. Conversely, the other mnemonics in this fact directly help the student understand the physiology behind the a, c, v, and y waves/descent. -Mitchell Katona03/26/19 10:36 AMDmytroPavlenkopavlenko.md@gmail.com
636285CardiovascularPhysiologyPressure-volume loops and cardiac cyclehttps://www.ncbi.nlm.nih.gov/books/NBK342/ https://www.ncbi.nlm.nih.gov/books/NBK344/S3 - add that it is a "ventricular gallop" and for S4 - "atrial gallop"Minor erratumRecommend rejecting. These are merely very uncommonly used synonyms for S3 and S4, which are not helpful for Step 1. -Mitchell KatonaAgree with Mitchell - LY information not relevant for Step 1.

Sarah		Reject by 2 authors + 1 editor03/26/19 10:39 AMDmytroPavlenkopavlenko.md@gmail.com
637285CardiovascularPhysiologyPressure-volume loops and cardiac cycleCostanzo PhysiologyOn the pressure-volume loop diagram, it displays a contractility increase as only affecting volume. There should also be an increase in left ventricular pressure as a consequence of the increased contractile force. Supporting reference is costanzo. Costanzo states "when contractility increases, the ventricle can develop greater tensiona dn pressure during systole and eject a larger volume of blood than normal.Major erratum08/22/19 6:21 PMJustinNewmanjustineliasnewman@gmail.com
638285CardiovascularPhysiologyPressure-volume loops and cardiac cycle-change in (P)ressure = valves o(P)en. Change in vo(L)ume= Valves c(L)oseMnemonicVerified09/09/19 4:28 AMAhmad Y.ObeidatObeidat.amd@hotmail.com
639285CardiovascularPhysiologyPressure-volume loops and cardiac cyclehttps://www.physiology.org/doi/full/10.1152/advan.00182.2018In the left atrial pressure graph (green dotted line) the a peak is lower than the c peak. C should be lower than a, and there should be more of an x descent. While Costanzo shows this printed relationship, all sources including the attached show a being significantly higher than c.Minor erratum10/30/19 6:06 PMPatrickBarrettpcbarret@gmail.com
640286CardiovascularPhysiologyHeart murmursSelf made mnemonicThe mnemonic BEAR for aortic regurgitation causes: Bicuspid aortic valve, Endocarditis, Aortic Root dilation, Rheumatic Fever (you can even put the R^2 for both the Root in Aortic Root and Rhuematic feverMnemonicVerifiedI personally like mnemonics, but i don't think this one is absolutely necessary. Between the 2 that are suggested, BEAR is the better one, however. If this doesn't add an extra line, then we should include in the text. -LilitBEAR could be easier to remember than BER^2.I don't think this is necessary but could be helpful. Confirmed info https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-chronic-aortic-regurgitation-in-adults?search=aortic%20regurgitation&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. -MKtrue03/01/19 2:43 AMAbdul SattarRaslananr06@mail.aub.edu
641286CardiovascularPhysiologyPhysiologic changes in valvular diseaseUWorld QID: 227 & supported by online articles on googleIn the pressure tracing diagram of aortic regurg: the dicrotic notch is exaggerated. With an incompetent aortic valve there is back flow resulting in loss of pressure in the aorta and disappearance/reduction of the dicrotic notchMinor erratumThis definitely makes sense and I wish I could access the World question to find the exact source that stated this. I was able to find only a few articles on this and they were all before 1980. However, it was basically an analysis of pulse pressure changes in people with severe aortic regurgitation, and aortic pressure tracings were performed. One of the papers said that only 1 case showed loss of the dicrotic notch (link below). I believe this finding correlates with the severity of disease and is not present in every individual with the condition. I would defer to expert faculty, as this is a change that would require their approval. -Lilit https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1018155/pdf/brheartj00344-0124.pdfAgree that this is something that would require expert faculty input. I do remember this Uworld question as well and that there's a diminished dicrotic notch. - HuzaifaGood discussion and excellent analysis by Lilit!
I agree we should ask for expert input on this to ensure the current diagram does not contain any errors. Migrated to Annotate for discussion.

- Sarah		Disagreement/need experttrue06/05/19 6:44 PMOsamaEl-Gabalawyga3balawy@gmail.com
642286CardiovascularPhysiologyPhysiologic changes in valvular diseaseUworld Question ID 227In aortic regurgitation there is loss of the dicrotic notch as there is immediate back flow of blood into the LV, resulting in loss of pressure in the aorta and disappearance of the dicrotic notch (figure needs to be corrected).Minor erratumDuplicate comment, see above. -LilitAgree, duplicate comment. - HuzaifaGood discussion and excellent analysis by Lilit!
I agree we should ask for expert input on this to ensure the current diagram does not contain any errors. Migrated to Annotate for discussion.

- Sarah		Disagreement/need experttrue06/24/19 4:32 AMNaylaMrouehnaylamroueh@gmail.com
643288CardiovascularPhysiologyAuscultation of the heartnot neededI recommend adding 3 rules to help understand how different bedside maneuvers affects heart murmurs; 1) Increase in Preload leads to increase intensity of all murmurs (except HCM and MVP; later click); Same for the opposite. 2) Increase in Afterload leads to increase intensity of Regurgitant murmurs and decrease intensity of stenotic murmurs (again except for HCM and MVP); Same for opposite. 3) HCM and MVP murmurs intensity always go opposite to Preload and afterload. This can be applied to all murmurs and will work!High-yield addition to next yearVerifiedI think the current text basically reflects everything suggested in this comment. I don't think any further changes/additions are necessary. -LilitThis is basically already stated in that section and FA goes more in depth on the MVP murmur with these maneuvers. Don't think this is necessary. - MK03/01/19 7:32 PMAlaJamalala.aljamal@hotmail.com
644288CardiovascularPhysiologyAuscultation of the heartno needIn the picture, its written "left sternal border: Diastolic murmur.." ,, Diastolic murmur and systolic murmur should be in bold to be as the same as others.Spelling/formattingThis is due to formatting. The mnemonic ATP M uses a different format for the auscultation areas. Left sternal border is an extra area that is not part of the mnemonic, hence the difference in formatting. I don't see this as a major issue. Leave text as is. -LilitLeave text as is. - Huzaifa07/20/19 12:04 PMZaid RNajdawiznajdawi@hotmail.com
645288CardiovascularPhysiologyAuscultation of the heartBoards and beyondInspiration - increases with rIght (bold i in inspiration and right) and expiration - increases left. ( bold e in expiration and left)MnemonicVerified09/22/19 11:36 AMNatalieHarfordnatalie.09.97@hotmail.com
646288CardiovascularPhysiologyAuscultation of the heartThis was published by the First Aid Team. It'd be worth the ink to include it in future editions. https://firstaidteam.com/2015/09/21/mnemonic-monday-positions-of-heart-auscultation/To remember the arrangement of the auscultation sites for heart sounds, "All Physicians Take Money" indicates the Aortic, Pulmonic, Tricuspid, and Mitral sites from superior to inferior and right to left, in typical order of examination.Mnemonic10/05/19 5:50 PMRayVickeryrvickery2@liberty.edu
647288CardiovascularAnatomy and PhysiologyCardiac and vascular function curvesIndexValsalva maneuver is listed as page 293 in the index.This is wrong. It should be listed as page 288.Minor erratumI believe there's a whole section of the index that's been messed up from last year and that there will be a significant effort to fixing it this year. Accept. - HuzaifaAgreed. Index issue to be addressed separately. -LilitYes - this is a known issue and will hopefully be rectified this year.

- Sarah		Prelim accept by 2 authors + 1 editortrue06/09/19 8:12 PMRamyLawandymarcolawandy@gmail.com
648289CardiovascularPhysiologyCongenital cardiac defect associationsNot applicableRomano-Ward syndrome can have an associated pneumonic of "RomaNO-ward syndrome", as in NO deafness.MnemonicVerifiedAlready included in FA 2019. -LilitThis looks like it is already applied in the FA 2019 edition. - MK02/25/19 10:47 PMRaziHashmihashmirazi1@gmail.com
649289CardiovascularPhysiologyHeart murmursGrammar mistakeUnder the entry for PDA, there should be no apostrophe in ("PDA's"). The full text should read PDAs are continuously annoying, not "PDA's are continuously annoying."Spelling/formatting10/23/19 8:24 AMAbhishekGamiagami@jhmi.edu
650289CardiovascularPhysiologyHeart murmursNone needed.The last sentence on the page has an extra apostrophe. It should state "PDAs are continuously annoying" instead of "PDA's" as this is referencing the plural (public displays of affection) not ownership..Spelling/formatting11/25/19 11:03 PMAbhishekGamiagami@jhu.edu
651290CardiovascularPhysiologyMyocardial action potentialRX express videosAdd in the image of the cardiac mm cell with the receptors that is used in the express videos. Makes easier to visualize and break down.High-yield addition to next yearWe should take a look at the RX video illustration to analyze which one is easier to digest. -Victor MartinezVerifiedI've been on the video review board for the new RX videos that are about to come out and am not sure which video illustration is mentioned here. We should try to find the said video perhaps? However, with the new videos coming in, I'm not sure if this is completely necessary. -Lilit02/15/19 8:44 AMJoannaGeorgakasjoanna_georgakas@brown.edu
652290CardiovascularPhysiologyOther antiarrhythmicshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516287/"Funny TaLK": The order of channels opening in pacemaker cells is “Funny”(If channel) – Phase 4, “TaL” Calcium T channel and then Calcium L channel – Phase 0, “K” Potassium channel – Phase 3MnemonicVerifiedIt's a clever way of remembering the sequence of events, even though not particularly in the order of phase 0 to phase 4. However, I think this might still go along with the illustration following the text. Although I don't think this will help too much for complete understanding of the physiology, it can be a good start for some students. Perhaps we can consider adding this mnemonic. -LilitAmbivalent about this suggestion but leaning towards accepting. It is reasonably high yield to know the order of the channels opening. On the other hand, it is not nearly enough to only know the order when the events of each phase must also be understood. -Mitchell Katona04/20/19 11:13 AMRyanBenderrbender49@gmail.com
653290CardiovascularPhysiologyPacemaker action potentialBoyett MR. Sophisticated architecture is required for the Sinoatrial node to perform its normal pacemaker function. J Cardiovasc Electrophysiol 2003In Phase 0 there is a slow Na/Ca inward current (Type T Ca channels open at -50). Theres a decrease in K efflux as K channels close. In the book you have: "there's a slow Na/K inward current" which makes it confusing. Should remove the K from that sentence and maybe add closure of repolarizing K channels .Clarification to current textVerifiedThe slow Na/K mixed inward current is the role of If channels and to remove K from this statement would be wrong. The repolarizing K channels are a separate entity, that the student must be confused about here. -LilitRecommend rejecting. I believe student is confusing role of If channels. Na/K inward current refers to If channels, so removing K as is suggested here would make If and INa channels (in the myocardial action potential) ambiguous and is simply less accurate. The second recommendation to add "closure of repolarizing K channels" is probably superfluous, but it is true that slow deactivation of IK channels contributes to pacemaker activity, so that addition could be considered. Source: Boron. Medical Physiology, 3e. pp485-8. -Mitchell KatonaAgree with Mitchell and Lilit.
Reject.

Sarah		Reject by 2 authors + 1 editor03/11/19 12:28 PMPaolaDel Cuetopaoladelcueto@gmail.com
654291CardiovasculartruePhysiologyElectrocardiogramhttps://www.cvphysiology.com/Arrhythmias/A003Speed of conduction is incorrect, it is listed in the text as: Purkinje >atria > ventricles> bundle of His >AV node. It should be His-Purkinje > atria > ventricles > AV nodeMinor erratumVerifiedAgree with the student's suggestion to change to His Purkinje > atria > ventricles > AV node. - MKYes, change to His-Purkinje > atria > ventricles > AV node.

I believe this is in the published errata but needs to still be migrated to Annotate to ensure this is being changed. - SS		Prelim accept by 2 authors + 1 editorjohn.r.butterly@dartmouth.eduI agree with most of the proposed change. It should be Purkinje>His>atria>ventricles>AV nodeAccepttrue02/16/19 6:55 AMMelissaSchechtermschech@gmail.com
655291CardiovascularPhysiologyElectrocardiogramUWorldAV node blood supply comes from PDA (mostly from RCA), but in Left dominant hearts, AV node blood supply would come from LCAClarification to current textVerifiedReject. The text clarifies that PDA can arise from both the RCA and LCX (a branch of LCA). -LilitDon't think this needs to be changed, I think the info in the text is correct. I cannot find supporting evidence on this student's suggestion. -MKAgree with Lilit and Mitchell.

Sarah		Reject by 2 authors + 1 editor03/01/19 7:27 PMAlaJamalala.aljamal@hotmail.com
656291CardiovascularPhysiologyElectrocardiogramFirst Aid 2019 page 291Add mneumonic for speed of conduction: "Park AT VENTure HIgh AVenue" listed from fastest to slowest: Perkinje > ATria > VENTricles > bundle of HIs > AV nodeMnemonicVerifiedWe are changing the order of these structures (there's a note on annotate), so this mnemonic wouldn't work with that order. -LilitAgree with Lilit. -Mitchell Katona04/28/19 1:51 PMJasminShahrestanijshahrestani@gmail.com
657292CardiovascularPhysiologyBrugada syndromefirst aidhurghada Renowned for Scuba Diving(hurghada-->brugada, Renowned-->Right bundle block, Scuba -->St elevation, Diving--> Dominant)MnemonicVerified08/31/19 12:39 PMMohamedMenofymohamed.a.menofy@gmail.com
658292CardiovascularPhysiologyElectrocardiogramhttps://step2.medbullets.com/cardiovascular/120019/supraventricular-tachycardiaParoxysmal supraventricular tachycardia. Specifically atrioventricular reentrant tachycardia was refrenced in Boards and Beyond and was tested on Uworld. High yield to know slow pathway of AV node is used also that there is slow conduction of AV node and prolongs AV node refractory period.High-yield addition to next yearVerifiedI agree with the student. I have seen board review questions testing knowledge for this condition. Consider adding to text. -LilitI agree we could include. AVNRT is the most common form of PSVT and is due to the presence of 2 conduction pathways (slow and fast) in the AV node. -MK03/01/19 11:00 AMTarekFatahiTarekf123@gmail.com
659292CardiovascularPhysiologyTorsades de pointeshttps://emedicine.medscape.com/article/157826-overview#a3The QT interval predisposes to the Torsades de point (FA2019). It would be good idea to add the normal value/range of QT interval as a reference to this information. Usually cQT interval <0.44 msec in males and <0.046 msec in females is considered normal.High-yield addition to next yearVerifiedI think I saw this suggestion as a note on annotate already, so this is already being considered perhaps? -LilitThis info may be beyond the scope of Step 1 - MK02/28/19 3:10 PMMurliMishramm.murli@gmail.com
660292CardiovascularPhysiologyTorsades de pointeshttps://www-uptodate-com.proxy1.library.jhu.edu/contents/acquired-long-qt-syndrome-definitions-causes-and-pathophysiology?search=fluoroquinolones%20torsades&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2For the ABCDE mneumonic, it mentions that Antibiotics (eg, macrolides) are a cause of drug-induced QT. In the Microbiology Pharmacology section of First Aid (and UpToDate), it lists both macrolides and fluoroquinolones as capable of prolonging the QT interval.High-yield addition to next yearConsider adding fluoroquinolones in the parenthesis along with macrolides. However, maybe implement this change in the pharmacology section, rather then CV? Each drug class only gives 1 example in the cardio section, it's not meant to be a comprehensive list. -LilitAgree with student. Some fluoroquinolones can prolong QT interval. Add antiBiotics (e.g. macrolides, fluoroquinolones). -MK03/26/19 4:02 PMNankiHurananki.hura@gmail.com
661292CardiovascularPhysiologyTorsades de pointeshttps://www.uptodate.com/contents/congenital-long-qt-syndrome-pathophysiology-and-genetics#H973343666It should be included that the "vast majority" of congenital long QT syndromes are caused by mutations leading to dysfunctional potassium channels. This is a commonly tested concept because potassium channels are a major contributor to the physiology regarding the QT length in the cardiac cycle.High-yield addition to next yearInclined to accept this one. According to the source, at least 2/3 of all CLQT syndrome cases are due to loss of function mutations of potassium channels, while 5-10% are due to gain of function sodium channel mutations. 2/3 is a significant majority. Perhaps we can add in parenthesis "most commonly due to loss of function K+ channel mutations." -LilitAgree with Lilit. Would be best for the fact to read: "...typically due to ion channel mutations (most commonly due to loss of function K+ channel mutations)" -Mitchell Katonatrue05/01/19 11:07 AMLeeSeiferlseif002@fiu.edu
662292CardiovascularPhysiologyTorsades de pointeshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474834/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3461497/ https://www.ncbi.nlm.nih.gov/pubmed/19668779A decrease in function mutation affecting the KCNH2 gene is one of the most common causes of congenital long QT syndrome .High-yield addition to next yearThere have already been changes implemented for this section during first pass. I don't think specific genes should be included, but we did address the fact that majority of cases of CLQT syndrome are caused by loss of function K channel mutations. This information should be enough. -LilitI agree that the current info in the text stating that there is a loss of function of K channels is sufficient. Don't think it's high yield to mention the specific gene. - Huzaifa06/16/19 3:29 AMMuhanadShaibmohanad.shaib@gmail.com
663292CardiovascularPhysiologyWolff-Parkinson-White syndromen/aWolff-Parkinson-White syndrome remember the initials "WPW": W - for delta Wave, P - for PR interval shortened, W - for Widened QRS complexMnemonicVerifiedThis actually sounds nice. Perhaps we can include this mnemonic. -LilitAgreed. This is a good mnemonic. -Mitchell Katona05/01/19 8:24 PMMaria LouiseAvenidolouise_a27@yahoo.com
664293CardiovascularPhysiologyECG tracingshttps://www.physiology.org/doi/full/10.1152/physrev.00031.2009Under atrial fibrillation, I recently came across a question asking about a specific anatomic location for the trigger of the aberrant electrical activity. "With prior atrial remodeling from a variety of factors, ectopic activity originating from the pulmonary veins (more likely) can occur, leading to longer episodes of afib."High-yield addition to next yearAgree with this. UTD has more detailed into. -Lilit https://www.uptodate.com/contents/mechanisms-of-atrial-fibrillation?search=atrial%20fibrillation%20pathophysiology&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H11423999I agree with the student. The pulmonary veins are the most frequent location of the ectopic foci that cause atrial fibrillation. I also noticed a similar comment on annotate marked "defer to 2020" -MK04/17/19 11:08 AMParthPatelmparth25@gmail.com
665294CardiovascularPhysiologyBaroreceptors and chemoreceptorsmnemoniccarotid Sinus vs. carotid bO2dy: Carotid SinuS: measures preSSure. Carotid bO2dy measures O2MnemonicVerifiedGood memory hook. Carotid body doesn't only respond to changes in oxygen, however the "O" in body is still a good way to remember its chemoreceptor role. Leaning towards accepting this one. -LilitAgree, it's better than anything we currently have and does help with remembering the functions. Comfortable accepting this one. - Huzaifa07/30/19 2:34 PMPaolaDel Cuetopaoladelcueto@outlook.com
666295CardiovascularPhysiologyCapillary fluid exchangeNot needed.Used as an example of a great number of facts that are not listed correctly in the index. Page numbers are off by quite a bit.Clarification to current textThe student is correct, on the current index " Capillary fluid exchange" is listed on pages 300 and 692, but it should be "pages 295 and 692." It is an easy fix. -Victor MartinezVerifiedThis is already being addressed.Reject by 2 authors + 1 editor01/12/19 10:17 AMEvanCrockettEvan Crockett
667295CardiovascularPhysiologyCapillary fluid exchangeMnemonicHydrostatic pressure pushes fluid out of a compartment/vessel = arrows pointing out from the tips of the "H". Oncotic pressure pulls fluid in to a compartment/vessel = arrows pointing in to the center of the "O" (like spokes on a wheel). Clarifying image attached.MnemonicThe illustration depicts clearly the basic concepts of hydrostatic and oncotic pressures with filtration and absorption. I don't believe it needs further clarification with a mnemonic. -Victor MartinezVerifiedI don't think this mnemonic is useful at all. The illustration very clearly depicts this phenomenon. Reject. -LilitI think either the image or the mnemonic could be used to describe hydrostatic and oncotic pression. - MK02/06/19 10:17 PMMatthew J.Christensenmattchristensen607@gmail.com
668295CardiovascularPhysiologyCapillary fluid exchangehttps://emedicine.medscape.com/article/157452-overviewMnemonic to remember order of net fluid flow equation= Kf [(Pc-Pi)- sigma(πc-πi)] Mnemonic: CiCi's Pizza π. Subtract Interstitial pressure (i in CiCi) from Capillary pressure (CiCi) P comes first (Pizza) and then π comes second in the equation.MnemonicVerified09/11/19 12:54 PMTiffanyHollandtiffany.holland@tamu.edu
669296CardiovascularPathologyCongenital heart diseaseshttps://www.uptodate.com/contents/tricuspid-valve-tv-atresiaTricuspid atresia needs both an ASD and a VSD/PDA to survive (in patients without a VSD, a PDA is needed to get blood into the lungsMinor erratumVerifiedI think this has more to do with subtypes of tricuspid atresia, based on presence/size of associated cardiac lesions. Adding more information as suggested would be unnecessary for Step 1 knowledge. -LilitDon't think this is necessary - beyond scope of Step 1. - MKAgree with Lilit and Mitchell - LY information.Reject by 2 authors + 1 editor02/27/19 8:13 PMSubhadraAcharyasxa089@jefferson.edu
670296CardiovascularPathologyCongenital heart diseasesnot neededIsolated Ebstein anomaly is not associated with any type of shunting, so I suggest putting it under the "other anomalies" along with the coarcation of Aorta on page 297Major erratumVerifiedLink from uptodate listing listing associated cardiovascular defects in einstein anomaly. -Lilit https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-ebstein-anomaly?search=ebstein%20anomaly&source=search_result&selectedTitle=1~46&usage_type=default&display_rank=1#H977796647Don't think this needs to be changed. Ebstein's anomaly often has an ASD or PFO which results in right-to-left shunting. https://www.sciencedirect.com/topics/medicine-and-dentistry/ebsteins-anomaly. - MKAgree with Lilit and Mitchell. Current text is accurate and does not require any change.

Sarah		Reject by 2 authors + 1 editor03/01/19 7:31 PMAlaJamalala.aljamal@hotmail.com
671296CardiovascularPathologyCongenital heart diseaseshttps://emedicine.medscape.com/article/2035949-clinicalNot all of congenital cyanotic heart diseases become evident immediately after birthMajor erratumDon't consider this a major erratum. In fact, the text doesn't even say that all congenital heart heart diseases present with cyanosis immediately after birth. The sentence says "often" and so I think it should be left as is. -LilitAgree with Lilit, plus this specifically is about right-to-left shunts, so I'm comfortable with the text saying it often presents with early cyanosis. - HuzaifaI agree with the authors. I don't think further clarification is necessary for the purposes of Step 1. - SarahReject by 2 authors + 1 editor05/16/19 8:56 AMRaedAbabnehraedababneh@gmail.com
672296CardiovascularPathologyCongenital heart diseasestrueNelson Essential of Pediatrics 7th edition page 501 or https://medlineplus.gov/ency/article/001111.htmPersistent truncus arteriosusis is not right to left shunt , it is cyanotic because of the mixing of the right and left sides blood. In overall, the blood shunted from left to rightMajor erratumUnfortunately I don't have access to this textbook but do see the point here. However, the student's assumption here is that right-to-left shunt is what's causing the cyanosis. Persistent truncus arteriorsus presents with cyanosis as a result of free mixture of oxygenated and deoxygenated blood. Technically Right-Left Shunts occur when oxygen-poor blood from the right heart flows in the left heart without passing through functional, ventilated alveoli. In this case however, some of the oxygenated blood is pumped back to the lungs too. Since the path of least resistance is to the lungs, most of the blood pumped will go into the lungs and pulmonary circulation will be overloaded. So, I can see the confusion here. Persistent truncus arteriosus is classified as a congenital cyanotic heart disease with admixture physiology, so I would defer to experts on this. Is it wrong to call this a right-to-left shunt, if blood flow is mostly directed to the pulmonary circulation? Or can this still be considered a right-to-left shunt because of mixing of oxygenated and deoxygenated blood? I found this paper that discusses the physiology of these conditions (listing both PTA and TAPVR displaying admixture physiology). -Lilit https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104535/Agree that we should have expert faculty review this. Couldn't find a primary source that clarifies this, but found a presentation from Columbia University that states there's both left to right and right to left shunting. http://www.columbia.edu/itc/hs/medical/pathophys/cardiology/2009/righttoleftshuntsBW.pdf - HuzaifaGreat discussion! Thanks, Lilit and Huzaifa, for your excellent research into this topic and discussion.
As far as I understand persistent truncus arteriosus is initially a left-to-right shunt with mixing of the blood but with time turns into a right-to-left shunt (Eisenmenger) syndrome.
I agree that it would be best to get faculty input here to ensure the current text is correct, or add a clarifying note (eg, initially left-to-right shunt with mixing of oxygenated and deoxygenated blood, can progress to right-to-left shunt).

Migrating to Annotate for discussion and faculty input.

- Sarah

https://www.ncbi.nlm.nih.gov/books/NBK534774/		Disagreement/need experttrue05/16/19 9:53 AMRaedAbabnehraedababneh@gmail.com
673296CardiovascularPathologyCongenital heart diseasesNelson Essential of Pediatrics 7th edition page 501 or https://www.cdc.gov/ncbddd/heartdefects/tapvr.htmlTotal Anomalous Pulmonary Venous Return is not left to right shunt , it is cyanotic because of the mixing of oxygenated and deoxygenated blood in the right atrium and that blood shunted to the rightMinor erratumIn line with the above discussion, TAPVR is also considered a CHD with admixture physiology, so I defer this to expert faculty as well, for the same reasons. Any other input from others will be much appreciated. -LilitHm TAPVR isn't even under left to right shunt in FA, it's listed under right to left, and the text specifically says right to left shunt. There is an obligatory right to left shunt at the atrial level to support systemic flow. In favor of rejecting this one. - Huzaifa05/16/19 9:56 AMRaedAbabnehraedababneh@gmail.com
674296CardiovascularPathologyCongenital heart diseaseshttp://www.dynamed.com/topics/dmp~AN~T115146/22q11-2-deletion-syndromeAssociated with 22q11 syndromes (instead of DiGeorge syndrome). Additional comment: DiGeorge syndrome is a commonly used synonym for 22q11.2 deletion syndrome. Historically a clinical diagnosis of DiGeorge syndrome could be made in the absence of genetic testing, but today it should be reserved for patients in whom 22q11.2 deletion has been excluded and genetic etiology remains unknown. In this topic "DiGeorge syndrome" is used only when genetic etiology is unknown or unreported.Clarification to current textInclined to accept this. TOF is also associated with velocardiofacial syndrome, which is also due to a deletion on chromosome 22q11.2. I think using a broader term like 22q11.2 deletion syndrome is probably a better option. Thoughts? -LilitI think perhaps consider expert review. According to the NIH, DiGeorge syndrome, and a few other names for this condition, are all variants of 22q11.2 deletion syndrome. But to avoid confusion 22q11.2 deletion syndrome is used. So I'm in favor of agreeing and changing per the suggestion. - HuzaifaI agree with the authors. This is not an erratum but it would be more accurate to generalise this to 22q11 syndrome (which we use more consistently throughout the book).

- Sarah		Prelim accept but NOT publishable erratatrue06/10/19 8:26 PMEstefaníaHenríquez Luthjeehenriquezluthje@gmail.com
675297CardiovascularPathologyAnatomy of the heartMade it upMneumonic for findings in Coarctation of the Aorta: ABCDE's --> A: berry Aneurysms, B: Bicuspid aortic valve, C: Costal notching, D: Delayed pulse in LE, E: EndocarditisMnemonicVerifiedAgree with second author. Some of these are associations, while others are direct effects of the condition. Mixing them up into a single mnemonic might confuse students. -LilitReject. Some of these refer to complications of coarctation while others are associations. I think combining these is not the best way to understand this material. -MK03/27/19 2:09 PMNankiHurananki.hura@gmail.com
676297CardiovascularPathologyCardiomyopathieshttps://www.uptodate.com/contents/genetics-of-dilated-cardiomyopathy?search=Genetics%20of%20dilated%20cardiomyopathy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Idiopathic dilated cardiomyopathy could be familiar: defect in gene TTN that codes for protein titin.High-yield addition to next yearI am inclined to reject this addition. It is not HY, the TTN gene is part of many skeletal and cardiac syndromes. But, it is not commonly tested. -Victor MartinezVerifiedI don't think this is HY enough to add. Also is this supposed to be referencing p 305? - EPI agree that this is not high-yield enough to be added. - MK01/16/19 12:33 AMNeryMaraLamothemaralamothe@hotmail.com
677297CardiovascularPathologyCongenital heart diseaseshttps://www.pediatricheartspecialists.com/blog/55-down-syndrome-and-congenital-heart-diseasenot only atrial septal defect associated with Down syndrome. In fact, the most common heart defects in Down syndrome are the following: atrioventricular septal defect, or AV canal defects (45%), ventricular septal defects (35%), secundum atrial septal defects (8%), and patent ductus arteriosus (7%).Minor erratumAV canal defects are mentioned in the Biochemistry chapter under "Down Syndrome" and in this chapter we just point out one high yield association. I don't think it is necessary to list everything here (should be in the biochem chapter if I had to pick one). Do you guys think the incidence rates of these defects are necessary to include in the book? I personally don't think it's needed, since we mentioned the MOST common congenital heart defect already. -LilitSince we've mentioned the most common, I don't think it's high yield to mention incidence rates. - HuzaifaI agree with the authors. The incidence of these is LY for Step 1.

- Sarah		Reject by 2 authors + 1 editor05/16/19 10:14 AMHalimaAloumraedababneh@gmail.com
678297CardiovascularPathologyCongenital heart diseasesnot neededIt is better to mention " PDA is normal in utero and normally closes only after birth." and "Patency is maintained by PGE synthesis and low O2 tension." below "In fetal period, shunt is right to left (normal)." since all of them discuss the ductus arteriosus before birthClarification to current textI think what we have in the text is fine. The embryology section along with PDA fact is enough to draw these conclusions. No changes are necessary. -LilitI believe what the student is suggesting is a reorganization of the existing text in the PDA fact. I think the current text flows fine though. No changes necessary. - HuzaifaAgree with the authors. The current text is fine and factually correct.

- Sarah		Reject by 2 authors + 1 editor05/16/19 12:29 PMRaedAbabnehraedababneh@gmail.com
679297CardiovascularPathologyCongenital heart diseasesn/a“TURN into an ARC” coARCtation of aorta associated with TURNer syndromeMnemonicVerifiedI don't like this, not catchy enough. Reject. -LilitI don't mind this mnemonic actually. Could improve on it by doing something like "Turn By the Arc" to show association of Turner syndrome and bicuspid aortic valve with coarctation. - Huzaifa07/08/19 2:18 PMAPandeyaranikopandey@gmail.com
680297CardiovascularPathologyCongenital heart diseasesn/a“Feeling DOWN to have A Septal Defect” DOWN syndrome associated with Atrial Septal DefectMnemonicVerifiedAgain, not catchy, wouldn't add much to the content and would take up too much space. Reject. -LilitReject, would be hard to remember. - Huzaifa07/08/19 2:20 PMapanikopandey@gmail.com
681297CardiovascularPathologyCongenital heart diseasesoriginal mnemonicDSLR mnemonic for left to right shunts (vsD, asD, pDa), D Shunts are Left to RightMnemonic11/24/19 12:21 PMJinsungKimjinsungkim@einsteinmed.org
682297CardiovascularPathologyCongenital heart diseasesoriginal mnemonic, previous submission had wrong emailDSLR for left to right shunts (vsD, asD, pDa), D Shunts are Left to RightMnemonic11/24/19 12:24 PMJinsungKimjinsung.kim@einsteinmed.org
683298CardiovascularPathologyCongenital cardiac defect associationsStep prep question on USMLE RX.The entry for Turner Syndrome under congenital cardiac defect associations should specify that these individuals are at risk for *juxtaductal* aortic coarctation.High-yield addition to next yearThis fact is already stated on the congenital heart diseases entry, page 297. The congenital cardiac defect associations table (page 298) provides an easy/quick association between the disorder and defect, so I would not add "juxtaductal" since it is redundant. -Victor MartinezVerifiedSays so already on page 297. Reject. -LilitI don't think this needs to be added. Turner Syndrome is discussed in detail on pg 297 and "juxtaductal: is included. The chart on 298 is meant to be a brief summary. - MK01/11/19 3:40 PMHalleyAlbertshalley8236@yahoo.com
684298CardiovascularPathologyCongenital cardiac defect associationshttps://www.uptodate.com/contents/congenital-cytogenetic-abnormalities?search=edwards%20syndrome&source=search_result&selectedTitle=1~76&usage_type=default&display_rank=1#H11Ventricular septal defects and patent duct arteriosus are the most common defects in Edwards syndrome presenting in neonates.High-yield addition to next yearOf course it's important to know this information. However, VSD and PDA don't only present in neonates with Edwards syndrome. There are many other conditions/diseases these cardiac defects are associated with. We don't have to list these and all the rest, as I think it is higher yield to be able to identify these defects based on physical exam findings provided in most question stems. -LilitRecommend accepting. Edwards is as high yield as the other syndromes and identifying the two most common defects would be a good addition. -Mitchell Katona03/21/19 3:11 AMNicolasCuri Gawlinskinicolascurii@gmail.com
685298CardiovascularPathologyCongenital cardiac defect associationsNot neededInfant of a (DI)abetic mother ---> {(2)switched vessels, Transposition}Mnemonic09/30/19 2:25 AMMamounSouleimanmamoon1995@hotmail.com
686298CardiovascularPathologyFeatures of renal disordersIndexFibromuscular Dysplasia is listed in the index as page 303. This is wrong. It should be listed as page 298 and 592Minor erratumThis will be resolved at the end of the editing process. Page numbers may change. -LilitIndex team will address. - HuzaifaYes - this is a known issue and will hopefully be rectified this year.

- Sarah		Prelim accept by 2 authors + 1 editortrue06/08/19 9:13 PMMikeLawandymarcolawandy@gmail.com
687298CardiovascularPathologyHypertensionhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634904/ https://www.uptodate.com/contents/overview-of-hypertension-in-adults?search=hypertension%20risk%20factors&sectionRank=1&usage_type=default&anchor=H8&source=machineLearning&selectedTitle=1~150&display_rank=1#Diabetes and smoking are not risk factors for hypertension. In fact, smoking is associated with lower blood pressureMinor erratumREJECT, there is a well-established association between smoking and high blood pressure. -Victor MartinezVerifiedFalse - will not change text - EPReject.Reject by 2 authors + 1 editor01/22/19 9:26 AMHasanAlarourihassan.arouri@hotmail.com
688298CardiovascularPathologyHypertension1. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. https://www.ncbi.nlm.nih.gov/pubmed/24352797. Published February 5, 2014. Accessed May 28, 2019. 2. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. https://www.ncbi.nlm.nih.gov/pubmed/12748199. Published May 21, 2003. Accessed May 28, 2019.Hypertension is defined as ‘persistent systolic BP > 130 mmHg and/or diastolic BP > 80 mmHg.’ I think the SBP and DBP values should be revised as follows: JNC-8 and JNC-7 define pre-hypertension as SBP >120 mmHg and/or diastolic BP > 80 mmHg, while hypertension is persistent SBP >140 mmHg and/or DBP > 90 mmHg (in otherwise healthy individuals), or >130/80 mmHg for patients with diabetes and chronic kidney disease. Thus, I suggest 1) changing 130 mmHg to 140 mmHg, (2) changing 80mmHg to 90mmHg, (3) including the phrase ‘or >130/80 mmHg for patients with diabetes and chronic kidney disease.’ and possibly (4) including the definition of pre-hypertension as SBP 120-139 mmHg and/or DBP 80-89 mmHg.Major erratumReject. These numbers were updated according to ACC/AHA guidelines. -LilitAgree with Lilit, these numbers are according to ACC/AHA guidelines. - HuzaifaAgree with the authors. The current text is accurate.

- Sarah		Reject by 2 authors + 1 editor05/28/19 5:31 AMVardanHambardzumyanhambvart@yahoo.com
689298CardiovascularPathologyHypertensionhttps://emedicine.medscape.com/article/241381-overviewThe First Aid 2019 states the following: "Hypertension: Persistent systolic BP > 130 mm Hg and/or diastolic BP > 80 mm Hg", which is a mistake, as the latest guideline from the American College of Cardiology/American Heart Association states the following: Hypertension: Persistent systolic BP ≥130 mm Hg and/or diastolic BP ≥80 mm Hg.Major erratumEqual signs will be added in the 2020 edition. This was already addressed during our first pass. -LilitHas been addressed. - HuzaifaAlready actioned during Pass 1.

- Sarah		Reject by 2 authors + 1 editor07/23/19 7:15 PMDomingoReynoso Saldanadr.domingoreynoso@gmail.com
690299CardiovascularPathologyBaroreceptors and chemoreceptorsno linkIn Index you will find "Carotid Massage p. 299" this is incorrect. Correct page number is 294.Major erratumThis will be addressed by the index team. -LilitPer Lilit, this will be addressed by index team. - HuzaifaYes - this is a known issue and will hopefully be rectified this year.

- Sarah		Prelim accept by 2 authors + 1 editortrue05/24/19 9:42 AMNicola HelenDuzaknhampel@mail.sjsm.org
691300CardiovascularPathologyAortic aneurysmhttps://www.sciencedirect.com/science/article/pii/S107858849990864XAAA (3 A's) is sometimes due to a defect in the gene encoding for type III procollagenMnemonicVerifiedI've never seen familial/genetic factors mentioned in board preparation books for AAA. Rejecting this suggestion. Smoking, HTN and atherosclerotic disease are the highest yield for this topic. -LilitReject, this is low yield as far as I know. - Huzaifa07/30/19 2:07 PMPaolaDel Cuetopaoladelcueto@outlook.com
692300CardiovascularPathologyAortic aneurysmhttps://www.ncbi.nlm.nih.gov/books/NBK470237/Add Hypercholesterolemia as one of the major causes of Abdominal aortic aneurysmClarification to current text08/26/19 5:54 PMJudithVásquezjudith.vasquez.11@gmail.com
693300CardiovascularPathologyAortic aneurysmhttps://emedicine.medscape.com/article/1979501-clinical#b1"May cause abdominal and/or back pain, which is a sign of leaking, dissection, or imminent rupture." Should also mention that the sudden onset abdo ± back pain can be a sign of "ruptured AAA" (i.e. not just imminent, but the AAA has ruptured). Any patient with sudden onset "tearing" abdo ± back pain who comes in with hemodynamic instability on a b/g of CV risk factors, should have AAA as a differential high on the list.Clarification to current text08/27/19 6:24 AMAnthony MartinLimanthony.m.lim@gmail.com
694300CardiovascularPathologyAtherosclerosisAorta. COronary. POpliteal. CArotid.A COPy CAtMnemonicWe already have a story mnemonic to remember the location of atherosclerosis. However, I do like this student's mnemonic since it is quite simple and includes all the arteries too. -Victor MartinezVerifiedI like this mnemonic a lot more than the story, as it seems easier to remember. It's a short phrase, rather than a long sentence. I would suggest replacing the story. -LilitI think this student's mnemonic may be easier to remember than the current "story" that is used on pg 300. It is short and simple and includes all of the affected arteries. - MKtrue02/08/19 10:47 AMMohamedElashwalmelashwal@outlook.com
695300.00IndexPhysiologyNormal cardiac pressures2019 First Aid for the USMLE Step 1The index says that you can find the "Swan-Ganz catheter" on page 300. There's no mention of it on that page, it is instead mentioned on page 295. The same thing applies to PCWP (Pulmonary capillary wedge pressure).Minor erratumThis appears to be an index issue, can be addressed by the index team. -Lilit05/07/19 1:58 PMPablo EmanuelRamirezpablorc@sanjuanbautista.edu
696301CardiovascularPathologyIschemic heart disease manifestationshttps://emedicine.medscape.com/article/155919-overview#showallSTEMI have characteristic of ST elevation and pathological Q wave. FA2019 mentions Q wave but is missing term "Pathological". It is very important to differentiate between pathological and physiological Q waves.Clarification to current textVerifiedI agree with the suggestion. There are physiologic and positional effects that contribute to Q waves on ECG. We can add the word "pathological." -Lilit https://www.uptodate.com/contents/pathogenesis-and-diagnosis-of-q-waves-on-the-electrocardiogram?search=physiologic%20q%20wave&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2Technically correct- we could add "pathologic" before Q waves. - MKAgree.

Sarah		Prelim accept but NOT publishable erratatrue03/03/19 10:47 AMMurliMishramm.murli@gmail.com
697301CardiovascularPathologyKussmaul signhttps://www.uptodate.com/contents/constrictive-pericarditis?search=Constrictive%20pericarditisConstrictive%20pericarditis&source=search_result&selectedTitle=2~95&usage_type=default&display_rank=2Constrictive pericarditis could be a complication of radiation therapy of non-honking lymphoma.High-yield addition to next yearI agree we could consider adding constrictive pericarditis to the next edition, this will lead to a further discussion on if we should place it in the cardiac tamponade entry or as a separate fact. -Victor MartinezVerifiedI think there's no need to add a new fact or include a new section on constrictive pericarditis. Any inflammatory process that results in pericardial inflammation/effusion will lead to fibrosis (hence lead to constrictive pericarditis). This phenomenon should be mentioned briefly with "Acute pericarditis" on page 308, as radiation therapy is already listed as a risk factor. -LilitI agree we could add constrictive pericarditis as a complication of radiation therapy, non-Hodgkin lymphoma, TB. Presents with Kussmaul sign, pulsus paradoxus, signs of right HF. I think this would need to be a separate fact rather than included with cardiac tamponade. - MK01/17/19 2:08 AMNeryMaraLamothemaralamothe@hotmail.com
698302CardiovascularPathologyEvolution of myocardial infarctionPathomaafter reperfusion due to influc of Ca leads to contraction; that is called (contraction band necrosis)Minor erratumVerifiedAccording to uptodate, necrosis is a result of myocyte hypercontracture. There are several factors that contribute to hypercontracture which are listed in the link below. Hypercontracture itself can then contribute to additional injury, LEADING to "contraction band necrosis." I would appreciate editor as well as expert input on this. -Lilit https://www.uptodate.com/contents/reperfusion-injury-of-the-heart?search=contraction%20band%20necrosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H5I think we could add (contraction band necrosis) next to the already discussed "hypercontraction of myofibrils through increased free calcium influx." -MKtrue03/01/19 7:28 PMAlaJamalala.aljamal@hotmail.com
699303CardiovascularPathologyDiagnosis of myocardial infarctionhttps://www.acc.org/latest-in-cardiology/ten-points-to-remember/2017/08/14/12/31/eliminating-creatine-kinase-myocardial-band-testingCK-MB is no longer recommended in the diagnosis of reinfarction following acute MI (ACC/AHA 2013 Guidelines)Major erratumAs per the student's link, the article proposes the elimination of CK-MB testing in suspected ACS. However, according to UTD " Reinfarction and late diagnosis- since CK-MB levels return to baseline 36 to 48 h after infarction, resampling can be used to detect very early infarction. Since cTn does not normalize that rapidly, it has been suggested that CK-MB might be value in this area. It is now clear that cTn increases rapidly, albeit from an abnormal baseline in patients with reinfarction." https://www.uptodate.com/contents/biomarkers-of-cardiac-injury-other-than-troponin?search=reinfarction&source=search_result&selectedTitle=4~104&usage_type=default&display_rank=4 I would leave the current text as is since the step 1 evaluates that CK-MB levels return to baseline 1 to 2 days after rising, and our wording is appropriate according to UTD. -Victor MartinezVerifiedWe can amend the text to make note that CK-MB is not routinely used to assess for re-infarction. Do not think this is MAJOR erratum - EPReject, CKMB is still used for repeat infarcts sometimes.Reject by 2 authors + 1 editor12/26/18 11:32 PMGenevievePentecostgspf66@health.missouri.edu
700303CardiovascularPathologyDiagnosis of myocardial infarctionhttps://emedicine.medscape.com/article/811905-overviewAlthough Myoglobin was deemed unnecessary, it should be added to graph as a note stating that it rises prior to Troponin after MI and declines rapidlyHigh-yield addition to next yearReject. This is not a high yield concept. -LilitReject. I don't think this is high yield. -MK04/09/19 11:09 AMAna CatarinaJacinta Fernandesa46845@ualg.pt
701303CardiovascularPathologyDiagnosis of myocardial infarctionRobbins and Cotran Pathologic Basis of Disease, Ninth Edition - Chapter 12, Under section "Myocardial Infarction" - "Troponins I and T are not normally detectable in the circulation. Following an MI, levels of both begin to rise at 3-12 hours."In the book, it says "Cardiac troponin I rises after 4 hours" but it is actually 3 hours.Minor erratum09/01/19 7:00 PMYuhungChouychou@student.uiwtx.edu
702303CardiovascularPathologyECG localization of STEMIn/aA Smart LAD scores 1st/2nd = LAD obstruction - AnteroSeptal infarct with V1-V2 ST elevation An Average LAD scores 3rd/4th = LAD obstruction - AnteroApical infarct with V3-V4 ST elevation A Lazy LAD scores 5th/6th = LAD obstruction - AnteroLateral infarct with V5-V6 ST elevationMnemonicVerifiedI find this very catchy. Perhaps we can include this? We certainly have space on that page. -LilitHmm it takes a bit to learn the actual mnemonic but I guess it gets the job done. I'm not sure, I don't like mnemonics where I feel I need to learn the mnemonic to learn the fact, but if it works for others and there's space then we could include. I was confused first at how this mnemonic worked. The S in Smart corresponds to the S in Septal, A in Average with A in Apical, L in Lazy with L in Lateral, so these will all get mnemonics treatment if included. - Huzaifa07/08/19 2:21 PMaPandeyaranikopandey@gmail.com
703304CardiovascularPathologyAcute coronary syndrome treatmentsJust turned the text in FA2019 into a mnemonicMONA BASH - Morphine Oxygen Nitroglycerin Aspirin (antiplatelet) Beta blocker ACEi Statins and Heparin (anticoagulation)Mnemonic12/15/19 6:52 PMMarcMarc El Khourymarkkhoury96@gmail.com
704305CardiovascularPathologyCardiomyopathieshttp://www.onlinejacc.org/content/23/3/586Important cause of dilated cardiomyopathy is coronary artery diseaseHigh-yield addition to next yearI agree we should add this cause to the next edition and it can be part of the ABCCCD mnemonic by adding an extra C (Coronary artery disease). -Victor MartinezVerifiedAgree adding CAD to cause of DCM. -EPAgree with adding CAD to a cause of DCM and including an extra C in the mnemonic ABCCCCD. - MKjohn.r.butterly@dartmouth.eduyes - absolutely. Ischemic heart disease is the number 1 cause of dilated systolic dysfunction in the US (but this might be a semantic issue as dilated cardiomyopathy is generally thought of as non-ischemic causes) so really a matter of definition.nish7886@gmail.comi think we should include it. DCM is more of a phenotype, and ischemia in addition to multiple other things can lead to this phenotype. it's important that we break the semantic issue John brings up -- totally agree with him.true01/08/19 10:51 AMFatimaMirzafatimanmirza@gmail.com
705305CardiovascularPathologyCardiomyopathieshttps://emedicine.medscape.com/article/153153-overviewI recommend changing the ABCCCD mnemonic to ABBCCCD (i.e. add a B). The extra B stands for "birth" -- thus incorporating peripartum cardiomyopathy as a cause of dilated CM. This also improves the mnemonic such that there is 1 A, 2 B's, and 3 C's to make it more memorable as the number corresponds to the letter position in the alphabet.MnemonicIt is a good suggestion. We could consider adding an extra B to the mnemonic to include Birth (peripartum cardiomyopathy) as one of the causes of dilated cardiomyopathy. -Victor MartinezVerifiedI like this suggestion. Peripartum cardiomyopathy has popped up on UWorld once or twice. The addition is minor and wouldn't add too much to the existing text. -LilitAlso agree with this addition to the mnemonic as permpartum cardiomyopathy is a significant cause of dilated CM. This would make the new mnemonic ABBCCCCD if you include the above change as well. - MKtrue01/19/19 6:04 PMAnthonyDeMarinisard3@uab.edu
706305CardiovascularPathologyCardiomyopathieshttps://www.ncbi.nlm.nih.gov/pubmed/22335739Came across a question on UWorld asking about sudden death in young man. I've always associated sudden death HOCM with sarcomeric mutations. However, familial cases in dilated cardiomyopathy are also associated with sarcomeric mutations specifically in the titin protein (TTN gene).High-yield addition to next yearSarcomeric mutations implies any protein involved in cardiac contractility. Beta myosin and myosin binding protein C are listed as examples in the text, but proteins such as titin, troponins T/I/C, etc may also be involved. Don't think it's worth listing all of these additional proteins, students just have to know that proteins involved in cardiac contractility are affected (which is clearly discussed in text). Here is the UTD link though. -Lilit https://www.uptodate.com/contents/hypertrophic-cardiomyopathy-gene-mutations-and-clinical-genetic-testing?search=hypertrophic%20obstructive%20cardiomyopathy%20genetics&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H22623491Would like editor input. I think the confusion for the student was in the fact that sarcomeric mutations are also seen in DCM not just HOCM, whereas in the text sarcomeric mutations are only discussed in HOCM. UTD says https://www.uptodate.com/contents/genetics-of-dilated-cardiomyopathy?search=dilated%20cardiomyopathy%20genetics&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H685023 that 30% of familial DCM is due to sarcomeric mutations. For example, beta myosin can have a mutation that causes DCM or a different mutation that causes HOCM. It may be important for students not to ONLY associate sarcomeric mutations such as to beta myosin with HOCM (on the other hand, it may be so much more common in HOCM as compared to DCM that this isn't necessary). I think we should consider adding sarcomeric mutations to the etiologies of DCM. -Mitchell Katona04/25/19 11:04 AMParthPatelmparth25@gmail.com
707305CardiovascularVirologyCardiomyopathieshttps://www.uptodate.com/contents/causes-of-dilated-cardiomyopathy?search=lyme%20myocarditis&topicRef=4935&source=see_linkABBCCCD = Alcohol abuse, wet Beriberi, Borrelia burgdorferi, Coxsackie B viral myocarditis, chronic Cocaine use, Chagas disease, DoxorubicinMnemonicVerifiedI think we decided against using this mnemonic on Annotate already. -LilitPer Lilit, reject. - Huzaifa05/07/19 8:44 PMJoyRathodjratho01@nyit.edu
708305CardiovascularPathologyCardiomyopathieshttps://www.nejm.org/doi/full/10.1056/nejmoa1110186truncating mutations that affect TTN gene which encodes for Titin protein are the most common cause of familial dilated cardiomyopathy (DCM)High-yield addition to next year"No unique clinical characteristics have been identified for these truncating mutations but adverse events may occur earlier in men than in women. The role of missense mutations, common among all patient groups, was not addressed in the study." While UpToDate does say that titin mutations are the most common known cause of DCM, I just don't think this information should yet be added to the text. I would definitely appreciate expert input for this. -Lilit https://www.uptodate.com/contents/image?imageKey=CARD%2F117134&topicKey=CARD%2F4911&search=dilated%20cardiomyopathy&source=see_link https://www.uptodate.com/contents/genetics-of-dilated-cardiomyopathy?search=dilated%20cardiomyopathy&topicRef=3516&source=see_link#H5900156I'm not sure how high yield this is either. Per the comments above, might be enough to just state sarcomeric mutations. Defer to expert input for this. - Huzaifa05/11/19 12:27 PMMuhanadShaibmohanad.shaib@gmail.com
709306CardiovascularPathologyHeart failurehttps://www.cvphysiology.com/Heart%20Failure/HF006Diastolic dysfunction causes Decrease in EDV and Increase in EDP according to the attached diagram , not normal EDVMajor erratumVerifiedI think this should be rejected. Diastolic dysfunction is a problem of ventricular filling due to impaired myocardial relaxation. Dysfunction in this process will lead to reduced early diastolic passive filling of the left ventricle. As a result, the late phase of diastolic filling (atrial contraction) will start making a bigger contribution than in an individual with normal physiology. This redistribution is the result of preserved EDV. I would appreciate editor/expert input on this subject. -Lilit https://www.uptodate.com/contents/pathophysiology-of-heart-failure-with-preserved-ejection-fraction?search=diastolic%20heart%20failure&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H19Recommend rejecting. Subject's reference is suspect. The JACC consensus is normal EDV (see below link). Anecdotally, this is a common misconception as I specifically recall from my Step studying being confused about this exact FAS1 fact and discussing with classmates. Pathophysiology of DD entails thickening of wall, which is commonly mistaken as leading to decreased EDV. Does anyone have a succinct way to clarify this? Source: http://www.onlinejacc.org/content/49/9/982. -Mitchell KatonaAgree with the authors.

Sarah		Reject by 2 authors + 1 editor03/01/19 7:34 PMAlaJamalala.aljamal@hotmail.com
710306CardiovascularPathologyHeart failureMnemonicDrugs that decrease mortality : (ABC) 1)Ace inhibitors 2)Beta Blocker 3) CpironolactoneMnemonicVerifiedI don't like the mnemonic. A simple word like "Abs" can still be more memorable and preserve the S for spironolactone. -LilitI don't think the C part (Cpironolactone) works very well for this. Reject. -MK03/05/19 10:04 PMahamdObeidatobeidat.amd@hotmail.com
711306CardiovascularPathologyHeart failurenone neededIn the pressure-volume loop diagrams, it would be helpful if the abbreviations were written out with their abbreviation in parentheses following. (I.e., "Heart failure with reduced ejection fraction (HFrEF)" and "Heart failure with preserved ejection fraction (HFpEF"). This is the only place where these abbreviations are used.Clarification to current textNot sure if this actually needs to be clarified as it could take up a lot of space. - MKAgree with Mitchell. These are also covered in the Abbreviation list at the end of the book. No need to include further detail here.

Sarah		Reject by 2 authors + 1 editor03/15/19 1:00 AMNatalieJansenjansen7@uic.edu
712306CardiovascularPhysiologyHeart failureN/ADiastolic dysfunction is associated with S4 heart sound and diastolic has 4 syllables for S4 (di-a-sto-lic --> S4) On the other hand, systolic dysfunction, which is associated with an S3 heart sound, has 3 syllables for systolic (sys-to-lic). Therefore, sys-to-lic --> S3MnemonicVerifiedReject. Inaccurate information is presented, as per link added by second author. In addition, not the best mnemonic. -LilitReject. S3 can also be heard in diastolic HF. https://www.uptodate.com/contents/auscultation-of-heart-sounds?search=s3%20s4&source=search_result&selectedTitle=1~104&usage_type=default&display_rank=1#H24 -MK04/18/19 2:42 PMJennyWeijustbeingjenny@gmail.com
713306CardiovascularPathologyHydralazineFirst aid 2019Hydralazine with nitrate therapy improves both symptoms and mortality in 'selected' patients. Text in the book says 'select'. Selected patients could be specified eg: African patientsSpelling/formattingI don't think the formatting of this sentence is off at all. As for specifying the select group of patients, its not just African Americans that benefit from combination Hydralazine/nitrate. They are also used in patients who are not tolerant of ACE inhibitors, ARBs or ARNI, as well as patients who have persistent class III/IV heart failure despite optimal medical therapy. This treatment is highly individualized, and to be this specific with defining the select group of patients is outside the scope of Step 1. -LilitAgreed with Lilit. The sentence is fine in its current form. AA patients are "classically" the select group that benefit but as Lilit said there are others and in any case this is very LY for S1. -Mitchell Katona03/17/19 7:14 AMPriyankaPriyankadr.priyankalalwani@gmail.com
714307CardiovascularPathologyBacterial endocarditisNot neededMnemonic -> Owsler nodes. Ow indicates pain and helps differentiating the hand lesions in endocarditis (Osler vs Janeway).MnemonicI am not inclined to accept or reject this mnemonic. It could help to differentiate between Osler and Janeway lesions. However, I think this difference would be more important for the step 2 clinical knowledge rather than the step 1. -Victor MartinezVerifiedReject. The text already mentions that Osler nodes are tender, whereas Janeway lesions are painless. I don't think adding a mnemonic would be useful, since both are symptoms of bacterial endocarditis. I don't think differentiating the two symptoms would be a critical factor in getting a question right on Step 1. -LilitI don't think it is an unreasonable suggestion since Osler nodes and Janeway lesions are easily confused as they are somewhat similar in appearance/location. I can say that the UWorld test bank contains a practice question (#72 in the Step 1 Qbank), which gives a description of "nontender lesions" and asks for the pathologic process with both immune complexes (Osler nodes) and microemboli (Janeway lesions) as answers. Even so, it may not be "high yield" enough for inclusion but it is possibly "testable" to know which is painful and which isn't. - Mitchell Katona01/07/19 4:05 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
715307CardiovascularPathologyShockNoticed itMissing a comma after anaphylaxis in what distributive shock is caused by. Right now it reads "anaphylaxis CNS injury," but should by "anaphylaxis, CNS injury"Spelling/formattingYes. Need to add a comma after anaphylaxis. -LilitAgree. Add comma after anaphylaxis. -MK03/27/19 5:35 PMNankiHurananki.hura@gmail.com
716307CardiovascularPathologyShockuWorldAccording to uWorld, anaphylactic shock results in decreased cardiac output, not increased. The attached figure shows a combined cardiac/vascular function curve for anaphylaxis. Anaphylaxis causes widespread venous/arterial dilation along with increased capillary permeability and third spacing , causing decrease in mean systemic filling pressure and venous return. Contractility and HR go up to compensate, but overall CO effect is still decreased.Minor erratumAccording to UpToDate, anaphylaxis can result in massive third spacing of fluid due to increased vascular permeability and result in severe intravascular volume depletion within 10 minutes. Depending on volume loss and peripheral vascular resistance, sympathetic stimulation may not be able to maintain appropriate cardiac output. I would like to get expert faculty input on this matter. -Lilit https://www.uptodate.com/contents/pathophysiology-of-anaphylaxis?search=anaphylactic%20shock&topicRef=392&source=see_link#H23I'm unable to open the figure the student has attached, but I've attached another reference showing the anaphylactic shock results in decreased cardiac output. Agree to have expert feedback on this. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877435/ - Huzaifa05/10/19 12:53 PMRobShvartsrob.shvarts@emory.edu
717307CardiovascularPathologyShockhttps://www.uptodate.com/contents/definition-classification-etiology-and-pathophysiology-of-shock-in-adults?search=shock&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H25Mnemonic for types of Shock: SANCHO. The first 3 letters are subtypes of Distributive shock (Septic, Anaphylactic, Neurogenic/CNS Injury). Rest of letters are: Cardiogenic, Hypovolemic, Obstructive.MnemonicVerifiedI don't think this is a high yield addition. Just don't think a mnemonic is necessary to remember the types of shocks. -LilitReject. Hard to remember. - Huzaifa07/19/19 2:09 PMErnestFloreseaf0182@gmail.com
718308Rapid ReviewPathologyRheumatic feverhttps://reference.medscape.com/calculator/jones-criteria-diagnosis-rheumaticHALF (minor criteria for rheumatic fever): H-Heart block (↑PR interval) A-Arthralgia “L”-Elevated ESR/CRP, Leukocytosis F-Fever Need 2 major criteria or 1 major & 2 minor criteria for diagnosis. (2 HALF make up for 1 J♥NES)MnemonicVerified01/01/19 7:03 PMSarahMcGriffscmcgriff@gmail.com
719309IndexPathologyCardiac tamponadeN/AThe fact for 'Pulsus paradoxus' below cardiac tamponade is incorrectly said to be on page 315 in the index.Spelling/formattingVerified01/04/19 12:34 PMHalleyAlbertshalley8236@yahoo.com
720309CardiovascularPathologyCardiac tamponadehttps://emedicine.medscape.com/article/157096-overviewConstrictive pericardisit : Pericardium loses its elasticity, Stiff, Thickened, sticky. Results from : Pericarditis, Radiation, Heart surgery. Symptoms of congestion - Heart cannot fill properly: Dyspnea, Raised JVP, Edema. Pulsus Paradoxus & kussmaul sign. Rapid Y desent in Jugular venous pulse curveHigh-yield addition to next yearI agree we could consider adding constrictive pericarditis to the next edition, this will lead to a further discussion on if we should place it in the cardiac tamponade entry or as a separate fact. -Victor MartinezVerifiedI believe I mentioned this in another comment, but all of these etiologies are already listed under acute pericarditis. We can just add a line about constrictive pericarditis and mention that it can lead to signs and symptoms of cardiac tamponade. It would take too much extra text if we added it with cardiac tamponade or if we created a new "constrictive pericarditis" section. Thoughts? -LilitI agree this is a necessary addition to the text. I think it should be a separate topic and not under cardiac tamponade as these are not the same thing. - MK01/10/19 2:55 PMAhmadY. ObeidatObeidat.amd@hotmail.com
721309CardiovascularPathologyCardiac tamponadehttps://www.google.com/url?sa=t&source=web&rct=j&url=https://en.m.wikipedia.org/wiki/Pulsus_paradoxus&ved=2ahUKEwiw9qv7ovzgAhVC6RoKHV8fAG4QFjAHegQICBAB&usg=AOvVaw0q8O4IojznhFHl4KwkEiWsCauses of pulsus paradoxus. CHACOT (Cardiac tamponade, constrictive pericarditis, Hypovolemic shock, Asthma, COPD, Obstructive sleep apnea, Tension pneumothoraxMnemonicVerifiedThere are many other non cardiac conditions with pulsus paradoxus. If we're going to add the suggested conditions, we should consider the rest as well. I suggest the mnemonic "Pea COAT" for what it already in the book. Pericarditis, Croup, OSA, Asthma, Tamponade. I used this and it helped me a lot. Attaching the link to more non cardiac conditions with pulsus paradoxus. -Lilit https://www.uptodate.com/contents/pulsus-paradoxus-in-pericardial-disease?search=pulsus%20paradoxus&source=search_result&selectedTitle=1~29&usage_type=default&display_rank=1#H6Agree with this. All of these can present clinically with pulsus paradoxus. -MKtrue03/12/19 5:21 AMMahamIrfanDr.irfan1691@gmail.com
722309CardiovascularPathologyMyocarditisn/a“Pulsus Paradoxus with a CrAP Cardiac Output” Croup, Asthma, Pericarditis, Cardiac tamponade, Obstructive sleep apneaMnemonicVerifiedWe have already introduced a mnemonic for pulsus paradoxus. -LilitI like the Pea COAT mnemonic better. - Huzaifa07/08/19 2:16 PMAPandeyaranikopandey@gmail.com
723310IndexIndexVasculitidesFAS1 2019Giant cell arthritis is listed as being on page 315, but it is actually on 310.Major erratumVerified01/08/19 1:18 PMChristineDiedrichchristinediedrich@yahoo.com
724310CardiovascularPathologyVasculitideshttps://www.ncbi.nlm.nih.gov/m/pubmed/23663684/ https://www.ncbi.nlm.nih.gov/m/pubmed/20457278/ https://www.ncbi.nlm.nih.gov/m/pubmed/23114585/It would be good to add that the production of cytokines, in particular Interleukin-6 (IL-6), appears to closely correlate with the severity of the Giant Cell Arteritis. A monoclonal antibody against IL-6 (tocilizumab) is effective in treatiing GCA.High-yield addition to next yearAccording to UTD " the use of Tocilizumab for the treatment of GCA was suggested by evidence that IL-6 is important in disease pathogenesis" Also UTD "At this time, we reserve TCZ (Tocilizumab) for the management of individual patients who are at high risk for glucocorticoid toxicity, who incur glucocorticoid-related side effects during the course of treatment, or who experience relapsing disease." https://www.uptodate.com/contents/treatment-of-giant-cell-arteritis?search=treatment%20of%20giant%20cell%20arteritis&source=search_result&selectedTitle=1~104&usage_type=default&display_rank=1 We could consider adding this to the next edition and put it in the Therapeutic antibodies table, page 122, immunology chapter as a second-line agent for the treatment of Giant cell arteritis. -Victor MartinezVerifiedThere are only case reports, series and a phase 2 clinical trial on this, according to UTD. Is this really enough clinical evidence to support its efficacy yet? I'm inclined to reject this suggestion for now. -Lilit https://www.uptodate.com/contents/treatment-of-giant-cell-arteritis?search=giant%20cell%20arteritis&source=search_result&selectedTitle=2~127&usage_type=default&display_rank=2#H179055212I'm not sure if this fact is considered high yield and would appreciate others' opinions on this. -MK01/30/19 1:11 AMLeidy LauraGuerrero HernándezLeidylauragh14@gmail.com
725310IndexPathologyVasculitidesindex clariicationleukocytoclastic vasculitis is predominantly discussed on this page (310) but is only listed in the updated index as being on page 173. This should be corrected. Thank you.Clarification to current textAgree we should correct the index list/pages regarding leukocytoclastic vasculitis. -Victor MartinezVerifiedThis is an index issue. -LilitIndex is already being fixed.Prelim accept but NOT publishable errata02/15/19 3:13 PMClaireDonnelleyclairedonnelley@gmail.com
726310CardiovascularPathologyVasculitidesUWorld, Pathomafor polyarteritis Nodosa; due to different stages of lumpy fibrosis (Nodosa) it gives the appearance of "String of Pearls". This appearance also found in renal FibroMuscular Dysplasia.High-yield addition to next yearVerifiedCan consider adding the phrase next to what's already written. -LilitAgree with student. We could add after "Transmural inflammation of the arterial wall with fibrinoid necrosis" and include that this eventually heals with fibrosis, creating a "string of pearls" appearance. - MK03/01/19 7:29 PMAlaJamalala.aljamal@hotmail.com
727310CardiovascularPathologyVasculitidesPathomafor Kawasaki disease: since Cardiac compication is such unique to know (kids with MI like pictures), suggest thinking of "kid on Kawasaki motorcycle"; their hands and feets are red and their heart is excited or beating fast same with disease.MnemonicVerifiedI think the mnemonic in the book is excellent and sufficient by itself. Also don't think we can just use a "mnemonic" that's used in Pathoma. -LilitRecommend rejecting. The existing mnemonic is already excellent in its memory hook and completeness. Although tachycardia out of proportion to fever is a good association, it is not a diagnostic criterion. Source: "UpToDate: Kawasaki disease: Clinical features and diagnosis" - Mitchell Katona03/01/19 7:30 PMAlaJamalala.aljamal@hotmail.com
728310IndexPathologyVasculitidesFirst Aid 2019Vasculitis is listed as page 315, 316 in the index but it's covered on page 310, 311Major erratumVerifiedThis is an index issue. -LilitNeeds to be discussed with index team - MK03/03/19 1:19 PMPriyankaLalwanidr.priyankalalwani@gmail.com
729311CardiovascularPathologyHeart failureN/AOn pg. 757 in the appendix, "heart failure" directs you to pg. 311. There is no mention of heart failure on pg 311. Additionally, under "heart failure - associations" on page 757, it directs you to page 690, which has no mention of heart failure.Spelling/formattingAgree, the index does not correlate appropriately with pages. -Victor MartinezVerifiedThis is an index issue. -LilitNeeds to be discussed with index team - MK02/09/19 2:37 PMDouglasMossdouglas.moss@my.rfums.org
730311CardiovascularPathologyVasculitidesSpelling errorImmunoglobulin A vasculitis is associated with BERGER disease (i.e. IgA nephropathy) not BUERGER disease (i.e. thromboangiitis obliterans)Spelling/formattingDuplicate01/04/19 10:26 AMDanielPakpaksungjoon91@gmail.com
731311CardiovascularPathologyVasculitidesN/APage 311 states that immunoglobulin A vasculitis is associated with IgA nephropathy (Buerger disease) when it should be *Berger* disease. Confusing because Buerger disease is another vasculidity.Spelling/formattingAgree with the student, I believe that this is a spelling issue. So, the next edition should be " Associated with IgA nephropathy (Berger disease)" -Victor MartinezVerifiedThis issue has already been addressed in another comment. -LilitAgree with student. IgA nephropathy is also known as Berger's disease, not Buerger. - MK01/04/19 10:16 PMHalleyAlbertshalley8236@yahoo.com
732311CardiovasculartruePathologyVasculitideshttps://emedicine.medscape.com/article/239927-overviewIn Immunoglobulin A vasculitis, "Associated with IgA nephropathy (Buerger disease)" must be "Associated with IgA nephropathy (Berger disease)"Minor erratumVerifiedAgree with student. IgA nephropathy is also known as Berger's disease, not Buerger. - MKNice catch.

Change in the third column of vasculitides:

FROM "IgA nephropathy (Buerger disease)"

TO "IgA nephropathy (Berger disease)"



- Vivek		Agree, change to "IgA nephropathy (Berger disease)"Prelim accept by 2 authors + 1 editorjohn.r.butterly@dartmouth.eduOK*CARDIO Anish Bhattgood findAccepttrue01/09/19 9:35 AMNajatFadlallahnajat.fadlallah@lau.edu
733311CardiovasculartruePathologyVasculitideshttps://emedicine.medscape.com/article/329255-overviewMixed cryoglobulinemia Vasculitis due to mixed IgG and IgA immune complex deposition. This is incorrect, mixed cryoglobulinemia contain rheumatoid factors (RFs), which are usually IgM and, rarely, IgG or IgAMajor erratumThe student seems to be correct about this since mixed cryoglobulinemia (Type II and type III) is the result of a monoclonal immunoglobulin, usually immunoglobulin M (IgM) or, less frequently, IgG and IgA. However, I think we need faculty input because it is not clear if the vascular symptoms are primarily produced by IgM or by IgA-IgG. -Victor MartinezVerifiedAgree with getting faculty input. Not an expert in this.Disagreement/need expertjohn.r.butterly@dartmouth.eduI can not comment - no expertiseMaria Antonellivasculitis is usually seen with type II and III (which are IgG and IgM). IgA rarely involved. Would remove IgA and replace with IgM - leave IgG as it usually does play an important role. I realize the Medscape article states that IgM is the sole common Ig involved but I checked with several rheumatology sources which suggest both are commonly involved in the mixed cryos.Accepttrue01/15/19 10:49 AMOmidShafaatomid.shafaat@yahoo.com
734311CardiovascularPathologyVasculitideshttps://www.mayoclinic.org/diseases-conditions/iga-nephropathy/symptoms-causes/syc-20352268On page 311 under Vasculitides (continued) and in reference to Immunoglobulin A vasculitis under the PATHOLOGY/LABS section it states that Immunoglobulin A vasculitis is associated with IgA nephropathy (Buerger disease). I believe this to be a mistake and should be corrected to its “ Associated with IgA nephropathy (Berger Disease)”. Page 583, 585, and 690 all make reference to Berger disease as being IgA Nephropathy. Buerger Disease is a Medium-vessel vasculitis associated with Gangrene and Amputation of extremities.Minor erratumI believe this is already addressed in another comment that was migrated to annotate. -LilitAgree with student. IgA nephropathy is also known as Berger's disease, not Buerger. - MKAgree!

Sarah		Prelim accept by 2 authors + 1 editortrue03/27/19 11:35 AMGabrielGrahamGabrielGraham1994@yahoo.com
735311CardiovascularPathologyVasculitideshttps://emedicine.medscape.com/article/239927-overviewImmunoglobulin A vasculitis associated wit Ig A nephropathy is "berger's" disease and the book says its "buerger's" disease which is TOASpelling/formattingAlready addressed. -LilitHas been addressed. - Huzaifa07/01/19 2:47 PMguneetgillgillguneet94@gmail.com
736311CardiovascularPathologyVasculitidesn/aW-egner Granulomatosis M-icroscopic Polyangiitis Take these diseases like an image in the mirror.MnemonicVerifiedBesides the W and M, I don't see how this is gonna helpful for memorization. -LilitUnhelpful. - Huzaifa07/08/19 5:41 PMAPandeyaranikopandey@gmail.com
737311CardiovascularPathologyVasculitidesYour own text verifies this. A simple typo.For IgA vasculitis, in the pathology/labs column it says “Associated with IgA nephropathy (Buerger disease).” It should say “Associated with IgA nephropathy (Berger) disease.” Buerger disease is thromboangitis obliterans. Berger disease is IgA nephropathy.Minor erratumAlready addressed. -LilitHas been addressed. - Huzaifatrue07/12/19 3:59 PMMedicalStudentJustwanttohelp@dontemailme
738311CardiovascularPathologyVasculitideshttps://emedicine.medscape.com/article/239927-overviewFor Immunoglobulin A vasculitis, it currently says it is "associated with IgA nephropathy (Buerger disease)", but it should be Berger's diseaseMinor erratum10/12/19 9:21 PMDanielZhuDzhu5@pride.hofstra.edu
739311CardiovascularPathologyVasculitideshttps://www.mayoclinic.org/diseases-conditions/iga-nephropathy/symptoms-causes/syc-20352268Under small-vessel vasculitis (p.311) when describing the pathology/labs of Immunoglobulin A vasculitis (HSP) there is a mention of the association with IgA nephropathy and in brackets it's referred to as Buerger disease. The actually spelling is Berger's disease. This is not simply a spelling error. There is a Buerger disease on the previous page (p.310) under medium-vessel vasculitis and since this is on the page right before the error in the text, it is safe to assume that some people will make an incorrect connection between the association of Buerger disease and HSP when in actuality the connection lies between HSP and Berger's disease (IgA nephropathy).Major erratum11/13/19 2:34 PMAmirGuirguisamir.guir123@gmail.com
740312CardiovascularPathologyCardiac tumorsFA2019 lists Myxomas as the most common primary cardiac adult tumor"Adults make myxed drinks" to remember that myxomas are the most common primary cardiac tumors in adults, vs. rhabdomyomas in children.MnemonicIt is a good suggestion. We could consider adding this mnemonic to the next edition. -Victor MartinezVerifiedIt's catchy. I think it's a good idea to add this. -LilitRecommend accepting. Good memory hook and high yield for Step 1.true01/03/19 10:19 PMGeorgeannaTsoumasg_tsoumas0412@email.campbell.edu
741312CardiovascularPathologyHereditary hemorrhagic telangiectasiaMnemonic, FA19 p. 312*Schnoz*ler-Weber-Rendu has *nose*bleedsMnemonicVerifiedNot a very comprehensive mnemonic. It only associates the syndrome with nose bleeds. OWR syndrome is much more complex. There's potential for a much better mnemonic. Reject. -LilitLeaning towards rejecting. Epistaxis is not sensitive or specific for HHT/OWR, so it is unlikely this mnemonic alone would be enough to help a student on a Step 1 question. -Mitchell Katona04/24/19 3:15 PMElanBaskirebask003@fiu.edu
742312CardiovascularPathologyHereditary hemorrhagic telangiectasiawikipedia.org/wiki/Rudolph_the_Red-Nosed_ReindeerRudolph the red nose "REiNDeer", "osler weber RENDu" red nose=recurrent epistaxisMnemonic10/25/19 12:23 PMEsatGunaymd.esatgunay@gmail.com
743312CardiovascularPharmacologyHypertension treatmenthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5270217/In discussion of "hypertension in asthma" it should be clarified that beta-2-receptor BLOCKADE can lead to bronchoconstriction which is why non-selective beta-blockers should be used in asthma. Currently it reads as if beta-two receptor agonism can lead to bronchoconstriction, but it means to say that beta-2 blockade leads to bronchconstriction and exacerbation of asthma.Clarification to current text11/25/19 11:06 PMAbhishekGamiagami@jhu.edu
744312IndexPharmacologyKussmaul signN/AThe index incorrectly lists this fact to be on page 319.Spelling/formattingVerified01/04/19 12:30 PMHalleyAlbertshalley8236@yahoo.com
745312CardiovascularPharmacologyThiazide diureticshttps://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.12679Thiazide-type diuretics are associated with significant but small adverse glycemic effects in hypertensive patients. Treatment with a lower dose might reduce or avoid glycemic changes.Clarification to current textReject. Don't think it's high yield to mention this here. Renal chapter discusses the adverse effects of thiazides and a mention here is for consistency. -LilitReject. Agree with Lilit, renal chapter discusses thiazide adverse effects. - HuzaifaAgree with the authors. This is covered elsewhere in the book in sufficient detail.

- Sarah		Reject by 2 authors + 1 editor07/19/19 8:46 PMLeshlieDe la Torre Mendozaldelatorre28@hotmail.com
746312CardiovascularPathologyUlcer complicationshttps://www.nhlbi.nih.gov/health-topics/varicose-veinsVaricose veins: dilated tortuous veins most commonly found on the superficial system. cussed by chronic elevation of venous pressure or loss of the strength in vessel wall leading to incompetent of the venous valves. common complication includes. edema,infection, dermatitis, ski ulcer and poor wound healing.High-yield addition to next yearWe could consider adding this to the next edition. It is an important concept. -Victor MartinezVerifiedEven though I think this is important knowledge, I don't think it should be added to the text. This will open up a whole new door to peripheral vascular disease progression, which I think is more applicable to step 2 and lower yield for step 1. -LilitRecommend accepting. Agreed that this is an important concept. Would be well-served as a brief, stand-alone fact in new edition +/- image(s). Would recommend brief description of appearance, typical anatomy, pathophysiology, and complications. Student's comment is sufficient in breadth and could simply be refined. Would use UpToDate: "Overview and management of lower extremity chronic venous disease", section "Varicose veins" - Mitchell Kaona02/10/19 3:48 AMahamdObeidatobeidat.amd@hotmail.com
747313IndexPathologyBacterial endocarditisIndex errorin the index,under Staph Aureus, bacterial endocarditis is said to be on pg 313 but it is on pg 307Minor erratumThis is an index issue, not part of the CV chapter. -LilitThis should be addressed with the index team. -MK03/14/19 10:17 AMIfrahZakiifrahdeccan@yahoo.com
748313CardiovascularPharmacologyCalcium channel blockers.Concerning dihydropyridines : MALO and NIMO are CLEaVIng and kNIFing each other in a CAR .All of them end with -dipine.MnemonicI am not inclined to accept or reject this mnemonic. It could help to remember these Ca channel blockers. -Victor MartinezVerifiedReject. Not a great suggestion. -LilitRecommend rejecting. In my view, this is a weak memory hook. -Mitchell Katona01/02/19 3:57 PMBahaa' eddineSuccarbahaasuccar@gmail.com
749313CardiovascularPharmacologyCalcium channel blockersNot applicabletypes of Ca channels: Think with your brain (T-type found mainly in the brain), Love with your heart (L-type found mainly in the heart)MnemonicVerifiedReject. This mnemonic would only work for pharmacology, as suggested by the second author, and it would send a wrong message about cardiac physiology. -LilitRecommend rejecting. Only utility of this would be knowing that CCBs act on L-type, while ethosuximide works on T-type. Otherwise, this mnemonic is not helpful as it may incorrectly imply to a student that T-type channels are not present/physiologically important to pacemaker cells. -Mitchell Katona04/05/19 4:51 PMAwabElnaeemawab.kamal@gmail.com
750313CardiovascularPharmacologyCalcium channel blockersself madefor remembering vasulcar smooth mucle drugs and heart muscle drugs. remember with andVdna. (for vasular smooth muscle go from Vascular smooth muscle—amlodipine = nifedipine > diltiazem > verapamil. Heart—verapamil > diltiazem > amlodipine = nifedipineMnemonic10/04/19 4:29 PMShreyaGulatigulatishreya23@gmail.com
751313CardiovascularPharmacologyHypertensive emergencyhttp://www.jbc.org/content/276/37/34681.longNitroprusside increases myosin light-chain phosphatase activity due to increase cGMP via direct release of NOHigh-yield addition to next yearThe role of cGMP in vascular smooth muscle relaxation is already described in MSK physiology, pg 449 in FA 2019. Don't think we need to repeat it for the mechanism of action of the drug. -LilitAgree with the student. Sodium nitroprusside breaks down to release NO which increases cGMP which then activates myosin light-chain phosphatases. -MK04/09/19 11:37 AMMariaMeanamameana91@gmail.com
752313CardiovascularPharmacologyLipid-lowering agentsmnemonicHMG -coa reductase : H: Hepatotoxicity - M: Myopathy - G: Git upsetMnemonic12/07/19 7:19 AMObaidaSafiooobbbooo@outlook.sa
753313CardiovascularPharmacologyNitratesNot neededAdd methemoglobinemia to the side effects of nitrates. Already mentioned on page 648 of FA2018. Knowledge of this fact is HY (seen on NBMEs).High-yield addition to next yearWe could consider adding methemoglobinemia as a side effect of nitrates to be consistent with our formatting without being redundant about this fact. -Victor MartinezVerifiedHigh concentrations of nitrates can lead to methemoglobinemia, so we should add this for consistency. -LilitRecommend accepting. Agree with student and VM. Would simply add "methemoglobinemia" to list of AEs as is done, for example, with the "Local anesthetics" fact in the Neurology chapter. Nitrates are a high yield example of iatrogenic methemoglobinemia. Source: UpToDate: "Nitrates in the management of acute coronary syndrome", section on "Side Effects and Caution" -Mitchell Katona01/07/19 4:07 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
754314CardiovascularPharmacologyAntianginal therapyWong GWK, Boyda HN, Wright JM. Blood pressure lowering efficacy of partial agonist beta blocker monotherapy for primary hypertension. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD007450. DOI: 10.1002/14651858.CD007450.pub2ACE card and Pi(e)NDulum cause anxiety .. ACE stands for acebutolol and Pi(e)NDulum stands for pindolol.MnemonicVerifiedI don't think this is a high yield fact to have a mnemonic for. Reject. -LilitDifficult mnemonic for something not that high yield. Reject. - Huzaifa07/08/19 10:21 AMiyads.albustamiisalbustami15@med.just.edu.jo
755314CardiovascularPharmacologySacubitrilhttps://www.drugbank.ca/drugs/DB00886captoPRIL- ACE inhibitor, sacubiTRIL- neprilyson inhibitor, omaPaTRILat- both ACE and NEP inhibitor. (Name contaim both PRIL and TRIL- PaTRIL. )MnemonicVerifiedReject. Omapatrilat is an experimental antihypertensive agent. -LilitOmapatrilat is not included in the text so I'm not sure what the student is suggesting for the mnemonic. - MK02/25/19 7:07 PMLokeshgoyallkh.lokesh@gmail.com
756314CardiovascularPharmacologySacubitrilhttps://www.uptodate.com/contents/use-of-angiotensin-receptor-neprilysin-inhibitor-in-heart-failure-with-reduced-ejection-fraction https://reference.medscape.com/drug/entresto-sacubitril-valsartan-1000010 https://www.ncbi.nlm.nih.gov/m/pubmed/30508581/Neprilysin is responsible for degradation of Natriuretic peptides , substance P, endothelins and other vasoactive peptide such as Atrial Natriuretic Peptide. It does not degrade ANGIOTENSIN II. So, sacubitril as such does not prevent degradation of Angiotension II. Angiotensinase degrades Angiotensin II. The slight increases level of angiotensin II is due to combination of Sacubitril with Valsartan, as Valsartan is ARB.Major erratum08/08/19 3:45 PMRuchirPaladiyaPruchir137@gmail.com
757315CardiovascularPharmacologyLipid-lowering agentshttps://www.uptodate.com/contents/pcsk9-inhibitors-pharmacology-adverse-effects-and-use?search=pcsk9&source=search_result&selectedTitle=1~31&usage_type=default&display_rank=1#H1063920136In the figure at the bottom of the page, an arrow going from PCSK9 to LDL receptor is marked with a ‘+’ which is misleading because PCSK9 works by reducing LDLR levels on the plasma membrane. Hence if PCSK9 is blocked, more LDLRs are recycled and are present on the surface of cells.Clarification to current textBlocking PCSK9 reduces the degradation of LDL receptors and increases the clearance of LDL cholesterol, that is the reason why it has an arrow with a green + sign. I would leave as is. -Victor MartinezAgree, leave as is.Reject by 2 authors + 1 editor12/31/18 7:46 AMMuhammad FaizanAlifaizanali.93@hotmail.com
758315CardiovascularPharmacologyLipid-lowering agentshttps://www.medscape.com/viewarticle/861024Figure indicates that PCSK9 stimulated LDL-R. While in fact PCSK9 stimulated degradation of LDL-R. Text after arrow should read "LDL-R Degradation" to avoid confusionMinor erratumVerifiedPCSK9 itself stimulates degradation of LDL-R which increases circulating LDL levels. PCSK9 inhibitors reverse this process by inhibiting degradation of LDL-Rs. The (+) arrow in the illustration indicates the higher levels of LDL receptors, not a stimulatory effect. -LilitThis student is incorrect. PCSK9 inactivates the degradation of LDL-R. - MKThe student likely got PCSK9 and PCSK9 inhibitors confused. PCSK9 indeed stimulates the degradation of LDL-R which is why PCSK9 inhibitors have been developed to interfere with this process. The below excerpt is from the medscape article cited by the student:

"PCSK9 functions as a binding protein; it is expressed primarily in hepatocytes and after secretion binds to the LDL-R and promotes their degradation. By blocking PCSK9, these drugs result in increased availability of LDL-R to remove LDL-C from the circulation.

The table refers to PCSK9 inhibitors which inactivate the degradation of LDL-R as Mitchell stated. Therefore no change needed.

- Sarah		Reject by 2 authors + 1 editor03/05/19 10:47 AMMurliMishramm.murli@gmail.com
759315CardiovascularPharmacologyLipid-lowering agentshttps://www.uptodate.com/contents/gemfibrozil-drug-information?search=gemfibrozil&source=panel_search_result&selectedTitle=1~73&usage_type=panel&kp_tab=drug_general&display_rank=1Gemfibrozil is spelled incorrectly. It is "Gemfi rozil" on the book.Spelling/formattingAppears correct on my PDF version of FA 2019. Perhaps this was from an older version of FA? -LilitIt appears to be spelled correctly in the annotate version. - MK03/18/19 6:34 PMHenryChanhenwyc@gmail.com
760315CardiovascularPharmacologyLipid-lowering agentshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489608/Fibrates are one of the main VLDL lowering agents.High-yield addition to next yearAgree with second author. High yield topics are drug effects of LDL, TG and HDL, not VLDL. Reject. -LilitRecommend rejecting. Lowering VLDL is implied in the description of MOA: "LPL upregulation". It is also depicted in the illustration. Further, agents' effects on LDL, HDL, and TG are more relevant both to Step 1 and in general than their effects on VLDL. -Mitchell Katona03/26/19 12:40 PMJose CarlosFernandezjosecarlos1593@yahoo.com
761315CardiovascularPharmacologyLipid-lowering agentsn/aGemfibrozil = Gall stones PPAR α = 7-α hydroxylase inhibitorMnemonicVerifiedI'm not the biggest fan of this one. We also don't have a lot of room on this page for additional mnemonics. -LilitI'm not sure what the mnemonic here is. Reject. - Huzaifa07/08/19 5:42 PMAPandeyaranikopandey@gmail.com
762316CardiovascularPharmacologyCardiac glycosideshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693787/The text suggests that van Gogh suffered the side effects of digoxin. However, medical historians now largely agree that Van Gogh's yellow period was likely not due to digitalis-induced xanthopsia (see reference).Minor erratumThis is just for a mnemonic to make things easier to remember. I don't think historical speculations are against the rules. Leave the text as is. -LilitYeah, I think the text is fine as is. It's meant to be a memory hook. - HuzaifaI agree with the authors. It is a decent mnemonic and I think most students still find it helpful.

- Sarah		Reject by 2 authors + 1 editor06/30/19 5:53 PMHannahAbramshannahrabrams@gmail.com
763316CardiovascularPharmacologyCardiac glycosideshttps://www.ncbi.nlm.nih.gov/pubmed/30529380In the mechanism of action of Digoxin, the indirect inhibition of the Na+/Ca2+ exchanger should not increase the Calcium influx- but rather, decrease the Calcium efflux. Same result, but minor difference. Based on the diagram shown as well as general directionality/mechanism of these pumps.Minor erratum09/06/19 2:43 PMMichaelMarkelmmarkel18@gmail.com
764317CardiovascularPharmacologyAntiarrhythmics—sodium channel blockers (class I)https://owl.purdue.edu/owl/general_writing/punctuation/quotation_marks/more_quotation_mark_rules.htmlThe mnemonic for Class IC is "'Can I have Fries, Please." It is a question, so it should end with a "?" instead of a "."Spelling/formattingMnemonics are allowed to be grammatically flexible. However, we could add "?" to the next edition. -Victor MartinezVerifiedVery picky with this suggestion, but we could add the "?" sign. -LilitMinor suggestion but technically correct. Could change "." to "?" - MK02/03/19 9:31 PMCollinGilmorenilloc33@gmail.com
765317CardiovascularPharmacologyAntiarrhythmics—sodium channel blockers (class I)https://www.cvpharmacology.com/antiarrhy/sodium-blockerssodium channel binding strength is a CAB to fastest dissociation. IC>IA>IB.MnemonicWe could consider this mnemonic for the next edition. However, we would have to reorganize the order of the Class I Na channel blockers in the current entry. -Victor MartinezVerifiedDon't think this is needed. I'm not sure this is a high yield concept, but would love to hear some editor/expert input. -LilitNot sure that this is something that requires mnemonic. -Mitchell Katona02/06/19 4:43 PMalaamohameddr.alaakhaled93@hotmail.com
766317CardiovascularPharmacologyAntiarrhythmics—sodium channel blockers (class I)https://emedicine.medscape.com/article/159222-treatmentIt should be added to the Clinical Use section within Class 1A that such antiarrhythmics, like procainamide, are used to treat Wolff-Parkinson-White syndrome. I have had many questions inquire about this concept, including the USMLE-Rx question bank. No where in first aid 2019 is the treatment for this syndrome included.High-yield addition to next yearVerifiedAgree. I think the best way to incorporate this is by including treatment with WPW syndrome. -LilitI agree this should be added. Procainamide can be used to treat Wolff-Parkinson White syndrome. - MK02/23/19 3:10 PMLeeSeiferlseif002@fiu.edu
767317CardiovascularPharmacologyAntiarrhythmics—sodium channel blockers (class I)https://en.wikipedia.org/wiki/Salt_BaeSalt Bae Kills Cows - Na block, B block, K block, Ca blockMnemonicVerifiedNot sure this is absolutely needed. Don't think everyone using this book will know who salt bae is (especially IMGs). There's definitely potential for a better mnemonic. -LilitAgree this mnemonic is helpful for remembering the classes of antiarrhythmics. I learned "So Be Po Ca". Either one could be helpful. - MK03/13/19 7:27 PMKristen TaylorAshourianktaylorashourian@gmail.com
768317CardiovascularPharmacologyAntiarrhythmics—sodium channel blockers (class I)Error in bookFor Class 1B sodium channel blockers the book forgets to list Tocainide. However the mnemonic still highlights the “T” in “I’d Buy Liddys Mexican Tacos”Clarification to current textReject. The T is capitalized in MexileTine. - MKAgree with Mitchell.
Mnemonic is correct.

Sarah		Reject by 2 authors + 1 editor03/25/19 10:23 PMShivaniDesaisdesai1701@gmail.com
769317CardiovascularPharmacologyAntiarrhythmics—sodium channel blockers (class I)n/aClass I”B” = Broken (Post MI) and Weak (Na channel blockade) Heart Class I”C” = Correct (Structurally normal without IHD) and Strong (Na channel blockade) Heart Class III = AmIODarone: “Check ALL before Treatment” = Amiodarone, Liver, Lungs, Thyroid Class IV = “It takes LONGER to get a Canadian PR” = CCB proLONGs PR interval.MnemonicVerifiedToo many mnemonics involved here. I don't think each one needs its own. All of this information is in the book already and I'm not even sure these provide a good memory hook for the facts. Leaning towards rejecting. -LilitAgree, mnemonic overload. Reject. - Huzaifa07/08/19 5:44 PMAPandeyaranikopandey@gmail.com
770318CardiovascularPharmacologyDrug nameshttps://jamanetwork.com/journals/jama/fullarticle/194661B-Blockers that lower (benefit) cardiac mortality.: Carvedilol, Bisoprolol, Metoprolol. • Mnemonic: B-Blocker that Benefit Cardiac Mortality (B= Benefit/Bisoprolol) (C= Cardiac/Carvedilol) (M= Mortality/ Metoprolol)MnemonicVerifiedThere's already a mnemonic on this in the pharmacology section on pg 245, FA 2019. No need to be repetitive in this chapter. -LilitAgree with Lilit. -Mitchell Katona04/30/19 9:55 AMDemetrioSharp Dimitridemetriosharpd@icloud.com
771319CardiovascularPharmacologyIvabradinen/aiVaBrAdiNe is a Funny drug that blocks Funny Na channels at phase Four. HEMATOLOGY AND ONCOLOGY Pathological RBC forms, pg 406 In the END, you are either BURRied or, burnt in a PYRE. So LIVE as you can! BURR cells – END stage renal disease, PYRuvate Kinase Deficiency, LIVEr disease. Heme synthesis, porphyrias and lead poisoning, pg 417 Porphyria cutanea tarda = affected UROporphyrinogen decarboxylase “URO – enzyme down towards URINE” = Accumulated substance = UROporphyrin (tea colored urine) Thrombotic Thrombocytopenic Purpura, pg 419 ROBOTIC ADAM’s Increased WILL to AGGREGATE in the human society! ROBOTIC – THROMBOTIC ADAMTS13 – Deficient or inhibited Increased large von WILLebrand Factor multimers Increased platelet AGGREGATION Factor V Leiden, pg 420 Lady GAGA will tour from ARGentina  Guatemala but not in the People’s Republic Of China. Lady = Leiden Guanine to Adenine DNA point mutation Amino acid change from ARGenine  Guanine Resistance ofMnemonicVerifiedUnsure why there are so many mnemonics suggested for different chapters here. But rejecting the suggestion for Ivabradine, the mnemonic we have is good. -LilitWent through each mnemonic anyways, they were not good. Too complicated. Reject. - Huzaifa07/08/19 5:53 PMAPandeyaranikopandey@gmail.com
772321EndocrineAnatomyEosinophilsNot Needed"pink PiG" -- Anterior Pituitary Acidophils are GH and PRL, the PiG in FLAT PiG. Pigs are Pink, Acidophils stain pink on H&E.MnemonicVerifiedFairly low yield, would reject
- FQ		Reject. -Scott05/08/19 10:07 AMSethOwitzmowitz@buffalo.edu
773321EndocrineAnatomyPituitary glandhttps://www.histology.leeds.ac.uk/glandular/pituitary.php"pink PiG" -- Anterior Pituitary Acidophils release GH and PRL, the PiG in FLAT PiG. Pigs are Pink, Acidophils stain pink on H&E.MnemonicVerifiedReject
- FQ		Reject. -Scott05/19/19 1:58 PMMichael SethOwitzmowitz@buffalo.edu
774322EndocrineAnatomyAdrenal cortex and medullaMnemonic"CorticOL" hormones are derived from "CholesterOL" (may also be placed on page 328)MnemonicIt could be misleading since the mnemonic does not include androgens which also come from the breakdown or transformation of cholesterol. - Victor MartinezVerifiedI don't know how HY this fact is. I teach it to my students, but it seems that this is pretty easy to remember, are we making something easy to learn into something more complicated? Reject. -Scott02/13/19 3:07 PMNathanielBorochovnateboro8@gmail.com
775322EndocrineAnatomyAdrenal cortex and medullaIt's a mnemonic“The deeper you go, the sweeter it gets, and out comes the 1^o hormones in alphabetical order; Aldosterone, Cortisol, DHEA, Epi, Ne”. (A, C, D, E, N marked in bold/red)MnemonicVerifiedLow Yield -Scott02/25/19 12:09 PMEirikKragereirik.krager@outlook.com
776322EndocrinetrueEmbryologyThyroid developmenthttps://emedicine.medscape.com/article/845125-overviewParafollicular cells are neural crest (ectoderm derived), not endoderm derivedMinor erratumVerifiedAs per the medscape reference which states "The C cells of the thyroid, therefore, are of neural crest origin", the student is correct.

UpToDate also states "The C cells originate from the embryonic neural crest; as a result, medullary carcinomas often have the clinical and histologic features of other neuroendocrine tumors such as carcinoid and islet cell tumors."

We had faculty input for the current statement in the FAS1 2019. However, it looks like we need to take faculty input again.

Going by the references (Medscape and UpToDate), we may need to correct that C-cells originate from the embryonic neural crest.

Reference:
1. https://emedicine.medscape.com/article/845125-overview#a3
2. https://www.uptodate.com/contents/medullary-thyroid-cancer-clinical-manifestations-diagnosis-and-staging?search=parafollicular&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1


- Vivek		Without fail this erratum is submitted every single year. Last year with expert input and extensive review we opted to state with confidence that the parafollicular cells are of endodermal origin as is currently stated within the book. Neural crest origin used to be cited, however, recent evidence led to this being changed. I wonder if these references are outdated.

As with all years, will automatically refer this to expert input, but with the hopes that no changes are needed for 2020 given our extensive history with this particular erratum.

-Matt

UPDATE: Dr. Schorr has a great proposal. I suspect that link is why this is an errata submission every single year. Let's publish her clarification in the official errata, then delete the information from the 2020 book.

-Matt		Disagreement/need expertMelanie SchorrWould it be possible to just remove the embryologic origin of the parafollicular C cells from future editions of the book since it is controversial? This article from the journal Development in 2015 states that although it was believed that the parafollicular C cells were from neural crest cells, they provide evidence that they are of endodermal origin. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631767/ I think there will be people who challenge either side. So perhaps state in the errata that is is controversial (neural crest vs endoderm) and then remove it from future editions.Accepttrue12/28/18 7:57 PMElizabethTsuielizabeth.tsui21@gmail.com
777322EndocrineEmbryologyThyroid developmentLast updated Mar 22, 2019: https://emedicine.medscape.com/article/845125-overviewError in errata: Newest errata (March '19) says: "Delete the last sentence “Thyroid follicular cells and parafollicular cells (aka, C cells, produce calcitonin) are derived from endoderm”. However, the parafollicular cells ARE derived from endoderm so the line doesn't need to be deleted.Minor erratumVerifiedThey are derived from endoderm. -Scotttrue04/09/19 11:15 AMDhruvSarwaldhruvsarwal@gmail.com
778323EndocrinePathologyAdrenal insufficiencyhttps://emedicine.medscape.com/article/116467-clinicalIn the hyperpigmentation induced by primary adrenal insufficiency (Addisons Disease), First Aid states that a-MSH is released by corticotrophs which is responsible for stimulating peripheral melanocytes and stimulating melanin production. However after consultation with multiple texts and Dr. Kathleen Giangiacomo (whom I would like acknowledged should this erratus submission be accepted), I have come to understand that while aMSH is cleaved from POMC along with ATCH, that process occurs peripherally as adrenal corticotrophs lack the protease necessary. Furthermore in the pathology of adrenal insufficiency it is ACTH binding to MC1R receptors in the dermis causing hyperpigmentation. I have provided some textbook references in the images attached.Minor erratumVerifiedThis may be true, but I think the fact is rather LY for this test. We can remove "Melanotropin (MSH) secreted from intermediate lobe of pituitary." It's not as important where it gets made as it is that it's associated with hyperpigmentation. -Scott03/08/19 8:39 AMKevinHendricksonKevin.hendrickson@temple.edu
779323EndocrineAnatomy and PhysiologyB cellsLutz, T.A., 2016. Gut hormones such as amylin and GLP-1 in the control of eating and energy expenditure. International Journal of Obesity 6, S15–S21. 2. https://doi.org/10.1016/B978-0-323-54852-6.00013-6Amylin, also known as islet amyloid polypeptide (IAPP), is a 37-amino-acid hormone that is co secreted with insulin from the pancreatic β-cells. Like insulin, amylin is to a certain extent tonically secreted into the circulation and its plasma concentration increases in proportion to body fat. In the pancreas, amylin inhibits the release of glucagon and thus decreases blood glucose via inhibition of hepatic glucose production. Beyond its paracrine action in the pancreas, amylin decreases GI motility and peripheral or central administration of amylin decreases body weight through inhibition of food intake. In the 2019 edition of first aid its not mentionated anything about the release of amylin from B pancreatic cells. The physiology is also relevant cause, nowdays has been a recently option of treatment for diabetes.High-yield addition to next yearAmylin seems to me to be a LY product of pancreatic B cells. -Scott07/30/19 9:28 PMLaura PatriciaAguilar Francolaura.aguilarfranco@gmail.com
780323EndocrineAnatomyEndocrine pancreas cell typesmnemonicstructure of pancreatic islets - ALPHA men at periphery guarding BETAful (beautiful) women in centre. Delta are dogs which are just everywhere.MnemonicVerifiedNot particularly helpful, would reject
- FQ		Reject. -Scott05/01/19 12:21 PMVirajShahmbbs160147@kem.edu
781323EndocrineAnatomyEndocrine pancreas cell typeshttps://www.springer.com/gp/book/9789400766853The photo and text of the islet of langerhans needs to be clarified, that distribution of alpha cells in the periphery and beta cell in the center of the islet is for murine species, in humans it is aleatorizedClarification to current textUnfortunately, I was not able to access the reference link uploaded by the submitter. Also I did not know what "aleatorized" means. (calling it "unique" may be less descriptive, but more appropriate？) The current data for human islet cell distribution state that it is very different from murine species as the submitter said. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908252/ https://diabetes.diabetesjournals.org/content/diabetes/early/2010/02/23/db09-1177.full.pdf But this can be deferred. Definitely not something that needs an errata.Reject. -ScottI don't think this is a particularly HY clarification but it appears the user is correct in that the location of alpha and beta cells in the human islets of Langerhans are less well known or understood.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867580/

It would be worthwhile getting faculty input on this for clarification.

- Sarah		Disagreement/need experttrue07/28/19 6:34 PMHelio ManuelGrullón Rodríguezheliomanuel@icloud.com
782323EndocrineAnatomyPituitary glandhttps://en.wikipedia.org/wiki/NeurophysinsNeurophysin 1 is a carrier protein for Oxytocin and Neurophysin 2 is a carrier protein for ADH.Clarification to current textReject
- FQ		Reject. -ScottAppears rather LY.

- Sarah		Reject by 2 authors + 1 editor05/13/19 8:23 PMMuhanadShaibmohanad.shaib@gmail.com
783324EndocrineAnatomy and PhysiologyInsulinN/AGLUT1= remember "RBC" -- R=RBC, B=baby (placenta), brain, C=cornea; GLUT3=the 2Bs of GLUT1 (=baby (placenta) and brain)-- remember this since 2+1=3MnemonicVerifiedReject. LY. -Scott02/18/19 3:40 AMOpalSekleropalsekler@gmail.com
784324EndocrinePhysiologyInsulinn/aADdicts are DEPENDENT 4 Substance Insulin DEPENDENT Glucose Transposters: GLUT 4 – ADipose tissue, Striated muscles.MnemonicVerified07/08/19 6:52 PMAPandeyaranikopandey@gmail.com
785324EndocrinePhysiologyInsulinuworld+my mnemonicINsulin - INtrinsic tyrosine kinase pathway (PI3K-MAPK), while Glucagon - Gs (cAMP-PKA)MnemonicVerified09/10/19 6:29 AMDmytroPavlenkopavlenko.md@gmail.com
786324EndocrinePhysiologyInsulinuworld question 1926In the figure at the bottom left please add Serine phosphorylation (glucagon, epi) that inhibits tyrosine phosphorylation and insulin receptor autophosphorylationHigh-yield addition to next year09/10/19 6:33 AMDmytroPavlenkopavlenko.md@gmail.com
787324EndocrinePhysiologyInsulinNot neededIn the diagram on the bottom of the page about insulin dependent glucose uptake, Insulin and insulin receptor can be labelled separately just like other labelled receptors.Clarification to current text09/29/19 8:46 AMAhmed AliKhanahmedalikhanjr@gmail.com
788325EndocrinePhysiologyHypothalamic-pituitary hormoneshttps://www.uptodate.com/contents/clinical-manifestations-of-adrenal-insufficiency-in-adults?search=addisons%20disease%20adult&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H3195785943Under MSH. It is stated that MSH causes hyperpigmentation in Cushing's disease. This is only correct if it is ACTH hypersectretion is causing the excessive cortisol. The ACTH and MSH pathway is classically suppressed in Cushing's. Addison's Disease is classically associated with hyperpigmentation.Major erratumReject, the current wording is appropriate since "Hyperpigmentation or abnormal darkening of the skin is found in patients with primary adrenal insufficiency (Addison's disease). In Addison's disease, the adrenal glands do not produce enough hormones (including cortisol). As a consequence, the hypothalamus stimulates the pituitary gland to release more adrenocorticotropic hormone to try and stimulate the adrenal glands to produce more cortisol. Adrenocorticotropic hormone can be broken down to produce melanocyte-stimulating hormone, leading to hyperpigmentation of the skin. Melanocyte-stimulating hormone levels are also raised during pregnancy and in women using birth control pills, which can cause hyperpigmentation of the skin. Cushing's syndrome, due to an excess production of adrenocorticotropic hormone, can also lead to hyperpigmentation." http://www.yourhormones.info/hormones/melanocyte-stimulating-hormone/ Therefore, diseases that course with an excess of ACTH display hyperpigmentation since ACTH and MSH have a common or shared precursor. -Victor MartinezVerifiedAppreciate feedback, and agree that this erratum may be rejected for the reasons stated.

-Matt		Reject by 2 authors + 1 editor01/31/19 3:58 PMTayler DeclanRosstaylerdeclanross@gmail.com
789325EndocrinePhysiologyHypothalamic-pituitary hormonesmnemonic for information already in text"S-eye-ADH" - ADH (elevated in SIADH) is produced in the supra-optic nucleus of the hypothalamusMnemonicI agree with Prashank, the mnemonic neglects the paraventricular nuclei. So, I wouldn't consider it. -Victor MartinezVerifiedThe production of ADH is mentioned in page 323 ( not 325) and we have not focused on the single hypothalamic nucleus ( mentioned both supraoptic and paraventricular). So, i think this mnemonic won't be appropriate

-Prashank		Reject. -Scott02/07/19 9:30 AMJoshuaMoranmoranjosh@live.com
790325EndocrinePhysiologyHypothalamic-pituitary hormonesFirst Aid 2019, pg. 323 (under "Pituitary Gland", there's a list of all the hormones for anterior vs. pituitary glands), 325 (shows how somatostatin inhibits GH)Instead of alphabetical order, it would be helpful to reorganize the "hypothalmic-pituitary hormones" table into sections depending on which part of the pituitary gland the hormone affects: 1. anterior pituitary (CRH/TRH/GnRH/GHRH/somatostatin (which inhibits GH release)), 2. intermediate lobe of pituitary (MSH) 3. posterior pituitary secretions (ADH and oxytocin)Clarification to current textThis is not really necessary as it's likely more important to know the individual hormones and their functions rather than which particular part of the pituitary they originate from
- FQ		Reject. -ScottAgree with the authors.

- Sarah		Reject by 2 authors + 1 editor05/07/19 1:07 AMWenyuDengwenyu.deng128@gmail.com
791326EndocrinePhysiologyAdrenal steroids and congenital adrenal hyperplasiasCostanzo17a-hydroxylase --> DHEA via 17,20-lyase (NOT 17a-hydroxylase). Similarly, 17-hydroxyprogesterone --> Androstenedione via 17,20-lyase (NOT 17a-hydroxylase). This is correct on the online Rx flaschards, but incorrect in the book.Minor erratumVerifiedClient is correct. Suggest change as they have prescribed. -SMtrue02/26/19 2:12 PMElanaKleinmanelana.p.kleinman@vanderbilt.edu
792326EndocrinePhysiologyProlactinNone neededIn the figure "Primary hypothyroidism" is misspelled as "Primary hypothroidism"Spelling/formattingAgree, minor spelling issue. -Victor Martinez.Staff acceptsAgree, it is a spelling mistake.

Should be "primary hypothyroidism"

- Vivek		Agree. -Scott01/15/19 5:11 PMHeewonChoihxc326@case.edu
793327EndocrinePhysiologyAntidiuretic hormoneN/AMnemonic for remembering that ADH is produced in the supraOPTIC nucleus: "S-eye-ADH"MnemonicVerifiedReject. -Scott03/12/19 3:19 PMJoshuaMoranmoranjosh@live.com
794328EndocrinePhysiologyAdrenal steroids and congenital adrenal hyperplasiashttps://emedicine.medscape.com/article/117140-overviewWrong enzyme mentioned when moving from zona fasciculata to zona reticularis, should say 17,20 lyase instead of 17 alpha hydroxylaseMajor erratumVerifiedThis is not a wrong enzyme.We have discussed this in our last revision cycle and they are same enzyme, so it is better to keep same names in both steps. Otherwise, student will further need to memorize new synonym. Moreover, word "hydroxylase" make more sense as to the process of the chemical reaction.

My recommendations:
1. Fine as is for upcoming errata report.
2. Revisit during next revision cycle and change only if we receive significant numbers of errata for the change.

- Vivek		They are synonyms, which I can only say off the top of my head because this same erratum was submitted last year (just in the opposite direction, we used to say lyase).

No change needed, I think keeping as is will be fine, and agree with Vivek that "hydroxylase" is the better enzyme name given it confers the function.

-Matt		Reject by 2 authors + 1 editor01/03/19 7:44 AMAliJilania.jilani.77@gmail.com
795328EndocrinePhysiologyAdrenal steroids and congenital adrenal hyperplasiashttps://emedicine.medscape.com/article/117140-overviewI submitted for the 2018 and it was ignoredHigh-yield addition to next yearI agree with the student. The reaction from 17-hydroxypregnenolone to DHEA and 17-hydroxyprogesterone to Androstenedione should be catalyzed by 17,20 lyase and not by 17 alpha-hydroxylase. The 2015 edition and 2016 edition had it correctly. - Victor MartinezVerifiedNot sure what this comment is referring to, but either way I think this is something that could be addressed next year

-Roshun S		"CYP17 is a microsomal enzyme that catalyzes both hydroxylation at C17 of progesterone or pregnenolone (17-alpha-hydroxylase activity) and cleavage of the residual 2-carbon side-chain at C17 (17,20-lyase activity)." From UTD

The commenter wants us to replace "17-alpha-hydroxylase" with "17,20 lyase" in the conversion of 17-hydroxypregnenolone to dehydroepiandrosterone (DHEA) & 17- hydroxyprogesterone to androstenedione. I think , this is reasonable as per the references provided.

https://www.uptodate.com/contents/adrenal-steroid-biosynthesis#H7

-Prashank		02/02/19 11:32 AMAnnaGarcia Bernalatgarciabernal@gmail.com
796328EndocrinePhysiologyAdrenal steroids and congenital adrenal hyperplasiasn/a"Girls read Seventeen Magazine" i.e. individuals with 17alpha-hydroxylase deficiency will be phenotypically female due to sex hormone deficiencyMnemonicVerifiedI actually like this, and I don't like many mnemonics. Suggest consideration for addition into next year's edition. -Scott02/17/19 4:23 PMElizabethMurrayelizabeth.murray@downstate.edu
797328EndocrinePhysiologyAdrenal steroids and congenital adrenal hyperplasiashttps://emedicine.medscape.com/article/920532-overview17,20 lyase instead of 17 alpha hydroxylase for 17 hydroxypregnenolone to DHEA and 17- hydroxyprogesterone to AndrostenedioneMajor erratumVerifiedMentioned previously -Scotttrue03/06/19 2:14 PMAkhandSinghMahalwar.akhand@gmail.com
798328EndocrinePhysiologyAdrenal steroids and congenital adrenal hyperplasiashttps://www-uptodate-com.proxy.kumc.edu/contents/adrenal-steroid-biosynthesis?search=adrenal%20steroid%20synthesis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Two instances of "17alpha-hydroxylase" are incorrect and must be changed to "17, 20-lyase". Need to change reaction to say 17-OHP —> DHEA using 17,20-LYASE enzyme Need to change reaction to say 17-OHP—>Androstenedione using 17,20-LYASE enzyme. The enzyme is currently listed incorrectly as 17alpha-hydoxylase for both reactions. See screenshot for error.Major erratumTrue. The enzyme on the right is 17,20-lyase https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5355729/ We are already working this up though and it will likely be implemented this year-Scotttrue05/06/19 9:49 PMShadiaSalehsal.shadia@gmail.com
799328EndocrinePhysiologyAdrenal steroids and congenital adrenal hyperplasiasThis suggestion does not require a reference.This is just a suggestion regarding how to organize the information. For the tip involving which enzyme deficiency (21-, 17a-, and 11b-hydroxylase) causes hypertension/virilization, it would be helpful to organize this into a table form (two columns, one BP, one testosterone; then for each major enzyme deficiency, change the "1" to an up arrow). Additionally, for clarity, it would be helpful to make the up/down arrows bigger/broader and assign colors for each direction. This would be helpful for other sections which contain these tables and up/down arrows (such as the iron interpretation table in the hematology section). I've attached images for clarity.Spelling/formattingReject. -Scott05/11/19 9:52 PMWenyuDengwenyu.deng128@gmail.com
800328EndocrinePhysiologyAdrenal steroids and congenital adrenal hyperplasiashttps://www.uptodate.com/contents/adrenal-steroid-biosynthesis#H11Production of DHEA and Androstenedione from 17-hydroxypregnenolone and 17-hydroxyprogesterone is done via 17,20-lyase. The book has the 17alpha-hydroxylase as the enzyme performing those reactions.Major erratum09/08/19 4:57 PMTylerAustintragbt@health.missouri.edu
801329EndocrinePhysiologyAdrenal steroids and congenital adrenal hyperplasiashttps://emedicine.medscape.com/article/920532-overviewThe reactions of 17-hydroxypregnenolone to DHEA and 17-hydroxyprogresterone to Androstenedione are catalyzed by 17,20 Lyase not by 17a-hydroxylase. They are both catalyzed by the same enzyme complex (P450c17). 17,20 Lyase deficiency presents similar to 17a-hydroxylase deficiencyClarification to current textI agree with the student. The reaction from 17-hydroxypregnenolone to DHEA and 17-hydroxyprogesterone to Androstenedione should be catalyzed by 17,20 lyase and not by 17 alpha-hydroxylase. The 2015 edition and 2016 edition had it correctly. - Victor MartinezVerifiedMentioned previously -ScottThey are synonyms. Thus, changing from one to the other isn't really an erratum.

For 2020 we can debate which of the two is better, but definitely not errata-worthy. Going to reflag as a clarification given these details.

-Matt		Prelim accept but NOT publishable erratatrue02/14/19 7:02 AMNathanielBorochovnateboro8@gmail.com
802329EndocrinePhysiologyCortisolhttps://www.sciencedirect.com/topics/neuroscience/glucocorticoids https://www.niddk.nih.gov/health-information/endocrine-diseases/national-hormone-pituitary-program/health-alert-adrenal-crisis-causes-death-people-treated-hghGlucocorticoids are essential to maintain life.High-yield addition to next yearYes, most hormones are. I think this is not a very testable fact about glucocorticoids. Reject. -ScottAgreed, not useful
- FQ		03/26/19 9:19 AMDmytroPavlenkopavlenko.md@gmail.com
803329EndocrinePhysiologyCortisolhttps://emcrit.org/pulmcrit/nlr/for cortisol's role in immune function one of the mneumonics I use is: INDE which stands for Increase neutrophils, Decrease Eosinophils. I found this helpful in my studies and thought maybe other students may benefit from this as well.MnemonicVerified08/29/19 2:23 PMJayShahjayshah0425@gmail.com
804330EndocrineAnatomy and PhysiologyParathyroid hormonehttps://www.ncbi.nlm.nih.gov/pubmed/10824426Under function for Parathyroid Hormone, it should be PTH binds RANK (Receptor) on osteoblasts, not osteoclasts as it is currently written.Major erratumRANK is located on osteoclasts, the current content is correct
- FQ		Reject. -ScottAgree with the authors. No change required.

- Sarah		Reject by 2 authors + 1 editor05/15/19 12:06 PMBrightZhoubrightz@stanford.edu
805330EndocrinePathologyThyroid cancerhttps://www.uptodate.com/contents/papillary-thyroid-cancer?search=Papillary%20thyroid%20cancer&source=search_result&selectedTitle=1~47&usage_type=default&display_rank=1Tall cell variant: folicular hiperplasia lined by tall epithelial cells, seen in adults with poor prognosis.High-yield addition to next yearTall cell variant of papillary thyroid carcinoma this subtype involves controversy regarding its definition. After some research "most of papillary thyroid carcinoma (PTC) are indolent with excellent long-term survival, several histological variants of PTC have been found to be associated with more aggressive biologic behavior and poorer prognosis." "Tall cell variant (TCV) of papillary thyroid carcinoma (PTC) has been recognized for the past few decades as an entity showing aggressive biological behavior; however, there is considerable controversy regarding the definition, clinical and pathological features of TCV because of its rarity and difficult diagnosis. No clinical features can accurately diagnose TCV. Thus, the results of histocytology, immunohistochemistry and molecular genetics tests have important clinical implications for diagnosis." "Tall cell variant (TCV), the most common aggressive variant of PTC, frequently has vascular invasion, extrathyroidal extension, lymph node metastasis, and distant metastases [3–9], and its 10-year overall and disease-free survival has been reported to be approximately 10% lower than that of classic PTC (cPTC)." We could add this Papillary thyroid carcinoma (PTC) variant to the next edition since it contrast the excellent prognosis of the vast majority of PTCs. -Victor MartinezVerifiedI think that this could provide the excellent contrast which Victor was mentioning, but I think that this subtype of Follicular carcinoma is relatively LY. -Scotthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682248/ Reject. -Scott01/06/19 7:46 PMNeryMaraLamothemaralamothe@hotmail.com
806331EndocrinePharmacologyThionamidesSelf-writtenPropylthiouracil - can be written as 'POLYthiouracil' as its used in multiple/poly areas. Both inside on organification + periphery on de-iodinase. Methimazole - can be written "methINazole" as it only works INside on organification in follicle.Mnemonic10/27/19 8:56 AMKhalidAlattarkhalid_alattar@hotmail.com
807331EndocrinePhysiologyThyroid hormones (T3/T4)https://www.uptodate.com/contents/thyroid-hormone-synthesis-and-physiology?search=iodine%20thyroid&sectionRank=1&usage_type=default&anchor=H3&source=machineLearning&selectedTitle=4~150&display_rank=4#H3It was stated in the first paragraph of this section, "organification of iodide...". However, the organification is with iodine (I2) not iodide.Clarification to current textVerifiedTechnically, I agree with the comment. I2 is elemental iodine. It is shown similarly in the diagram of the same page. I suggest the following:

" Functions of thyroid peroxidase include oxidation of iodide, organification and coupling of monoiodotyrosine ( MIT) and diiodotyrsoine (DIT)"

-Prashank		Agree with Prashank. -ScottReasonable, non-urgent changes. Accept for incorporation this year to make this fact clearer.

No need to publish in official errata.

-Matt		Prelim accept but NOT publishable erratatrue02/07/19 5:20 PMMonicaNematmonicanemat@gmail.com
808331EndocrinePhysiologyThyroid hormones (T3/T4)eMedicine: https://emedicine.medscape.com/article/2089554-overview#a2The text says "decreased TBG in hepatic failure", however there is actually generally an increased TBG in chronic liver disease. (studies show increased TBG in all cases studied of liver disease, though eMedicine states it may be increased or decreased).Minor erratumVerifiedI think that this would be a great step 3 question, but I doubt it's going to show up on Step 1. Reject. -ScottOn looking into this a little further, it appears the user is partially correct. However, I would not go as far as saying "in all cases studied".
It seems the effects of liver disease/failure (acute and chronic) on TBG levels is more complex and controversial.

Here is an excerpt from one review article (https://scialert.net/fulltextmobile/?doi=pjbs.2013.1641.1652):
It seems the biosynthesizing of TBG is increased during the acute liver diseases. TBG production is simultaneously elevated as result of the acute onset of disease along side of proteins which are produced due to liver acute illness. Therefore following enhanced concentration of TBG the level of total T4 is increased, which is the manifestation of early acute liver abnormality. On condition of more TBG reduction as result of progressed liver disease the T4 level is also reduced.
In other word it can be stated that in the initial state of acute liver diseases the total T4 production increases and subsequently as liver function is worsen it will reduced due the higher and lower concentration of TBG respectively.

But there does appear to be some evidence that TBG is increased in hepatic disease despite the fact that it is synthesised in the liver e.g.

Schussler GC, Schaffner F, Korn F. Increased serum thyroid hormone binding and decreased free hormone in chronic active liver disease. N Engl J Med (1978) 299:510–5. doi:10.1056/NEJM197809072991003


Shigemasa C, Tanaka T, Mitani Y, Ueta Y, Taniguchi S, Urabe K, et al. Are increases in thyroxin-binding globulin in patients with acute hepatitis ascribable to synthesis by regenerating hepatocytes? Clin Chem (1988) 34:776–80.

Huang MJ, Liaw YF. Thyroxine-binding globulin in patients with chronic hepatitis B virus infection: different implications in hepatitis and hepatocellular carcinoma. Am J Gastroenterol (1990) 85:281–4.

Danilovic DL, Mendes-Correa MC, Chammas MC, Zambrini H, Barros RK, Marui S. Thyroid disturbance related to chronic hepatitis C infection: role of CXCL10. Endocr J (2013) 60:583–90. doi:10.1507/endocrj.EJ12-0321

Shimada T, Higashi K, Umeda T, Sato T. Thyroid functions in patients with various chronic liver diseases. Endocrinol Jpn (1988) 35:357–69. doi:10.1507/endocrj1954.35.357

Nagasue N, Ohmori H, Hashimoto N, Tachibana M, Kubota H, Uchida M, et al. Thyroxine-binding globulin and thyroid hormones after resection of hepatocellular carcinoma. Am J Gastroenterol (1997) 92:1187–9.

Most of these articles are 20-30 years old but regardless I think it is probably best to delete "hepatic failure" from this page. As Scott pointed out it is generally LY for Step1 and it is better to remove it than risking an erratum or controversy.		Prelim accept but NOT publishable erratatrue02/27/19 10:39 PMBrianTanksleytanksley@usc.edu
809331EndocrinePhysiologyThyroid hormones (T3/T4)https://www.medscape.com/viewarticle/452667_5Add dopamine (alongside somatostatin) as an inhibitor of TSH release. Dopamine is acknowledged as an inhibitor of TSH release in the schematic on page 325.Clarification to current textVerifiedYes it is, I don't think it's important to make this change -ScottI agree with Scott that it is not essential and it is too late in the revision process to amend illustrations. However, for completeness it would make sense to add dopamine to the illustration in 2021 considering that we are mentioning it in the table on p. 326.

- Sarah		true03/07/19 5:44 PMLisa-QiaoMacDonaldllm012@jefferson.edu
810331EndocrinePhysiologyThyroid hormones (T3/T4)UworldReverse T3 is a byproduct generated almost entirely from the peripheral conversion of T4. Exogenous T3 supplementation will decrease TSH, T4, and reverse T3 (rT3) due to less T4 available for conversion.High-yield addition to next yearI agree that rT3 is a testable fact. This is not an erratum, but think that it should be considered for addition in 2020. -ScottGood addition, may be tested.
- FQ		03/28/19 8:54 AMCatherine T.Ricart Garciacatherinericartg@hotmail.com
811331EndocrinePhysiologyThyroid hormones (T3/T4)https://www.medscape.com/viewarticle/459924_4Wolff-Chaikoff Effect - Excess Iodide temporary inhibits iodide organification as a defense mechanism of thyroid gland use to prevent synthesis of large quantities of hormones.Clarification to current textVerifiedReject. LY -ScottI agree. This is covered in sufficient detail on p. 331 and further referenced throughout the chapter.
More detail is unnecessary and LY.

Sarah		Reject by 2 authors + 1 editor03/28/19 9:11 AMCatherine T.Ricart Garciacatherinericartg@hotmail.com
812331EndocrinePhysiologyThyroid hormones (T3/T4)First Aid Step 1 2019 p.331, Table "Thyroid hormones"I suggest to add "β-blockers, glucocorticoids" after PTU, as 5'-deiodinase inhibitors to the picture located at the bottom of the page.Clarification to current text09/04/19 1:35 PMAlsuZagorulkoalsu.zagorulko@gmail.com
813331EndocrinePhysiologyThyroid hormones (T3/T4)First Aid Usmle Step 1 2019, page 331to remember 5'deiodinase inhibitors, use mnemonic ' 3 P's " PTU, Propranolol (beta-blockers), Prednisone (glucocorticoids)MnemonicVerified09/04/19 1:47 PMAlsuZagorulkoalsu.zagorulko@gmail.com
814332EndocrinePhysiologySignaling pathway of steroid hormonesMnemonicV1 receptor and H1 receptor use the 1P3 (IP3) signaling pathway. Bold the 1s and I in IP3MnemonicI think the current text mnemonic is better. I would leave as is. - Victor MartinezVerifiedReject. -Scott02/14/19 1:24 PMNathanielBorochovnateboro8@gmail.com
815332EndocrinePhysiologySignaling pathways of endocrine hormonesnot neededI think it is better to delete "Think Growth Factor" ,we don't need it because the new mnemonic "Get Found In the MAP" is clearClarification to current textI think that we should leave the mnemonic as is since it reinforces the name of these hormones. This fact is HY for the step 1. -Victor MartinezVerifiedAgree, not a compelling reason to delete it.

-Matt		Reject by 2 authors + 1 editor12/30/18 2:19 PMMoatasemAl-Janabiassoomi88@yahoo.com
816332EndocrinePhysiologySignaling pathways of endocrine hormonesBRS, Linda Constanzo 6th edition; Physiology, Linda S. Constanzo fith editionBoth "BRS" and "Physiology" have the GHRH as with a signaling pathway of "Phospholipase C Mechanism (IP3/Ca)"Minor erratum07/31/19 7:27 PMPriscilaMohammedpriscilamohammed@gmail.com
817332EndocrinePhysiologySignaling pathways of endocrine hormonesLinda Constanzo Physiology 5th editionGHRH has both (cAMP and IP3/Ca) signaling pathways.Minor erratum08/05/19 8:03 PMPriscilaMohammedpriscilamohammed@gmail.com
818333EndocrinePathologyCushing syndromehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340771/The text indicates that Cushing Syndrome may have a finding of pseudohyperaldosteronism. That is true. But it will be good to specify that it is an transient increase in aldosterone level. As the disease progress, the aldosterone level decreases. Hypothetically, the pseudohyperaldosteronism is due to acute rise in ACTH wherease decreased aldosterone later will be due to direct actions of increased Cortisol.Clarification to current textVerifiedThis doesn't sound important to me, and I've never seen a question on this before. -ScottI agree this sounds rather LY and is likely that adding additional information would cause more confusion for students (plus add unnecessary text to the page).

- Sarah		Reject by 2 authors + 1 editor02/25/19 8:08 AMMurliMishramm.murli@gmail.com
819333EndocrinePathologyCushing syndromehttps://www.uptodate.com/contents/acquired-hyperpigmentation-disordersIn the "Findings" subsection of Cushing Syndrome, the skin changes include thinning and striae; however, it is also important to remember that Cushing Syndrome caused by an ACTH-secreting pituitary adenoma (Cushing Disease) can also cause hyperpigmentation due to the increased production of ACTH. Although it was mentioned in the physiology section, it is important to include "hyperpigmentation" in the skin findings of Cushing Syndrome, as this is a VERY high-yield point that students should be reminded of in the context of Cushing Syndrome and Cushing Disease.Major erratum08/12/19 1:21 AMRyanLeeryanlee@gwu.edu
820334EndocrinePathologyAdrenal insufficiencyhttps://www.ncbi.nlm.nih.gov/pubmed/216821Adrenal insuffuciency metyrapone test-it says "In 1* adrenal insufficiency, ACTH is (arrow pointing up) but 11 deoxycortisol remains (arrow pointing down)" which I think should clarify that the ACTH is high before test even (not increased by metyrapone) and that after test it stays high too and the 11-deoxycortisol remains low after test.Clarification to current textVerifiedAs per the reference, I feel the student is correct that the algorithm can be further clarified. I suggest revisiting this algorithm for next edition.

Since, we are not reflecting baseline levels of ACTH and deoxycortisol, we can mention under metyrapone stimulation test*-

- "No change from baseline levels" in the third box and
- extra "up arrow and down" arrow" in the first and second box (these would clarify that the change is more pronounced from baseline after administering metyrapone).

* I would also suggest to take faculty input on it.


- Vivek		I like Vivek's suggestion -ScottI am open to clarifying this part of the fact further. Agree that, on further analysis, it is not as succinctly stated as it could be.

In primary adrenal insufficiency, what is technically seen is an already elevated ACTH (independent of metyrapone) and an 11-deoxycortisol level that does not rise at all from its low baseline, given that lack of adrenal cortisol production in primary disease. Cortisol is unlikely to drop further and, thus, ACTH is unlikely to rise further. Thus, Vivek's proposal is reasonable.

In a normal HPA axis, metyrapone will decrease cortisol levels, raise ACTH levels, and increase 11-deoxycortisol levels, all from their pre-treatment baselines.

In secondary/tertiary, the ACTH baseline is already low and does not rise in response to metyrapone. The lack of ACTH stimulation means that 11-deoxycortisol does not rise beyond baseline with metyrapone, and cortisol does not decrease beyond baseline.

In summary, I am amenable to clarifying this fact this year. Nothing here is published errata worthy, but can be non urgently addressed by the chapter team.

-Matt		Prelim accept but NOT publishable erratatrue01/03/19 12:17 PMGull ShahmirHasnatgull.hasnat@hotmail.com
821334EndocrinePathologyAdrenal insufficiencyhttps://www.uptodate.com/contents/metyrapone-stimulation-tests?source=autocomplete&index=0~1&search=metyrapone#H3541141777Under the metyrapone stimulation test, the text states that you would observe decreased ACTH if 2º/3º adrenal insufficiency. This is misleading; the ACTH response would still be elevated but just not as elevated as expected. It might also be useful to include a note that metyrapone stimulation test is most sensitive for detecting defects in ACTH secretion, whereas random serum ACTH is a better tool for differentiating between 1º and 2º/3º adrenal insufficiency.Clarification to current textThe reviewer is technically correct in referencing Uptodate's interpretation of Metyrapone test. In "partial" secondary or tertiary adrenal insufficiency ACTH will increase, though not as much as expected VS the decrement shown in the chart. However, the chart does not distinguish whether the 2/3 adrenal deficiency is partial or complete. I think we are referring to complete 2/3 adrenal deficiency, in which case the current interpretation would be correct. Need faculty advice for clarification. -PriyeshVerifiedThere is a pedagogical conundrum here. Yes, the client is correct in that it is misleading, however in teaching, we need to make things as simple as possible so that the maximum amount of information will be retained. I think that we have done that in this example, even though it's not entirely true, it is mostly true, and my remembering this, it will allow the student to get the question right on their boards. -ScottMelanie SchorrI think the way to resolve this is to put 2 "up" arrows to the left of ACTH for the boxes that correspond to "normal response" and "primary adrenal insufficiency" (meaning that there should be a robust increase to ACTH in these two cases) and then to change the arrow next to ACTH for the box that corresponds to "secondary/tertiary adrenal insufficiency" to "low, no change or mildly increased ACTH." The "low or no change" would signify a case of COMPLETE secondary or tertiary adrenal insufficiency, and the mildly increased ACTH would signify a case of PARTIAL secondary or tertiary adrenal insufficiency.true01/16/19 11:31 AMNicholasYeisleynwygz4@mail.umkc.edu
822334EndocrinePathologyAdrenal insufficiencyn/aBlack ADDidas shoes at low COst! ADDison disease Black - Hyper pigmentation Low COrtisol/aldosteroneMnemonicVerified07/08/19 6:56 PMAPandeyaranikopandey@gmail.com
823334EndocrinePathologyAdrenal insufficiencyuworld has the whole question considering this concept. Q.id 608Add changes of 17-hydroxycorticosteroid under metyrapone testHigh-yield addition to next year09/11/19 5:38 AMDmytroPavlenkopavlenko.md@gmail.com
824334EndocrinePathologyAdrenal insufficiencyhttps://www.uptodate.com/contents/causes-of-secondary-and-tertiary-adrenal-insufficiency-in-adults?search=tertiary%20adrenal%20insufficiency&source=search_result&selectedTitle=1~41&usage_type=default&display_rank=1The description for secondary and tertiary adrenal insufficiency is misleading. Secondary adrenal insufficiency can also be caused by glucocorticoid therapy. It should also explain that tertiary adrenal insufficiency is the interference with corticotropin-releasing hormone (CRH) from the hypothalamus.Major erratum12/05/19 11:46 AMNishaReddynishagetsreddy@gmail.com
825334EndocrinePathologyHyperaldosteronismIt's MnemonicNormal K (potassium) = No Konn’s (Conn’s) syndrome .MnemonicI am not inclined to reject or accept. The mnemonic only states that normal potassium cannot be Conn's. But, I don't feel it adds an extra value since the mnemonic does not mention the three most important consequences of hyperaldosteronism: hypernatremia, hypokalemia, and alkalosis. -Victor MartinezVerifiedReject. -Scott01/22/19 1:47 PMMoatasemAl-Janabiassoomi88@yahoo.com
826334EndocrinePathologyHyperaldosteronismhttps://casereports.bmj.com/content/2016/bcr-2016-216209Current text states that primary hyperaldosteronism is seen with bilateral adrenal hyperplasia. I believe this is incorrect. According to various research online, it is seen with unilateral adrenal hyperplasia.Major erratumA quick scholar search brought up multiple papers with both unilateral and bilateral adrenal hyperplasia causing aldosteronism. Reject. -ScottI agree with Scott. Primary hyperaldosteronism can be caused by both unilateral and bilateral adrenal hyperplasia. The current text states as much and therefore does not need to be changed.
Here is a small Swedish study for reference https://bmcendocrdisord.biomedcentral.com/articles/10.1186/1472-6823-12-17

- Sarah		Reject by 2 authors + 1 editor05/30/19 6:04 PMSarahZubairs.zubair@mua.edu
827335EndocrinePathologyCarcinoid syndromemy brainCARCINOID 5yndrome mnemonicMnemonicI don't understand the purpose of this mnemonic. I guess "5yndrome" has something to do with serotonin being 5-HT. I wouldn't add this one to the next edition. -Victor MartinezVerifiedReject -Scott01/12/19 12:45 PMLeviMarshallLSMmt4@health.Missouri.edu
828335EndocrinePathologyHypothyroidism vs hyperthyroidismhttps://academic.oup.com/jcem/article/91/3/1159/2843609 Radiology. 1993 Jul;188(1):115-8. https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-graves-orbitopathy-ophthalmopathy?search=graves%20ophthalmopathy&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2In ocular findings of Hyperthyroidism (Graves Disease), lid lag/ retraction is due to either thickening of the Levator Palpebrae Superioris or fibrosis of the Superior Tarsal muscle. However, the innervation of the levator palpebrae is totally by oculomotor nerve instead of sympathetic nerve. And the Superior Tarsal is innervated by sympathetic nerve. Pathologic changes of the Levator Palpebrae is for sure, (Radiology. 1993 Jul;188(1):115-8.), however it's mechanism is still under debate. According to Uptodate, this is due to thyroid hormone excess. (https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-graves-orbitopathy-ophthalmopathy?search=graves%20ophthalmopathy&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2) And the pathologic change of the Superior Tarsal is also proved in this article. https://academic.oup.com/jcem/article/91/3/1159/2843609 I think FA2019 page337 fail to demonstrate the exact neurological innervation of these two closely related eyelid muscle :-).Major erratumVerifiedYes, we fail to demonstrate the exact innervation, because it's a LY fact for this exam. -ScottAdditional detail was added to the fact this year.
No need for further changes.
- Sarah		Prelim accept but NOT publishable erratatrue03/09/19 9:54 PMSHICHENGSONGnicksong66@gmail.com
829336GastrointestinalPhysiologyGastrointestinal secretory productshttps://www.sciencedirect.com/topics/neuroscience/stomach-chief-cellthe CHIEFs drinks PEPSInMnemonicVerifiedReject, it doesn't appear easy to remember to me.

-Connie		Reject. -VVReject by 2 authors + 1 editor03/26/19 11:38 PMSteffanieCamilo Tertuliensteffkmilo@hotmail.com
830336EndocrinePathologyPheochromocytomaN/A"Rule of 10's:" 10% of MEdullary, Chromaffin cells, Be, Kids (10% Malignant, 10% Extra-adrenal, 10% Calcify, 10% Bilateral, 10% KidsMnemonicThe mnemonic is not bad. However, it is not complete since it does not include that 10% calcify. -Victor MartinezVerifiedReject. -Scott01/11/19 3:04 PMJasonTegethofftegethoffjason@gmail.com
831336EndocrinePathologyPheochromocytomathis is just a mnemonic revision suggestion, not a citable content revision.Please change the Rule of 10's to the Rule of 90's: 90% are benign, 90% are unilateral, 90% are adrenal only, 90% are uncalcified, 90% occur in adults. It seems much more intuitive to describe the rule as that of the primary presentation the vast majority of the time (90%), and the exceptions to those rules are easy to remember as the 10% occurrences.MnemonicVerifiedReject. -Scott03/01/19 6:45 PMAdamRippetoeadam.rippetoe@yahoo.com
832336EndocrinePathologySomatostatinomahttps://www-uptodate-com.webproxy2.ouhsc.edu/contents/pathology-classification-and-grading-of-neuroendocrine-neoplasms-arising-in-the-digestive-system?search=somatostatinoma&source=search_result&selectedTitle=2~21&usage_type=default&display_rank=2Also known to have psammoma bodiesHigh-yield addition to next yearVerifiedIt is the psammomatous variant that has psammoma bodies. Reject. -Scott03/02/19 10:56 AMRaulOrozco Villalobosraulcollege@gmail.com
833336EndocrinePathologySomatostatinomaself explanatoryclarify that Somatostatin is needed supplemented after the surgery (I think that's how its meant?) but it really doesn't help for "symptom control" acutely!Clarification to current textReject. LY -ScottAgree with Scott. I don't think additional clarification is required.

- Sarah		Reject by 2 authors + 1 editor06/07/19 10:33 AMNoamDegnernoam.degner@me.com
834336EndocrinePathologyZollinger-Ellison syndromehttps://www.ncbi.nlm.nih.gov/pubmed/2565843 + also had a World Question which brought this to my attentionAfter administration of secretin, gastrin does not only *remain elevated* but it even rises! I think this is a key difference between a just autonomous gastrin secreting tumor and the special "inversion" of endocrine mechanism in ZES!Minor erratumReject. https://www.gastrojournal.org/article/0016-5085(89)90510-6/pdf I think all they need to know is that the levels remain elevated. It doesn't matter if they go higher, they're still elevated and abnormal. -ScottI agree with Scott. The additional information seems LY.

- Sarah		Reject by 2 authors + 1 editor06/26/19 5:22 AMNoam LeanderDegnernoam.degner@me.com
835337EndocrinePathologyHypothyroidism vs hyperthyroidismNoneNo blue brackets present in image to indicate onycholysisSpelling/formattingAgree we should be consistent with our formatting. We need to include the blue racket regions. -Victor MartinezVerifiedAgree

- Vivek		Agree. -Scott01/02/19 9:47 PMElizabethTsuielizabeth.tsui21@gmail.com
836337EndocrinePathologyHypothyroidism vs hyperthyroidismwikiin Hyperthyroidism, lid lag is due to sympathetic stimulation of superior tarsal muscle or muller muscle, not levator palpebrae superiors, which is innervated by cranial nerve IIIMajor erratumVerifiedWould reject, as this has been discussed and brought up numerous times and while the literature is not definitive, most source indicate that it is in fact the levator palpebrae superioris that is affected

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1042179/

-Roshun S		Agree, this was an erratum last year and with expert input we left it as is. No change for 2020 given that same extensive review.

-Matt		Reject by 2 authors + 1 editor01/19/19 3:23 AMHangSonghwh1991@163.com
837337EndocrinetruePathologyHypothyroidism vs hyperthyroidismhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384127/Lid retraction is due to increased sympathetic stimulation of the SUPERIOR TARSAL MUSCLE (muller's muscle)Clarification to current textWe need faculty input. The sources state different things regarding the sympathetic tone acting on Müller's or levator palpebrae superioris. "...Sagittal MR imaging demonstrated thickening of the levator muscles in patients with persistent upper eyelid retraction. The authors conclude that a thickened levator muscle probably causes upper eyelid retraction in patients with GO (Graves ophthalmopathy)." https://www.ncbi.nlm.nih.gov/pubmed/8511284 "Upper eyelid retraction – the most common presenting sign of TED (Thyroid eye disease) Up to 90% of patients affected (bilateral or unilateral) [2] Multifactorial cause [2] Increased sympathetic tone acting on Müller's muscle Contraction of the levator palpebrae superioris Proptosis Scarring between the lacrimal gland and the levator palpebrae superioris." https://webeye.ophth.uiowa.edu/eyeforum/tutorials/thyroid-eye-disease/2-clinical-presentation.htm -Victor MartinezVerifiedPlenty of papers showing that it is the levator palpebrae superioris. Reject. -ScottExcellent commentary by Victor. I will agree that this appears controversial and I am not able to personally find support in favor of one or the other. We can have expert input here to help us with the final say.

-Matt

UPDATE: Per expert feedback, update official errata to mention that both muscles are involved.

-Matt		Disagreement/need expertMelanie SchorrThe eyelid retractors are BOTH the levator muscle AND Müller's muscle in the upper eyelid according to this website: https://www.sciencedirect.com/topics/immunology-and-microbiology/eyelid-retraction So you could therefore include both the levator palpebrae superioris and Müllers muscle.Accepttrue01/30/19 9:36 AMHasanAlarourihassan.arouri@hotmail.com
838337EndocrinePathologyVIPomaIt's MnemonicV*1*poma --> associated with MEN *1*.MnemonicThe mnemonic seems appropriate. We should consider adding this one to the next edition. -Victor MartinezVerifiedReject. -Scott12/30/18 8:36 AMMoatasemAl-Janabiassoomi88@yahoo.com
839338EndocrinePathologyHypothyroidismN/AIn the description of Postpartum thyroiditis, the second sentence mistakenly lists transient hyperthyroidism twice. "Presents as transient hyperthyroidism, hypothyroidism, or hyperthyroidism followed by hypothyroidism."Minor erratumThat's not a mistake, these are two different presentations of Postpartum thyroiditis. Reject. -ScottAgree with Scott.

Sarah		Reject by 2 authors + 1 editor03/23/19 2:49 PMAhmedBaghdadyabaghdady786@marian.edu
840339EndocrinePathologyHyperthyroidismhigh fibroblast secretion of hydrophilic GAGs leads to high adipocyte count which leads to exophthalmosadipocyte count ?Clarification to current textReject. -ScottAlready mentioned in the Graves disease fact.

- Sarah		Reject by 2 authors + 1 editor07/21/19 6:54 PMGevorgGrigoryangevorgrigoryan@gmail.com
841340EndocrinePharmacologyInsulinhttps://www.uptodate.com/contents/general-principles-of-insulin-therapy-in-diabetes-mellitus?search=General%20principles%20of%20insulin%20therapy%20in%20diabetes%20mellitus&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1regular insulin start its effect at 30 minutes and peek 4=6 hr andaréis acting insulin star at 15 minutes and peek at 2=4 hr.High-yield addition to next yearWe already mentioned this fact under Diabetes mellitus management fact, injectables entry. There, we have a graph showing the plasma insulin level vs. hours. -Victor MartinezVerifiedThis is all present in the graph on page 348. Reject. -Scott01/08/19 9:33 PMNeryMaraLamothemaralamothe@hotmail.com
842340EndocrinePathologyThyroid adenomahttps://www.uptodate.com/contents/diagnostic-approach-to-and-treatment-of-thyroid-nodules"Cold" or nonfunctional thyroid adenomas are more often cancerous than "hot" or "toxic" thyroid adenomas. "Cold" adenomas may require biopsy by fine needle aspiration.Clarification to current textVerifiedI haven't been able to find anything stating that cold nodules are more likely to be cancerous. However, I did find some papers that related the cancer risk back to Iodine Deficiency. -ScottI believe there is some evidence that cold nodules, on average, are more likely to be cancerous than hot nodules. See below:

https://www.mayoclinic.org/diseases-conditions/thyroid-nodules/diagnosis-treatment/drc-20355266		04/23/19 1:05 PMYurinaMiyamotomiyamoty@upstate.edu
843340EndocrinePathologyThyroid cancernot neededNew table to more deep understanding of the topicHigh-yield addition to next yearI believe current information regarding thyroid cancer is appropriate. The student doesn't specify what fact should be added. -Victor MartinezVerifiedReject. -Scott01/22/19 7:14 AMMohamed AshrafMokhtarMohamed94Mokhtar@gmail.com
844340EndocrinePathologyThyroid cancernone neededRemember that Medullary Carcinoma is associated with MEN2A and MEN2B by writing it as "MENdullary" (with the two Ls highlighted to remember its association with type 2)MnemonicVerifiedReject. -Scott03/11/19 5:14 PMNatalieJansenjansen7@uic.edu
845341EndocrinePathologyDiagnosing parathyroid diseasehttps://emedicine.medscape.com/article/2089334-overview#a1 , First Aid Usmle Step 1 2019 page XXI suggest to add normal range values of calcium(8.4 - 10.2 mg/dL) and parathyroid hormone (10-65 pg/mL) near graphic for better visualization.Clarification to current text09/04/19 2:10 PMAlsuZagorulkoalsu.zagorulko@gmail.com
846341EndocrinePathologyHypoparathyroidismn/aPseudohypoparathyroidism Type 1A: Mother: There won’t be PEACE until there’s resistance. Inherited from Mother PEACE – Shortened 3rd and 4th digits (Albright Syndrome) Resistance to PTH. Pseudopseudohypoparathyroidism: Father: Yes! When there’s NO Resistance, there will be PEACE. Inherited from Father PEACE – Features of Albright Syndrome seen But, NO resistance to PTH.MnemonicVerified07/08/19 6:58 PMAPandeyaranikopandey@gmail.com
847341EndocrinePathologyParathyroid hormoneMade upPseudohypoparathyroidism (alliteration/Stress the S)---> G"S" protein defect resulting in "S"hortened stature, "S"hortened 3/4th digits & Subnormal PTH responseMnemonicWe could make the "S" red bold to highlight this constellation of clinical manifestations. It is a good suggestion. - Victor MartinezVerifiedReject. -Scott02/15/19 1:38 PMAlecHastyalechasty2017@gmail.com
848343EndocrinePathologyHyperparathyroidismhttps://emedicine.medscape.com/article/127351-overviewAdd that bone resorption in osteitis fibrosa cystica occurs in the SUBPERIOSTEAL layer of boneHigh-yield addition to next yearVerifiedReject. Of course it would occur below the periosteum. -Scott03/07/19 7:16 PMLisa-QiaoMacDonaldllm012@jefferson.edu
849344EndocrinePathologyDiabetes insipidusIt's Mnemonic*N*ephrogenic DI --->* N*ormal ADH levels.MnemonicI am not inclined to accept or reject this mnemonic. -Victor Martinez.VerifiedI don't think adding mnemonic would be helpful in this case.
-Prashank		Reject. -Scott01/05/19 9:42 AMMoatasemAl-Janabiassoomi88@yahoo.com
850345EndocrinePathologyDiabetes mellitushttps://www.uptodate.com/contents/pathogenesis-and-prevention-of-diabetic-polyneuropathy?search=cause%20of%20diabetic%20polyneuropathy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H1Osmotic damage as a cause of diabetic peripheral neuropathy has been shown to be a less likely etiology after failure of aldose reductase inhibitors in clinical trials. There is evidence that abnormalities of the vaso nervorum parallel the severity of nerve fiber loss. Thus, diabetic neuropathy is now thought to be caused by vascular or metabolic etiologies.Major erratum10/28/19 6:49 PMJamieSimpsonjsimpson@oakland.edu
851346EndocrinePathologyDiabetes mellitusPathoma page 166: "Due to autoimmune destruction of beta cells by T lymphocytes." Other authoritative sources include Robbins. Also research articles: https://www.ncbi.nlm.nih.gov/pubmed/16280652; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119381/; and many, many other reviews and research articles.The autoimmune destruction of of beta cells in type 1 diabetes mellitus from T cells and macrophages, not the autoantibodies. The autoantibodies are present but they are not what causes the destruction. The text implies the antibodies cause the destruction.Major erratumVerifiedAgree, Suggest autoimmune T-cell destruction of B cells(e.g. due to presence of glutamic acid decarboxylase antibodies. -ScottThere is major role of cellular immunity in the pathogenesis of type 1 diabetes. Current text appears as if the antibodies itself is causing autoimmune destruction of islets. I think we need to tweak the text in 2020 revision to reflect the exact pathogenesis.


Final comment:
- No errata for now.
- Revisit in 2020.


- Vivek		I agree. This fact needs to be slightly revised to be more accurate and avoid confusion. Scott's suggestion is good. Let's migrate this to Annotate for further discussion and work up. Here is a reference https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5723426/

Sarah		Prelim accept by 2 authors + 1 editortrue02/16/19 11:35 AMEvanDishionevandishion@yahoo.com
852346EndocrinePathologyDiabetic ketoacidosishttps://www.uptodate.com/contents/diabetic-ketoacidosis-and-hyperosmolar-hyperglycemic-state-in-adults-clinical-features-evaluation-and-diagnosis?topicRef=1795&source=see_link#H10Please consider adding the value of hyperglycemia in diabetic ketoacidosis is often >250 mg/dlClarification to current textI hesitate adding a value because HHS and DKA can have similar values, and patients who aren't in DKA may have values that high. Reject. -ScottI don't think this value is particularly HY for Step 1. It is more relevant for Step 2 +/- 3.
Reject.

Sarah		Reject by 2 authors + 1 editor07/23/19 2:15 PMLeshlieDe la Torre Mendozaldelatorre28@hotmail.com
853346EndocrinePathologyDiabetic ketoacidosisnot neededI have created a helping mnemonic for DKA. D for DKA (Diabetic ketoacidosis), K for Ketones / Kussmaul respirations and A for metabolic Acidosis are important criteria for diagnostic.MnemonicVerifiedReject. -Scott07/23/19 2:25 PMLuisApolinario Rojasluisapolinario90@hotmail.com
854346EndocrinePathologyHyperosmolar hyperglycemic statehttps://emedicine.medscape.com/article/1914705-overviewIn this section, near the end where the "Labs" are reported. It says there is "ketone production inhibited by presence of insulin". However, there is no ketone production in hyperosmolar hyperglycemic state. It should state "NO ketone production". This is an important fact.Major erratumVerifiedI think that we should bring it out to the forefront. Suggest bolding "ketone production inhibited" -ScottAgreed, we could also just emphasize that no ketones are produced (due to inhibition by insulin)
- FQ		I agree with the authors. This is being addressed this year. Accepting for credit.

- Sarah		Prelim accept but NOT publishable erratatrue03/04/19 4:28 PMAndrewTrinhandy.d.trinh@gmail.com
855346EndocrinePathologyHyperosmolar hyperglycemic statehttps://emedicine.medscape.com/article/1914705-overviewIn the "Labs," there is an extra parentheses after the word "normal," as it should read "no acidosis (pH normal, ketone production inhibited by presence of insulin" or "no acidosis (pH normal), ketone production inhibited by presence of insulin."Spelling/formatting08/12/19 1:25 AMRyanLeeryanlee@gwu.edu
856346MicrobiologyVirologyNegative-stranded viruseshttps://www.clinicalkey.com/#!/content/book/3-s2.0-B9780323482554001661?scrollTo=%23topRift Valley Fever is transmitted by mosquito or blood-feeding fly not TicksMajor erratum11/26/19 6:08 PMDanielAtchleydaniel.atchley@arcomedu.org
857346EndocrineEmbryologyThyroid developmenthttps://embryology.med.unsw.edu.au/embryology/index.php/Neural_Crest_DevelopmentThe text says "Thyroid follicular cells and parafollicular cells (aka, C cells, produce Calcitonin) are derived from endoderm." This is false, because C cells or parafollicular cells are derivates of the Neural Crest and therefor of Ectoderm.Major erratumSee annotate for latest updates. I think further discussion should go there. -weelicReject. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631767/ In summary, we show here that neuroendocrine cells of the mammalian thyroid gland are derived from foregut endoderm, indicating that the current view referred to in major medical textbooks (that those thyroid C cells are neuroectodermal and of neural crest origin) is fallacious. -ScottThis has been addressed (and resolved) with Dr. Schorr's input.

-Sarah		Reject by 2 authors + 1 editor07/27/19 4:58 PMJudithVásquezjudith.vasquez.11@gmail.com
858346EndocrinePathologyType 1 vs type 2 diabetes mellitusSelf-writtenType 2 Diabetes Mellitus = 2 much fat (strong link with obesity). Obesity has a genetic component (hence type 2 DM has a very strong genetic predisposition). Your fat starts to accumulate the more you age so it tends to occur in adulthood (>40yrs). More fat means more resistance to insulinMnemonic10/27/19 9:04 AMKhalidAlattarkhalid_alattar@hotmail.com
859347EndocrinePathologyMultiple endocrine neoplasiashttps://emedicine.medscape.com/article/123447-overviewMEN 1(1 Person): Pituatry,Pancreas,Parathyroid. MEN 2(2 people=Male & Female): Feochromocytoma+Medullary thyroid. Male/Boy(2B) :(Mucosal neuromas/Marfanoid)MnemonicThe 3 P's, 2 P's and 1P mnemonics are painless. I would leave as is. - Victor MartinezVerifiedLooks more confusing. The current mnemonic is fine.
-Prashank		Reject. -Scott01/09/19 5:05 AMalaamohameddr.alaakhaled93@hotmail.com
860347EndocrinePathologyMultiple endocrine neoplasiasFirst Aid 2019MEN 1: there is 1 pituitary gland (pituitary tumor), and 1 pancreas (pancreatic tumor). MEN 2: there are 2 adrenal glands (pheochromocytoma) and 2 thyroid lobes (medullary carcinoma of thyroid)MnemonicThe 3 P's, 2 P's and 1P mnemonics are painless. I would leave as is. - Victor MartinezVerifiedI think , this mnemonic would be more confusing. The current one is fine.

-Prashank		Reject. -Scott02/06/19 11:44 AMPrarthana PatelPateloprarthana@yahoo.com
861347EndocrinePathologyMultiple endocrine neoplasiashttps://www.cancer.net/cancer-types/multiple-endocrine-neoplasia-type-2Medullary carcinoma of the thyroid can be remembered in MEN2(A/B) by reading it as "MEN-two-llary carcinoma"MnemonicVerified07/13/19 3:25 AMJustynaKacarowjustynakacarow@gmail.com
862348EndocrinePharmacologyDiabetes mellitus managementhttps://emedicine.medscape.com/article/119020-medication#2Glimepiride is a 3rd generation sulfonylurea (Tex classifies it as 2nd)Clarification to current textVerifiedIt appears that it is in fact a second generation, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448454/ -Scott03/30/19 1:10 PMMurliMishramm.murli@gmail.com
863348EndocrinePharmacologyDiabetes mellitus managementhttps://www.ncbi.nlm.nih.gov/books/NBK409379/Metformin - lactic acidosis occurs because metformin increases anaerobic glycolysis and decrease uptake by liver so less glucose is made. Most importantly, In addition to patients with renal insufficiency, caution with HEART FAILURE and ALCOHOLIC patients should be taken as they also have high lactate levels. These types of patient scenarios are highly tested with the drug. I believe they should be mentionedHigh-yield addition to next year10/27/19 9:19 AMKhalidAlattarkhalid_alattar@hotmail.com
864349EndocrinePharmacologyDiabetes mellitushttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801817/ https://www.uptodate.com/contents/sodium-glucose-co-transporter-2-inhibitors-for-the-treatment-of-hyperglycemia-in-type-2-diabetes-mellitus?search=sglt2%20inhibitors&source=search_result&selectedTitle=1~67&usage_type=default&display_rank=1SGLT2 inhibitors were not found to cause hyperkalemia in large clinical trials, risk of Euglycemic DKA, necrotizing fasciitis of the perineum (Fournier's gangrene) and amputations should be addedMajor erratum10/02/19 12:33 PMAhmadNaserahmad.mn@live.com
865349EndocrinePharmacologyDiabetes mellitus managementhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620230/#!po=0.375940In the 4th row, the adverse effects column reads ‘Not recommended if kidney function is impaired.’ This text should be deleted or modified as acarbose is considered an ideal candidate for patients with Chronic Kidney Disease.Clarification to current textVerifiedThanks for raising this point.

I have reviewed the current evidence-base for Alpha-glucosidase inhibitors in CKD and as per UpTodate:

"Alpha-glucosidase inhibitors, such as acarbose or miglitol, are not recommended in patients with renal dysfunction [33]. With acarbose, increased levels of the parent drug and metabolites are observed with CKD, although an increased risk of hypoglycemia has not been documented. Miglitol is absorbed to a greater extent than acarbose and is largely renally excreted, with increased accumulation in patients with decreased kidney function."

Though with acarbose, increased risk of hypoglycemia is not observed with CKD, but this is still not an ideal drug of choice and not recommended in CKD given its increased levels of the parent drug and metabolites observed.


Recommendation:

1. No errata for upcoming errata report as we are correct; however, we may take faculty inputs.

- Vivek

Reference: https://www.uptodate.com/contents/management-of-hyperglycemia-in-patients-with-type-2-diabetes-and-pre-dialysis-chronic-kidney-disease-or-end-stage-renal-disease?source=autocomplete&index=0~2&search=management%20of%20hyperglyce#H6		Agree with Vivek

-Prashank		Agree with Vivek, that this does not appear to be a valid erratum. These drugs do appear to have significant renal excretion and should thus be used cautiously in patients with renal impairment. The easiest solution is to probably say something along the lines of "Use with caution in patients with renal impairment" such that it is implied that there is a renal component to watch out for, but that some practitioners may decide to use these drugs anyway. We have done similar things with other drugs (eg, beta blockers in diabetics) where the decision to use the drug may be more controversial in the context of some comorbidity.

Accepting for consideration of rewording, but this is most definitely a clarification, not an erratum, and this need not be published in the official errata.

-Matt		Prelim accept but NOT publishable erratatrue12/25/18 12:51 AMMuhammad FaizanAlifaizanali.93@hotmail.com
866349EndocrinePharmacologyDiabetes mellitus managementN/ADPP-4 inhibitors: "GLIPTIN suffix= GLP-1 LifTIN"MnemonicVerifiedReject. -Scott02/18/19 10:20 AMOpalSekleropalsekler@gmail.com
867349EndocrinePharmacologyDiabetes mellitus managementhttps://www.uptodate.com/contents/thiazolidinediones-in-the-treatment-of-diabetes-mellitus?search=thiazolidinediones&source=search_result&selectedTitle=1~124&usage_type=default&display_rank=1#H8Addition of "cardiotoxicity" as a side effect of Glitazones/Thiazolidinediones -- encountered in QBank in which the deciding factor was knowing which DM drug class has noted cardiotoxicityHigh-yield addition to next yearAccept. -ScottWe seem to already have HF listed as a side effect. The "cardiotoxicity" he's referring to, as in cardiac ischemic events seem to mostly apply to rosiglitazone and does not seem to be a class-wide effect.
- FQ		04/24/19 11:53 AMMalcolmKatesmalcolmkates@ufl.edu
868349EndocrinePharmacologyDiabetes mellitus managementN/AThe -FLOZIN drugs keep the glucose flowin through the kidneyMnemonicVerifiedReject
- FQ		05/08/19 6:26 PMDillonYaldoyaldodil@msu.edu
869349EndocrinePharmacologyDiabetes mellitus managementhttps://www.medscape.com/viewarticle/916131, https://bmjopen.bmj.com/content/9/1/e022577, https://www.medscape.com/viewarticle/915452, https://www.healio.com/endocrinology/diabetes/news/online/%7Ba134e981-50a6-4b25-92f1-5ac2cc47e466%7D/no-urinary-tract-infection-risk-with-most-sglt2-inhibitorsCommon misconception that SGLT2 inhibitors are associated with "urinary tract infections." However, SGLT2 inhibitors are actually associated with "genital infections" (e.g. Fournier's gangrene). Only dapagliflozin is associated with increased risk of UTI.Major erratum09/29/19 6:59 AMAnthony MartinLimanthony.m.lim@gmail.com
870349EndocrinePharmacokinetics & PharmacodynamicsThionamidesn/a“γ–zone is a nexus working to INCREASE sensitivity towards patients with HEART FAILURE” Activate PPAR-γ Zone – ThiaZOlidinedioNEs Nexus – Increase level of adipoNECTIN Increase Insulin SENSITIVITY Adverse drug reaction: HEART FAILUREMnemonicVerifiedReject. -Weelic07/08/19 7:00 PMAPandeyaranikopandey@gmail.com
871350EndocrinePharmacologyCinacalcethttps://www.uptodate.com/contents/management-of-secondary-hyperparathyroidism-in-adult-nondialysis-patients-with-chronic-kidney-disease?search=cinacalcet&source=search_result&selectedTitle=3~31&usage_type=default&display_rank=2Under secondary hyperparathyroidism in CKD should include the specification that it’s approved for dialysis patients only, as it’s not recommended, according to UpToDate, for nondialysis patients.Clarification to current textVerifiedAgreed. It is only for patients on dialysis. -ScottYes, agree. The calcimimetic, cinacalcet, to suppress PTH is recommended for nondialysis CKD patients.

It is associated with hypocalcemia and increased urinary calcium excretion and require a close monitoring which is difficult in outpatient settings.

Also, the KDIGO 2017 guideline does not provide recommendations on the use of cinacalcet.


Final comment:

- no errata for now
- defer to 2020, perhaps we may need to specifically add "in dialysis CKD." (though we can argue if this is HY for step 1 or not).


- Vivek		Great discussion!

I agree we should migrate this potential clarification to Annotate to discuss further and implement the change this year if deemed HY.

Addendum: The literature is pretty consistent on the benefit of cinacalcet in patients with CKD 5 (dialysis) only. So it would be worthwhile clarifying this particularly as we have some space on the page.

https://www.nice.org.uk/guidance/ta117
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640084/
https://annals.org/aim/fullarticle/2672941/diagnosis-evaluation-prevention-treatment-chronic-kidney-disease-mineral-bone-disorder
https://cjasn.asnjournals.org/content/4/9/1405

- Sarah		Prelim accept but NOT publishable erratatrue02/19/19 8:11 PMAndreaLeal-Lopezandrea.leall11@gmail.com
872350EndocrinePharmacologyCinacalcetMnemonicSomeone could remember that Cinacalcet is used to sensitize Ca2+-sensing receptors in the parathyroid gland to circulating Ca2+, which decreases PTH by remembering, "'SEN'acalcet (Cinacalcet) 'SEN'sitizes Ca2+-'SEN'sing receptor..."MnemonicVerifiedReject. -Scott03/20/19 11:12 AMAmerMohiuddinamemohiu@iu.edu
873350EndocrinePathologyHypothalamic/pituitary drugsIt's Mnemonicpronounce (Cinacalcet) like (Sena*Ca*lcet )= *Sen*sitizes *Ca*2+-sensing receptor.\highlight "sen" and "ca".MnemonicI find this mnemonic difficult to remember. I wouldn't add it to the next edition. - Victor MartinezVerifiedI don't think this would be a good addition. Reject

-Prashank		Reject. -Scott01/05/19 9:58 AMMoatasemAl-Janabiassoomi88@yahoo.com
874350EndocrinePharmacologyHypothalamic/pituitary drugshttps://emedicine.medscape.com/article/947954-overviewIn addition to treatment of GH deficiency and Turner syndrome, GH is also used in Prader-Willi SyndromeHigh-yield addition to next yearVerifiedTrue, however, I believe this to be a LY fact about Prader willi syndrome -Scott02/17/19 3:08 PMNathanielBorochovnateboro8@gmail.com
875350EndocrinePharmacologySevelamern/a“Pho @ $7” SEVElamer decrease absorption of PHOsphate in hyperPHOsphatemia.MnemonicVerified07/08/19 7:02 PMAPandeyaranikopandey@gmail.com
876353GastrointestinalEmbryologyTracheoesophageal anomalieshttps://www.uptodate.com/contents/approach-to-the-adult-with-nausea-and-vomitingIn the book it says: "neonates drool, choke and vomit.." when it should say "neonates drool, choke and regurgitate..." as it is important to differentiate the two especially in such presentation. These babies (TEF w/ EA) have proximal blockage, therefore, they cannot vomit (i.e. evacuate gastric contents)Minor erratum11/17/19 8:36 AMMohammed KhalifaAlEnezim.khalifa2018@gmail.com
877354GastrointestinalAnatomyPancreas and spleen embryologyFirst Aid 2019Pancreas and spleen embryology (that contains annular pancreas and pancreas divisum) is mistakenly placed in the first part of the anatomy section instead of the embryology section.Clarification to current textVerifiedReject.

The topic "pancreas and spleen embryology" is placed under embryology section in page 345. The anatomy section starts after this topic.

- Humood		Reject.

I see how it's potentially confusing because the page header does say "anatomy" but there's not really anything we can do about that.

-Connie		Agree, reject. -VVReject by 2 authors + 1 editor02/28/19 1:00 AMMohammadKatatomkatato@yahoo.com
878354GastrointestinalAnatomyPancreas and spleen embryologyBoards and BeyondAnnular pancreas complications include duodenal obstruction, polyhydramnios, and pancreatitis.High-yield addition to next yearVerifiedBorderline reject.

Duodenal obstruction is mentioned in the text (duodenal narrowing). I don't think the other two are HY enough to be mentioned in the book. If others believe otherwise, feel free to accept it.

- Humood.		Reject, agree with humood here.

2/3 of annular pancreas pts are asymptomatic, manifestations depend on severity of obstruction, but it looks like pain and n/v are the most common.

Pathogenesis of pancreatitis in pts with annular pancreas is unclear.

Annular pancreas has been associated with maternal polyhydramnios but the association is pretty poorly documented.

both too ly

-Connie

https://www.uptodate.com/contents/annular-pancreas?search=annular%20pancreas&sectionRank=1&usage_type=default&anchor=H4&source=machineLearning&selectedTitle=1~16&display_rank=1#H4		Duodenal obstruction is likely the most important to know of the three listed. Agree that other two complications are LY for step 1 purposes. Would not recommend addition. -VVReject by 2 authors + 1 editor02/28/19 1:03 AMMohammadKatatomkatato@yahoo.com
879354GastrointestinalEmbryologyPancreas and spleen embryologyhttps://embryology.med.unsw.edu.au/embryology/index.php/Gastrointestinal_Tract_-_Pancreas_Development"Ventral pancreatic bud contributes to uncinate process and main pancreatic duct. The dorsal pancreatic bud alone becomes the body, tail, isthmus, and accessory pancreatic duct" as well as the main pancreatic duct.Minor erratumAccording to the student's reference: "Main Pancreatic Duct (MPD or Wirsung's duct) forms within the dorsal pancreatic bud and is present in the body and tail of the pancreas. Discovered by Johann Georg Wirsung (1589 - 1643) a German physician who worked as a prosector in Padua." I don't think the current wording is wrong, we could consider adding this for the next edition. -Victor M.Reject. That's exactly what we have drawn in the figure. -ScottReject, -VVReject by 2 authors + 1 editor07/29/19 3:57 PMXavierDe Penaxavierdpp@gmail.com
880355GastrointestinalAnatomyImportant gastrointestinal ligamentshttps://www.uptodate.com/contents/surgical-techniques-for-managing-hepatic-injuryIt should be included under the pringle maneuvor fact that failure to stop bleeding upon completion of the maneuvor suggests bleeding from hepatic outflow source (the IVC, hepatic vein). This is the clinical relevance to the manuevor and this is how it is tested on board exams.High-yield addition to next yearBorderline reject.

Seems too advanced for the Step 1. I suppose the concept students should keep in mind is that if pringle maneuver succeeds, the bleeding vessel is inside the hepatoduodenal ligament. If the maneuver fails, the bleeder is somewhere else.

- Humood		Agree with Humood that this seems out-of-scope for step 1.

-Connie		Agree with Humood and Connie, no changes to the text. -VVReject by 2 authors + 1 editor04/25/19 11:43 AMLeeSeiferlseif002@fiu.edu
881355GastrointestinalAnatomyImportant gastrointestinal ligamentshttps://radiopaedia.org/articles/ligament-of-treitz & https://www.ncbi.nlm.nih.gov/pubmed/17653583 & Standring S. Gray's Anatomy. 41st ed. London: Elservier; 2016:1026.Ligament of Treitz- Also known as suspensory ligament of the duodenum. Connects the right crus of the diaphragm and connective tissue around celiac trunk. Is avascular, does not contain any vessel. Clinically use to distinguish if a GI bleeding is considered to be an upper GI bleeding or a lower GI bleeding, also used radiologically to diagnose intestinal complete or partial rotation.High-yield addition to next yearI don't know if this is commonly tested. -Victor MLY for Step 1. Reject. -ScottReject, LY. This is more of a clinical rather than Step 1 concept. -VVReject by 2 authors + 1 editor07/29/19 5:26 PMXavierDe Penaxavierdpp@gmail.com
882355GastrointestinalAnatomySpleenhttps://emedicine.medscape.com/article/1948863-overview#a2The fact "splenorenal ligament" says that it connects the spleen to the posterior abdominal wall. However, as per the name, the splenorenal ligament is known to connect the spleen to the anterior surface of the left kidney. Per emedicine "The splenorenal ligament extends from the hilum of the spleen to the anterior surface of the left kidney; it contains the tail of the pancreas and splenic vessels."Major erratumVerifiedFaculty input.

Most of other exam review info says that the splenorenal ligament connects from the tail of the pancreas to the left kidney.

But technically, the communication is between the pancreatic tail and the perirenal space, which contains the kidney. Despite apparent contiguity, there appears to be structures between the spleen and kidney besides the peritoneal layer (pararenal fat, prerenal fascia, perirenal fat), which one paper (cited below) states is the reason the "term splenorenal ligament is vague." I haven't worked on this chapter previously but I'm guessing this might be why we state that this ligament runs from the spleen to the posterior abdominal wall despite apparent contiguity with the left kidney

For step 1, I think the contained structures and general location is important. I think it might be beneficial to change the entry to "spleen to left kidney" to avoid confusion, but I don't know if this is not technically correct enough.

-Connie

sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821589/
https://pubs.rsna.org/doi/full/10.1148/rg.e34#R9
https://www.ncbi.nlm.nih.gov/pubmed/3683035		Yes, would certainly benefit from faculty input. Would it be appropriate to leave the wording for splenorenal ligament as "Spleen to posterior abdominal wall" or would it be better to change to "Spleen to left kidney"? Like Connie, I did not work on the chapter in previous years, so I am unsure whether this change was made in the past due to previous errata. -VVDisagreement/need experttrue03/03/19 10:02 AMMelissaSchechtermschech@gmail.com
883356GastrointestinalAnatomyDigestive tract anatomynot neededTo help remember frequencies of basal electric rhythm, fast to slow: "digestion is slow (stomach), mixing is fast (duodenum), absorption is in between (ileum)"MnemonicVerifiedReject.

Not a big fan, sorry.

- Humood		Reject,

It's not more helpful to memorize than the actual fact itself?

-Connie		Reject, not a fan. -VVReject by 2 authors + 1 editor01/09/19 10:40 AMNicholasYeisleynwygz4@mail.umkc.edu
884356GastrointestinalAnatomyDigestive tract anatomyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603487/ and Dr. Jason Ryan of Boards & BeyondSlow waves originate in the interstitial cells of CajalHigh-yield addition to next yearVerifiedBorderline reject.

I don't believe this is super HY info. We're looking to cut down on text as well. If others feel otherwise, feel free to accept it.

- Humood		Accept.

I actually think this is HY info. The ICC is the "pacemaker" and we have to know it for both understanding the physiology of gut motor function as well as the pathophys behind gastroparesis. I definitely remember this being an important tested fact.

-Connie

https://www.uptodate.com/contents/pathogenesis-of-delayed-gastric-emptying?search=interstital%20cells%20of%20cajal&source=search_result&selectedTitle=1~12&usage_type=default&display_rank=1		It's fair to add to the text. Please add as "Frequencies of basal electric rhythm (slow waves), which originate in the interstitial cells of Cajal:" -VVPrelim accept by 2 authors + 1 editortrue01/20/19 8:28 AMNathanielBorochovnateboro8@gmail.com
885356GastrointestinalAnatomyDigestive tract anatomyN/AFor Muscularis layers: Bold and color "i" in both inner and circular then bold and hi-light "o" for outer and longitudinal (for the different layers)MnemonicVerifiedReject.

Not a big fan, sorry.

- Humood		Reject, it doesn't quite make sense to me

-Connie		Agree, reject. -VVReject by 2 authors + 1 editor03/09/19 10:32 PMFrederickBurton IIIfalb409@gmail.com
886357GastrointestinalAnatomyAbdominal aorta and branchesN/AOrder of anterior-branching arteries of the abdominal aorta = CSI [Crime Scene Investigation], for Celiac, SMA, IMA.MnemonicVerifiedReject.

Knowing the order is not that helpful. I would look for a mnemonic that links the vertebral levels at which these arteries branch.

- Humood		Reject.

While I agree with humood that this isn't super important, it's also already intuitive that superficial MA is going to be above the inferior MA.

-Connie		Agree, reject. -VVReject by 2 authors + 1 editor01/10/19 11:29 AMEricaCohenmehrecohenmehr@gmail.com
887357GastrointestinalAnatomyAbdominal aorta and brancheswas in a Question stem but also see here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2878259/A Varicocele is symptom in the Nutcracker Syndrome because when the left renal vein becomes trapped under the SMA there is also distention of the left gonadal vein! Also this makes a kind of easy to remember Mnemonic since the Name of the Syndrome is "Nutcracker"...High-yield addition to next yearAccept. https://www.ncbi.nlm.nih.gov/pubmed/20660448 -scottCan be deferred to next year -VV06/07/19 10:18 AMNoam LeanderDegnernoam.degner@me.com
888357GastrointestinalAnatomyGastrointestinal blood supply and innervationFA 2019 Page 360Hind gut is suppleid by IMA until upper portion of anal canal (not the rectom)Minor erratumAccept.

Change "rectum" to "anal canal." IMA supplies entire rectum up until anal canal

-Connie

https://www.uptodate.com/contents/overview-of-intestinal-ischemia-in-adults?search=inferior%20mesenteric%20artery&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1		Accept, Please change "rectum" to "anal canal" -VVPrelim accept by 2 authors + 1 editortrue04/29/19 7:49 PMLaithRahabnehraedababneh@gmail.com
889357GastrointestinalAnatomyIschemiahttps://emedicine.medscape.com/article/366808-overviewRecto-sigmoid Water shed- IMA and hypogastric (Internal Iliac) arteryMinor erratumAccept.

The user seems to be correct.

"The IMA ( Fig. 118-3 ) arises 3 to 4 cm above the aortic bifurcation close to the inferior border of the duodenum. It branches into the left colic artery, gives off multiple sigmoid branches, and terminates as the superior rectal artery. The IMA and its branches supply the large intestine from the distal transverse colon to the proximal rectum. The distal rectum is supplied by branches of the internal iliac (hypogastric) artery. "


- Humood

Sleisenger and Fordtran's Gastrointestinal and Liver Disease, Chapter 118, 2076-2101.e5		Reject.

The text as we have it is correct.

If the location of the IMA is of concern, we very clearly mark the lumbar vertebrae level. If the watershed areas that are more susceptible to ischemia is the concern, we have the areas correct. eMed is not always a good resource, there are so many typos/mistakes/outdated info.

-Connie

https://www.uptodate.com/contents/colonic-ischemia
https://www.uptodate.com/contents/overview-of-intestinal-ischemia-in-adults?search=inferior%20mesenteric%20artery&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577613/
https://www.ncbi.nlm.nih.gov/pubmed/13529513		Based on my literature search, the text is correct as is. Would not recommend any changes -VVReject by 2 authors + 1 editor04/26/19 10:30 PMSherifGuirguissherif.guirguis@hotmail.com
890358GastrointestinalAnatomyCeliac trunkNetter's Clinical Anatomy, 3rd Ed (p. 181); Essential Anatomy 5; https://www.imaios.com/en/e-Anatomy/Thorax-Abdomen-Pelvis/Digestive-system-Illustrations (slide 63)In the figure of the celiac trunk, the anterior superior pancreaticoduodenal artery and the posterior superior pancreaticoduodenal artery appear to wrap around the duodenum. Instead, they should wrap around the pancreas: (1) the anterior superior pancreaticoduodenal artery would fit more appropriately at the current location of the posterior superior pancreaticoduodenal artery, and (2) the posterior superior pancreaticoduodenal artery could be depicted as faded behind the pancreas, branching from the gastroduodenal artery at the branchpoint of the current anterior superior pancreaticoduodenal artery.Minor erratumVerifiedAccept.

The reader is totally correct. Anterior superior pancreaticoduodenal and posterior superior pancreaticoduduodenal arteries are shown wrapping around the duodenum, but should be wrapping around the head of the pancreas.

Link they provide is fine, but I confirmed with Netter 5th ed plates 283 and 284.

-Connie		Accept. Please add to annotate and flag the illustration team. -VVPrelim accept by 2 authors + 1 editortrue03/09/19 2:53 PMJacquelineAredojaredo@stanford.edu
891359GastrointestinalAnatomyPortosystemic anastomoseshttps://www.ncbi.nlm.nih.gov/pubmed/8873859 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940321/Diagram suggests that the superior epigastric vein (which doesn't drain into iliac veins, but rather the internal thoracic) is not involved with caput medusae. "Small epigastric veins" may be vague to some readers and can be clarified to include inferior, superficial, and superior epigastric veins.Minor erratumReject. The illustration shows the INFERIOR epigastric vein draining into the external iliac vein. - Victor M.I think this is LY -ScottAgree, LY -VVReject by 2 authors + 1 editor07/01/19 3:07 PMJosephYasmehjyasmeh@gmail.com
892360GastrointestinalAnatomyPectinate lineThere was an erratun provided and approved for page 97 dated 2/14/18 for switching internal iliac to common iliac LNLymphatics for above the line drain into internal iliac LN; It should be Common iliac LNs based on newly approved erratumMajor erratumVerifiedReject.

I checked the FA errata from 2017 onward and can't find this, and the text right now is correct as is.

-Connie		Reject, text is correct as is. -VVReject by 2 authors + 1 editor03/01/19 7:51 PMAlaJamalala.aljamal@hotmail.com
893360GastrointestinalAnatomyPectinate linenot applicableunder anal fissure: possible addition to mnemonic innervated by (P)udendal nerveMnemonicVerifiedAccept.

This is a nice, easy, and helpful addition.

-Connie		Accept please migrate to annotate. -VVPrelim accept by 2 authors + 1 editortrue04/23/19 11:41 PMAwabElnaeemawab.kamal@gmail.com
894361GastrointestinalAnatomyLiver tissue architectureMnemonicDistinguishing which type of hepatitis (viral or alcoholic) affects which hepatic zone (Zone I or Zone III) = the # of single full downwards pen strokes made when writing the word “viral” or “alcoholic”, as if you are writing roman numerals of the affected Zone. Clarifying image attached.MnemonicVerifiedBorderline accept.

It is reasonable.Not sure how he make mnemonic treatment for the letter "h" though.

- Humood		On the fence.

The idea is really cute initially! But once I thought about it more, it could be too confusing. Why would the downward stroke on "h" count towards the number count, but not the downward stroke on the letter "i?"
-Connie		I'm inclined to reject. There is room for interpretation, which could make it confusing for the reader. Would not recommend. -VVReject by 2 authors + 1 editor02/06/19 8:42 PMMatthew J.Christensenmattchristensen607@gmail.com
895361GastrointestinalAnatomyLiver tissue architecturehttps://library.med.utah.edu/WebPath/LIVEHTML/LIVER003.htmlAddition of a histological picture illustrating the zones of the liver, with accompanying text illustrating which area is affected by what. For example- the picture would be as attached, with under "zone 1"; viral hepatitis, ingested toxins, and so on.Clarification to current textVerifiedAccept, if illustration team is on board.

Even if we just add dotted/colored lines to designate where in the current image the zones are, it could be really helpful to help illustrate where the zones are. The text is accurate but the visualization would be really helpful! I'm not sure the histological picture is HY to recognize, but understanding where the zones are is HY.

-Connie

another example:
https://discovery.lifemapsc.com/library/images/liver-structure		Accept, please add a note to annotate with notification for illustration team. -VVPrelim accept by 2 authors + 1 editortrue02/27/19 11:52 AMDylanErwinderwin@smu.edu
896362GastrointestinalAnatomyFemoral regionhttps://www.ncbi.nlm.nih.gov/books/NBK482388/ & https://emedicine.medscape.com/article/1923032-overview#a2"Femoral sheath: Fascial tube 3-4 cm below inguinal ligament. Contains femoral *V*ein, femoral *Artery* and *C*anal (deep inguinal lymph nodes) but no femoral *N*erve" Propose mnemonic *V*odka, *A*le or *A*bsinthe and *C*hampagne for the party, but no *N*ectar allow.MnemonicVerifiedIt's easier to just remember NAVeL. Reject. -ScottReject.

NAVeL is a much easier mnemonic to remember. It is also pretty common, so it is the better option.

Ashten		NAVeL is better. No changes. -VVReject by 2 authors + 1 editor07/29/19 6:29 PMXavierDe Penaxavierdpp@gmail.com
897362GastrointestinalAnatomyFemoral regionFirst Aid 2019Femoral Sheath contains the femoral ARTERY, VEIN, and canal (deep inguinal lymph nodes. This minor switch of order would be nice because organization and "lateral to medial" orientation is mentioned 2 sentences above. Consistency is key, especially as this is in the anatomy section. Much appreciated. Thanks!Minor erratum10/16/19 1:52 AMTashaPhillips-Wilsontphilli1@sgu.edu
898363GastrointestinalAnatomyInguinal canaln/aTransversus abdominis muscle + Internal oblique muscle = Conjoint tendon TIC = T+I = C.MnemonicVerifiedAccept.

This is reasonable and looks like it would fit nicely on the page.

Ashten		07/10/19 9:23 PMAPandeyaranikopandey@gmail.com
899363Musculoskeletal, Skin, and Connective TissuePathologyNeuromuscular junction diseasesI thought of this mnemonic myself"L before M" for Lambert-Eaton vs Myasthenia Gravis autoantibodies that affect PRE-synaptic and POST-synaptic channels, respectively.MnemonicVerified07/05/19 9:16 PMSinaMoridzadehsinamorid91@gmail.com
900364GastrointestinaltrueAnatomyHerniashttps://www.uptodate.com/contents/classification-clinical-features-and-diagnosis-of-inguinal-and-femoral-hernias-in-adults?search=inguinal%20hernia&source=search_result&selectedTitle=2~119&usage_type=default&display_rank=2#H4Move the most common in males to the top of the paragraph to read: "Most common in males. Goes through the...scrotum." Or, change the word scrotum to groin to reflect that it can occur in both sexes.Clarification to current textVerifiedReject.

I would leave it alone. I understand and agree with the commenter's point, but leaving scrotum in will probably remind readers about the higher incidence rates among males.

Ashten		Defer to expert, if we change this would we have to change the other text? Since we mention testes etc.Disagreement/need expertBrooks CashAM assuming this is about indirect inguinal hernias, but is much more common in males. Then would simply say most common type of inguinal hernia. Would say that it goes into the groin to "de-gender" the statement and delete the last statement since it has been moved upAccept02/01/19 5:34 PMBeth AnneGeorgeElisabeth_George@brown.edu
901364GastrointestinalAnatomyHerniashttps://www.uptodate.com/contents/classification-clinical-features-and-diagnosis-of-inguinal-and-femoral-hernias-in-adults#H5Slide into the DMs: Direct = Medial to inferior epigastric vesselsMnemonicVerifiedReject.

The mnemonic that is already in the book is better. This one does not really add anything new.

Ashten		Reject, -VVReject by 2 authors + 1 editor06/05/19 8:31 PMKevinKronkevkron123@gmail.com
902365GastrointestinalPhysiologyGastrointestinal regulatory substanceshttps://www.uptodate.com/contents/physiology-of-gastrin ,Negative regulation of gastrin is by somatostatin which is missing from the list of regulators. It is especially worth adding here in the table because of its clinical utility as treatment in gastrinomas.High-yield addition to next yearVerifiedOn the fence.
The reader is correct and this is important, but this page is so crowded that I don't think it will fit if we add an extra line to gastrin's regulation column.
One option is to add something in the notes column saying that somatostatin inhibits gastrin release by G cells?

-Connie		Inclined to reject, considering that there are multiple hormones that somatostatin inhibits, and it is not mentioned in any of the other entries. Additionally, the notes for somatostatin mention that it inhibits secretion of various hormones. Would not recommend changes to the text. -VVReject by 2 authors + 1 editor02/11/19 1:25 AMBasimAlibasim.ajafri@gmail.com
903365GastrointestinalPhysiologyGastrointestinal regulatory substanceshttps://www.sciencedirect.com/topics/neuroscience/motilin https://books.google.com.eg/books?id=zZINAEddjA0C&pg=PA357&dq=mo+cell+motilin&redir_esc=y#v=onepage&q=mo%20cell%20motilin&f=falseThe Motilin is secreted by Mo cells in small intestine, what if you write it between 2 brackets under Small intestine.Clarification to current textI don't think we should consider adding this since it is not HY. - Victor M.https://www.ncbi.nlm.nih.gov/pubmed/7479330 Accept. Suggest (Mo cells) under Small Intestine. -ScottLY, -VVReject by 2 authors + 1 editor05/15/19 6:05 PMMuhanadShaibmohanad.shaib@gmail.com
904365GastrointestinalPhysiologyGastrointestinal regulatory substanceshttps://www.uptodate.com/contents/physiology-of-somatostatin-and-its-analogues?search=somatostatin%20cell%20type&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Somatostatin "D"isables hormone secretion. Secreted from "D" cellsMnemonic09/27/19 5:26 PMJordanO'Steenjosteen441@gmail.com
905366GastrointestinalPhysiologyGastrointestinal secretory productsmnemonic"CHIEF of PEPSI-Cola" Chief cells of stomach produce pepsinMnemonicVerifiedReject. -ScottNo changes recommended. -VVReject by 2 authors + 1 editor07/30/19 2:31 PMPaolaDel Cuetopaoladelcueto@outlook.com
906366GastrointestinalPhysiologyGastrointestinal secretory productsFirst Aid 2019PepsinOGEN is secreted by the chief cells not pepsin. You have listed in the notes area an explanation of the conversion from the zymogen form to active enzyme which is nice. This is a matter of accuracy, which in the end is the goal. Please do consider.Minor erratum10/16/19 1:10 PMTashaPhillips-Wilsontphilli1@sgu.edu
907366GastrointestinalPhysiologyGastrointestinal secretory productshttps://www.uptodate.com/contents/physiology-of-gastric-acid-secretionPARIetal cell: Produce Acid Release Intrinic factorMnemonic11/07/19 12:21 AMHamzaUddinhamzauddin@gmail.com
908367GastrointestinalPhysiologyCarbohydrate absorptionnot neededAll are t(2)ransported to blood by GLUT 2 .( Highlight "t" and "2")MnemonicVerifiedReject.

Not a big fan, sorry.

- Humood		Reject, it feels a little forced and hard to remember.

-Connie		Reject. -VVReject by 2 authors + 1 editor12/30/18 8:24 AMMoatasemAl-Janabiassoomi88@yahoo.com
909367GastrointestinalPhysiologyCarbohydrate absorptionNot needed.'Fructose' is spelt as 'Frutose' in the diagram of the enterocyte.Spelling/formattingStaff acceptsAccept.

User is correct. Spelling error.

- Humood		Accept.

Change "frutose" to "fructose" in diagram of enterocyte on the bottom of the page.

-Connie		Accept. Change "frutose" to "fructose" in diagram of enterocyte on the bottom of the page per authors. -VVPrelim accept by 2 authors + 1 editortrue02/10/19 9:21 AMBasimAlibasim.ajafri@gmail.com
910367GastrointestinalPhysiologyGastrointestinal secretory productshttps://www.ncbi.nlm.nih.gov/pubmed/10433005ECL cells are illustrated outside the stomach diagram and it gives the impression that they are not found in the stomach, when in fact, they are.Minor erratumVerifiedAccept.

This is confusing. ECL cells are in the gastric mucosa, so having them floating outside of the stomach is a little confusing. The diagram is pretty full so I do feel for the illustration team, but I think it might be worth trying to move the ECL cells into the stomach and not just floating outside.

-Connie		Borderline accept.

I do see the commenter's point. Looking at the current illustration, it seems like this organization of information was intentional given how much is already conveyed in the diagram. That being said, I do not feel that showing ECL cells this way is so distracting that it makes it hard to understand.

I am not sure if this would be worth the illustration team's time.

Alternative: include a short phrase in the text to make it clear that the ECL cells are within the gastric mucosa.

- Ashten		Accept. Please add a note to annotate and tag the illustration team. -VVPrelim accept by 2 authors + 1 editortrue02/06/19 12:05 PMOliviaKeller-Barucholiviakellerb@gmail.com
911367GastrointestinalPhysiologyPancreatic secretionsMnemonicThe only pancreatic enzyme that does not require cleavage/activation by trypsin is ɑ-amylase because “ɑ-amylase is ɑlways active” (or “ɑlready active”). Clarifying image attached.MnemonicVerifiedReject,
This is REALLY cute but not completely accurate, because there are other pancreatic enzymes that don't require cleavage/activation, like lipase, amylase, ribonuclease, deoxyribonuclease, gelatinase, and elastase.

-Connie		Yea, actually it's pretty cute. But like Connie says, not all-encompassing. Would not recommend -VVReject by 2 authors + 1 editor02/06/19 9:34 PMMatthew J.Christensenmattchristensen607@gmail.com
912367GastrointestinalPhysiologyPancreatic secretionshttps://www.ncbi.nlm.nih.gov/books/NBK54127/Pointing out just amylase as being secreted in its active form may mislead students into thinking it's unique; lipase is also secreted as a non-zymogen, and is unacknowledged as in in the notes right below amylase. (DNase and RNase are also active).Clarification to current textI say we just remove "secreted in active form", because that's not very important at all. -Scott07/30/19 8:51 PMJosephYasmehjyasmeh@gmail.com
913370GastrointestinalPathologySalivary gland tumorshttps://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/cranial-nerve-disorders/trigeminal-neuralgiaIt currently says "CN VII signs (ie, facial paralysis or pain) suggest malignant involvement". However, CN VII only innervates facial muscles and all sensation from the face is from CN V.Minor erratumhttps://www.sciencedirect.com/science/article/pii/B9780123851987000072 This is technically correct. The facial afferents usually don't have nociceptive fibers, but the signal can get rerouted and cause pain. Likewise the Trigeminal nerve is closely nearby and can receive the nociceptive impulses. I think we can just take out CNVII signs and change it to read: "facial paralysis and pain suggest malignant involvement." -ScottI agree with Scott's point. There really is no need to get lost in the weeds about the afferent neurons involved in the sensation when the main point is that a space-occupying lesion in the glands can cause pain and paralysis. I support taking out "CN VII signs."

Ashten		It's fair to change. Please replace "CV VII signs (ie, facial paralysis and pain)" with "Facial paralysis or pain" I will include a note in annotate to reflect this change. -VVPrelim accept by 2 authors + 1 editor06/25/19 3:16 PMNicholasCook-Rostiecookr002@umn.edu
914371GastrointestinalPathologyEsophageal pathologiesNoneThe 'New image' annotation box was left in next to the picture of pseudomembrane, on the bottom of the page. It is a yellow box in the margin. Just a formatting error, I don't believe this was supposed to be left in.Spelling/formattingVerifiedHahaha accept.

I checked my printed copy of FA2019 and the yellow "new image" box was in fact left in.

-Connie		Funny. -ScottLol, add a note to delete -VVPrelim accept by 2 authors + 1 editortrue12/22/18 9:53 PMJerrinBawajerrin.bawa@gmail.com
915371GastrointestinalPathologyEsophageal pathologiesFirst AidPlumber DIES instead of Plumbers DIE. The S for increase risk for "S"quamous cell carcinoma.MnemonicVerifiedAccept!!

Yes yes this is fantastic, it is more accurate to the disease name (Plumber-Plummer, no "s") and it adds in a risk we already have listed.

"Triad of Dysphagia, Iron deficiency anemia, and Esophageal webs. Increased risk of esophageal Squamous cell carcinoma ("Plumber DIES"). May be associated with glossitis.

-Connie		Accept.

This makes sense and ties in the increased risk of squamous cell carcinoma nicely.

Ashten		Accept. Please add per Connie with appropriate red marking: "Triad of Dysphagia, Iron deficiency anemia, and Esophageal webs. Increased risk of esophageal Squamous cell carcinoma ("Plumber DIES"). May be associated with glossitis." -VVPrelim accept by 2 authors + 1 editortrue01/11/19 11:47 AMClaraSzecsze@sgu.edu
916371GastrointestinalPathologyEsophageal pathologiesFirst Aid 2018Boerhaave Syndrome along with its description is completely missing from the 2019 edition. It is indexed correctly but seems to be deleted.Major erratumOn page 371 FA 2019, you see Boerhaave syndrome written under esophageal perforation main entry. So, not sure why reader is saying its deleted? It is indexed in pages 659 (under pneumomediastinum) and 371 (albeit not its own entry) -AidaVerifiedWe decided to include in esophageal perforation, not missing.Reject by 2 authors + 1 editor01/30/19 9:41 PMYousifMakadsiymakadsi@gmail.com
917371GastrointestinalPathologyEsophageal pathologieshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639970/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387146/GERD does not show signs of dysphagia. Signs of dysphagia only appears when the patient has progressed to esophageal adenocarcinoma, as they also show signs of weight loss. I think this point should be stated clearly, as it can help students differentiate if a patient has GERD or cancer based on presentationMajor erratumVerifiedAgree with expert, leave as is.Reject by 2 authors + 1 editorThis is incorrect. GERD can present with dysphagia in the absence of adenocarcinoma, such as when patients have esophagitis or a peptic stricture. Dysphagia is an alarm feature and should prompt EGD to evaluate for advanced pathology.02/04/19 2:28 PMMohammedIsmailmismail987@gmail.com
918371GastrointestinalPathologyEsophageal pathologiesMnemonicTo remember that Boerhaave syndrome is a transmural esophageal rupture caused by excessive vomiting, think of it like all those episodes of vomiting have bored a hole through the esophagus and into the mediastinum; like miners drill boreholes into the wall of a cave or mine shaft.MnemonicVerifiedI like this, would be willing to add if another author agrees.

Maybe something like, "Boerhaave bores-a-hole through the esophagus."

-Connie		Agree with Connie's suggestion. The mnemonic needs to be simple and to the point.

Ashten		I'm on the fence but we can transfer to annotate to vote on it. -VVPrelim accept by 2 authors + 1 editortrue02/08/19 8:14 AMMatthew J.Christensenmattchristensen607@gmail.com
919371GastrointestinalPathologyEsophageal pathologieshttps://www.uptodate.com/contents/eosinophilic-esophagitis-eoe-genetics-and-immunopathogenesis?search=eosinophilic%20esophagitis&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4For eosinophilic esophagitis, it is now known that many patients will respond to PPIs (it is not necessarily "typical"), From UpToDate: It is now appreciated that a substantial number of patients with esophageal eosinophilia can respond to proton pump inhibitor (PPI) therapy, an entity that is now referred to as PPI-responsive esophageal eosinophilia (PPI-REE)Minor erratumVerifiedReject.

True, but it seems too new of an entity to be tested on step 1. The UTD entry linked here say's it's a separate entity, but the UTD entry on EoE diagnosis says that, "PPI-responsive esophageal eosinophilia is therefore considered a subset of eosinophilic esophagitis rather than a distinct disease." Seems a little too poorly delineated to be tested for step 1.

-Connie

https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-eosinophilic-esophagitis?sectionName=Distinction%20from%20GERD&search=eosinophilic%20esophagitis&topicRef=90146&anchor=H7&source=see_link#H7
https://www.uptodate.com/contents/eosinophilic-esophagitis-eoe-genetics-and-immunopathogenesis?search=eosinophilic%20esophagitis&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4		This is more a pediatric boards and/or allergy immunology boards kind of question. Additionally, this is a relatively new entity that is still being delineated. Therefore, it would be less likely to be tested on Step 1. Would not recommend addition. -VVReject by 2 authors + 1 editor03/08/19 6:28 AMMelissaSchechtermschech@gmail.com
920372GastrointestinalPathologyEsophageal cancerhttp://www.dynamed.com/topics/dmp~AN~T114594/Plummer-Vinson-syndromeRisk factors for squamous cell carcinoma: add Plummer Vinson Syndrome (PVS is associated with an increased risk for squamous cell carcinoma of the esophagus)High-yield addition to next yearOkay, we can add it. -Scott06/10/19 8:19 PMEstefaníaHenríquez Luthjeehenriquezluthje@gmail.com
921373GastrointestinalPathologyGastric cancerMnemonicKrukenberg tumors are metastases to the ovaries from gastric adenocarcinoma. There are two more common metastases (Virschow- supraclavicular node, Sister Mary Joseph- periumbilical metastases) and the locations are difficult to remember along with the names. If you remember "Krack the Eggs" then it helps to remember that Krukenberg tumor is a metastasis to the ovaries as eggs are made in the ovaries.MnemonicVerifiedWhile I agree that it would be nice to have a mnemonic for these metastases locations, I'm a little lukewarm about this one. "Krack the Eggs Krukenberg" isn't bad, but it also doesn't strike me as particularly helpful? Very open to other opinions!

-Connie		Borderline reject.

I agree with Connie. The mnemonic does get the point about metastatic disease in the ovaries across, but it does not strike me as very memorable.

I would be more inclined to keep the original text.

- Ashten		Reject, not that memorable. -VVReject by 2 authors + 1 editor02/07/19 11:20 AMDanielLubarskydaniel.lubarsky@rockets.utoledo.edu
922373GastrointestinalPathologyGastritisn/aCURling ulcer = “BURNt by high CURrent”MnemonicVerifiedReject.

Not necessary. The current mnemonic is better; this really does not add anything particularly useful.

Ashten		07/10/19 9:28 PMAPandeyaranikopandey@gmail.com
923373GastrointestinalPathologyMénétrier diseaseNot neededFor -Men-etrier think mens (Latin for mind) —> brain —> brain-looking stomachMnemonicVerifiedReject, I like it but I don't think most people (including myself) know that the Latin word for mind is mens.

-Connie		Agree with Connie, reject. -VVReject by 2 authors + 1 editor02/02/19 12:43 PMMarioShammasmshammas95@gmail.com
924373GastrointestinalPathologyMénétrier diseasementerier disease increase overproduction of TGF-a https://www.gastrojournal.org/article/0016-5085(92)91455-D/pdfmenterier disease increase overproduction of TGF-aClarification to current textI don't think this is commonly tested. - Victor M.This isn't a must, the pathophysiology hasn't been fully elucidated. -Scott https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734964/Not inclined to include, LY -VVReject by 2 authors + 1 editor05/15/19 6:10 PMMuhanadShaibmohanad.shaib@gmail.com
925374GastrointestinalPathologyPeptic ulcer diseasehttp://www.pathologyoutlines.com/topic/smallbowelbrunnersgland.htmlDuodenal ulcers are associated with Brunner gland hyperPLASIA NOT hyperTROPHY.Major erratumVerifiedThis keeps coming up and we have had experts look at this. Leave as is.Reject by 2 authors + 1 editor02/16/19 11:57 AMBasimAlibasim.ajafri@gmail.com
926374GastrointestinalPathologyUlcer complicationsmnemonic, FA 19 9. 374*a*nterior ulcer--> *a*ir in *a*bdomen... *p*osterior ulcer --> bleeding from *g*astro*d*uodenal artery *p*ray to *g*-*d* (** indicates highlight in red)MnemonicVerifiedReject.

Too much for a mnemonic. I recall pathoma put it all in a single sentence. "Anterior perforate, posterior bleed."

- Humood		Reject, feels excessive and forced

-Connie		Reject. -VVReject by 2 authors + 1 editor04/24/19 4:05 PMElanBaskirebask003@fiu.edu
927375GastrointestinalPathologyBugs causing diarrheahttps://www.uptodate.com/contents/whipples-disease?search=whipple%20disease&source=search_result&selectedTitle=1~71&usage_type=default&display_rank=1#H6Add "S" for steatorrhea to the current mnemonic "PAS the foamy Whipped cream in a CAN". So the revision will read "PAS the foamy Whipped cream in CANS". This change will help students remember another important symptom due to the pathophysiology of Whipple disease.MnemonicVerified08/24/19 3:36 PMErikAlvaradoerik.a.alvarado@uth.tmc.edu
928375GastrointestinalPathologyMalabsorption syndromesPathoma (‎Fundamentals of Pathology) 2016mucosal absorption affects the jejunum (duodenum is less commonly involved)Minor erratumVerifiedThis was reviewed by expert. Leave as is.Reject by 2 authors + 1 editor02/01/19 10:23 PMElohoAkpovieloho_akpovi@brown.edu
929375GastrointestinalPathologyMalabsorption syndromesMnemonicABCDE mnemonic for celiac disease: Ig”A” antibodies destroy intestinal “B”illi (villi) to cause “C”eliac disease. “D”uodenum is most commonly affected. May lead to “E”ATL.MnemonicVerifiedReject.
A little too forced for me, and not all encompassing. Those are the easiest to remember aspects of Celiac disease and there are a lot of other things that need to be memorized that are not included.

-Connie		Reject.

Too long, too forced, and not a lot of payoff for committing the mnemonic to memory. I do appreciate the emphasis on the Ab class and the pathophysiology, but this may not be very helpful while studying for Step.

- Ashten		Reject. -VVReject by 2 authors + 1 editor02/08/19 1:54 PMMatthew J.Christensenmattchristensen607@gmail.com
930375GastrointestinalPathologyMalabsorption syndromesMnemonicTo remember what celiac disease is and that is it associated with HLA-DQ2/HLA-DQ8: "People with CELIAC disease H8 2 eat GLUTEN"MnemonicVerifiedCute but on the fence because it doesn't seem super easy to remember due to it depending on a preposition in a random phrase.

-Connie		Our current mnemonic is better. -VVReject by 2 authors + 1 editor02/26/19 7:26 PMSamanthaAbdallahsamantha.abdallah2@med.wayne.edu
931375GastrointestinalPathologyMalabsorption syndromeshttps://en.wikipedia.org/wiki/Parts-per_notationPPM stand for parts per million. It should be added on the abbreviations at the end of the book.Spelling/formattingAgree! Victor M.This is being added this year. -ScottYes, already added -VVPrelim accept by 2 authors + 1 editor05/15/19 6:17 PMMuhanadShaibmohanad.shaib@gmail.com
932375GastrointestinalPathologyMalabsorption syndromesRobbins & Cotran Pathologic Basis of Disease 9th Edition by Vinay Kumar (ISBN: 9781455726134) pg. 784Tropical sprue does NOT respond to antibioticsMajor erratum10/30/19 2:34 PMKatrinaChuahkchuah08546@med.lecom.edu
933376GastrointestinalPathologyInflammatory bowel diseaseshttps://www-uptodate-com.ezproxy.med.nyu.edu/contents/clinical-manifestations-diagnosis-and-prognosis-of-ulcerative-colitis-in-adults?search=ulcerative%20colitis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H1844647392In comparing UC and Crohns, the text says aphthous ulcers are found in both diseases. But we were taught (and UptoDate seems to confirm) that aphthous ulcers are only seen in Crohn's disease.Minor erratumVerifiedReject.
The reader is incorrect.

UTD says that aphthous ulcers are deeper in Crohn's and only involve the mucsa in UC. Also citing a couple recent pubs on oral ulcers in UC.

-Connie

https://www.uptodate.com/contents/endoscopic-diagnosis-of-inflammatory-bowel-disease?search=ulcerative%20colitis%20aphthous%20ulcers&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870502/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017478/		Reject, agree with Connie. -VVReject by 2 authors + 1 editor03/05/19 10:06 PMAlisonLissalisonmliss@gmail.com
934376GastrointestinalPathologyInflammatory bowel diseasesN/ACrohn (1 word)= Th1 mediated vs Ulcerative Colitis (2 words)= Th2 mediatedMnemonicVerifiedReject,
Our Crohn's entry is "crohn disease" which is also 2 words...too easy to mix up.

-Connie		Agree with Connie, reject. -VVReject by 2 authors + 1 editor03/09/19 10:20 PMFrederickBurton IIIfalb409@gmail.com
935376GastrointestinalPathologyInflammatory bowel diseasesContent directly from FA 2019 (p. 376)Extraintestinal manifestations of IBD: (ARE U IBD?) A - arthritis (ankylosing spondylitis, sacroilitis, migratory polyarthritis) R - rash (erythema nodosum, pyoderma gangrenosum) E - eye (uveitis, episcleritis) U - ulcers (aphthous)MnemonicVerifiedReject.

It's a little weak.

-Connie		Reject. -VVReject by 2 authors + 1 editor03/20/19 10:58 AMSaieeshRaoimsa.projects@gmail.com
936377GastrointestinalPathologyAppendicitishttps://www.uptodate.com/contents/image?imageKey=SURG%2F115333&topicKey=SURG%2F1383&search=appendicitis&source=outline_link&selectedTitle=1~150Treatment for appendicitis is only listed as appendectomy. However, treatment for appendicitis has now been shown to include either appednectomy ORMajor erratumVerifiedReject, surgery is correct. Antibiotic only is controversial.Reject by 2 authors + 1 editor02/11/19 11:15 AMPeterNobackpn2245@cumc.columbia.edu
937377GastrointestinalPathologyAppendicitishttps://www.ncbi.nlm.nih.gov/books/NBK499946/add "Y.enterocolitica infection" in parentheses after "pseudoappendicitis"Clarification to current text09/04/19 4:42 PMAlsuZagorulkoalsu.zagorulko@gmail.com
938378GastrointestinalPathologyHirschsprung diseasehttps://www.aafp.org/afp/2006/1015/p1319.htmlrectal suction biopsy (Submucosa). writing submucosa between 2 brackes at the end !Clarification to current textRectal biopsy is enough. - Victor M.https://www.ncbi.nlm.nih.gov/pubmed/26850196 The full thickness biopsy and the submucosal biopsy are seen as equivalent pathologically. -ScottNo changes recommended. -VVReject by 2 authors + 1 editor05/15/19 6:22 PMMuhanadShaibmohanad.shaib@gmail.com
939379Hematology and OncologyEmbryologyBlood groupshttps://www.ncbi.nlm.nih.gov/books/NBK2270/If an AB positive patient receives blood from O negative then after that gets hemolytic transfusion reaction its due to Kell AB.High-yield addition to next year09/26/19 4:00 PMJamilNomanJamel.h2o.101@gmail.com
940379GastrointestinalPathologyIntussusceptionUworld question, https://step1.medbullets.com/gastrointestinal/110050/intussusception,Treatment should be added to Intussuseption- Barium enema is diagnostic/therapeutic and surgical intervention is mandated if intussusception does not resolve with enemaHigh-yield addition to next yearVerifiedOn the fence.

Hearing this is a UW question makes me inclined to accept it and add treatment.

However, looking at UTD, it looks like CT is the recommended diagnostic tool (as we have written) not barium enema. It is rare in adults, and the UTD entry doesn't include treatment. For children, UTD recommends nonoperative reduction and talks about that extensively, with surgery only recommended in specific situations where the pt is acutely ill.

I don't remember tx of intussusception being HY (just cause and what it is), but if we can confirm it is a UW question, might be worth adding a sentence on treatment.

-Connie

https://www.uptodate.com/contents/epidemiology-clinical-features-and-diagnosis-of-mechanical-small-bowel-obstruction-in-adults?sectionName=Intussusception&search=intussusception&topicRef=89300&anchor=H939842785&source=see_link#H939842785
https://www.uptodate.com/contents/intussusception-in-children?search=intussusception%20in%20children&source=search_result&selectedTitle=1~112&usage_type=default&display_rank=1		This is more of a Step 2 type of topic. I remember clearly learning this for the first time when I was on peds wards. It is more important to recognize the presentation and diagnosis. The treatment for intussusception is not as HY for purposes of Step 1. Would not recommend addition -VVReject by 2 authors + 1 editor03/10/19 1:43 PMVyshnavyBalendravyshe11@hotmail.com
941380GastrointestinalPathologyGastrointestinal blood supply and innervationhttps://www.uptodate.com/contents/chronic-mesenteric-ischemiaChronic Mesenteric Ischemia is defined as atherosclerosis of celiac artery, SMA, or IMA. Mesenteric ischemia has to do solely with the blood flow of the small intestine. The IMA-Inferior Mesenteric Artery has no blood flow directed towards the small bowel. As you can see in the UpToDate article under etiology "The majority of cases of chronic mesenteric ischemia are caused by atherosclerotic narrowing of the origins of the celiac or superior mesenteric arteries."Minor erratum10/02/19 4:42 PMAamerNaofalaamer.naofal@utsouthwestern.edu
942380GastrointestinalPathologyOther intestinal disordershttps://www.nejm.org/doi/full/10.1056/NEJM200209123471122 https://academic.oup.com/ageing/article/38/3/267/16387acquired type IIA von Willebrand's syndrome + Aortic Stenosis patients ⇒ Angiodysplasias bleed = Heyde's Syndrome. Stenotic/calcified valve makes vWF multimer uncoil and cleaved by ADAMTS13. Got a UW q from this mechanism.High-yield addition to next yearOn the fence, leaning towards reject.

Once again, wanted to accept bc reader claims the mechanism is a UW question. But looking on UTD, they say "it has been called Heyde" and the UTD reference is from 1958. UTD says that aspects of the mechanism are controversial, but all of their sources are at least 15 years old here. Both citations by the reader are interesting but seem to be addressing commentary on the mechanism (the NEJM article is a letter reporting 2 cases). It seems just too...esoteric to be tested on step 1, but if we can confirm it is a UW question (maybe see what the question is asking), might be worth adding a sentence on proposed etiology.

Need expert review, or experienced editor input.

-Connie		The USMLE is moving away from naming Eponyms and just including the description of the disease process. I'm inclined to reject, this seems pretty esoteric to be included as part of Step 1. Would not recommend addition -VVReject by 2 authors + 1 editor03/21/19 3:02 AMNicolasCuri Gawlinskinicolascurii@gmail.com
943380GastrointestinalPathologyVolvulusFirst Aid versions 2018, 2019, and this NCBI article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780196/.Mnemonic suggestion: Midgut volvulus more common in infants/children (Midgut=Minors); Sigmoid volvulus more common in elderly (Sigmoid=Seniors)MnemonicVerifiedThis is great, accept!

The fact is already in there (midgut volvulus more common in children, sigmoid more common in the elderly. This mnemonic is helpful and easy to remember!

We could easy fit this into the current text, suggest:

Midgut volvulus more common in infants and children (Minors)
Sigmoid volvulus (coffee bean sign on x-ray) more common in Seniors



-Connie		Accept. -ScottAccept. Please add to annotate per Connie with appropriate red font: "Midgut volvulus more common in infants and children (Minors)
Sigmoid volvulus (coffee bean sign on x-ray) more common in Seniors" -VV		Prelim accept by 2 authors + 1 editortrue01/16/19 7:52 PMChristopherParrinocrp2013@gmail.com
944381GastrointestinalPathologyColonic polypshttps://emedicine.medscape.com/article/175377-overview#a4Familial adenomatous polyps- should be 5q21Minor erratumReject,

This is actually a typo in the source that they cite. We have it correct, 5q22, two reputable databases cited below:

https://ghr.nlm.nih.gov/gene/APC#location
https://www.omim.org/entry/611731

-Connie		Agree, text is fine as is. -VVReject by 2 authors + 1 editor04/08/19 11:35 AMUroojWaseyUroojwasey@hotmail.com
945381GastrointestinalPathologyPolyposis syndromesIt's Mnemonic*P*eutz-Jeghers syndrome ----> hyper*p*igmented .\highlight "P".MnemonicVerifiedReject, mnemonics using a relatively random letter in the middle of a word are hard to remember.

-Connie		Reject, agree with Connie. -VVReject by 2 authors + 1 editor01/11/19 12:19 PMMoatasemAl-Janabiassoomi88@yahoo.com
946381GastrointestinalPathologyPolyposis syndromesuworld, uptodate: https://www.uptodate.com/contents/peutz-jeghers-syndrome-epidemiology-clinical-manifestations-and-diagnosis?search=peutz%20jeghers%20syndrome&source=search_result&selectedTitle=1~47&usage_type=default&display_rank=1#H2Gene mutations associated with Peutz-Jeghers syndrome: STK11High-yield addition to next yearVerifiedReject, there's also a second gene locus but all of this is too LY. We cover what is tested on Peutz-Jeghers.

-Connie		Agree, LY for Step 1. -VVReject by 2 authors + 1 editor01/16/19 9:33 PMPrasannaPatelrinzal.jsn@gmail.com
947381GastrointestinalPathologyPolyposis syndromeshttps://www.uptodate.com/contents/molecular-genetics-of-colorectal-cancer?search=apc%20mutation&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Autosomal dominant mutation of APC tumor suppressor gene on chromosome 5q21, NOT 5q22Major erratumReject. It is 5q22. http://atlasgeneticsoncology.org/Genes/GC_APC.html - Victor M.It can be both 5q21 or 5q22 https://academic.oup.com/jjco/article/44/12/1243/845784 Let's just leave it. It's probably LY anyway. -ScottReject.

I agree that this is likely LY. Also, it looks like it is 5q21-q22: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404874/.

Ashten		Reject. -VVReject by 2 authors + 1 editor06/04/19 10:33 PMMarkWintersmark.winters@usuhs.edu
948381GastrointestinalPathologyPolyposis syndromesSelf.Gardner Syndrome = FAP + JAW Tumors = eat food from the GARDEN (Gardner)MnemonicVerifiedReject, not a fan. -VVReject by 2 authors + 1 editor08/01/19 6:49 PMIvanKimivan.sangjin@gmail.com
949381GastrointestinalPathologyPolyposis syndromesno neededGardner syndrome, mnemonic: "GARDen in FOREST". GARDen for Gardner syndrome, FOREST for F: familial adenomatous polyposis O: osseous/soft tissue tumors RE: Retinal epithelium hypertrophy ST: supernumerary teethMnemonicVerified08/26/19 9:07 PMLaura PatriciaAguilar Francolaura.aguilarfranco@gmail.com
950382GastrointestinalNeoplasiaColorectal cancerUworldClostridum septicum is associated with colonic malignancy and can lead to spontaneous gas gangrene, rapid-onset muscle pain, fever, hemorrhagic bull with dusky surrounding skin, and tissue crepitusHigh-yield addition to next yearAccept.

Having come across it often, I would vote to add C. septicum as a new entry. It'll have to be re-written.

- Humood		Fair to add to the text this year. Please migrate to annotate with drafted entry to be worked up this year. -VVPrelim accept by 2 authors + 1 editor04/24/19 10:45 AMNicholasMillermil2434@msu.edu
951382GastrointestinalPathologyLynch syndromeuworld, uptodate: https://www.uptodate.com/contents/lynch-syndrome-hereditary-nonpolyposis-colorectal-cancer-clinical-manifestations-and-diagnosis?search=lynch%20syndrome&source=search_result&selectedTitle=1~99&usage_type=default&display_rank=1#H345552210Gene mutations associated with Lynch syndrome: MSH2/6, MLH1High-yield addition to next yearVerifiedReject. See above, too LY.

-Connie		Agree, LY for Step 1. -VVReject by 2 authors + 1 editor01/16/19 9:25 PMPrasannaPatelrinzal.jsn@gmail.com
952382GastrointestinalPathologyLynch syndromeN/a (Just a mnemonic, not stating any new facts)I think of this is as: you CLOSE the genes involved in DNA mismatch repair, where CLOSE is an acronym standing for: (C)olorectal, (L)ynch Syndrome, (O)varian, (S)kin, and (E)ndometrial cancer.MnemonicVerifiedNot bad, but on the fence because L for Lynch is the second letter of the mnemonic and may make this harder to recall?

-Connie		Yea...I'm inclined to reject. It may just be easier to remember that Lynch is associated with the cancers rather than remembering the mnemonic. -VVReject by 2 authors + 1 editor02/17/19 10:09 AMSanamSolankisolankism@vcu.edu
953383GastrointestinalPathologyCirrhosis and portal hypertensionhttps://emedicine.medscape.com/article/185856-overviewCirrhosis increases estrogen effects (which is the cause of gynecomastia, palmar erythema, testicular atrophy and impotence)High-yield addition to next yearVerifiedReject.

True, but the mechanism seems multifactorial with a couple possible confounding variables (rate of gynecomastia is about the same in age-matched non-cirrhotic population, these pts also can be receiving high doses of spironolactone)

Seems too poorly established to be something tested on step 1

-Connie

https://www.uptodate.com/contents/epidemiology-pathophysiology-and-causes-of-gynecomastia?search=gynecomastia%20cirrhosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H6318961		Reject. Agree, this would be beyond the scope of Step 1. It is more important to know the presentation of someone with liver failure or cirrhosis. -VVReject by 2 authors + 1 editor02/25/19 10:59 AMNathanielBorochovnateboro8@gmail.com
954383GastrointestinalPathologyColorectal cancerN/AText is written as: "Chromosomal instability pathway: mutations in APC cause FAP and most sporadic CRC (via adenoma-carcinoma sequence; (firing order of events is “AK-53”)." - there should be no start parenthesis before "via"!Spelling/formattingAccept!

What a horrid typo. Remove open parenthesis before "via"

-Connie		Accept.

Good catch!

- Ashten		Agree, please remove open parenthesis before the word "via" Also, please remove semicolon after the word "sequence" -VVPrelim accept by 2 authors + 1 editortrue04/20/19 3:45 PMAndrewKoandrewko@hawaii.edu
955383GastrointestinalPathologyMolecular pathogenesis of colorectal cancernaafter CRC on the 1st line, there is open parentheses before via, but there os no closing of parenthesesSpelling/formattingAlready taken care of. - Victor M.True. delete open parentheses -ScottImplemented. No changes needed -VVReject by 2 authors + 1 editor06/12/19 7:33 PMOmairChaudryochaudry19@gmail.com
956384GastrointestinalPathologyCirrhosis and portal hypertensionhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697093/it states that spontaneous bacterial peritonitis is caused by AEROBIC organisms (such as E.COLI and KLEBSIELLA); however, these bacteria are ANAEROBICMinor erratumAccept that we need to remove "aerobic" from the description.

E. coli and klebsiella are both facultative anaerobic. UTD says that these two are the most common, followed by strep, which is what we say. Looking at other causative organisms, I don't think we can make an encompassing statement about aerobic vs anaerobic, and UTD doesn't either. Looking at treatment, they recommend broad spectrum bc of the variety.

Suggest removing aerobic Gram-, and just say that e coli and kelbsiella are most common.

-Connie

Causative organisms of SPB: https://www.uptodate.com/contents/image?imageKey=GAST%2F80188&topicKey=GAST%2F1249&search=spontaneous%20bacterial%20peritonitis%20klebsiella&rank=1~150&source=see_link

More sources:
https://www.uptodate.com/contents/spontaneous-bacterial-peritonitis-in-adults-treatment-and-prophylaxis?sectionName=TREATMENT&search=spontaneous%20bacterial%20peritonitis%20klebsiella&topicRef=1249&anchor=H2&source=see_link#H2
https://www.uptodate.com/contents/spontaneous-bacterial-peritonitis-in-adults-diagnosis?search=spontaneous%20bacterial%20peritonitis%20klebsiella&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1		Agree with Connie. Please remove "aerobic" from the description. -VVPrelim accept by 2 authors + 1 editortrue03/31/19 4:27 PMNidaaRasheednidaa.rasheed@mail.utoronto.ca
957386GastrointestinalPathologyHepatocellular carcinoma/hepatomahttps://www.ncbi.nlm.nih.gov/pubmed/7694895Polycythemia is just listed as a finding of HCC, while the other findings can be inferred based on the decreased function of the liver, polycythemia is not. It should be added that the proposed mechanism is increased EPO from the malignant cells (also referred to in PCV section in secondary causes).High-yield addition to next yearVerifiedReject.

We cover both the mechanism (EPO secretion, no longer "proposed" mechanism, the paper the reader cited is from 1993, this is now established) and the associations including HCC on page 425 of the heme/onc chapter with the pretty extensive polycythemia vera entry. I think that fits better there, because secondary polycythemia in the context of malignancy is not unique to HCC. We list it as a finding here, and I think that is enough.

-Connie		Agree with Connie. No changes to the text. -VVReject by 2 authors + 1 editor02/27/19 2:44 PMDylanErwinderwin@smu.edu
958386GastrointestinalPathologyOther liver tumorsUWorldPer UWorld, cavernous hemangiomas are described as "abnormally dilated capillaries separated by thin connective tissue septa" and can occur in both the liver and brain.High-yield addition to next yearVerifiedReject. It's another word for cavernous malformations in the brain. I can't find any association between liver cavernous hemangiomas and brain cavernous malformations, so I don't know think it is worth talking about nomenclature here.

If someone can find the UW question, maybe we can get a better idea what it is testing?

-Connie

https://www.uptodate.com/contents/vascular-malformations-of-the-central-nervous-system?search=cavernous%20hemangioma&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H13		Reject. While there is an association with AV malformations in the brain and liver, not so much with the association of cavernous malformations in the brain and cavernous hemangiomas in the liver. It would be nice to see the question. Would not recommend going into this nomenclature. -VVReject by 2 authors + 1 editor02/05/19 6:21 PMEstebanCasasolaecasasol@sgu.edu
959386GastrointestinalPathologyOther liver tumorshttps://www.ncbi.nlm.nih.gov/pubmed/24707153 https://www.ncbi.nlm.nih.gov/pubmed/23689692Transcription factor ERG is a specific and sensitive diagnostic marker for hepatic angiosarcoma, but it can express CD 31 as well.Clarification to current textReject. This is true, but is LY at the MS2 level. -ScottAgree, LY -VVReject by 2 authors + 1 editor05/15/19 6:32 PMMuhanadShaibmohanad.shaib@gmail.com
960386GastrointestinalPathologyOther liver tumorshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728840/ https://www.stanfordchildrens.org/en/topic/default?id=hepatoblastoma-90-P02728i think it would be better if you write something about Hematoblastoma.Clarification to current textI don't think it is HY. - Victor M.LY -ScottReject.

I never came across this during my time studying for Step 1, both in books and Q banks. I doubt this is HY.

Ashten		Yes, LY. No changes. -VVReject by 2 authors + 1 editor05/15/19 6:36 PMMuhanadShaibmohanad.shaib@gmail.com
961387GastrointestinalPathologyBiliary atresiaN/AAlcoholic is misspelled as "acholic."Spelling/formatting10/10/19 2:21 PMGraysonMynattgrayson.mynatt@lmunet.edu
962387GastrointestinalPathologyJaundicemnemonic, FA 19 p. 387Indirect bilirubin elevated in *h*emolysis, *C*rigler-Najjar, *G*ilbert, *neonatal* jaundice // *hCG* elevated before having a "neonate* (everything in ** to be highlighted in red)MnemonicVerifiedReject.

Not a big fan, sorry.

- Humood		Reject
-Connie		Reject -VVReject by 2 authors + 1 editor04/17/19 2:30 PMElanBaskirebask003@fiu.edu
963387GastrointestinalPathologyJaundiceSelf-writtenFor the Hereditary Hyperbillirubinemias, they are either issues 1) BEFORE/AT conjugation (indirect high) 2) AFTER billirubin conjugated (direct high). For AFTER (2) - we have DUBLIN + ROTOR (you use ROTOR/MOTOR boat to travel to FAR! country AFTER country till DUBLIN. Meaning this is LATER/AFTER conjugation defect). For 'Before/at' conjugation (1) we have crigler and Gilbert. "Craig/CRIG and GILBERT both want to STAY AT home and don't want to travel.Mnemonic10/30/19 9:16 AMKhalidAlattarkhalid_alattar@hotmail.com
964388GastrointestinalPathologyHereditary hyperbilirubinemiasn/aDR = DiRect hyperbilirubinemia Dubin Johnson and Rotor syndrome.MnemonicVerifiedReject.

Current content sufficiently summarizes key features of the disorders. I would leave the text alone.

Ashten		07/10/19 9:29 PMAPandeyaranikopandey@gmail.com
965389GastrointestinalPathologyBiliary tract diseaseRobbins and Cotran Pathologic Basis of Disease ninth edition , page 858 , table 18 - 11- Most common autoimmune association with Primary biliary cholangitis is Sjogren syndromeHigh-yield addition to next yearVerifiedOn the fence,

True, PBC is associated with autoimmune diseases and of these pts most develop symptoms of Sjogren's. However, PBC is an uncommon development in people with primary Sjogren's. I think the association with autoimmune disease may be of significance and could be tested. If we want to add that after the association with middle-aged women, I think it would fit well because we already state that PBC is an autoimmune reaction.

PBC>autoimmune reaction>associated with middle-aged women>pts also often diagnosed with other autoimmune diseases. It makes sense, but I'm on the fence about whether this is HY enough to spell out.

-Connie

https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-prognosis-of-primary-biliary-cholangitis-primary-biliary-cirrhosis?search=primary%20biliary%20cholangitis%20sjogren&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1		I'm inclined to reject. It is more important to know the presentation of Sjogren's and PBC, rather than the direct association. Step 1 focuses more on recognizing the diseases rather than knowing that it is the most common association. Would not recommend addition -VVReject by 2 authors + 1 editor01/23/19 3:43 PMMuhammadKamal Ismailmqk0111@gmail.com
966389GastrointestinalPathologyBiliary tract diseasebrainprimary (S)clerosing cholangitis (= Sperm for Men) // primary (B)iliary cholangitis (= Breasts for Women) .|| only way I can differentiate the twoMnemonicVerifiedReject.

Not a big fan, sorry.

- Humood		Um this one makes sense and it's not a terrible way to differentiate two similarly named diseases that are pretty frequently tested. But the "sperm" for men and "breasts" for women seems a little boorish.

If someone can come up with a related but slightly better mnemonic, it might be a nice addition to help differentiate these diseases.

-Connie		Reject. I'm kind of not a fan. -VVReject by 2 authors + 1 editor01/31/19 9:26 AMEmanuelGrantewg4bd@virginia.edu
967389GastrointestinalPathologyBiliary tract diseaseRobbins Basic Pathology 10th Page 664 https://books.google.jo/books?id=YYZMDgAAQBAJ&lpg=PA664&ots=YixrI4sZvu&dq=Interlobular%20bile%20ducts%20are%20actively%20destroyed%20by%20lymphoplasmacyticinflammation%20with%20or%20without%20granulomas(the%20florid%20duct%20lesion)&pg=PA665#v=onepage&q&f=falsePrimary Biliary Cholangitis can be with or without granulomas so it should be ± instead of +Minor erratumAccording to UTD: "The pathognomonic florid bile duct lesion is uncommonly seen in percutaneous needle biopsies of the liver. However, the greater the number of portal triads in the specimen, the more likely it is that these lesions and granulomas will be present. The continuous assault on the bile duct epithelial cells leads to their gradual destruction and eventual disappearance. The hepatocyte injury is associated with foamy degeneration, which is thought to be due to the toxic effect of retained bile acids." https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-prognosis-of-primary-biliary-cholangitis-primary-biliary-cirrhosis?search=primary%20biliary%20cholangitis&source=search_result&selectedTitle=2~145&usage_type=default&display_rank=2#H58140687 The first aid is a review textbook and this fact is highly tested. I would keep as is. - Victor M.https://www.ncbi.nlm.nih.gov/pubmed/8609810 True, change to ±. -ScottAgree. Please add to the text. -VVPrelim accept by 2 authors + 1 editor05/08/19 7:37 PMRaedAbabnehraedababneh@gmail.com
968389GastrointestinalPathologyBiliary tract diseasehttps://emedicine.medscape.com/article/2087891-overview & https://www.medscape.com/viewarticle/467020 & https://www.medscape.com/answers/187001-69452/what-ggt-levels-suggest-biliary-obstruction"May present with pruritus, jaundice dark urine, light-colored stool, hepatosplenomegaly. Typically with cholestatic pattern of LFTs ( increase conjugate bilirrubin, increase cholesterol, increase ALP", increase GGT).Minor erratumAgreed. GGT is an important test to differentiate biliary from bone sources of elevated ALP, I don't know why it was left out. -ScottAgree to add to the text. -VVPrelim accept by 2 authors + 1 editortrue07/30/19 6:34 PMXavierDe Penaxavierdpp@gmail.com
969389GastrointestinalPathologyBiliary tract diseaseI made this mnemonic up on my ownIf it has a “P” it has INTRAhepatic involvement. If it has an “S” it has EXTRAhepatic involvement (“S for outSide”). Ex: Primary Sclerosing Cholangitis: Intra AND Extrahepatic involvement (has a "P" for Primary and a "S" for Sclerosing). Primary Biliary Cholangitis: Has a "P" for "Primary", so INTRAhepatic involvement. Secondary Biliary Cholangitis: Has an"S" for "Secondary", so EXTRAhepatic involvementMnemonic10/31/19 8:27 PMsinamoridzadehsina.moridzadeh@gmail.com
970389GastrointestinalPathologyHemochromatosishttps://emedicine.medscape.com/article/177216-differentialHemochromatosis is associated with increased susceptibility to Listeria monocytogenes, Vibrio vulnificus and Yersinia enterolitica infections.High-yield addition to next yearVerifiedSo interesting but reject.

The susceptibility to siderophilic bacteria appears only in those with iron overload but UTD says data is limited so I'm inclined to say this won't be tested.

-Connie		Yea, that is pretty interesting. More of trivia fact that what would be tested on Step 1. Would not recommend addition -VVReject by 2 authors + 1 editor01/25/19 7:00 PMVirginiaRuiz Namisvirginia.ruizcs@gmail.com
971389GastrointestinalPathologyHemochromatosisMnemonicTo remember that Prussian blue stains iron deposits, imagine a Russian weightlifter turning blue while “pumping iron”. (Also may be applied to the “Sideroblastic Anemia” section on pg. 411). Colored image attached.MnemonicVerifiedReject.

Clever. However, we don't use such graphics as mnemonics in the book.

- Humood		Reject.

This just doesn't feel like a very strong mnemonic for me.

Also Prussia generally is used to constitute parts of east and central Europe when it was a German state, I'm not sure why we would want to use a Russian weightlifter but I hope it's a typo.

-Connie		Reject -VVReject by 2 authors + 1 editor02/07/19 12:05 AMMatthew J.Christensenmattchristensen607@gmail.com
972389GastrointestinalPathologyHemochromatosisnot neededcurrently H"FE" is highlighted in red to reflect "iron", but down the road this can be forgotten especially with too many genes to memorize as you study the book. I suggest changing it to; HFE stands for human “Ferrous Enterocytes” and by that you remember that the problem with intestinal enterocytes absorbing Fe!MnemonicVerifiedReject.

It makes it more confusing that it is. The gene name HFE stands for "high Fe" which is exactly what hemochromatosis is, and adding this seems unnecessary.

-Connie		Reject. -VVReject by 2 authors + 1 editor03/01/19 7:13 PMAlaJamalala.aljamal@hotmail.com
973389GastrointestinalPathologyHemochromatosisnot neededmedications: deFERasirox, deFERoxamine, deFERiprone for ferrous, is for FeMnemonicVerifiedreject.

Great mnemonic which is probably why we already have it implemented.

-Connie		Yup, already in the text. -VVReject by 2 authors + 1 editor03/01/19 7:13 PMAlaJamalala.aljamal@hotmail.com
974389GastrointestinalPathologyHemochromatosisnone neededHemochromatoSIX as a reminder that the mutation is located on chromosome 6.MnemonicVerifiedOn the fence.

Not bad, but also not sure this is HY enough for a mnemonic?

-Connie		May be worth adding in, considering that two people suggested. Please add to Annotate. -VVPrelim accept by 2 authors + 1 editortrue03/17/19 3:35 PMNatalieJansenjansen7@uic.edu
975389GastrointestinalPathologyHemochromatosisFirst Aid 2019It is mentioned in the text that " C282Y mutation > H63D mutation on HFE gene" it is not clear that the both mutations occurs in HFE geneClarification to current textReject, I'm not sure how to make it more clear.

-Connie		Reject.

We could reorganize the line to put HFE before the specific mutations, but then the chromosome number would be out of place.

I would leave this part alone.

- Ashten		Reject, would not recommend changes to the text. -VVReject by 2 authors + 1 editor03/22/19 2:33 PMRaedAbabnehraababneh153@med.just.edu.jo
976389GastrointestinalPathologyHemochromatosis--HFE gene location mnemonic : hemochromatoSIX (chromosome 6)MnemonicVerifiedMentioned above, on the fence bc of questionable HY value?

-Connie		Reject. Questionable HY value. -VVReject by 2 authors + 1 editor04/07/19 8:35 PManubhavsoodanubhavsood89@gmail.com
977389GastrointestinalPathologyHemochromatosishttps://www.ncbi.nlm.nih.gov/pubmed/12547214Hemochromatosis increase dmt 1 expressionHigh-yield addition to next yearLY -ScottLY -VVReject by 2 authors + 1 editor05/15/19 6:40 PMMuhanadShaibmohanad.shaib@gmail.com
978389GastrointestinalPathologyWilson diseaseMnemonicTo remember Wilson Disease results from impaired copper transport/excessive deposition, picture 28th U.S. President Woodrow Wilson on the penny. Image attached.MnemonicVerifiedVery cute! But I don't think most people can recall the 28th president off the top of their heads.

-Connie		Borderline reject.

Agree with Connie on this one. To make this work, an illustration would definitely be needed. However, I am not sure if the payoff will be great enough to justify the effort and space required to pull this off.

- Ashten		That's really really cute. However, I'm inclined to reject, considering that while it's a good association, most people will remember that it's associated with impaired copper transport, so this would not be as helpful as a mnemonic. No changes to the text. -VVReject by 2 authors + 1 editor02/07/19 12:33 AMMatthew J.Christensenmattchristensen607@gmail.com
979390GastrointestinalPathologyCholelithiasishttps://www.uptodate.com/contents/gallstones-epidemiology-risk-factors-and-prevention?search=tpn%20gallstone&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2608614826TPN is mainly a risk factor for cholesterol stones not pigment stonesMinor erratumVerifiedReject: https://www.hopkinsmedicine.org/gastroenterology_hepatology/_pdfs/pancreas_biliary_tract/gallstone_disease.pdfReject by 2 authors + 1 editor02/09/19 9:57 AMHasanAlarourihassan.arouri@hotmail.com
980390GastrointestinalPathologyCholelithiasisHarrison Principles of Internal Medicine 20th editionCholesterol stones account for >90% of stones indicated by Harrison. FA book has 80%.Clarification to current textReputable sources say different things.

UTD says 80 (which is what we say).
AAFP says 90
NIH NIDDK says 75

I think we're okay (majority are cholesterol, we're in the range so students remembering this should be able to answer the question correctly) but I guess we can get expert review if we want to pick a specific percentage.

https://www.uptodate.com/contents/gallstones-beyond-the-basics
https://www.aafp.org/afp/2000/0315/p1673.html
https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/definition-facts

-Connie		Let's stick with 80%, considering that it's consistent with UTD. Honestly, I highly doubt that this would be tested on Step 1, and it should be the student's bigger concern to know the fact that cholesterol stones are the most common. Would not recommend any changes to the text. -VVReject by 2 authors + 1 editor04/30/19 11:55 AMDanielaCarralero Somozadanielacarralero@hotmail.com
981392GastrointestinalPharmacologyHistamine-2 blockershttps://www.drugbank.ca/drugs/DB00455The mnemonic currently is "table for 2" because H2 blockers have "dine" in it and block H2 receptors. The issue is that Loratadine and Terfenadine also have "dine" in it and are H1 blockers. I would suggest just changing it to include the "idine" to add accuracy. So the new mnemonic can be "I dine with H2o" because most of us do have water when we eat or "I dine at 2" which is a bit weird since 2 is a weird time to eat. Either way, you get the drift.MnemonicVerifiedInteresting point, inclined to reject.

Terfenadine is no longer on the market and therefore a moot point. The mnemonic works because we don't include loratadine here. While the reader is correct, loratadine is mostly used for allergic rhinitis/urticaria so I'm not sure it would be relevant when thinking of acid blocking therapies. If other authors or editors think this could be really confusing, might be worth just taking out the mnemonic because the suggested one isn't fantastic?

-Connie		Reject. Agree that there are other "dines" like loratadine, but the mnemonic currently in the text is really good so would be inclined to reject proposal and/or changing the text. -VVReject by 2 authors + 1 editor01/17/19 12:38 PMLuxShahluxshah@utexas.edu
982393GastrointestinalPharmacologyAntacidsN/AI suggest changing Mg2+ = Must go to the bathroom -> Mg2+ Must go 2 the bathroom. It will help remember Mg2+ because the mnemonic now has a 2 in it correlating to the 2+ in Mg2+. Thank you for the consideration.MnemonicVerifiedAccept.

Makes so much sense.

-Connie		Accept.

I really like this one!

- Ashten		Accept. Please migrate to annotate with appropriate red font changes. -VVPrelim accept by 2 authors + 1 editortrue03/19/19 4:00 PMNiravShahniravs@health.usf.edu
983394GastrointestinalPharmacologyDrug nameshttps://www.uptodate.com/contents/alosetron-drug-information?search=alosetron&source=panel_search_result&selectedTitle=1~10&usage_type=panel&kp_tab=drug_general&display_rank=1Alosetron, sold under the brand name Lotronex among others, is a 5-HT3 antagonist used for the management of severe diarrhea-predominant irritable bowel syndrome (IBS)High-yield addition to next yearReject.

I do not think that this is HY for Step 1.

Ashten		Reject, LY -VVReject by 2 authors + 1 editor07/31/19 9:17 PMPavelAksionavpavlusha_aksenov@mail.ru
984394GastrointestinalPharmacologyLaxativesN/ASenna turns the colon black like Henna (melanosis coli). Colonoscopy pictures of melanosis coli actually look strangely like they are coated with Henna!MnemonicVerifiedI don't think this is HY enough to include a mnemonic for, but would accept if other authors/editors think this is HY.

-Connie		Yea, agree it's not as HY on Step 1 than it is on wards. No changes to the text. -VVReject by 2 authors + 1 editor02/18/19 2:58 AMBasimAlibasim.ajafri@gmail.com
985394GastrointestinalPharmacologyLaxativesNone neededSENNa - Stimulate ENteric NervesMnemonicVerifiedAccept.

This is appropriate and makes it easier to remember the mechanism of action.

Ashten		05/16/19 4:06 AMJulianMaamarijulian.maamari@lau.edu
986394GastrointestinalPharmacologyLaxativeshttps://www.uptodate.com/contents/treatment-of-irritable-bowel-syndrome-in-adults#H230371755-hydroxytryptamine (serotonin) 4 receptor agonists - TegaserodHigh-yield addition to next yearReject.

I do not think that this is HY for Step 1. Also, I do not believe there is enough space to add in this information.

Ashten		Agree, LY. No changes recommended. -VVReject by 2 authors + 1 editor07/31/19 8:59 PMPavelAksionavpavlusha_aksenov@mail.ru
987394GastrointestinalPharmacologyLaxativeshttps://www.uptodate.com/contents/treatment-of-irritable-bowel-syndrome-in-adults#H23037175Guanylate cyclase agonists — Linaclotide and plecanatide are guanylate cyclase agonists that stimulates intestinal fluid secretion and transitClarification to current textReject.

I do not think that this is HY for Step 1.

Ashten		Reject, LY -VVReject by 2 authors + 1 editor07/31/19 9:01 PMPavelAksionavpavlusha_aksenov@mail.ru
988394GastrointestinalPharmacologyLaxativeshttps://www.uptodate.com/contents/treatment-of-irritable-bowel-syndrome-in-adults#H23037175Lubiprostone — Lubiprostone is a locally acting chloride channel activator that enhances chloride-rich intestinal fluid secretionClarification to current textReject.

I do not think that this is HY for Step 1.

Ashten		Reject, LY -VVReject by 2 authors + 1 editor07/31/19 9:02 PMPavelAksionavpavlusha_aksenov@mail.ru
989394GastrointestinalPharmacologyProton pump inhibitors*Loren Laine. Gastrointestinal Bleeding. In: Harrison’s Principles of Internal Medicine 19th edition. McGraw-Hill Education, 2015. pp. 276 – 279. *Jeffery A. Baker. Gastrointestinal Bleeding. In: Clinical Emergency Medicine. McGraw-Hill Education, 2014. pp.128- 130. * C. Prakash Gyawali and Amit Patel. Gastrointestinal Bleeding. In: Washington Manual of Medical Therapeutics 34th edition. Department of Medicine, Washington University School of Medicine, 2014. Pp. 620-626. *NEJM 2016; 374: 2367Proton Pump Inhibitors are used for Upper Gastrointestinal Bleeding. It is an important clinical use and should be taken into account to be added to the next First Aid edition.High-yield addition to next yearIt sounds more like a step 2 CK fact to me. -Victor M.PPIs are ised for upper GI bleeding, but that's more of a step 2 question. Reject. -ScottAgree, this is more of a Step 2 and clinical concept. Would not recommend addition to the text. -VVReject by 2 authors + 1 editor07/20/19 8:14 PMStephanieDel Riostep.dt@outlook.es
990395Hematology and OncologyIndexHematopoiesisN/AAnatomy is said to be in page 400 when it starts in page 398Spelling/formattingI don't see the error in FA2019. -WeelicYes I can see this error. However, in the new edition pages may be differently numbered. We should make sure that the first page of the chapter correctly displays the pages of the different sections. -Lilit04/22/19 8:06 AMAserLabibAserlabib@rcsi.ie
991396Hematology and OncologyEmbryologyHemoglobinFirst Aid 2019Hemoglobin HbA2 (alpha2,Delta2), we can memorize Delta by the Decreased (D) number of this Hb (because it’s little in blood)MnemonicVerifiedDon't think this adds any value, not the best memory tool. -Lilit05/09/19 11:02 AMFarisBinyouseffaris-v@hotmail.com
992396Hematology and OncologyAnatomyNeutrophilsits mnemonicimportant neutrophil chemotactic agents : 5 Children eat(8) Ice Kream and 4 Large Pizza. ( 5 Children means C5a - 8 Ice means IL8 - kream means kallikrein - 4 Large means LTB4 - Pizza means platelet activating factor)Mnemonic12/04/19 1:39 PMObaidaSafiooobbbooo@outlook.sa
993397Hematology and OncologyPathologyBlood groupshttps://www.uptodate.com/contents/red-blood-cell-antigens-and-antibodies?search=Red%20blood%20cell%20antigens%20and%20antibodies&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1In the table , row “Antibodies in plasma” , column “Rh-“ , replace the image of the anti-D igG with None. In fact the Anti-D igG is an immune antibody and not a natural antibody like anti-ABO antibodies. It’s clearly stated in the paragraph “Rh antibodies” of the UpToDate article “Red blood cell antigens and antibodies”.Major erratumVerifiedFaculty input?
The reader is correct, in that anti-D IgG is not naturally occurring, in contrast to the ABO antibodies. Even with an inadvertent exposure to Rh(D)+ RBCs, the risk of alloimmunization is small. In a study of 130 Rh(D)- individuals who received Rh(D)+ platelets, nome formed antibodies (https://www.ncbi.nlm.nih.gov/pubmed/23829356)

Still, the use of Rh immune globulin in Rh(D)- women during pregnancy has greatly reduced the frequency of DFN due to maternal anti-D, and this is definitely the most HY concept that is tested. I think it's important that we cover that (and we do). I think the issue is that ABO antibodies are naturally occurring, while Rh antibodies arise when exposed to blood from another individual (pregnancy or transfusion). I don't think this is tested in great detail, but if we want to change anything, I suppose making it clear that ABO Abs are natural, Rh are required would be better than just removing it and replacing it with "none."

-Connie		I guess I'm confused - I agree it's not naturally occurring, but I don't see mention of where we are making a distinction between naturally occurring and non-naturally occurring antibodies. The row is meant to show the antibody present that contributes to the pathophysiology. If we delete the antibody, then it's going to be trickier to understand why one would administer "anti-D IgG."

I guess what is confusing is that we say things like "administer anti-D IgG to Rh negative mothers prevent formation of maternal anti-D IgG" - so I can see why it might be a bit confusing. Perhaps using a different name for the administered anti-D IgG from the naturally occurring maternal anti-D IgG would make this clearer.

I would say we can improve this fact for 2020. I like Connie's suggestions and think they have great merit. Certainly nothing that needs to go into the published errata, however!

-Matt		Prelim accept but NOT publishable erratatrue01/23/19 5:57 AMBahaa' eddineSuccarbahaasuccar@gmail.com
994397Hematology and OncologyEmbryologyBlood groupshttps://en.wikipedia.org/wiki/ABO_blood_group_systemAnti-A and anti-B antidodies that RBC Type O are most likly IgG and not IgM as the text picture indicatesMinor erratumVerifiedDisagreed. Individuals who have type O blood type produce both IgG and IgM antibodies.

During pregnancy, a type O mother produces IgM antibodies against a type A/B fetus.

Type O individuals are also exposed to A and B antigens early in life, and produce IgG antibodies in response.

(from UWorld)

- Sarina		Per Sarina, this is not an erratum and no change needed. Appreciate the thorough response!

-Matt		Reject by 2 authors + 1 editor02/23/19 6:00 PMMosheNathannathanmoshe@gmail.com
995397Hematology and OncologyEmbryologyHemolytic disease of the newbornnot neededType O mother; typer A or B fetus. To add Type AB fetus tooMajor erratumVerifiedAdding "or AB" adds 4 letters, and that does add a new line. I think this does not fit into a major erratum, but can be added to 2020. -weelicI don't think it is too necessary to add "or AB" since it is implied that a type AB fetus will have A and B antigens.

- Sarina		Agree, this change is not needed here.

-Matt		Reject by 2 authors + 1 editor03/01/19 7:19 PMAlaJamalala.aljamal@hotmail.com
996398Hematology and OncologyAnatomyHematopoiesishttps://books.google.com/books?id=zolYg-SsVhQC&pg=PA358&lpg=PA358&dq=myeloblast+lineage&source=bl&ots=pLKZqP70bt&sig=ACfU3U3TlfSFnczw3ff4w0zIiK-MBtBrXg&hl=en&sa=X&ved=2ahUKEwipmuHE-PzgAhUHP6wKHQ6LCAcQ6AEwFnoECAkQAQ#v=onepage&q=myeloblast%20lineage&f=falseMost people use BEN (basophil, eosinophil, neutrophil) to remember myleoblast lineage - next year's book can list the cells in that order, and add the mnemonic!MnemonicVerifiedAs I understand it, this comment says to swap basophil and eosinophil on page 398, and then format the three starting letters in red. If this mnemonic helps people, I think that can be done. There is, however, an image annotation by Peter Marks that says replacing this with "granulocyte and monocyte maturation". Is that a different image, or simply replacing the images as we have with those words? -weelicI think this is in reference to the anatomy chart on 398. If we can somehow incorporate the mnemonic then it would be a good addition. This would be something perhaps the illustration team can work on incorporating? -Lilit03/12/19 11:45 AMTrevaughnBaptistetbapt001@fiu.edu
997399Hematology and OncologyAnatomyMacrophageshttps://www.ncbi.nlm.nih.gov/pubmed/19388527It mentions that Langerhans cells are macrophages derivatives. Whereas in old first aid (2016) and on uworld it says that Langerhans cells are dendritic cells.Major erratumVerifiedWe have hemmed and hawed over this for a very long time (and for good reason!). Although the idea of LCs have been around since the 1980s (https://www.ncbi.nlm.nih.gov/pubmed/6993584), their superficial similarities with conventional DCs have led them to be classified as a specialized subset of such for years. But based on recent (2017 onward) literature with transcriptome analysis and talks at the last couple national immunology (AAI) meetings, it seems like in the basic science world, they are accepted to be more closely related to macrophages despite obvious functional similarities to DCs. Looking at UTD, however, LCs are still considered to be specialized DCs.

Because of the disagreement, I really don't think that this will be tested on step 1 (I think LCs are most HY in the context of LCH and their birbeck granules). Even if it does become accepted that LCs are a specialized macrophage, it will take time to adopt completely.

Maybe the best thing we can do is add a very small blurb for LCs alone. It looks like we have room for it on the bottom of page 399 after macrophages or 400 after dendritic cells. We can have a small blurb and maybe a picture of a birbeck granule, although I wouldn't want it to be too redundant of page 426.

Can probably defer to 2020 with some faculty input.

-Connie		Yes indeed, this is another one of our "chronic errata" that pops up every year without fail. It is controversial as Connie points out. But, in past years, we did review the literature with faculty input and firmly decide that Langerhans cells are specialized macrophages.

For that reason, wold definitely not change this. Will flag once again for expert input. Overall, I suspect the best thing to do may be a clarification as Connie proposes to hopefully prevent further errata submissions about this from being made in the future.

No need to publish in the official errata.

-Matt

UPDATE: Appreciate faculty input. Add to Annotate for implementation, but not published errata worthy.

-Matt		Disagreement/need expertPeter MarksAgree with the discussion that there is fair amount of controversy here. Perhaps explaining that Langerhans cells appear to be derived from a dentritic cell precursor and have similarity to macrophages would represent the most recent state of the science (Blood 2015)Reject01/14/19 7:37 PMKiranNizamaninizamani.kiran1@gmail.com
998399Hematology and OncologyAnatomyMacrophageshttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)14323-1/fulltextChange Langerhans cells to Langhans cell. Langhans cells is a are large cells found in granulomatous conditions. They are formed by the fusion of epithelioid cells (macrophages), and this cells is different than langeRhans cells, which are mononuclear epidermal dendritic cells derived (like Langhans cells) from monocytes.Major erratumDuplicateAddressed in above comment. This has been an ongoing topic of discussion :)

-Connie		01/30/19 1:10 PMDunyaImaddra.dunya.imad@gmail.com
999399Hematology and OncologyAnatomyMacrophageshttps://www.ncbi.nlm.nih.gov/pubmed/16405098to add "Langhans cells" when describing granuloma formation, and to remind not to mix it with "Langerhans" dendritic cells in skinHigh-yield addition to next yearVerifiedI think it could be helpful to distinguish between the terms "Langerhans" vs. "Langhans".

According to this article, Langhans cells play a role in TB granuloma formation.

https://www.resmedjournal.com/article/S0954-6111(06)00179-X/abstract

- Sarina		Yes I think Langhans cells can be added to the section with macrophages, since they are multinucleate giant cells formed from the fusion of epithelioid macrophages in granulomas. I can see this being high yield in histology and heme/immune. -Lilit03/01/19 6:57 PMAlaJamalala.aljamal@hotmail.com
1000399Hematology and OncologyAnatomyThrombocytes (platelets)not neededplatelet factor *f*our (4) \suggest writing "four" and highlight *f* or highlight *4* to match mnemonic.MnemonicVerifiedIt appears that this change has already been added. -weelicYes this has already been implemented. -Lilit12/31/18 3:30 PMMoatasemAl-Janabiassoomi88@yahoo.com
1001399Hematology and OncologyAnatomyThrombocytes (platelets)N/AThink DenCe granules ( aDp, Ca )MnemonicVerifiedReject? Having to capitalize D in aDp makes it look like a different thing from the ADP (adenosine diphosphate) that we are familiar with. However, it is still a helpful (but not great) mnemonic. -weelicReject. I do not think a mnemonic is necessary in this situation.

- Sarina		01/04/19 4:31 AMFerasAl-Moussallyferas226@hotmail.com
1002399Hematology and OncologyAnatomyThrombocytes (platelets)First Aid 2019Dense granules (delta in some books) => (these dense granules are in the SAC) => (Serotonin, ADP, Calcium),,, the delta symbol is already a sac shapeMnemonicVerifiedReject. I notice we have already added serotonin and histamine to the contents of dense granules with the mnemonic CASH. -Lilit05/10/19 11:04 PMFarisBinyouseffaris-v@hotmail.com
1003400Hematology and OncologyAnatomyEosinophilshttps://www.uptodate.com/contents/embolism-from-atherosclerotic-plaque-atheroembolism-cholesterol-crystal-embolism PS* photo attached is from Pocket Medicine, 6thCholesterol emboli syndrome is a cause of eosinophilia. Add to one of the causes and add to the mnemonic: PACCCMANHigh-yield addition to next yearVerifiedVerified by UTD. I think it is possible to add cholesterol embolism syndrome to this mnemonic but I am not sure how high yield this information is.

- Sarina		I don't think cholesterol emboli are a high yield concept for step 1. Recommend rejecting. -Lilit02/09/19 12:59 AMNicolasCuri Gawlinskinicolascurii@gmail.com
1004402Hematology and OncologyPhysiologyHemoglobin electrophoresismy brainCan Santa Fly Around the world ?MnemonicVerifiedDefer to 2020 ? This mnemonic goes in the CSFA direction, which reflects how the bands travel from the cathode to the anode, and thus is arguably better than the existing one that goes AFSC. I would need more input to see if people like this. On annotate, there is one that tries to add CA to "A fat Santa Claus can't go far", but that direction is reversed, I think that one might be more confusing so I would reject that. -weelicI'm not a big fan of this one. The one that's already in FA 2019 looks pretty good to me. -Lilit02/03/19 3:33 PMBahaa' EddineSuccarbahaasuccar@gmail.com
1005402Hematology and OncologyPhysiologyHemoglobin electrophoresisFirst Aid 2019We can memorize the sequence of the electrophoresis (A-F-S-C) by the first litters of the phrase: (Abnormally Folded Sickle Cell)MnemonicVerifiedI see we have already edited the current mnemonic. No need for a new one. -Lilit05/09/19 11:15 AMFarisBinyouseffaris-v@hotmail.com
1006402Hematology and OncologyPhysiologyHemoglobin electrophoresisjust a clarificationunder the Diagram the label should state something like "normal HbA consisting of alpha2beta2" oder similar. because like this there could be a lot of confusion (at least for me) if Point A is just labeled with "normal beta chain"...Clarification to current textI don't think further clarification would make this diagram easier to understand. Fine as is. -LilitAgree. Current text is clear and concise and I am not sure how this change would help. Hemoglobin is already discussed elsewhere where one can look up what HbA means. Reject clarification.

-Matt		Reject by 2 authors + 1 editor06/07/19 10:24 AMNoam LeanderDegnernoam.degner@me.com
1007403Hematology and OncologyPhysiologyThrombogenesisuptodate.com, UWorldadd Desmopressin activate release of vWF from endothelial cellsHigh-yield addition to next yearVerifiedAgreed! I think this is very high yield. Always shows up in question banks.

- Sarina		Agreed. Would like some input from the illustration authors on adding this to the diagram. -weelic03/01/19 7:01 PMAlaJamalala.aljamal@hotmail.com
1008404Hematology and OncologyPhysiologyCoagulation and kinin pathwayshttps://www.uptodate.com/contents/overview-of-hemostasis?search=hmwk&source=search_result&selectedTitle=2~17&usage_type=default&display_rank=2Add HMWK = High-molecular-weight kininogen to the image captionClarification to current textVerifiedYes, but can be deferred.
We do use the abbreviation HMWK in this chapter without writing it out. It would be helpful to have "HMWK = high-molecular-weight kininogen" right under the LMWH abbreviation explanation in the lower left corner of the diagram. Can probably be deferred since HMWK is explained on page 704 in the abbreviations index, but would be nice to have in the chapter/diagram.

-Connie		Agree with Connie, this can be added with next publication.
John		I am okay adding this. Non-urgent addition to 2020, this need not be published in the official errata.

-Matt		Prelim accept but NOT publishable errata01/02/19 1:29 PMBahaa' eddineSuccarbahaasuccar@gmail.com
1009404Hematology and OncologyPhysiologyCoagulation and kinin pathwayshttp://www.bloodjournal.org/content/bloodjournal/100/3/743.full.pdf?sso-checked=trueFactor XIII requires calcium to convert to XIIIa.Minor erratumVerifiedYes, it appears this is correct.

For consideration, does anyone even feel knowing which factors require calcium is important? I don't remember that being useful.

-John		Reject.
Agree with John and reader that this fact is technically correct.

Do not recall memorizing which factors require Ca2+ as being a tested point. Vit K requirement was definitely tested. Several other factors also require Ca2+ (clotting in general requires Ca2+), so I don't think it's necessary to point out factors that need Ca2+.

-Connie		I suspect this is because we show which steps require calcium for other reactions in the cascade, and omitting this one makes us appear inconsistent.

Also agree that the value of knowing which reactions require calcium is unclear. I do not recall this ever being tested. Would be helpful to get input from recent test takers on if this information is even worth learning.

Let's visit in 2020. If we keep the calcium requirements, I would be in favor of adding this. Alternatively, if we determine that these calcium requirements are lower yield, I would be in favor of deleting all of them to make this diagram cleaner.

Nothing here needs to be put into the published errata.

-Matt		Prelim accept but NOT publishable errataPeter MarksKnowing that calcium is necessary for coagulation to take place in general is useful knowledge, as it explains why chelation of calcium with citrate works as an anticoagulant. Knowing which factors/reactions require calcium, however, is not something that would be expected to be tested at this level. That said, would try to be consistent showing all reactions that require calcium, if possible, though calcium plays a different role in factor XIII activation than it does in the tenase and prothrombinase complexes.01/11/19 8:13 AMJaquelinePadlipskylynn.padlipsky@gmail.com
1010404Hematology and OncologyPhysiologyCoagulation and kinin pathwaysUWORLD question banksFor Fibrinolytic system: to add the following thrombolytics (Urokinase, Kallikerin, Hageman faxtor XII), also both tPA and Urokinase are inhibited by PAI( Plasminogen activator inhibitor). Also the following are direct PLASMIN inhibitors (Tranexamic Acid, Aprotinin, alpha 2 microglobulin, alpha 2 atitrypsin)High-yield addition to next yearVerifiedI am not sure how high yield it is to add these drug names to the current image, especially since Urokinase and Streptokinase are in the same family. I think purpose of the image is to give a few examples of drugs that work at each step of the coagulation pathway.

According to UTD, Tranexamic acid "forms a reversible complex that displaces plasminogen from fibrin resulting in inhibition of fibrinolysis; it also inhibits the proteolytic activity of plasmin"

Maybe we can discuss with the illustration authors to see if they want to add an extra inhibitory arrow pointing towards plasmin.

- Sarina		Came across all of this information on the wikipedia page for "kallikrein." Not sure how reliable this resource is and exactly which UW item this reviewer is referring to. I'm inclined to reject. -Lilit03/01/19 6:59 PMAlaJamalala.aljamal@hotmail.com
1011404Hematology and OncologyPhysiologyCoagulation and kinin pathwayshttps://www.ncbi.nlm.nih.gov/pubmed/27906870under anti IIa (tmrombin) meds box: it say heparin (greatest efficacy). Actually there is obvious conflict in literature regarding the effictivness of H vs LMWH and the general sense is that there is no superiority in effectivness of one over the other although many practitioners claim that LMWH is more effective than Heparin. LMWH is associated with less HIT. I recommend removing "Greatest Efficay"Major erratumVerifiedI think this person is referring to the 2018 edition. The 2019 edition does not have "greatest efficacy" written next to heparin.

- Sarina		Agree, cannot find this submission. Must be earlier version.

-Matt		Reject by 2 authors + 1 editor03/01/19 7:10 PMAlaJamalala.aljamal@hotmail.com
1012404Hematology and OncologyPhysiologyCoagulation and kinin pathwaysn/aI remember that Hemophilia B is aka as Christmas disease and is due to factor IX deficiency, by the mnemonic "NINE Before CHRISTMAS" = factor NINE, hemophilia B, CHRISTMAS diseaseMnemonicVerifiedIt would be better if there was a more comprehensive mnemonic for all 3 hemophilias listed. This is just for one of them. Plus I don't think board style questions would refer to hemophilia B as christmas disease. Thoughts? -Lilit03/04/19 2:08 PMJustinWinklerjmwink04@louisville.edu
1013404Hematology and OncologyAnatomy and PhysiologyCoagulation and kinin pathwayshttps://www.sciencedirect.com/science/article/pii/B9780123822192006384activated Factor XII converts prekallikrein to kallikrein. this should be included on the graphic since elevated PTT implies Kallikrein could be affected and the bradykinin activation thus might be impaired.High-yield addition to next yearThe described mechanism is similar to the action of activated factor XII in the activation of factor XI. However, I don't think this amount of detail is necessarily high yield and the diagram itself is already very crowded and detailed. Thoughts? -Lilit04/20/19 12:31 AMAdamRippetoeadam.rippetoe@yahoo.com
1014405Hematology and OncologyPhysiologyVitamin K–dependent coagulation componentshttps://www.ncbi.nlm.nih.gov/pubmed/19141161The inactive vitamin K dependent coagulation factors are listed as II, VII, IX, C, S. Factor X was neglected. It is, however, listed as a mature, carboxylated factor.Minor erratumVerifiedYes, accept, we did forget to add factor X to the list of inactive factors being converted to active with vit K. Right now it is:
"Inactive II, VII, IX, C, S --> Mature, carboxylated II, VII, IX, X, C, S"

Just add X to read:
"Inactive II, VII, IX, X, C, S --> Mature, carboxylated II, VII, IX, X, C, S"

-Connie		Agree, important catch.
- John		I'm looking at the diagram and I see factor X there listed under inactive factors. The whole page seems to always list X appropriately. Confirm with the copyeditors that final print version lacks X. If that is the case, then agree with adding it back in, and would publish in the official errata.

-Matt

UPDATE: Still awaiting copyeditor confirmation on if this was truly deleted or not!		Prelim accept by 2 authors + 1 editorPeter MarksAgree that factor X should be added back in.Reject01/04/19 12:15 PMEduardoHernandezeduardo.hernandez@utsouthwestern.edu
1015405Hematology and OncologyPhysiologyVitamin K–dependent coagulation componentsFa 2017Factor 10 should be included for the inactive stateMinor erratumVerifiedIf the submitter is referring to the figure, then Factor X is already included in the latest version of annotate. -weelicAgree w/ Weelic.

- Sarina		Agree, already on Annotate, duplicate submission.

-Matt		Reject by 2 authors + 1 editor02/22/19 11:15 AMRioVargheservarghese@mail.sjsm.org
1016406Hematology and OncologyPathologyPathologic RBC formshttps://www.sciencedirect.com/topics/medicine-and-dentistry/acanthocytein Acanthocytes can you add in Notes section Spikes are irregular,Clarification to current textI don't think this is necessary as the table is in the works to be rearranged. In this case acanthocytes and echinocytes will follow and the distinction will be clear. -LilitPer Lilit, we are organizing this table differently and that should address this. And even if we were not, I would not see a critical need for this change.

-Matt		Reject by 2 authors + 1 editor05/15/19 6:46 PMMuhanadShaibmohanad.shaib@gmail.com
1017406Hematology and OncologyPathologyPathologic RBC formsn/aIn the END, you are either BURRied or, burnt in a PYRE. So LIVE as you can! BURR cells – END stage renal disease, PYRuvate Kinase Deficiency, LIVEr disease.MnemonicVerifiedI don't think this is a good mnemonic. It's too long and not a very valuable memory tool. -Lilit07/08/19 5:55 PMAPandeyaranikopandey@gmail.com
1018407Hematology and OncologyPathologyPathologic RBC formshttps://www.ncbi.nlm.nih.gov/pubmed/18285271 https://www.labce.com/spg28881_target_cells_continued.aspxin Iron deficiency anemia you can see Target cells as well.Minor erratum"Target cells were present in most IDAs and thalassemia and in similar numbers." Sentence from abstract of first paper. I don't think this is necessarily high yield and wouldn't consider this a minor erratum either. I wouldn't add this on without consulting experts. -LilitA quick search shows that, yes, IDA can be associated with target cells. Target cells essentially arise any time there is a size-surface area mismatch (eg, your surface area exceeds the volume greatly, as can happen with synthesis of red blood cells is hemoglobin-limited owing to iron deficiency). While true, my strong suspicion is that this is extremely low yield, and would probably just be confusing at the Step 1 level. I would therefore say that this should be rejected. Moreover, it is more of an addition or clarification, not an erratum, as we are certainly not wrong to include this condition under causes of target cells.

See: https://www.ncbi.nlm.nih.gov/books/NBK263/

Reject submission, no need for expert review as this is very low yield.

-Matt		Reject by 2 authors + 1 editor05/15/19 6:53 PMMuhanadShaibmohanad.shaib@gmail.com
1019408Hematology and OncologyPathologyNon-Hodgkin lymphomaInformation taken from First AidBurkitt Lymphoma, a t(8:14) of C-myc with a starry sky appearance. "At 8:14pm look up and SEE(c-myc) the STARRY SKY"MnemonicVerifiedI think this mnemonic is good. This fact belongs in page 422 now. Currently the column is quite busy. So, this mnemonic may add a line. Thoughts/comments? - weelicAgree with Weelic on this one. It's a nice sentence and easy to remember. However, space may be an issue. This is the only reason why I'd vote against this. -Lilit02/07/19 4:45 PMHaleyBasingerhaley.basinger@my.rfums.org
1020409Hematology and OncologyPathologyAnemiashttps://emedicine.medscape.com/article/780334-overview ; https://emedicine.medscape.com/article/2086146-overviewConsider adding "acute blood loss" to the graphic depicting the differential diagnosis of anemia. Acute blood loss typically presents as a normocytic anemia with an elevated reticulocyte index. This addition should be considered since acute blood loss is stated as "the most common cause of acute anemia seen in the emergency department (ED)" in Medscape. Links provided in the "supporting references" section.High-yield addition to next yearVerifiedI agree! I think acute blood loss can be added under the normocytic anemia section.

- Sarina		-Note that currently in the diagram, the normocytic is subcategorized into hemolytic(reticulocyte <2%) and non-hemolytic (reticulocyte >2%). My question is: where would acute blood loss be? If it is very acute e.g. after car accident trauma, then reticulocyte is not elevated since it takes a few days to elevate. -weelic01/04/19 7:42 PMMatthewNealematthew_neale@brown.edu
1021409Hematology and OncologyPathologyAnemiashttps://www.uptodate.com/contents/approach-to-the-adult-with-anemia?search=Approach%20to%20the%20adult%20with%20anemia&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1In normocytic hemolytic anemia, the bone marrow response is usually normal so the reticulocyte index is > 3% and not > 2% according to the UpToDate article “Approach to the adult with anemia”, paragraph “decrease in effective red cell production”, line 4. So In the diagram, under “hemolytic”, replace reticulocyte index > 2% with > 3%.Minor erratumVerifiedI think the current text is probably fine, deferring to editor to decide whether it's worth the change. I'm leaning towards yes, change it, but it's not an urgent change and can be deferred.

Merck's calculator says that a RPI of <2 is inadequate, >3 is adequate (https://www.merckmanuals.com/medical-calculators/ReticProdIndex.htm).
The Manual of Pediatric Heme/Onc 5th ed says >3 adequate, < 3 is inadequate.
Original article from 1996 about the RPI just states that 2 or less is inadequate. I guess that technically makes >2 accurate? https://watermark.silverchair.com/ajcpath108-0069.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAlswggJXBgkqhkiG9w0BBwagggJIMIICRAIBADCCAj0GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMqR1suANHVMXrwI7JAgEQgIICDsE0MP0NcbYIyI297IlDUyq31uf-LSk5tRn8GcbDOh3SFxH33wUZI9spp8X-4XDzYSla_ZVu-tuaNj6bOaa1-A2KXvwI8v-eJ86vJkS4bp1X4fzAIYfVUt7OkuWFdNNfL7Dgw0j5B0TjVKUE-rt2TKAtssYLk_Im6c4esCjPpgnf5QhJXBaJ8jSIpWZUVMy2A1P2dv4py5G1A7aNEnrjl3g37vvQ-9dA3dRomFni9ZDvpDZpSeNwj8k8JPkUbcWq-jFmlKMT7Ir7SK5se8yqV8qdtZJ_cQ8nnUfMfLhCV8zMPT_MqbOr-Fh9AiVPQqnFSPdWMeZyXS9ccor-HlQJrPH71PVEdUNcfbAehopi3KFgN0VFvcjDMRRPHNfzj9MxhyxZZ-DkFKVHClSwGJ-u7UtXWSWTDSmxOfwun_Gdxblx2lVkLD-apADKAT4cJEDh_j-ul-qvYQbnk3tcZvxTEQn938zQftrsXRQ6Q-www0P3YAmWhqCbMhfOjIZuthNbE0-oLWsDv49vxMAISiBkULpYtXggLdrqFutBNIOWayJqacceQzdna7Ii7aWrJiZJgcTI_QSX1tzHLOCvniDrZDipjcUvsWtKuBfERvJ_dXN-p6mz1JEhBWNqSIdLH-BLrLpb_8EljkBpndHlXj66U7uAT7hT3aE54LTBYoproa0544igofh9x1uRWbtOT78

-Connie		According to UTD "An RPI >3 shows a normal marrow response to anemia. An RPI <2 is an inadequate response to anemia"

I think the current text is accurate because it reads "> 2%", not including 2. So it means that anything 3% and above is a normal response. Perhaps it can be changed to " ≥ 3%" to make it more clear.

- Sarina		I suspect that a very specific cutoff is probably unnecessary here. The important thing to take home is that nonhemolytic anemias generally have a low reticulocyte index, and hemolytic anemias generally have a high reticulocyte index. Thus, I would favor changing "<2%" to "low" and ">2%" to "high" which would keep it correct, but not have students obsess over specific numbers.

Let's consider this for 2020, but no need to publish anything in the official errata.

-Matt		Prelim accept but NOT publishable errata01/23/19 5:28 AMBahaa' eddineSuccarbahaasuccar@gmail.com
1022409Hematology and OncologyPathologyAnemiashttps://www.uptodate.com/contents/hereditary-spherocytosis?search=hereditary%20spherocytosis&source=search_result&selectedTitle=1~87&usage_type=default&display_rank=1#H1623571274'Hereditary Spherocytosis' is listed as an Intrinsic (Intravascular) Hemolytic, Normocytic Anemia. I believe it is more properly categorized as an 'Extrinsic' (Extravascular) Hemolytic, Normocytic Anemia. While progressive cell membrane loss does impair RBC ability to traverse microcirculation, the spleen is where the ultimate destruction (phagocytosis) of the Spherocytes takes place.Minor erratumVerifiedAgree w/ Vivek.

- Sarina		Reject.

Intrinsic HA — the destruction of the red blood cells due to a defect within the red blood cells themselves. In case of HS, the defect is within the RBCs. The UTD link itself exemplify HS as intrinsic, which is not synonymous with intravascular.


- Vivek		Agree, no change needed. This is an intrinsic RBC defect leading to extravascular hemolysis.

-Matt		Reject by 2 authors + 1 editorPeter MarksHereditary spherocytosis represents an intrinsic red blood defect associated with extravascular hemolysis as cells pass through the sinusoids of the spleen. It is indeed generally a normocytic anemia.02/19/19 4:27 PMSaiPolinenispp50@med.miami.edu
1023409Hematology and OncologyPathologyAnemiasFA 2017Sideroblastic Anemia is not included among Microcytic Anemias in the chartMinor erratumVerifiedAgree.

I think we can add sideroblastic anemia under microcytic anemias since it is included in the text.

I also agree w/ Vivek. I think the "(late)" should be added next to microcytic iron deficiency to clarify that late stages of Fe deficiency result in microcytic anemia while early stages of Fe deficiency result in normocytic anemia.

- Sarina		Agree. This is detailed in the text but deleted from the chart. Also, "late" is deleted from the parenthesis of iron deficiency. This was helpful because early stages of IDA would show normocytic anemia.

Final comment:
- No errata.
- revisit in 2020 revision.


- Vivek		Agree, not an errata but merits review of the text and possible edits. Propose migrating over for consideration in 2020.

-Matt		Prelim accept but NOT publishable erratatrue02/22/19 1:12 PMRioVargheservarghese@mail.sjsm.org
1024409Hematology and OncologyPathologyAnemiashttps://www.uptodate.com/contents/sideroblastic-anemias-diagnosis-and-management?search=sideroblastic%20anemia&source=search_result&selectedTitle=1~102&usage_type=default&display_rank=1#H1524133059In the "Anemias" flow chart, under "Microcytic (MCV<80 fL), Hemoglobin-affected (TAIL)" section, sideroblastic anemia should be included under "Defective Heme Synthesis". The mnemonic, "TAIL," should subsequently be changed to "TAILS".Minor erratumThis is essentially the same suggestion as #16 on smartsheet. However, this submitter added a useful uptodate reference (which does not support the submitter's claim). Quote: "In adults, an acquired sideroblastic anemia is much more common than an inherited form, although the diagnosis of a congenital type has not infrequently been delayed until adulthood. The two typical presentations in adults are those in which the clinical history gives a clue to a reversible cause, and those for whom the bone marrow aspirate performed for unexplained anemia reveals ring sideroblasts. Almost all of the acquired sideroblastic anemias are associated with normocytic or macrocytic RBCs rather than microcytosis." Thus, it is unfortunate that we have placed "Defective Heme synthesis" under microcytic. It is accepted that sideroblastic anemia is under "defective heme synthesis", and it is accepted in preclinical dogma that "defective heme synthesis is generally microcytic", but it is also written in UptoDate that most acquired sideroblastic anemia is not microcytic. I think this suggests that some defective heme synthesis is not microcytic, which may be controversial. I think this requires expert review. -weelicWhile this UpToDate link does state that nearly all acquired forms of sideroblastic anemia are either normocytic or macrocytic, it does also mention other forms that are usually microcytic and hypochromic in nature. I also think that if we do add sideroblastic anemia to the "defective heme synthesis" list, it will generate more errata. But I do agree that expert review is needed here. -LilitWe have actually discussed this before. Sideroblastic anemias were initially included on the list and in fact TAILS was the mnemonic proposed if I am not mistaken. However, our research showed that the causes of sideroblastic anemias were quite diverse and not well-associated with size (eg, many are normocytic or macrocytic) and more determined by the underlying cause as opposed to general sideroblastic anemia. Thus, we kept it out. Owing to this controversy, I will confidently state that adding this back in would subject us to many more errata from people finding exceptions (eg, macrocytic or normocytic variants) and is unlikely to be high-yield at all compared to the other causes listed such as iron deficiency.

We thus do not require expert review and can safely reject this erratum.

-Matt		Reject by 2 authors + 1 editor05/06/19 12:57 AMWenyuDengwenyu.deng128@gmail.com
1025409Hematology and OncologyAnatomy and PhysiologyMicrocytic, hypochromic anemiasNone needed.Consider adding "S" to the mnemonic TAIL (TAILS), under microcytic anemia, and include Sideroblastic anemia.MnemonicVerifiedSame comment as above. Expert review may be required, but I'm leaning towards not accepting, as errata may be generated. -Lilit06/26/19 4:22 PMDanielleKacendkacen@aol.com
1026410Hematology and OncologyPathologyMicrocytic, hypochromic anemiashttps://www.ncbi.nlm.nih.gov/books/NBK22200/Alpha thalassemia is more commonly due to defect on chromosome 16High-yield addition to next yearVerifiedI think it is important to add c. 16. So it would read "a-globin gene deletions on C. 16"

- Sarina		Already implemented during 1st pass for 2020 edition. -Lilit12/30/18 3:31 AMKamleshunRamphuladramphul@hotmail.com
1027410Hematology and OncologyPathologyMicrocytic, hypochromic anemiashttps://www.ncbi.nlm.nih.gov/books/NBK22200/Beta thalassemia is more commonly due to defect on chromosome 11High-yield addition to next yearVerifiedI think it is important to add c. 11. So it would read "point mutations in splice sites and promoter sequences on c. 11"

- Sarina		Already implemented during 1st pass for 2020 edition. -Lilit12/30/18 3:32 AMKamleshunRamphuladramphul@hotmail.com
1028410Hematology and OncologyPathologyMicrocytic, hypochromic anemiashttps://emedicine.medscape.com/article/202333-overview#showall (as well as Pathoma [2018] pg. 42 . Dr. Husain Sattar)Hookworms (namely Ancylostoma duodenale and Necator Americanus) cause Iron Deficiency AnemiaHigh-yield addition to next yearVerifiedI guess we can add hookworms as a cause of Fe deficiency anemia but on p. 159 it already says that they cause microcytic anemia by sucking blood from intestinal wall.

Maybe it can be added to the chronic bleeding section, so it would read "chronic bleeding (eg, GI loss, menorrhagia, hookworms)".

But I am not sure if this is completely necessary as it may disrupt the text,which already seems crowded.

- Sarina		If adding one word will add a line, then I suggest not doing it.hookworms is a part of GI blood loss after all. But if it doesn't add a line, I think it should be considered. -weelic01/06/19 1:41 PMNathanielBorochovnateboro8@gmail.com
1029410Hematology and OncologyPathologyMicrocytic, hypochromic anemiasFirst Aid 2019We can corrlate (CiS with aSian) & (tRaNs with afRicaN)MnemonicVerifiedDon't think this is absolutely necessary here. Plus I don't find this to be a great memory tool anyway. -Lilit05/09/19 11:21 AMFarisBinyouseffaris-v@hotmail.com
1030411Hematology and OncologyPathologyIntrinsic hemolytic anemiashttps://ghr.nlm.nih.gov/condition/hereditary-spherocytosisHereditary Spherocytosis has increased risk for pigmented gallstonesHigh-yield addition to next yearAgreed. This is something that we should consider adding, as pigment gallstones are common presenting symptoms in adults with HS. -Lilit https://www.uptodate.com/contents/hereditary-spherocytosis?search=hereditary%20spherocytosis&source=search_result&selectedTitle=1~89&usage_type=default&display_rank=1#H204147598805/22/19 11:27 AMCameronHansoncameronglennhanson@kcumb.edu
1031411Hematology and OncologyPathologyMicrocytic, hypochromic anemiasN/AExposure risk in Lead Poisoning should include exposure to batteries (like workers in a factory), or exposure to ammunition. Both of these exposure risks are included in the Lead Poisoning section on page 417.High-yield addition to next yearVerifiedHmm, I am not sure if we need to add exposure to batteries as RF for lead poisoning on p. 411 if it is already listed on p. 417. But I guess it can be added for clarification.

- Sarina		- I suggest not adding these because having lead being featured on both 411 and 417 is already a lot. -weelic01/06/19 1:38 PMAdamKurnickadam@kurnick.net
1032411Hematology and OncologyPathologyMicrocytic, hypochromic anemiasDr. Sattar's PathomaClarify the increase in RBC protoporphyrin for lead poisoning as inhibited ALAD should lead to a decrease (hence why lead poisoning can lead to a sideroblastic anemiaClarification to current textVerifiedReject.
Text is clear, directly says that lead inhibits ALA dehydratase (=ALAD).

-Connie		Agree with Connie that this can be rejected.
- John		Agree with authors, reject erratum.

-Matt		Reject by 2 authors + 1 editor01/06/19 6:57 PMJoannaGeorgakasJoanna_Georgakas@brown.edu
1033412Hematology and OncologyPathologyMacrocytic anemiashttps://www.ncbi.nlm.nih.gov/books/NBK459295/some drugs that causes Nonmegaloblastic anemia: 5-Fluorouracil, Zidovudine , HydroxyuriaHigh-yield addition to next yearThe list is much more extensive according to the article provided. However, I don't think this is a high yield suggestion. Leaning towards rejecting. -LilitReclassifying as a high-yield addition to consider in 2021.

-Matt		05/15/19 7:11 PMMuhanadShaibmohanad.shaib@gmail.com
1034412Hematology and OncologyPathologyMacrocytic anemiasNADiamond Blackfan anemia: a fan has three wings triphalangeal thumbMnemonicVerifiedClever, but I'm a bit torn. There have been quite a few times where diamond-blackfan anemia and fanconi anemia have been mixed up because both present with thumb defects. Perhaps we can consider using this mnemonic? -Lilit05/26/19 7:57 AMAwabElnaeemawab.kamal@gmail.com
1035413Hematology and OncologyPathologyHeme synthesis, porphyrias, and lead poisoningmnemonicTo remember intermediates in heme synthesis and porphyrias: Pour Hot Ugandan Coffee Pronto (Porphobilinogen, Hydroxymethylbilane, uroporphyrinogen III, Coproporphyrinogen III, Protoporphyran)MnemonicVerifiedI welcome anything which can help, especially since it is HY and appeared in my exam. Currently we do not have a mnemonic for this fact. -weelicI don't think I was ever able to memorize these intermediates while I studied for step 1. Can definitely be useful. My only concern is do we have room to include this? Also, what about aminolevulinic acid? I would want a more comprehensive mnemonic. -Lilit12/22/18 2:31 PMAmberYoungaby4zp@virginia.edu
1036414Hematology and OncologyPathologyIntrinsic hemolytic anemiashttps://emedicine.medscape.com/article/206107-overviewUnder Intrinsic hemolytic anemias there is hereditary spherocytosis listed. Hereditary spherocytosis is an intrinsic defect in the RBC but it is an extravascular hemolytic anemia. I suggest moving hereditary spherocytosis to page 415 under extrinsic anemia.Minor erratumVerifiedDisagree. Although hereditary spherocytosis has features of extrinsic hemolytic anemia (eg, splenic consumption), it is listed as an intrinsic hemolytic anemia due to instrinsic defects in RBC membrane proteins.

- Sarina		Agree, no change needed. This is an intrinsic RBC defect leading to extravascular hemolysis.

-Matt		Reject by 2 authors + 1 editor01/20/19 2:48 PMConnorBarryconnorbarry3@gmail.com
1037415Hematology and OncologyPathologyExtrinsic hemolytic anemiashttps://coldagglutinindisease.org/cold-agglutinin-disease/In cold agglutinin if you can add to RBC agglutinates (Clumping agglutination) , so that can be easy differentiated from anything that causes stacked coin agglutination.Clarification to current textReject. I don't think this needs to be clarified. Rouleaux formation is mentioned in multiple myeloma, where its meaning is explained. Agglutination, on the other hand, is pretty self explanatory. -LilitAgree with Lilit. I think the distinction is clear enough and is discussed in detail for each respective pathology. Adding this clarification would not improve the text or students' ability to learn the material.

Reject.

-Matt		Reject by 2 authors + 1 editor05/15/19 6:59 PMMuhanadShaibmohanad.shaib@gmail.com
1038416Hematology and OncologyPathologyInterpretation of iron studiesGoljan 4th edition page 295, Pathoma 2018 edition page 43For anemia of chronic disease the % transferrin saturation is decreased.Major erratumVerifiedI reviewed the UpToDate article as well and I agree with Vivek that the submission is accurate.

I suggest we put entry as "-- / down-arrow" to indicate that it could be normal or low

- John		Need faculty input.

After reviewing the provided references and UTD, I feel the student is correct.

In UTD, it is mentioned that in anemia of chronic disease (ACD)- "the transferrin saturation (TSAT) is usually normal or low-normal." However, in the same chapter, they mentioned and tabulated that low TSAT is one of the diagnostic clue in ACD. However, approximately 20 percent of patients with ACD have a TSAT in the iron deficiency range.

UTD: Anemia of chronic disease/inflammation


- Vivek		I think it is reasonable to list it as normal to low. Saturation will generally be on the lower end due to the lack of available iron, but can also be normal depending on the relative decreases in iron and iron binding proteins. Concomitant iron deficiency can be diagnosed with an unusually low saturation (eg, below 15%).

Not published errata worthy, but reasonable as a clarification/HY addition for 2020.

-Matt		Prelim accept but NOT publishable erratatrue01/12/19 11:48 PMKamleshunRamphuladramphul@hotmail.com
1039416Hematology and OncologytruePathologyInterpretation of iron studieshttps://www.uptodate.com/contents/causes-and-diagnosis-of-iron-deficiency-and-iron-deficiency-anemia-in-adults?search=iron%20deficiency%20stages&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1In the table it’s indicated that the first disturbance of iron deficiency is decreased serum iron. In fact, the first disturbance of iron deficiency is low ferritin (iron stores) , so the down arrow next to ferritin should be in red and the one next to serum iron should be in black. It is clearly specified in the UpToDate article (Causes and diagnosis of iron deficiency and iron deficiency anemia in adults) in “Progressive Iron depletion” and illustrated in table 4.Minor erratumVerifiedYES accept we definitely need to change this.
The depletion of iron stores is the first defined stage of iron depletion. Iron stores can be completely depleted without causing anemia, because serum iron levels from daily turnover of RBCs is available. Further loss of iron results in anemia.

Suggest implementing the reader's change as is, down arrow next to ferritin should be red, down arrow next to serum iron should be black.

Source provided is fine, here is a link to the table: https://www.uptodate.com/contents/image?imageKey=HEME%2F76236&topicKey=HEME%2F7150&search=iron%20deficiency%20stages&rank=1~150&source=see_link

-Connie		I agree it is more accurate to list the depletion of ferritin as the major finding, over serum iron. It is a much more accurate indicator of iron stores, and agree that other factors (eg, diet, RBC turnover) can maintain the serum iron levels even when the ferritin stores are depleted.

Overkill to call this a "major" erratum, however, it is better classified as a minor one. We're emphasizing the wrong lab, but we did not write something overly incorrect. I have reflagged it as such. I agree with making this change and support including it in the published errata.

-Matt

UPDATE: We can include this as a minor erratum addition to the published errata,		Prelim accept by 2 authors + 1 editorPeter MarksAgree that ferritin is the first thing that is depleted in iron deficiency. Also agree that this is a minor erratum, as the order of depletion is not what is really relevant in clinical practice (and the exam) - it is the pattern of low or absent ferritin, low iron and high transferrin or TIBC.Accepttrue01/23/19 4:56 AMBahaa' eddineSuccarbahaasuccar@gmail.com
1040416Hematology and OncologyPathologyInterpretation of iron studiesMnemonicTo remember which iron storage molecule is exclusively intracellular and which is found in serum, remember that HemoSIDErin “Hides inSIDE” the cell, while FERRitin is FREE to Float in the serum. Color coded image attached.MnemonicVerifiedAccept. But, in the context of the page, this is a mnemonic for a HY entry that we do not have. So, we start by considering this as a HY fact addition. I currently do not see a good place to add this HY fact. Best place so far is to squeeze it in the text below the table. Also we can debate if this is actually HY. -weelicI personally don't think this is high yield. Explaining where hemosiderin or ferritin can be found isn't necessary. This should be intuitive for the students. And why are we necessarily trying to compare hemosiderin with ferritin, when the table is titled "interpretation of iron studies?" I would reject. -Lilit02/06/19 11:51 PMMatthew J.Christensenmattchristensen607@gmail.com
1041416Hematology and OncologyPathologyInterpretation of iron studieshttps://www.boardsbeyond.com/members/video.cfm?ID=D296C101DAA88A51F6CA8CFC1AC79B50&moduleID=75On the Boards and Beyond "Microcytic Anemias" video on 12:00, it says that in Pregnancy and OCP usage, there is Low Ferritin and it is used for diagnosis. On the First Aid 2019 pg416, it says Ferritin doesn't change in Pregnancy/OCP use..Major erratum11/18/19 7:44 PMEsatGunaymd.esatgunay@gmail.com
1042417Hematology and OncologytruePathologyHeme synthesis, porphyrias, and lead poisoningUpToDate: Porphyria cutanea tarda and hepatoerythropoietic porphyria: Pathogenesis, clinical manifestations, and diagnosis; https://www-uptodate-com.proxy1.lib.tju.edu/contents/porphyria-cutanea-tarda-and-hepatoerythropoietic-porphyria-pathogenesis-clinical-manifestations-and-diagnosis?search=porphyria%20cutanea%20tarda&source=search_result&selectedTitle=1~58&usage_type=default&display_rank=1acquired not autosomal dominantMinor erratumVerifiedAccept.
PCT is caused by an acquired inhibition of hepatic UROD which can occur due to a variable combination of acquired factors (etoh, smoking, hepC, hiv, etc). But genetic factors are present in some, PCT type 1 is sporadic, accounting for 80% of cases, PCT type 2 is the autosomal dominant form (but low penetrance).

Seems like the autosomal dominant form is not the MCC and probably isn't HY.

Suggesting changing to (acquired deficient activity, some familial forms with UROD mutation), or just deleted "autosomal dominant mutation."

-Connie		Accept. Most cases of PCT are acquired, although as Connie points out, there are likely contributory genetic factors. Suspect this genetic variability is way beyond scope of the Step 1, however. Looking up the condition seems to support the majority of cases being sporadic in the context of insults such as HCV infection.

I favor deleting "autosomal dominant mutation" just to keep things simple, as Connie has proposed. OK to include in the published errata.

For 2020 we can consider the addition of text that highlights that most cases are sporadic.

-Matt		Prelim accept by 2 authors + 1 editorPeter MarksIndeed, there are both acquired (type 1) and familiar (type 2) forms of porphyria cutanea tarda. Indeed, type 2 is autosomal dominant, but it is incompletely penetrant. Please see the review in BLOOD by Balwani and Desnick from 2012 (excerpt pasted below): PCT, the most common of the porphyrias, may be either sporadic (type 1) or familial (type 2). For clinical symptoms to manifest in either type, the hepatic URO-decarboxylase activity must be 20% of normal or less. Type 1 (or sporadic) PCT patients have no URO-decarboxylase (UROD) mutations and, when asymptomatic, have normal URO-decarboxylase activity systemically. Type 2 (or familial) PCT patients are heterozygous for UROD mutations, and asymptomatic patients have approximately half-normal enzyme activity systemically. Of note, although type 2 PCT is an autosomal dominant disease, it is incompletely penetrant; the half-normal enzyme activity in type 2 patients is a significant predisposing factor but is insufficient by itself to cause symptomatic PCT. Other genetic and environmental factors contribute to susceptibility in both types 1 and 2 PCT. For this reason, penetrance of this genetic trait is low, and many patients who present with type 2 PCT have no family history of the disease and may appear to have sporadic disease. Although a diagnosis of PCT is usually made by a family physician, internist, and/or dermatologist the most common treatment for this disease is repetitive phlebotomies, so these patients are typically referred to hematologists. Phlebotomies are thought to decrease the hepatic iron load. An alternative oral treatment for PCT is low dose chloroquine treatment (see “Treatment”).Accept01/17/19 8:56 AMDinaZaretdsz002@jefferson.edu
1043417Hematology and OncologyPathologyHeme synthesis, porphyrias, and lead poisoninghttps://themedicalbiochemistrypage.org/heme-porphyrin.php#synthesisleaD poisoning= ALA(D) deficiency. Vitamin B Six deficiency= ALA(S) deficiencyMnemonicVerifiedThis is not a correct assumption. Vitamin B6 deficiency has no effect on ALA synthase levels, rather the absence of B6 cofactor essentially inactivates enzyme activity. Reject this mnemonic. -Lilit02/07/19 3:26 AMalaamohameddr.alaakhaled93@hotmail.com
1044417Hematology and OncologyPathologyHeme synthesis, porphyrias, and lead poisoningn/aTo remember the enzymes related to the two main porphyrias (PBG for AIP and UROD for PCT): It is INTERMITTENTLY necessary to Pull out the Big Guns. U were TARDy (tarda) becase U ROD the bus to stay out of the sun.MnemonicVerifiedMnemonic is too long and not a great memory tool. I would reject. -Lilit02/22/19 3:12 PMElizabethMurrayelizabeth.murray@downstate.edu
1045417Hematology and OncologyPathologyHeme synthesis, porphyrias, and lead poisoningn/aPorphyria cutanea tarda = affected UROporphyrinogen decarboxylase “URO – enzyme down towards URINE” = Accumulated substance = UROporphyrin (tea colored urine)MnemonicVerifiedI don't find this mnemonic particularly effective. Only the phrases URO are highlighted, which doesn't really add too much substance. Reject. -Lilit07/08/19 5:58 PMAPandeyaranikopandey@gmail.com
1046417Hematology and OncologyPathologyHeme synthesis, porphyrias, and lead poisoningSelf-writtenFor illustration showing pathway - In order, "hockey PHUC/PHUCk" (like a hockey puck, only emphasize letters PHUC that are involved) are the cytoplasmic intermediates between first and last mitochondrial reactions.Mnemonic10/30/19 8:46 AMKhalidAlattarkhalid_alattar@hotmail.com
1047418Hematology and OncologyPathologyCoagulation disordersN/AHemophilia A is deficient in factor Aight ( 8 )MnemonicVerifiedI like this, it is easy to remember. -weelicThis is easy to remember, but if we added a mnemonic, I'd prefer one that includes all three hemophilias discussed. Just thinking that maybe a short sentence mnemonic could put all three together much better than a single phrase for hemophilia A. -Lilit01/04/19 4:29 AMFerasAl-Moussallyferas226@hotmail.com
1048418Hematology and OncologyPathologyCoagulation disordersNoneIt helped me establish a bond for memorizing these concepts more easily due to it's short and very practical: PTT (3 letters): IntrInsIc (3 I's) , PT (2 letters): extrInsIc (2 I's).MnemonicVerified07/24/19 12:16 PMJose GiojanPelaezrural18@outlook.es
1049418Hematology and OncologyPathologyIron poisoninghttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215844/Replace "Seen in patients with 1 (hereditary ) " to "Seen in patients with 1 (hereditary hemochromatosis)".Clarification to current textVerifiedReject.
Hemochromatosis is at the end of the sentence, adding it into the parenthesis too would make it redundant. The sentence is trying to specify 2 types of hemochromatosis, either primary (1, hereditary) or secondary (2).

-Connie		Reject.
- John		Agree with authors, reject change. It is not needed here.

-Matt		Reject by 2 authors + 1 editor01/04/19 2:45 PMMoatasemAl-Janabiassoomi88@yahoo.com
1050418Hematology and OncologyPathologyIron poisoningnot neededIron (Ferrous) chalting agents: IV deFERoxamine, oral deFERasiroxMnemonicVerifiedDon't think this is necessary at all. Chelating agent names are easy to remember without a mnemonic. -Lilit03/01/19 7:20 PMAlaJamalala.aljamal@hotmail.com
1051418Hematology and OncologyPathologyIron poisoninghttps://www-uptodate-com.proxy1.library.jhu.edu/contents/approach-to-the-patient-with-suspected-iron-overload?search=iron%20overload&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Under chronic causes of Iron poisoning, it lists "(eg, chronic blood transfusions for thalassemia or sickle cell disease) hemochromatosis." The close parenthesis should be removed, and a comma "and" should be added before hemochromatosis. Could also mention that "Chronic Iron Poisoning" is know as "Iron Overload" as well.Spelling/formattingReject. It wasn't completely clear in our text that there are two forms of hemochromatosis: primary and secondary. Primary is hereditary hemochromatosis (usually HFE mutations). Secondary is due to other causes. As such the paranthesis lists the various causes of secondary hemochromatosis. Thus the proposed changes did not make sense. -weelicAgreed with Weelic. Reader didn't carefully read the text. We have no errors here. -Lilit03/20/19 8:37 PMNankiHurananki.hura@gmail.com
1052418Hematology and OncologyPathologyNon-Hodgkin lymphomahttps://www-uptodate-com.proxy.medlib.uits.iu.edu/contents/epidemiology-clinical-manifestations-pathologic-features-and-diagnosis-of-burkitt-lymphoma?search=burkitt%20lymphoma&source=search_result&selectedTitle=1~74&usage_type=default&display_rank=1Burkitt Lymphoma - t(8;14) - translocation of c-myc (8) and heavy-chain Ig (14). "C-my-crush? We had our first kiss (EBV) when we were in 8th grade, at age 14."MnemonicVerifiedWe have another mnemonic suggestion for Burkitt Lymphoma above, which I thought was better than this one. However, we are tight for space on this page, so I'm not sure a sentence mnemonic can be incorporated. -Lilit03/08/19 3:35 PMGrantAdamsgrtadams7@gmail.com
1053419Hematology and OncologyPathologyPlatelet disordershttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989643/ as well as Dr. Hussien Satar (Pathoma)IgG against the platelet antigens (GpIIb/IIIa) can cross the placenta and cause a short-lived thrombocytopenia in the newbornHigh-yield addition to next yearVerifiedInclined to reject this addition. Here we are discussing the pathophysiology of the condition, so I don't think we should add this on to the text. Just my opinion though, what do you guys think? -Lilit01/03/19 5:59 AMNathanielBorochovnateboro8@gmail.com
1054419Hematology and OncologyPathologyPlatelet disordersUWORLD, https://www.uptodate.com/contents/platelet-dysfunction-in-uremiaUremic Platelet Dysfunction: Excessive bleeding in patients with renal dysfunction due to accumulation of uremic toxins that impair platelet aggregation and adhesion. Increase BT with normal PC. Patients improve with dialysisHigh-yield addition to next yearVerifiedI think this is a very high yield concept. Uremic platelet dysfunction is mentioned in the renal chapter (pg 590), however not discussed in a lot of detail. Perhaps it would be better to include further clarification in the renal chapter, instead of adding a new fact to this one. Thoughts? -Lilit01/04/19 4:42 AMFerasAl-Moussallyferas226@hotmail.com
1055419Hematology and OncologyPathologyPlatelet disordersUptodate and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136592/Add in: "Treatment dependent on severity of thrombocytopenia; observation only for those with mild cases." Also note that ITP is most commonly caused by IgG against GPIIb/IIIa (there are other platelet glycoproteins that can be targeted resulting in ITP as well as T-cell/cell-mediated route opposed to just antibody mediated).Clarification to current textVerifiedReject. This is true but many of the first aid entries, the details of management are excluded as students are not usually tested on these aspects in Step 1 and it is more important to know what treatment options exist.

For the mechanism of ITP, I would also reject. This is the most common mechanism and what I remember being tested. I don't think we need to go further than that.
-John		Agree with John to reject.
-Connie		I agree with John. I think this proposed addition takes this disorder into detail that is beyond the scope of the Step 1. ITP treatment is somewhat nuanced and patient-dependent, and getting into such detail could serve students poorly.

No change needed.

-Matt		Reject by 2 authors + 1 editor01/11/19 7:23 PMJoannaGeorgakasjoanna_georgakas@brown.edu
1056419Hematology and OncologyPathologyPlatelet disordersN/ASymptoms of TTP mnemonic: FAT RN (Fever, microangiopathic hemolytic Anemia, Thrombocytopenia, Renal Failure, Neurologic symptoms)MnemonicVerifiedIf we wanna add a mnemonic for the symptoms, we should probably steer clear of possibly offensive phrases. Of the top of my head... something like Full TANK. F for fever, T thrombocytopenia, A anemia, N neurologic symptoms, K kidney failure. What do you guys think? -Lilit01/12/19 11:53 AMAdamKurnickadam@kurnick.net
1057419Hematology and OncologyPathologyPlatelet disordershttps://www.uptodate.com/contents/acquired-ttp-initial-treatmentA new drug has been approved in Europe for acquired TTP (US FDA most likely to approve on Feb 6th, 2019 - currently on fastrack) - Anti-von Willebrand factor Caplacizumab (Cablivi™) is set to become the first line treatment for acquired TTP (vs existing plasmapheresis). *The target action date for the FDA decision is February 6, 2019.*High-yield addition to next yearVerifiedThis drug was actually FDA approved in February for TTP treatment. Provided UpToDate link confirms this. However, I'm not sure if this information will be incorporated into board exams so soon. Should we wait and see how high yield this will be? Currently I don't think this addition is necessary. Thoughts? -Lilit01/19/19 3:53 PMAnilA Kumaranil_kumarans@yahoo.co.in
1058419Hematology and OncologyPathologyPlatelet disordershttps://emedicine.medscape.com/article/202158-clinicalITP can also be drug induced mainly by drugs that target GpIIb/IIIA e.g. Abciximab, eptifibatideHigh-yield addition to next yearDefer? At first I thought of it as just another drug class that cause ITP, and perhaps not HY. But, ITP mechanism involves the production of anti-GpIIb/IIIa antibodies from idiopathic or autoimmune processes... And thus ITP from therapeutic antibodies targeting GpIIb/IIIA actually reinforces the concept. But, why would eptifibatide, a small peptide inhibitor, cause ITP? -weelicI'm leaning towards rejecting this, as drug induced ITP is relatively low yield. Besides, UpToDate lists infections and alterations to the immune system as the most probable inciting events. I wouldn't add any drugs as the cause. -Lilit https://www.uptodate.com/contents/immune-thrombocytopenia-itp-in-adults-clinical-manifestations-and-diagnosis?search=itp&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H203/24/19 1:59 PMMurliMishramm.murli@gmail.com
1059419Hematology and OncologyPathologyPlatelet disordersthis is just wording change from the textunder TTP/HUS section should state presentation: Laboratory triad of thrombocytopenia(quantitative platelet disorder),microangiopathic hemolytic anemia(low H/H,elevated LDH,schistocytes) and acute renal injury(elevated creatinine). It seems presentation should be referrable to clinical presentation or physical findingsClarification to current textAgree with Matt. Separately, looking at page 419, it seems to me that TTP/HUS may require a overhaul that requires illustrator's input. -weelicMost labs are already listed at the bottom of the section. Perhaps we can add "elevated creatinine (TTP)". Other than that, I don't think were missing anything. -LilitOK to consider this text layout change for 2020.

-Matt		Prelim accept but NOT publishable errata04/11/19 3:39 PMDarylTurnerdturner2@cfl.rr.com
1060419Hematology and OncologyPathologyPlatelet disordersFirst Aid 2019Platelet disorders is the one that affect the Bleeding time (Coagulation disorders doesn’t)MnemonicVerifiedReject. Not really a mnemonic. This is basically written at the top of the page. -Lilit05/10/19 11:09 PMFarisBinyouseffaris-v@hotmail.com
1061419Hematology and OncologyInflammationPlatelet disordershttps://www.uptodate.com/contents/platelet-dysfunction-in-uremiawe should remind students about UREMIC changes in platlets , add the following ( platlets disorders are divided into acquired and familial) uremic is acquired , also remind them about effect of Aspirin on platletsHigh-yield addition to next yearDon't think aspirin really fits here. We are discussing actual conditions here, not just drug effects or metabolic changes. Uremic platelet dysfunction can either be addressed with more detail in the renal chapter OR we can add a small new fact here? I'm not sure what the best move would be here. What do you guys think? -Lilit05/30/19 6:00 PMAbdelrahmanAltaraziabodtaraze@gmail.com
1062419Hematology and OncologyPathologyPlatelet disordershttps://emedicine.medscape.com/article/202158-overviewsplenomegaly is not assoicated with ITP, in fact it exculdes ITPHigh-yield addition to next yearNo changes needed. First, out text does not mention splenomegaly as a physical exam finding in ITP. Second, hepatosplenomegaly may or may not be seen in ITP. Presence of this would suggest an underlying condition responsible the thrombocytopenia. -Lilit https://www.uptodate.com/contents/immune-thrombocytopenia-itp-in-adults-clinical-manifestations-and-diagnosis?search=itp&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H11053012305/30/19 6:46 PMAbdelrahmanAltaraziabodtaraze@gmail.com
1063419Hematology and OncologyPathologyPlatelet disordersn/aROBOTIC ADAM’s Increased WILL to AGGREGATE in the human society! ROBOTIC – THROMBOTIC ADAMTS13 – Deficient or inhibited Increased large von WILLebrand Factor multimers Increased platelet AGGREGATIONMnemonicVerifiedI don't think this is good at all. Reject. -Lilit07/08/19 6:31 PMAPandeyaranikopandey@gmail.com
1064420Hematology and OncologyPathologyHereditary thrombosis syndromes leading to hypercoagulabilityn/aLady GAGA will tour from ARGentina  Guatemala but not in the People’s Republic Of China. Lady = Leiden Guanine to Adenine DNA point mutation Amino acid change from ARGenine  Guanine Resistance of Factor V to degradation by PROtein CMnemonicVerifiedI like this, but not the whole thing. "Lady Gaga will tour from Argentina to Guatemala" is enough. I don't think that resistance to protein C needs to be incorporated. Do you guys like this? -Lilit07/08/19 6:34 PMAPandeyaranikopandey@gmail.com
1065420Hematology and OncologyPathologyMixed platelet and coagulation disordershttps://www.uptodate.com/contents/clinical-features-diagnosis-and-treatment-of-disseminated-intravascular-coagulation-in-adults?search=DIC%20causes&sectionRank=1&usage_type=default&anchor=H255175&source=machineLearning&selectedTitle=1~150&display_rank=1#H255175Transfusion is too generic. DIC often occurs in the setting of intravascular hemolysis, often due to an Acute Hemolytic Transfusion Reaction (AHTR).Clarification to current textVerifiedReject. We cover acute hemolytic transfusion reaction in detail earlier in this chapter. In this mnemonic, "transfusion" should be fine.

-Connie		Agree, no change needed, "transfusion" is fine here, since in rare cases that can cause DIC.

-Matt		Reject by 2 authors + 1 editor01/16/19 3:31 PMNicolasCuri Gawlinskinicolascurii@gmail.com
1066420Hematology and OncologyPathologyMixed platelet and coagulation disordershttps://www.uptodate.com/contents/clinical-features-diagnosis-and-treatment-of-disseminated-intravascular-coagulation-in-adults?search=DIC%20causes&sectionRank=1&usage_type=default&anchor=H255175&source=machineLearning&selectedTitle=1~150&display_rank=1#H255175Intravascular hemolysis is one of the causes of DIC (e.g., AHTR and malaria).High-yield addition to next yearVerified01/16/19 3:32 PMNicolasCuri Gawlinskinicolascurii@gmail.com
1067421Hematology and OncologyPathologyBlood transfusion therapyhttps://www.uptodate.com/contents/red-blood-cell-transfusion-in-infants-and-children-selection-of-blood-products?search=irradiated%20blood%20SCID&usage_type=default&source=search_result&selectedTitle=2~145&display_rank=2Irradiated packed RBCs: Preserve RBCs, platelets, but remove any inmune cells which may cause a reaction. CLINICAL USE: SCIDHigh-yield addition to next yearVerified02/19/19 12:15 AMLissetteOrozcolissetteorozco_004@hotmail.com
1068421Hematology and OncologyPathologyBlood transfusion therapyhttps://www.uptodate.com/contents/image?rank=1~17&source=graphics_search&imageKey=HEME%2F102695&search=cryoprecipitate&sp=4 and https://www.uptodate.com/contents/clinical-use-of-plasma-componentsI've made this table for a better differentiation of either clinical use or contents of cryoprecipitate vs fresh frozen plasma. This was a very confusing topic, and I used only UpToDate to assembly this table.High-yield addition to next yearReject. While I agree with the submitter that this is a confusing topic, and I do think it will be useful in the wards or Step 2...But strangely for Step 1 this does not seem HY in my personal experience (uworld etc). -weelic03/21/19 3:34 AMNicolasCuri Gawlinskinicolascurii@gmail.com
1069421Hematology and OncologyPathologyBlood transfusion therapyn/aMr and Mrs Hodgkin are 30 and 15 years old (CD 30 + and CD 15+). They live together in their cell with 4 children:  Nodular (Nadia) is a female child (Common in female)  Lympho are twins; one of them is RICH and BEST while the other is DEPLETED  Last one is MIXED, a simple guy who LOVES surfing in the OCEAN (Eosinophilia) Non Hodgkin Lymphoma: Burkitt Lymphoma, pg 422 Alphabetically, B  C-myc B looks like 8 = t(8;14) Starry sky at 8 PM 8 = ATE = Jaw lesion Associated with E8VMnemonicVerified07/08/19 6:40 PMAPandeyaranikopandey@gmail.com
1070421Hematology and OncologyPathologyHodgkin lymphomaFirst Aid 2019In Hodgkin, Reed-Sternberg cells are binucleate & bilobed, (we READ by glasses [2 lobes] while eating HODog) (READ-Srnb+ HODgkin)MnemonicVerified05/09/19 12:12 PMFarisBinyouseffaris-v@hotmail.com
1071421Hematology and OncologyPathologyLeukemia vs lymphomaFIRST AID-RX Videos (Video 8- Heme and Oncology Pathology)Please introduce LEUKMOID Pathology (esp: Leukocyte Alkaline Phosphatase levels) in comparison to Leukemia here along with Lymphoma. You could show how they (Leukmoid and Leukemia) are similar with regards to elevated WBCs, elevated Neutrophils, and a Left Shift w/ Band Cells. This could be followed by how they are different with respect to LAP levels (ex: Elevated LAP in Leukmoid- WBCs are attempting to fight the pathogen) vs (DECREASED LAP in Leukemia-just an elevation in WBCs, but not actively fighting). This will clear up the three statement sentence included under CML- Chronic Myelogenous Leukemia) on pg 424- which with respect, isn't clearly written and could in the future could simply be replaced with a "DECREASE in LAP" mention). This would also give students a better understanding regarding the lab value and how to interpret its findings when reading a CBC. Please and Thanks!Clarification to current text10/13/19 5:26 PMTashaPhillips-Wilsontphilli1@sgu.edu
1072422Hematology and OncologyPathologyHodgkin vs non-Hodgkin lymphoman/aAlphabetically, B  C-myc B looks like 8 = t(8;14) Starry sky at 8 PM 8 = ATE = Jaw lesion Associated with E8V Non Hodgkin Lymphoma: Diffuse Large B-Cell Lymphoma, pg 422 Large = Older adults Non Hodgkin Lymphoma: Follicular Lymphoma, pg 422 “Waxing and waning” course = Waxing your hair follicles at Folliderm clinic. Mantle Cell Lymphoma, pg 422 Mantle = Mental = 11 (odd number) = t(11;14); CD 5+ (odd number) Cyclin D1 = D1 (Dopamine in Psychics); Aggressive mental Marginal Zone Lymphoma, pg 422 People were MARGINALized during WW II = t(11;14)MnemonicVerified07/08/19 6:45 PMAPandeyaranikopandey@gmail.com
1073422Hematology and OncologyPathologyNon-Hodgkin lymphomahttps://en.wikipedia.org/wiki/BCL6for the Diffuse large B-cell lymphoma please include that "BCl-6 is on chromosome 3"High-yield addition to next yearVerified12/31/18 12:48 AMKamleshunRamphuladramphul@hotmail.com
1074422Hematology and OncologyPathologyNon-Hodgkin lymphoma1. https://www.uptodate.com/contents/clinical-manifestations-pathologic-features-and-diagnosis-of-adult-t-cell-leukemia-lymphoma 2. https://www.uptodate.com/contents/human-t-lymphotropic-virus-type-i-virology-pathogenesis-and-epidemiology1. Only approximately 25% of the adult T-cell lymphoma patients will have skin lesions at diagnosis. So the text should be corrected as "Adults may present with cutaneous lesions", as 75% of the patients do not experience this symptom. 2. HTLV-I is primarily transmitted by breastfeeding, although spread via blood transfusion, sharing of needles, and sexual intercourse also occurs. So authors should add "breastfeeding" to the "associated with IV drug abuse" sentence, as it is the most common method of transmission.Clarification to current textVerified1. Reject, I think it's okay to leave the text as is, because while it's true only 25% present with skin lesions, it's still listed as a common clinical finding, and the presentation of the disease is variable. Also I feel like step 1 tests this in connection with mycosis fungoides most commonly.

2. Accept, this I think should be changed because it is very clear from the source that breast feeding is the most common mode of transmission. suggest changing the text in parenthesis to, "primarily transmitted by breastfeeding, associated with IV drug abuse)

-Connie		For #1, I am OK adding "may" so that it reads as "adults may present with cutaneous lesions." However, that is most certainly not an erratum, but rather a clarification. Can consider for 2020 non-urgently, but it need not be published in the official errata.

For #2, I agree with Connie that we can change the emphasis to how HTLV is acquired. However, it is similarly more of a clarification, since we're not wrong to say IV drug abuse, but rather incomplete missing HY information. Can consider this a non-urgent change for 2020.

Accepting this and reflagging as a clarification/HY addition. No need to publish either submission in the official errata.

-Matt		Prelim accept but NOT publishable errata01/25/19 3:48 PMCemTuramcemturam@gmail.com
1075422Hematology and OncologyPathologyNon-Hodgkin lymphomaN/AMickey MANtle hit for the CYCLE batting 11-14MnemonicVerified05/04/19 4:39 PMDillonYaldoyaldodil@msu.edu
1076422Hematology and OncologyPathologyNon-Hodgkin lymphomapersonal mnemonicFOllicUlaR lymphoma has 18 total letters and the number 4 inside for the 14;18 translocationMnemonic12/04/19 11:38 AMMinhwanKimminhwanmd@hotmail.com
1077423Hematology and OncologyPathologyMultiple myelomahttps://emedicine.medscape.com/article/204369-overview#a3; Dr. Jason Ryan of Boards and Beyond mentions this as an important fact in his reputable board-review series.Multiple Myeloma, and the growth of myeloma cells, is highly dependent on IL-6. It is required required for myeloma cell proliferation.High-yield addition to next yearVerifiedAgreed. I think we should say that IL-6 is implicated in MM.

According to UTD, "(IL-6) is a cytokine that encourages the growth and survival of both normal and abnormal plasma cells. IL-6 appears to be required for the survival of myeloma cells"

https://www.uptodate.com/contents/pathobiology-of-multiple-myeloma?search=il%206%20and%20multiple%20myeloma&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

- Sarina		01/06/19 6:08 AMAdamKurnickadam@kurnick.net
1078423Hematology and OncologyPathologyMultiple myelomahttps://jasn.asnjournals.org/content/17/9/2533; uworldThe filtered light chains may cause intrarenal obstruction in the distal nephron by co-aggregating with the carbohydrate moiety of Tamm-Horsfall glycoprotein, which is produced in the thick ascending limb of the loop of HenleHigh-yield addition to next yearVerifiedAgreed.

I think the text should include briefly the fact that MM can cause renal failure due to the aggregation of light chains + Tamm Horsfall protein (apparently now called uromodulin) --> form obstructive casts --> decreased urinary flow

Due to the increased number of light chains, they can't be absorbed in the PCT. They reach the DCT where they combine with TammHorsfall proteins and obstruct urinary flow.

Although I am not sure how HY it is, I do remember the term "Tamm Horsfall protein" appearing in question banks.

https://www.uptodate.com/contents/epidemiology-pathogenesis-and-etiology-of-kidney-disease-in-multiple-myeloma-and-other-monoclonal-gammopathies?search=renal%20failure%20in%20multiple%20myeloma&sectionRank=2&usage_type=default&anchor=H1571307495&source=machineLearning&selectedTitle=1~150&display_rank=1#H1571307495

- Sarina		Agreed. can be added to the white space below the CRAB findings. -weelic.02/27/19 9:20 AMAtishaPatelpatela31@students.rowan.edu
1079423Hematology and OncologyPathologyMultiple myelomahttps://www.uptodate.com/contents/multiple-myeloma-clinical-features-laboratory-manifestations-and-diagnosisMnemonic Addendum (CRAB)- A- AL Amyloidosis and B- Bence Jones Proteins should be added as they are relevant buzzwords related to this disease.Mnemonic10/13/19 3:06 PMTashaWilsontphilli1@sgu.edu
1080423Hematology and OncologyPathologyMultiple myelomaN/ATo remember the most commonly elevated gamma-globulins in MM, think "GAmma-globulin" (IgG and IgA in that order are the most common)Mnemonic10/13/19 10:55 PMDanielZhuDzhu5@pride.hofstra.edu
1081423Hematology and OncologyPathologyMyelodysplastic syndromeslecture slidesWould be helpful to mention that MDS has increased bone marrow cellularity (cells don't leave marrow). and the 100-age for normal cellularity estimation. This is in contrast to aplastic anemia which is hypocellular.High-yield addition to next yearVerified01/16/19 12:14 PMJoannaGeorgakasjoanna_georgakas@brown.edu
1082423Hematology and OncologyPathologyMyelodysplastic syndromeshttps://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-the-myelodysplastic-syndromes?search=myelodysplastic%20syndrome&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H37if Blast in bone marrow is high but less than 20% so it suggests MDS. Bone marrow blasts of >20% suggest AML. improtant way to diffrentiate between them.High-yield addition to next yearVerifiedAgreed.

I think it should be added that there are < 20% blasts on BM biopsy and that myelodysplastic syndromes transform to AML when blasts > 20%.

- Sarina		03/01/19 7:15 PMAlaJamalala.aljamal@hotmail.com
1083424Hematology and OncologyPathologyLeukemiasMnemonicAML - "A*uer rods, M*yeloperoxidase positive, myeL*oblasts" (bolded pathognomonic signs)MnemonicVerified01/11/19 7:01 AMNathanielBorochovnateboro8@gmail.com
1084424Hematology and OncologyPathologyLeukemiashttps://www.nejm.org/doi/full/10.1056/NEJMoa1300874arsenic +ATRA treatment is specific to acute promyelocytic leukemiaClarification to current textVerifiedReject. APL is a subset of AML, I don't think it is HY to tease out this detail.

-Connie
https://www.uptodate.com/contents/acute-myeloid-leukemia-treatment-and-outcomes-in-older-adults?search=aml%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1		We already say this anyway with the current text. No change needed.

-Matt		Reject by 2 authors + 1 editor01/16/19 12:01 PMJoannaGeorgakasjoanna_georgakas@brown.edu
1085424Hematology and OncologyPathologyLeukemiashttps://www.ncbi.nlm.nih.gov/pubmed/30030507; https://www.astrazeneca.com/media-centre/press-releases/2018/us-fda-approves-lumoxiti-moxetumomab-pasudotox-tdfk-for-certain-patients-with-relapsed-or-refractory-hairy-cell-leukaemia.htmladd in Moxetumomab pasudotox for treatment for relapse/ refactory hairy cell leukemiaHigh-yield addition to next yearVerifiedDisagree. This information seems low yield.

- Sarina		Drug regimens for refractory/relapsed cancer often changes every years.I think this is low yield. -weelic01/16/19 10:31 PMJoannaGeorgakasjoanna_georgakas@brown.edu
1086424Hematology and OncologyPathologyLeukemiasPathomaHairy cell leukemia; stain positive for TRAP. these cells get TRAPped in spleenic redbulb causing spleenomegaly. so less Lymphadenopathy found, also bone marrow gets dry (fibrosis) as they are TRAPped in SpleenMnemonicVerified03/01/19 7:17 PMAlaJamalala.aljamal@hotmail.com
1087424Hematology and OncologyPathologyLeukemiasN/AThe word "cell" smudged = CLL. CLL has smudge cellsMnemonicVerifiedReject? CLL = smudge cells has been in both the hemonc fact and in 2 rapid review spots. I think a mnemonic is not useful. thoughts? -weelicI like the mnemonic in the book. Reject. -Lilit03/24/19 2:28 PMBenjaminSaracbsarac19@gmail.com
1088425Hematology and OncologyPathologyChronic myeloproliferative disordersFA2018I saw that the JAK2 mutation (V617F) was removed from FA2019. While it makes sense that it was removed from the general section description as it does not pertain to ET or myelofibrosis, it should be readded under the subsection of polycythemia vera as it is present in ~95% of cases)Clarification to current textVerifiedYes accept. 95-100% of patients with polycythemia vera have a JAK2 mutation and I think this is HY to know. We also provide JAK1/2 inhibitors as a treatment for PV.

Suggest adding, "95-100% of patients have a JAK2 mutation" after "disorder of increase RBCs"

-Connie

https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-polycythemia-vera?search=polycythemia%20vera&source=search_result&selectedTitle=1~124&usage_type=default&display_rank=1#H3008612693		Agreed that JAK2 should be re-added, especially since one of the treatments listed is a JAK inhibitor.

- Sarina		Note that the table below does note JAK2 mutation positivity, so we already mention this, although I agree it would be more accurate to list the specific mutation in the primary disorder text as well.

Agree with considering the addition of said text in 2020, but this is non urgent and need not be published in the official 2019 errata.

-Matt		Prelim accept but NOT publishable erratatrue01/16/19 1:36 PMJoannaGeorgakasjoanna_georgakas@brown.edu
1089426Hematology and OncologyPathologyChromosomal translocationsSelf-writtent(14;18) - FALLicular Lymphoma. TEENS are usually FALLing in love when they are fourTEEN (14) and eighTEEN (18). They have Big Crushes for each other (Big Crush Lovers/BCL's, especially at 18).Mnemonic10/30/19 8:53 AMKhalidAlattarkhalid_alattar@hotmail.com
1090426Hematology and OncologyPathologyLangerhans cell histiocytosisFirst Aid p 228, Uworld"Cells express S-100 (mesodermal origin)" should say "Cells express S-100 (neural crest origin)" because Langerhans cells are of neural crest origin, not mesodermal origin. The stain S-100 also only stains for cells of neural crest origin.Major erratumVerifiedFaculty input.
Origin is still debated. S-100 is a strong neural crest marker, which I think is why originally LCs where thought to be of neural crest origin, but it seems like LCs are more and more thought to be of mesodermal origin. Not sure whether it is HY because it is still contested, but might be worth consulting faculty as to which is more broadly recognized. From a literature review, I can't tell.

-Connie		Another chronic erratum. In years past we reviewed this extensively with faculty input and opted to keep them as mesodermal origin despite their S-100 positivity, which is traditionally neural crest origin. This appears to be hotly debated.

Will flag for expert input such that we can get the most up to date input, but my suspicion is that this will be kept as is.

-Matt

UPDATE: Agree with Dr. Marks' suggestion. Need not be published in official errata, can be a change made for 2020.

-Matt		Disagreement/need expertPeter MarksGiven the debate over this area, I would suggest finessing this with: Cells express S-100 (which is usually seen in cells of neural crest origin)Reject02/06/19 10:11 PMCharanpreetSahotacsahota@sgu.edu
1091426Hematology and OncologyPathologyTumor lysis syndromeN/APUcK for remembering the electrolytes imbalances in TLS. Capitalization means hyper and lowercase means hypo. P (hyperphosphatemia) U (hyperuricemia) c (hypocalcemia) K (hyperkalemia)MnemonicVerified01/14/19 12:26 PMRachelWatsonrcfh7@health.missouri.edu
1092426Hematology and OncologyPathologyTumor lysis syndromeN/ATumor lysis syndrome is associated with chemotherapy which often makes you vomit/puke: so remember hyperPUKe for TLS--> hyperPhosphatemia, hyperUricemia, hyperKalemiaMnemonicVerifiedAccept? Didn't like it at first but it grew on me, it will be nice if it helps people to remember metabolic disturbances. While the mnemonic doesn't account for hypocalcemia... but still it is good. -weelic01/14/19 3:19 PMOpalSekleropalsekler@gmail.com
1093427Hematology and OncologyPharmacologyDirect thrombin inhibitorshttps://reference.medscape.com/refdrug-srch/angiomax-angiox-bivalirudin-342137bivaliruDIN - direct inhibitor of thrombin., dabigaTRAN- ThRombin antagonist.MnemonicVerifiedBoth drugs are direct thrombin inhibitors. Reject. -Lilit02/25/19 7:14 PMLokeshgoyallkh.lokesh@gmail.com
1094427Hematology and OncologyPharmacologyDirect thrombin inhibitorsn/aDirect Thrombin Inhibitors for Heparin Induced Thrombocytopenia (HIT) HIT BAnD = Bivalirudin, Argatroban, Dabigatran.MnemonicVerified07/08/19 6:47 PMAPandeyaranikopandey@gmail.com
1095427Hematology and OncologyPathologyHemophagocytic lymphohistiocytosishttps://www.uptodate.com/contents/clinical-features-and-diagnosis-of-hemophagocytic-lymphohistiocytosis?search=lymphohistiocytosis&source=search_result&selectedTitle=1~86&usage_type=default&display_rank=1Add "Associated with Chediak-Higashi Syndrome", as this is nogted in the Chediak-Higashi section in the Immunology section in first aid on page 117.High-yield addition to next yearVerifiedWhen framed as a cross-reference, this is fine and well. I have not encountered this association in questions though. Still, submitter was correct in that this is already referenced in page 117. -weelic01/22/19 3:24 PMAdamKurnickadam@kurnick.net
1096427Hematology and OncologyPharmacologyHeparinUWorldProtamine is isolated from Salmon Sperm; contraindicated in case of shell-fish allergy. Causes HSR type IHigh-yield addition to next yearVerifiedI don't think this is HY. The main point is to highlight the fact that protamine is an antidote to heparin and works via chemical antagonism.

- Sarina		Agree that this is not HY. -Weelic03/01/19 7:03 PMAlaJamalala.aljamal@hotmail.com
1097427Hematology and OncologyPharmacologyHeparinuptodate.comAntithrombin decrease the action of activated IIa, IXa, Xa, XIIa and XIIa (not only IIa and Xa)Major erratumVerifiedAlthough correct, I am not sure how necessary it is to add XIIa. I think the main idea is to point out that UFH inhibits IIa and Xa, while LMWH only inhibits Xa (indirectly).

- Sarina		Can migrate this over for consideration, agree adding mention will be tricky due to the diagram, it may be possible and is worth review by both text and illustration teams.

-Matt		Prelim accept but NOT publishable errata03/01/19 7:06 PMAlaJamalala.aljamal@hotmail.com
1098428Hematology and OncologyPharmacologyWarfarinFirst Aid 2019WAR against FAitamine-K,, (WAR-FA-rin) Warfarin inhibits Vit-K dependent factorsMnemonicVerified05/09/19 11:10 AMFarisBinyouseffaris-v@hotmail.com
1099429Hematology and OncologyPharmacologyADP receptor inhibitorsnot neededmechanism is inhibiting platelets "activation" (no expression of p2y12 R) which leads to inhibition of platelets "aggregation"Minor erratumVerifiedYes, technically this is correct. According to UTD, Clopidogrel "irreversibly blocks the P2Y12 component of ADP receptors on the platelet surface, which prevents activation of the GPIIb/IIIa receptor complex, thereby reducing platelet aggregation"

Perhaps the text should read something like "Irreversibly blocks ADP (P2Y12) receptor, which prevents activation and subsequent platelet aggregation"

- Sarina		Agree with Sarina. The proposed phrasing is clearer than what is currently on FA2019. -weelicAgree that this should be adjusted, mainly for clarity. Would migrate over for consideration in 2020.

-Matt		Prelim accept but NOT publishable erratatrue03/01/19 7:05 PMAlaJamalala.aljamal@hotmail.com
1100429PsychiatryPharmacologyAntidepressantshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100363/xarelto-rivaroxabanAn important very new use of rivaroxaban is to prevent major cardiovascular events in patients with CAD or PVD following the COMPASS TrialHigh-yield addition to next yearWill let Cardiovascular/Hemat-Onc team have a look at the recommendation. Not for this section - Rohanagree with Rohan -YK04/16/19 11:52 AMJan AndreGraumanjgrauman@gmail.com
1101429Hematology and OncologyPharmacologyDirect factor Xa inhibitorsnot neededApixaban, rivaroxaban (Api-Xa-BAN because it bans Xa)MnemonicVerifiedIt appears the mnemonic submitter wants to put the letters BAN in red. I think that is not necessary. In page 429, the letters Xa are already in red. -weelic01/09/19 1:35 PMNajatFadlallahnajat.fadlallah@lau.edu
1102429Hematology and OncologyPharmacologyDirect factor Xa inhibitorshttps://www.uptodate.com/contents/management-of-bleeding-in-patients-receiving-direct-oral-anticoagulants?sectionName=Rivaroxaban,%20apixaban,%20edoxaban,%20betrixaban%20(reversal)&search=direct%20factor%20Xa%20inhibitors&topicRef=1370&anchor=H3105446&source=see_link#H3105446Antidote for rivaroxaban and apixaban toxicity was FDA approved in 2018. It's called Andexanet.High-yield addition to next yearVerifiedSeconding the comment by Dr Peter Marks to defer (see his comments on annotate in Oct 2018). As of April 2019, many hospitals do not have this on the formulary (mainly due to the high cost). UptoDate mentions that "There is insufficient evidence about risks and benefits to strongly favor either 4-factor PCC or andexanet over the other." (note that 4F-PCC is off-label). -weelic02/18/19 1:23 AMBasimAlibasim.ajafri@gmail.com
1103429Hematology and OncologyPharmacologyDirect factor Xa inhibitorshttps://reference.medscape.com/refdrug-srch/xarelto-rivaroxaban-999670rivaroxaban- RIVAR-read like reversible O- oral, XA- XA , B- blocker, or AN - antagonist.MnemonicVerifiedreject? -weelic02/25/19 7:20 PMLokeshgoyallkh.lokesh@gmail.com
1104429Hematology and OncologyPharmacologyDirect factor Xa inhibitorshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100363/xarelto-rivaroxabanAn important very new use of rivaroxaban is to prevent major cardiovascular events in patients with CAD or PVD following the COMPASS TrialHigh-yield addition to next yearDefer to next year? -weelic04/16/19 11:56 AMJan AndreGraumanjgrauman@gmail.com
1105429Hematology and OncologyPharmacologyGlycoprotein IIb/IIIa inhibitorsMnemonicTEA at 2 or 3? (Tirofiban, Eptifibatide, Abciximab bind to Gp2b3a)MnemonicVerifiedcould be useful. prelim migrate to annotate? -weelic02/20/19 8:54 AMAaronMilleraaronm314@yahoo.com
1106429Hematology and OncologyPharmacologyGlycoprotein IIb/IIIa inhibitorsnot neededIIb/IIIa is a FIBrinogen receptor; to highlight eptiFIBatide and tiroFIBanMnemonicVerifiedthis could be useful too. I like this slightly more than the above one. Although they have different memory hooks, so potentially they can both be used. migrate to annotate? -weelicMnemonic. OK to consider this year.

-Matt		Prelim accept but NOT publishable erratatrue03/01/19 7:02 PMAlaJamalala.aljamal@hotmail.com
1107429ImmunologyImmunosuppressantsTherapeutic antibodieshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100325/cimzia-certolizumab-pegol-certolizumab pegol is another clinically relevant TNF alpha antibodyHigh-yield addition to next yearReject.
Approved by FDA <1 yr ago won't be tested.

-Connie		Reject. -VVReject by 2 authors + 1 editor04/16/19 11:58 AMJan AndreGraumanjgrauman@gmail.com
1108429Hematology and OncologyPharmacologyThrombolyticshttps://www.medicinenet.com/script/main/art.asp?articlekey=2988It should be "diathesis" instead of "known bleeding diatheses".Spelling/formattingReject. It appears to me that the commenter wanted a singular instead of a plural noun. I think that it should stay as plural. From the citation that the commenter provided (and from another dictionary), diathesis is simply an obscure word for "tendency". We can consider a change from "known bleeding diatheses" to "known bleeding tendencies". -weelic04/17/19 1:03 AMMatthew Yat HonChungmchung@mail.sjsm.org
1109430Hematology and OncologyPharmacologyCancer drugs––cell cycleFirst AidCladribine is not S-phase specific. It is cell-cycle independent. This is clarified on page 432 but the current diagram is not consistent with the clarification.Minor erratumVerifiedReject.
Cladribine is S-phase specific. On page 432, we elaborate that it has multiple mechanisms to inhibit DNA synthesis (which is the S phase), and give clear examples.

-Connie		Reject.
John		Agree with authors, it is S-phase specific and no change is needed here.

-Matt		Reject by 2 authors + 1 editor12/27/18 12:37 AMJerrinBawajerrin.bawa@gmail.com
1110430Hematology and OncologyPharmacologyCancer drugs––cell cyclehttps://pubchem.ncbi.nlm.nih.gov/compound/ProcarbazineAdd "Procarbazine" to "alkylating agents" in cell-cycle independent drugs.Clarification to current text09/04/19 5:20 PMAlsuZagorulkoalsu.zagorulko@gmail.com
1111431Hematology and OncologyPharmacologyAntitumor antibioticshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3461790/Bleomycin is also used as an intra-lesional sclerotherapy agent in lymphangiomas. Add this clinical use will also reinforce the idea that it promotes fibrosis (pulmonary fibrosis).High-yield addition to next yearVerifiedReject? I went to uptodate to find anything that might support this, but could not. It may reinforce idea, but the therapy itself is not known, and citation was a single-center study. I propose this as not HY. -weelic02/18/19 2:41 AMBasimAlibasim.ajafri@gmail.com
1112431Hematology and OncologyPharmacologyAntitumor antibioticshttps://reference.medscape.com/drug/bleomycin-342113#4Interstitial pneumonitis should be added to adverse effect of Bleomycin. The incidence of pneumonitis in these patient is 10% i.e. almost same as incidence of Pulmonary fibrosis.High-yield addition to next year03/24/19 3:50 PMMurliMishramm.murli@gmail.com
1113432Hematology and OncologyPharmacologyAntimetaboliteshttps://www.uptodate.com/contents/fluoropyrimidine-associated-cardiotoxicity-incidence-clinical-manifestations-mechanisms-and-management5-fluorouracil-induced coronary artery spasm is a potentially lethal side effect that needs to be addressed here.High-yield addition to next yearVerifiedActually, the citation used by the commenter paints a slightly nuanced story. "The underlying mechanism of toxicity is not established and is likely to be multifactorial [61]. The mechanism that is best supported by preclinical and clinical data is coronary vasospasm." and goes on about observations inconsistent with that hypothesis. As such, the statement "5-FU is associated with cardiac side effects" is valid but evidence for the statement "this cardiac side effect is due to coronary artery vasospasm" is inconclusive. -weelic01/10/19 12:50 PMElmiraTaghi Zadehelmira.taghizadeh9@gmail.com
1114432Hematology and OncologyPharmacologyAntimetaboliteshttps://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.1990.tb00195.xadding Aplastic anemia to adverse effects of Azathioprine and 6-mercatopurine when used with Allopurinol and Febuxostat.High-yield addition to next yearReflagging as high-yield addition to consider in 2021.

-Matt		05/15/19 7:18 PMMuhanadShaibmohanad.shaib@gmail.com
1115432Hematology and OncologyPharmacologyAntimetaboliteshttps://www.ncbi.nlm.nih.gov/pubmed/9815688 https://www.sciencedirect.com/topics/neuroscience/fluorouraciladding photosensitivity to adverse effect of 5-fluorouracil, and Uridine is used as rescue agent.High-yield addition to next yearReflagging as high-yield addition to consider in 2021.

-Matt		05/15/19 7:21 PMMuhanadShaibmohanad.shaib@gmail.com
1116434Hematology and OncologyPharmacologyEtoposide, teniposideN/AMove II the -side. To memorize that etoposide and teniposide are topoisomerase II inhibitors.MnemonicVerifiedIt wasn't impressive on its own, but with the other mnemonic "irinotecan" it suddenly makes a lot of sense. (especially for those who do not like the ones by sketchypharm.) But I will like to get more opinions from others. -weelic01/13/19 6:50 AMGennadiyGuralnikhenryguralnik@gmail.com
1117434Hematology and OncologyPharmacologyEtoposide, teniposidenoneE"2"poside to remember that etoposide inhibits topoisomerase 2Mnemonic11/19/19 11:17 PMFNUDeepalideepali.238@gmail.com
1118434Hematology and OncologyPharmacologyImatinib, dasatinibN/A"Im -abl to inhibit tyrosine kinase". In order to remember that IMatinib is an inhibitor of bcr-abl.MnemonicVerified01/13/19 6:56 AMGennadiyGuralnikhenryguralnik@gmail.com
1119434Hematology and OncologyPharmacologyImatinib, dasatinibhttps://en.wikipedia.org/wiki/MnemonicI'M A Tyrosine kinase INhIBitor "im a t in ib" (The capitol letters spells imatinib)Mnemonic11/19/19 3:36 PMEsatGunaymd.esatgunay@gmail.com
1120434Hematology and OncologyPharmacologyIrinotecan, topotecanN/A"I -can". To memorize that Irinotecan and Topotecan are topoisomerase I inhibitorsMnemonicVerifiedIt wasn't impressive on its own, but with the other mnemonic "etoposide" it suddenly makes a lot of sense. (especially for those who do not like the ones by sketchypharm.) But I will like to get more opinions from others. -weelic01/13/19 6:53 AMGennadiyGuralnikhenryguralnik@gmail.com
1121435Hematology and OncologyPharmacologyBortezomib, carfilzomibn/aMultiple proto-ZOMBIes with Mantle Retardation! borteZOMiB, carfilZOMiB Mechanism: PROTEOsome inhibition Clinical use: MULTIPLE Myeloma, MANTLE cell lymphoma.MnemonicVerified07/08/19 6:49 PMAPandeyaranikopandey@gmail.com
1122435Hematology and OncologyPharmacologyRituximabhttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100362/rituxan-rituximabAlso for the treatment of pemphigusHigh-yield addition to next yearDefer to next year? -weelic04/16/19 1:41 PMJan AndreGraumanjgrauman@gmail.com
1123435Hematology and OncologyPharmacologyTamoxifen, raloxifenehttps://www.uptodate.com/contents/mechanisms-of-action-of-selective-estrogen-receptor-modulators-and-down-regulators "Both raloxifene and tamoxifen also induce hot flashes (an estrogen antagonist effect)"Hot flashes can be caused by raloxifene as well, not only tamoxifen.Clarification to current textVerifiedYes accept.
Hot flashes are not exclusive to tamoxifen. Source supports this. Should move "hot flashes" to the last sentence of shared adverse effect. Suggest removing "hot flashes" from the Tamoxifen line, and last line to read:
"Both ↑ risk of thromboembolic events (eg, DVT, PE) and "hot flashes.""

-Connie		Good suggestion, accept also.
John		Agree with addition for 2020, non-urgent, no need to publish in the official errata.

-Matt		Prelim accept but NOT publishable erratatrue01/07/19 4:10 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
1124435Hematology and OncologyPharmacologyTrastuzumabhttps://reference.medscape.com/drug/herceptin-ogivri-trastuzumab-342231In adverse effects, it says that "Heartceptin" damages the heart. I didn't understand what heartceptin was referring to so I googled and found out it is another name for trastuzumab. In First Aid 2018 there is herceptin written next to the fact title but in First Aid 2019 there isn't.Clarification to current textVerifiedAccept.
Yes, we have the "heartceptin" mnemonic without specifying that herceptin is the brand name of trastuzumab. Because brand names are not tested, we shouldn't assume students would know the herceptin brand name.

Suggest either removing the mnemonic, or adding "herceptin" in parenthesis after the generic name, "Trastuzumab (herceptin)."

-Connie		I do see that this could be confusing now. I'd favor Connie's second suggestion to just drop the mnemonic altogether since its a simple fact to remember and I'd rather not include brand names at to simplify things.
-John		Good catch. We deleted the trade name Herceptin but neglected to update the mnemonic. Without mentioning Herceptin by name, the mnemonic makes little sense.

Let's delete the mnemonic for 2020, as I do not support us using trade names for drugs. Not a published errata-worthy entry, however!

-Matt		Prelim accept but NOT publishable errata12/28/18 4:51 PMIbrahimHyderibrahim.hyder@gmail.com
1125435Hematology and OncologyPharmacologyTrastuzumabNAIf you trust (trastuzumab) her too (HER-2) much she will break your heart (cardiotoxicity)MnemonicVerified05/26/19 8:39 PMAwabElnaeemawab.kamal@gmail.com
1126436Hematology and OncologyPharmacologyKey chemotoxicitiesFA 2018 page 431, Antitumor antibiotics sectionAdd daunorubicin next to doxorubicin (same format with the D capitalized and in red color).High-yield addition to next yearVerifiedI think that's fine. There's space, and multiple other facts in FA2019 have both daunorubicin and doxorubicin. Add? -weelic01/07/19 4:12 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
1127438Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyRotator cuff muscleshttps://en.wikipedia.org/wiki/Teres_minor_muscle. https://www.uptodate.com/contents/rotator-cuff-tendinitis-and-tear-beyond-the-basics#H1Rotator cuff muscles: Teres minor: (axillary nerve) Adducts* and externally rotate arm I would like to suggest a correction over here, it should be abduction, I have gone through multiple resources and it confirms that it should be Abduction. Referred Books: Textbook of Orthopedics by JOHN EBNEZAR,HARRISON MEDICINE ,GRAYS ANATOMYMinor erratumVerifiedDisagree. Teres minor helps to abduct the hand. Neither source provided support this student's statement. No change to the text recommended. -VVReject by 2 authors + 1 editor02/14/19 11:43 PMTirthPateltirthpatelb@gmail.com
1128438Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyRotator cuff musclesMnemonic/FA 2019 p. 438Sub-Intern Ex-It. Subscapularis Internally rotates arm, Infraspinatus and teres minor externally rotate arm.MnemonicVerifiedPartial. The "Sub-intern" doesnt really stick out to me. Maybe someone else thinks this works? I feel like it doesnt help to remember the actions all that well. -ZanderNot a huge fan TBH. -MALol, I'm honestly not a fan. Would not recommend addition -VVReject by 2 authors + 1 editor04/16/19 3:07 PMElanBaskirebask003@fiu.edu
1129438Musculoskeletal, Skin, and Connective TissuePathologySpinal cord—lower extenthttps://www.uptodate.com/contents/evaluation-of-low-back-pain-in-adults?search=Evaluation%20of%20low%20back%20pain%20in%20adults&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Differential diagnosis of back pain.High-yield addition to next yearIm partial to this. I know backpain was HY for step 2 because of the "next step in management" questions. Interested in reading some of the other authors thoughts. If we do put ddx dx of back pain, we should put it in a table format with key words to tip off the reader -AidaVerifiedReject. Although it would be helpful to have a table for the differential of back pain I feel it doesnt fit with the "flow" of FA. All of the information in the submitted/attached table is mentioned throughout FA, just not all together. -ZanderReject.
LY for Step 1. -MA		Agree with authors. LY for purposes of Step 1, this is more relevant for wards. -VVReject by 2 authors + 1 editor01/16/19 12:52 AMNeryMaraLamothemaralamothe@hotmail.com
1130439Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyWrist regionFA 2019 for Usmle step 1 Text Book, Page 439on line 11th, after the phrase "the radial artery", there are two dots: (..) instead of one at the end of the sentence.Spelling/formattingAccept. There are two dots. -AidaVerifiedYes there is!
Harder to see on the version on Annotate because of a blue editing mark, but it's definitely there.

Remove one period after the word "artery"

-Connie		Please remove one period after the word "artery" -VVPrelim accept by 2 authors + 1 editor01/06/19 7:32 PMElmiraTaghi Zadehelmira.taghizadeh9@gmail.com
1131439Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyWrist regionwww.skillsyouneed.com/write/punctuate1.htmlThere are two periods at the end of the sentence "Complications of proximal scaphoid fractures include..."Spelling/formattingAgree. Minor formatting issue. -Victor M.05/11/19 6:40 PMShazliJalalisaj0141@my.unthsc.edu
1132439Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyWrist regionhttps://emedicine.medscape.com/article/397230-overviewProximal scaphoid fractures have greater risk of delayed union, nonunion, and avascular necrosis but all scaphoid fractures can lead to the same complicationsClarification to current textI would keep current text as is. - Victor M.06/16/19 3:16 PMRa'edAbabnehraedababneh@gmail.com
1133440Musculoskeletal, Skin, and Connective TissueAnatomyHand musclesN/AMuscles of the hands supplied by the median nerve: LOAF: L: lumbricals (1st 2) O oponens pollicis A: abductor pollicis brevis F: flexor pollicis brevisMnemonicVerified05/12/19 10:14 AMHaithamAlaithanhsaithan93@gmail.com
1134440Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyUpper extremity nerveshttps://teachmeanatomy.info/upper-limb/muscles/upper-arm/ https://www.uptodate.com/contents/overview-of-upper-extremity-peripheral-nerve-syndromes?search=musculocutaneous%20nerve&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H7507770The musculocutaneous nerve supplies the muscles of the anterior compartment of the arm, not the triceps and thus the triceps reflex should not be affected although it is supplied by C7 (radial nerve)Major erratumAccept. agree with reader. Suggest placing the triceps reflex under radial nerve instead. However, it should be still mention that although Triceps is peripherally innervated by radial nerve, the reflex is via stimulation of C7 nerve root (ie: reflexes test for functioning spinal roots) source:https://teachmeanatomy.info/upper-limb/muscles/upper-arm/ –AidaVerifiedAgree, accept.
Looking through literature, it was very find to find anything on the presentation of an isolated musculocutaneous nerve injury because of its rarity. Therefore, most papers talk about it in combination with other nerve injuries. I did find one book chapter (2013) that covers musculocutaneous nerve injury in isolation, and it seems that the triceps reflex is in fact preserved: https://www.sciencedirect.com/science/article/pii/B9781455726721000301

It does seem that the tricep nerve reflex is absent in radial nerve injury (reader-provided sources are good).

Suggest for radial nerve presentation section: "↓ triceps (C7) reflex; wrist drop: ...."
and to just delete the triceps reflex from the musculocutaneous row.

-Connie		Agree with authors. Please add per Connie: For radial nerve presentation section: "↓ triceps (C7) reflex; wrist drop: ...."
and delete the triceps reflex from the musculocutaneous row.		Prelim accept by 2 authors + 1 editorMaria Antonelliagree with change; couldn't find other sources than the science direct one connie listed about reflexes involved in the rare musculocutaneous n injury.Nathan Skelleyagree with edit01/13/19 4:23 AMJulianMaamarijulian.maamari@lau.edu
1135440Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyUpper extremity nervesZorrilla S. de Neira, J., Prada-Cañizares, A., Marti-Ciruelos, R. et al. International Orthopaedics (SICOT) (2015) 39: 2287. https://doi.org/10.1007/s00264-015-2975-4Supracondylar fractures that are anterolateral may damage the radial nerve. If it is anteromedial, it will affect the median nerve.Clarification to current textreject. I agree with Connie. This level of information is relevant for orthopaedic rotation (where I was tested on this). -AidaVerifiedReject. Way too much detail for step 1.
Right now, we just specify that supracondylar fracture of the humerus can cause a proximal lesion of the median nerve.

UTD says that a radial nerve injury is more likely with posteromedial distal fracture fragment displacement. Too much detail

-Connie

https://www.uptodate.com/contents/evaluation-and-management-of-supracondylar-fractures-in-children?search=supracondylar%20fracture&source=search_result&selectedTitle=1~26&usage_type=default&display_rank=1#H7		Reject, beyond the scope of Step 1. No changes. -VVReject by 2 authors + 1 editor02/04/19 6:58 PMEstebanCasasolaecasasol@sgu.edu
1136440Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyUpper extremity nervesZorrilla S. de Neira, J., Prada-Cañizares, A., Marti-Ciruelos, R. et al. International Orthopaedics (SICOT) (2015) 39: 2287. https://doi.org/10.1007/s00264-015-2975-4Supracondylar fractures that are anterolateral may damage the radial nerve. If it is anteromedial, it will affect the median nerve.Clarification to current textrepeat.VerifiedRepeat as above
-Connie		As above. Reject. -VVReject by 2 authors + 1 editor02/04/19 8:40 PMEstebanCasasolaecasasol@sgu.edu
1137440Musculoskeletal, Skin, and Connective TissueAnatomyUpper extremity nervesMnemonicTo remember the directional movements of supination and pronation, use your left hand and position it with your palm facing the floor. From this position, thumbs up = supination (“super”nation) and thumbs down = pronation (your hand makes the shape of a “P”). Clarifying image attached.Mnemonicreject. The reader should have a basic understanding of anatomical movements (or else we would have to do this with all directions). -AidaVerifiedReject. Agree with Aida. I feel as though this would not fit into any of the existing sections. Not worth creating a new section for this. -ZanderReject. Agree with other authors. -MAEh, not a fan. Would not recommend. -VVReject by 2 authors + 1 editor02/08/19 8:22 AMMatthew J.Christensenmattchristensen607@gmail.com
1138440Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyUpper extremity nerveshttps://www.sciencedirect.com/topics/immunology-and-microbiology/musculocutaneous-nerveInjuries to the musculocutaneous nerve are associated with weakness of arm flexion and sensory loss along the lateral forearm " not lateral arm"Major erratumAgree, it is the lateral forearm. - Victor M.06/17/19 5:05 PMRa'edAbabnehraedababneh@gmail.com
1139440Musculoskeletal, Skin, and Connective TissuePhysiologyUpper extremity nerves[1] https://en.wikipedia.org/wiki/Cervical_spinal_nerve_8 [2] https://www.kenhub.com/en/library/anatomy/the-thenar-muscles [3] https://www.physio-pedia.com/Brachial_plexus_injuryThe recurrent branch of median nerve composed of C8-T1 (not C5-T1), and innervate hand muscles. [1,2] Intrinsic hand muslces are innervated by lower trunk of brancial plexus, as what is seen in Klumpke palsy (vs. Erb palsy, no intrinsic hand muscle involved). [3]Major erratumAgree. - Victor M.07/12/19 5:11 AMSHICHENGSONGnicksong66@gmail.com
1140441Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyBrachial plexus lesionsselfBranches of brachial plexus "MoM Avoids Rats Universally" Musculocutaneous, Median, Axilar, Radial and UlnarMnemonicVerified08/30/19 2:37 PMJudithVasquezjudith.vasquez.11@gmail.com
1141441Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyBrachial plexus lesionsselfFor Erb's palsy: "ErBB DrInkS 7Up" Erb's palsy Biceps Brachialis-Deltoid-Infraspinatus-Supraspinatus-Upper trunk lesionMnemonicVerified08/30/19 2:40 PMJudithVasquezjudith.vasquez.11@gmail.com
1142441Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyBrachial plexus lesionsselfKlumpke palsy: "Klumpke buys In Lowe's Outlet" In-Intrinsic muscles of the hand, Lowe's-Lower trunk lesion, Outlet- as thoracic outlet syndrome. Winged scapula: "SArah has Long Wings" Serratus Anterior, Long thoracic nerve, Winged scapulaMnemonicVerified08/30/19 2:44 PMJudithVasquezjudith.vasquez.11@gmail.com
1143441Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyMovement disordershttps://www.medscape.com/viewarticle/510573_9under erb palsy, the teres minor muscle and serratus anterior are also affected but it is not mentioned under muscle deficit.Major erratumI suggest faculty input on adding teres minor to the muscles involved. Understanding the pathoanatomy of the waiters tip is based on loss of S.A. M. The Axillary nerve is formed by the C5 & C6 roots, which means the peripheral nerve (axillary nerve) would be out for the same reason deltoid the deltoid is. In addition to infraspinatous weakness, the arm is as such medially rotated(since external rotators are out). I agree with connie about incorporating HY information, however i respectively ask for faculty input on this. Original comment: The reader is correct about adding teres minor, since the axillary nerve is also damaged. As per Orthobullets(trusted ortho equivalent to uptodate), erbs palsy is predominately C5-C6 lesion; they have listed C5 deficiency (predominantly affecting S.A.M nerves thus suprasipinatus/infraspinatus, teres minor/deltoid, and biceps/brachialis. The C6 deficiency leads to radial nerve deficits (brachioradialis/supinator). With that being said, I think we should fix the entry to show roots --> nerve deficits and corresponding muscular deficits and clinical manifestation (ie: C5 def --> def in S.A.M --> etc). with respect to serrates anterior, as per Wheeless textbook of ortho(another ortho trusted resource), only if the roots are affected above their junction, will there be involvement. I suggest not placing this because its conditional and not high yield. -Aida source:http://www.wheelessonline.com/ortho/erbs_palsy source: https://www.orthobullets.com/pediatrics/4117/obstetric-brachial-plexopathy-erbs-klumpkes-palsyVerifiedLeaning towards reject. While teres minor can be involved, it seems to LY to include. There teres minor muscle is innervated by C5-6, the primary nerves affected by erb palsy, but its actions are mostly in tandem with the posterior deltoid, and the movement deficiencies tested when looking for erb palsy are usually just attributed to the deltoid. I think we are including the most HY and commonly referred to muscles in erb palsy, and I'm just not sure the details of other muscles will be tested.

-Connie

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724163/		Agree with Connie, inclined to reject. It is more important to know that erb palsy is caused by defect in C5-C6. The most HY muscles are included, so would not recommend including teres minor, which is more LY. No changes recommended. -VVReject by 2 authors + 1 editorMaria AntonelliAgree this is nit picking. I found a rare source or two saying serratius anterior can rarely be involved and a few more sources saying teres minor can be weak and potentially involved depending where the lesion is; however both muscles are RARELY involved and so it's not very HY to include them.Nathan SkelleyAlthough good points, I agree with previous comments, this is very low yield information.01/19/19 8:49 PMMaryFahmymaryfahmy07@hotmail.com
1144442Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyDistortions of the handhttps://emedicine.medscape.com/article/1243669-overviewTo remember that clawing is best elicited with distal lesions while extending the fingers: "The lion must EXTEND his CLAWS to catch DISTAL prey."Mnemonicreject. I actually think the ulnar paradox is better at explaining this (ie: paradox is that distal lesion looks worse than proximal lesions). This is more informative and often also asked. -AidaVerifiedAccept. I think this is a simple way to remember that both the median and ulnar claw(s) are associated with distal lesions and are noticed when trying to extend the digits. It would be a small addition to the page. -ZanderReject. Agree with other authors. -MAReject. I love the current mnemonic, considering that it fully explains the reasoning for the distal and proximal lesions. Would not recommend addition -VVReject by 2 authors + 1 editor02/14/19 12:13 PMKevinMilligankevinjohnmilligan@gmail.com
1145442Musculoskeletal, Skin, and Connective TissueAnatomyDistortions of the handN/ATo differentiate between the proximal and distal lesions of the median and ulnar nerves: Making a Phist = Proximal ExtenDing the fingers= DistalMnemonicVerified07/26/19 5:02 PMUroosaMazharuroosam@auamed.net
1146442Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyDistortions of the handhttps://www-uptodate-com.medproxy.hofstra.edu/contents/ulnar-neuropathy-at-the-elbow-and-wrist"CDE" - see a Claw with a Distal nerve lesion upon ExtensionMnemonic10/12/19 9:09 PMDanielZhuDzhu5@pride.hofstra.edu
1147442Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyDistortions of the handhttps://www.uptodate.com/contents/ulnar-neuropathy-at-the-elbow-and-wristCoDE - see a Claw with a Distal nerve lesion upon ExtensionMnemonic10/12/19 11:01 PMDanielZhuDzhu5@pride.hofstra.edu
1148442Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyDistortions of the handN/ATo remember when a claw is seen, use the mnemonic "ClawED" - You see a Claw upon Extension in a Distal nerve lesionMnemonic10/13/19 1:17 PMDanielZhuDzhu5@pride.hofstra.edu
1149444Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyLower extremity nervesGray's Anatomy for Students, http://dergipark.gov.tr/download/article-file/413852, https://www.clinicalkey.com/#!/content/book/3-s2.0-B9780702051319000067?scrollTo=%23hl0003000While the pectineus is part of the adductor muscle group of the medial thigh, it is not innervated by the obturator nerve. It is in fact majorly innervated by the femoral nerve and should be classified as such. Anatomical literature reflects conflicting evidence as to the existence of an accessory obturator nerve (AON), which is believed to contribute to pectineus function. However the AON is an anatomical variant infrequently expressed among the population. While obturator nerve damage will result in loss of adduction and medial thigh sensation, the vats majority of this pathology will be caused by denervation of the other adductor muscles, not the pectineus.Clarification to current textreject. Although pectineus is predominately innervated by the femoral nerve, as per Orthobullets, it is MAY also be innervated by the obturator nerve. do not think we should remove it from obturator entry. I think in this case its a femoral>obturator. So, if the student has to pick between the two, femoral should be chosen. However, if femoral isn't there, obturator is the next best answer. source:https://www.orthobullets.com/anatomy/10056/pectineus -AidaVerifiedReject. Pectineus is innervated by both femoral and obturator nerves.

Aida is correct, it may (like 20%) be innervated by obturator nerve. But UTD just states it's innervated by both (link below).

Right now, we have pectineus under both and I feel like it would be okay to keep it that way.

-Connie
https://www.uptodate.com/contents/image?imageKey=EM%2F98416&topicKey=SM%2F93980&search=pectineus&source=outline_link&selectedTitle=1~11		Reject, text is fine as is. -VVReject by 2 authors + 1 editor01/30/19 6:55 PMFaithRobinsonfaith94@vt.edu
1150444Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyLower extremity nervesMichael Schuenke, Erik Schulte, Udo Schumacher, Lawrence Ross, Edward Lamperti, Voll Wesker-General Anatomy and Musculoskeletal System (THIEME Atlas of Anatomy) -Thieme (2010) https://teachmeanatomy.info/lower-limb/nerves/lumbar-plexus/#Genitofemoral_NerveThe genital branch innervates the skin of the anterior scrotum (in males) or the skin over mons pubis and labia majora (in females). The femoral branch innervates the skin on the upper anterior thigh.Clarification to current textAccept. I think it may be worth changing the text to reflect the individual branches. The section could be written exactly as it is in the "main comment" section. It's confusing how it exists in text because it doesnt distinguish between the branches. -ZanderReject. We could possibly clarify, but not really HY for purposes of Step 1. It is more important to understand the main points regarding the genitofemoral nerve. Would not recommend any changes. -VVReject by 2 authors + 1 editor03/27/19 1:56 PMSHICHENGSONGnicksong66@gmail.com
1151444Musculoskeletal, Skin, and Connective TissueAnatomyLower extremity nervesnot applicableTo OBTain AOA, you need a good GPA. (OBT is obturator nerve, which innervates the following muscles - AOA (is adductor longus, obturator externus, adductor magnus) GPA is (gracilis, pectineus, adductor brevis)Mnemonic10/07/19 9:05 PMTYLERHUMPHREYTHUMPHREY1@PRIDE.HOFSTRA.EDU
1152444Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyPeripheral nerveNothing on up to date. This is a link for Kenhub (I am sorry). If you could think about the motion based on the attachment sites of the muscles and muscle contraction will approximate those attachment points, the motion should be understood. Thank you. https://www.youtube.com/watch?v=MdLFfHjGSIYHello. On page 444 of FA 2019, it says common fibular nerve injury will unable dorsiflexion and eversion. I believe that deep fibular nerve innervates tibialis anterior, which is responsible for dorsiflexsion and inversion. Also superficial fibular nerve innervates peritoneal longus, and bravis (also tertious). Those two (not tertious) are responsible for planter flexion and eversion. I think the explanation of those is not very clear and slightly misleading in the FA 2019.Minor erratum05/16/19 1:34 PMKaoriMorimotokaori.morimoto@westernu.edu
1153445Musculoskeletal, Skin, and Connective TissueAnatomyActions of hip musclesNetter AtlasUnder the flexors category, rectus femoris is listed, which is one of the muscles considered part of the quadriceps. Although, under the femoral nerve section the innervated muscle is the "quadriceps"- without explanation that this is actually 4 muscles, or that one of these is the rectus femoris (which is the flexor the hip), which is listed later. In short- suggestion to make consistent either just using quadriceps, or saying rectus femoris (quadriceps)- so that it is clear what its innervation is.Clarification to current textreject. Of the quadriceps, only the rectus femoris crosses the hip joint and thus the only one of the 4 that flexes the hip. So do not suggest replacing rectus femoris with quadraceps in the "action of hip muscles". The quadriceps is pleural so its short hand for multiple muscles which gets the job done if space is an issue. -AidaVerifiedReject. I think the text is clear is it is currently. -ZanderReject. Agree with other authors. Additionally, FA is a review book not a detailed reference. -MAReject, text is fine as is. -VVReject by 2 authors + 1 editor02/27/19 7:56 PMDylanErwinderwin@smu.edu
1154445Musculoskeletal, Skin, and Connective TissueAnatomyLower extremity nervesThere are many anatomy books organizing it this way, but here is Medscape: https://emedicine.medscape.com/article/1898964-overview#a2Currently the book has grouped these as the EXTERNAL ROTATORS OF HIP: "Iliopsoas, gluteus maximus, piriformis, obturator". I suggest removing iliopsoas (it is not a major external rotator), and consider removing gluteus maximus (it has a more minor contribution to external rotation). The MAIN SIX muscles of external rotation of the hip are: piriformis, gemellus superior, obturator internus, gemellus inferior, quadratus femoris, obturator externus (organized from superior to inferior if you look at the hip joint form posterior view - also many other sources with great images for this). Not extremely high yield, but it would good to have this properly organized. In addition, these are all innervated by the sacral plexus (EXCEPT for obturator externus - which is innervated by obturator nerve).Major erratum05/23/19 9:22 PMAndrewKoandrewko@hawaii.edu
1155445Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyLower extremity nervesnot neededtensor fascia latae --> tensor fasciae lataeSpelling/formattingI believe both are accepted. I would keep as is. - Victor M.06/19/19 2:40 AMRaedAbabnehraedababneh@gmail.com
1156446Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologySigns of lumbosacral radiculopathyhttps://www.uptodate.com/contents/lumbosacral-plexus-syndromes?search=knee%20flexion%20lumbosacral&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H3 (search under "Clinical Features")In the image of lumbosacral radiculopathies, injury to the L4 nerve root at the level of the lumbosacral plexus would cause weakness of knee flexion, not weakness of knee extension as written. At the level of the lumbar plexus, L4 contributes to the femoral nerve, which allows for knee extension. However, at the level of the lumbosacral/sacral plexus, L4 contributes to the sciatic nerve, which provides motor innervation to the posterior thigh (hamstrings) to flex the knee. This is why a patient with an injury to L4 at the lumbosacral plexus commonly presents with weakness of knee flexion but normal knee extension. (Saw this scenario in UWorld question (Question ID: 15705) but won’t attach due to copyright)Major erratumI had trouble finding a reliable source to double-check this fact. However, according to UTD: "L2/L3/L4 radiculopathy — There is marked overlap of the L2, L3, and L4 innervation of the anterior thigh muscles, making it difficult to differentiate these spinal nerve root levels based on symptoms, neurologic examination, or electrodiagnostic testing. Thus, these radiculopathies are generally considered as a group. These nerve roots are most commonly involved in older patients with symptoms of spinal stenosis. Acute back pain is the most common presenting complaint, often radiating around the anterior aspect of the thigh down into the knee and occasionally down the medial aspect of the lower leg as far as the arch of the foot. On examination, there may be weakness of hip flexion, knee extension, and hip adduction. Higher lesions may result in greater weakness of the hip flexors. Sensation may be reduced over the anterior thigh down to the medial aspect of the lower leg. A reduced knee reflex is common in the presence of moderate weakness." https://www.uptodate.com/contents/acute-lumbosacral-radiculopathy-pathophysiology-clinical-features-and-diagnosis?search=l4%20compression&sectionRank=1&usage_type=default&anchor=H16&source=machineLearning&selectedTitle=1~150&display_rank=1#H23 - Victor Martinez06/01/19 3:22 PMStacy MSebastianstacy.sebastian01@utrgv.edu
1157448Musculoskeletal, Skin, and Connective TissuePathologyAchondroplasiahttps://www.uptodate.com/contents/achondroplasia?search=achondroplasia&source=search_result&selectedTitle=1~114&usage_type=default&display_rank=1"Membranous ossification is affected", should instead be "Membranous ossification is NOT affected". Endochondral ossification is affected while membranous ossification is not affected, hence leading to a large head relative to limbs.Minor erratumReject. I agree with Connie. I think the reader might have been mistaken -AidaVerifiedReject.
Reader must be using an older edition. There is nothing on achondroplasia on 448, instead, it is on page 454 of FA2019. We very clearly say membranous ossification is not affected, but endochondral ossification is affected (text correct as is).
-Connie		Yup, agree with authors. No change. -VVReject by 2 authors + 1 editor12/27/18 8:50 AMXiaoxuanZhangzxiaoxuan01@gmail.com
1158448Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyActions of hip muscleshttps://www.ncbi.nlm.nih.gov/pubmed/20625501Fact name is incorrect because "NEW FACT" wasn't available. Add titin to sarcomere graphic. Titin connects myosin to the Z-line.High-yield addition to next yearLY IMHO. -MAReject. Agree that it's pretty low yield info. -ZanderReject, LY for Step 1. -VVReject by 2 authors + 1 editor03/18/19 7:23 PMLisa-QiaoMacDonaldllm012@jefferson.edu
1159449Musculoskeletal, Skin, and Connective TissuePathologyOsteopetrosishttp://www.cda-adc.ca/jcda/vol-73/issue-9/839.htmlAlso known as "Marble Bone Disease". was a question about in UWorldHigh-yield addition to next yearpartial. If text authors believe its necessary (ie: an answer choice will say Marble Bone disease.. instead of osteopetrosis so the student would then miss the question.) -AidaVerifiedAccept. This would be a short addition, "also known as marble bone disease", within the text. Though anecdotal, I have definitely seen this come up in questions and in our path lecture in med school. - ZanderICD, MeSH and other coding systems use Osteopetrosis. I think the NBME would adhere to using one of these coding/naming systems. -MAStep 1 has been moving away from eponyms and "nicknames" for diseases, so it is unlikely that this would be tested on Step 1. More important to know the presentation of the disease rather than the other names. -VVReject by 2 authors + 1 editor12/22/18 10:35 PMAlaJamalala.aljamal@hotmail.com
1160449Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyTypes of muscle fibersFA 2018 and Kaplan Physiology LN 2017I've made this entry in a table format, adding additional information according to FA2018 and Kaplan Physiology Lecture Notes 2017.High-yield addition to next yearAccept. There appears to be plenty of room within the page to turn this into a table format. I don't think it would take up much room to do so. -ZanderAccept. Looks great!

-Connie		Looks great and HY. Please migrate the table to annotate. -VVPrelim accept but NOT publishable errata03/21/19 3:23 AMNicolasCuri Gawlinskinicolascurii@gmail.com
1161449Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyTypes of muscle fibershttps://emedicine.medscape.com/article/1923188-overviewType 2 Muscle Fibers are Fast Twitch: 2 Fast 2 FuriousMnemonicVerified06/05/19 10:01 PMKevinKronkevkron123@gmail.com
1162450Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyCell biology of bonen/acALcium deposits in ALkaline media via ALp.MnemonicVerified07/08/19 7:44 PMAPandeyaranikopandey@gmail.com
1163450Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyMuscle proprioceptorsnot neededthe title "Muscle proprioceptors" is highlighted in yellow ,I suggested removing the highlight , It's not in the book style.Clarification to current textVerifiedReject.
"Muscle proprioceptors" is not highlighted in yellow at all. Maybe the reader highlighted it himself?
-Connie		Haha, probably. No changes. -VVReject by 2 authors + 1 editor01/01/19 11:15 AMMoatasemAl-Janabiassoomi88@yahoo.com
1164450Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyMuscle proprioceptorsFAMuscle Spindle--- bold in red the LE at the end of muscle and spindle and the LE of length. Golgi Tendon organ-- Golgi "Tension" organMnemonicAccept. this is a clear mnemonic. -AidaVerifiedAccept. Clear mnemonic. -ZanderI like it but I think the info isn't HY enough to deserve dedicated mnemonics. -MANot a fan. It's harder to remember when the letters are the end of the word, so this would not be as easy to recall the mnemonic. Would not recommend addition -VVReject by 2 authors + 1 editor02/27/19 8:14 PMDylanErwinderwin@smu.edu
1165450Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyMuscle proprioceptorshttps://www.ncbi.nlm.nih.gov/books/NBK531502/It should be added within the section on muscle spindle that muscle spindles mediate the stretch reflex and thus responsible for the deep tendon reflexes. This concept is commonly tested as it is a clear clinical correlate.High-yield addition to next year05/08/19 5:18 PMLeeSeiferleeseifer16@gmail.com
1166450Musculoskeletal, Skin, and Connective TissuePathologyOsteitis deformanshttps://www.medscape.com/viewarticle/713989_9Pagets disease is caused by: Paramyxovirus (measles and RSV)High-yield addition to next yearreject: As per up to date, this is still unclear and there is mixed evidence (if any). "Viral — Compared with the genetic findings, more limited information is available regarding potential environmental influences on PDB, including the possible role of viral infection." source:https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-paget-disease-of-bone?search=paget%20disease%20of%20bone%20disease&source=search_result&selectedTitle=1~54&usage_type=default&display_rank=1#H16031898 -AidaVerifiedReject. Agree with Aida on this. Even within the posted medscape reference article they mention that it's still up for debate. -ZanderReject. Agree with other authors.
-MA		Reject, agree with authors. -VVReject by 2 authors + 1 editor12/24/18 6:37 PMnoorhasannoorhasan1@gmail.com
1167451Musculoskeletal, Skin, and Connective TissuePathologyOveruse injuries of the elbowMyselfGolfer's try to put ball in Middle of the holes. Tennis players try to hit balls in Lateral court. Hence, Golfer's have medial epicondyle injury while tennis players have lateral epicondyle injury.Mnemonicreject. It is too long and not a mnemonic IMHO -AidaVerifiedReject. Too drawn out, not concise enough. -ZanderNot very good. Reject. -MAReject. Too convoluted of a mnemonic when you can just think of the motions that a tennis player and golf player uses to remember whether it affects the medial or lateral side. -VVReject by 2 authors + 1 editor01/31/19 10:08 AMMurliMishramm.murli@gmail.com
1168451Musculoskeletal, Skin, and Connective TissuePathologyPregnancy complicationshttps://www.uptodate.com/contents/congenital-muscular-torticollis-clinical-features-and-diagnosisCongenital torticollis – Congenital torticollis is a postural deformity of the neck because of Sternocleidomastoid injury and fibrosis that develops due to Birth trauma (breech delivery) or Malposition of the head in utero (Fetal macrosomia, oligohydramnios). Children with this condition can have additional musculoskeletal anomalies such as hip dysplasia, talipes equinovarus, metatartus adductus.High-yield addition to next year07/15/19 7:40 AMFahadAhmadfahad.fhda@gmail.com
1169451Musculoskeletal, Skin, and Connective TissuePathologyWrist and hand injuries1- https://www.uptodate.com/contents/metacarpal-neck-fractures , 2-https://en.wikipedia.org/wiki/Boxer%27s_fracture , 3-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060459/ ,, 4-https://www.webmd.com/a-to-z-guides/boxers-fracture#1boxer's fracture :most commonly seen in 5th metacarpal ,then in 4th metacarpal .(to be more precise).Clarification to current textreject. I agree with connie. I think its important to know mechanism of injury which is basic science and major point behind step one. Knowing that 5th MC is affected more than 4th is outofscope of STEP 1 and in the ortho residency level. –AidaVerifiedReject, boxer's fx does most frequently affect the 4th and 5th metacarpals, specifying that it is most common in the 5th than the 4th might be too much detail for step 1. The question stem is not going to test which finger is more likely, but probably give a scenario for a mechanism for injury and specify the 4th/5th fingers.

-Connie		Agree, more important to know that boxer's fracture happens in the 4th and 5th metacarpals and the mechanism. No changes to the text. -VVReject by 2 authors + 1 editor01/24/19 2:22 PMMoatasemAl-Janabiassoomi88@yahoo.com
1170451Musculoskeletal, Skin, and Connective TissuePathologyWrist and hand injurieshttp://learningradiology.com/notes/bonenotes/boxersfx.htminjury is to 2nd and 3rd metacarpal of professional boxers, and 4th and 5th metacarpals in amateur fightersClarification to current textI don't think this is HY.- Victor M.05/30/19 8:13 PMShajethaIyathuraiShajetha.iyathurai@gmail.com
1171451Musculoskeletal, Skin, and Connective TissuePathologyWrist and hand injuriesn/aGuy-on a Cycle for Guyon canal syndrome.MnemonicVerified08/07/19 9:41 PMNiranjanPandeyndprulz@gmail.com
1172451Musculoskeletal, Skin, and Connective TissuePathologyWrist and hand injurieshttps://www.uptodate.com/contents/metacarpal-neck-fracturesIn regards to the metacarpal neck fracture, A cohesive mnemonic suggestion: "4 or 5 boxers met a wall" The 4th and 4th metacarpals are mentioned. "Boxer" as a word trigger, "met a" for metacarpals. and wall to suggest the mechanism of injury.MnemonicVerified09/19/19 12:15 PMAriannaGordonsachianna7591@gmail.com
1173452Musculoskeletal, Skin, and Connective TissuePathologyCommon hip and knee conditionsits a clarificationI think the term lateral force in combination with the picture can cause confusion... maybe specify by "force from the side/lateral" or add the picture a suggested because it is not clear water this is a left or a right leg! (picture included)Clarification to current textThe current term is correct. I'd keep as is. - Victor M.06/07/19 10:30 AMNoam LeanderDegnernoam.degner@me.com
1174452Musculoskeletal, Skin, and Connective TissuePathologyCommon hip and knee conditionshttps://www.ncbi.nlm.nih.gov/books/NBK431067/It says in the text "lateral meniscus involvement is more common than medial mensicus involvement in conjunction with ACL and MCL injury". However other sources state that medial meniscus tears are more common.Clarification to current text09/15/19 11:54 AMJoyBerbanoaryapalantiri@gmail.com
1175452Musculoskeletal, Skin, and Connective TissuePathologyCommon musculoskeletal conditionshttps://www.ncbi.nlm.nih.gov/books/NBK431095/In the description of the "unhappy triad" it is described as "due to lateral force applied to a planted foot" and the zoomed out (full leg) picture next to it shows that described "lateral force". HOWEVER, the force is actually a medially directed force applied to the lateral leg. The zoomed in picture correctly shows this. Technically the medial foot has a lateral force from friction against the ground, but that isn’t what the picture is describing. So the zoomed in picture correctly shows a medially directed force to the lateral leg, however the full-leg picture shows the opposite. The best description of this would be a “Valgus force” which is equally accurate for both the lateral force applied to the medial ankle, and medial force applied to the lateral knee. Both result in Valgus stress that would tear the MCL. (The importance of this is that in the abnormal passive abduction test for MCL tear on page 443, the force is correctly described as a lateral force, so the force description on page 452 would directly contradict that)Clarification to current textreject. for two reasons. The source cited also does not describe what the reader is suggesting. Second, the mechanism of injury the reader is suggesting is incorrect. The correct mechanism of injury is a lateral force onto the posterolateral knee while the foot is planted on the ground. a medial force would cause a varus stress, not valgus. We show that there is a force applied to the lateral structures in both images and the non-zoom in image shows that there is a valgus force onto a fixed foot. source:https://slideplayer.com/slide/4181099/ -AidaVerifiedPartial. It appears there is a comment within the text and this will be addressed by the text authors. If anything I think the "lateral force" arrow could be clarified by saying "medially directed force". -ZanderIt is a lateral force applied to the left knee in full-leg picture. Agree with other authors. -MAI think the student is imagining that it is a right foot rather than a left foot. Illustration is fine as is. -VVReject by 2 authors + 1 editor03/03/19 2:23 AMAdamRippetoeadam.rippetoe@yahoo.com
1176453Musculoskeletal, Skin, and Connective TissueAnatomy and PhysiologyActions of hip muscleshttps://www.uptodate.com/contents/iliotibial-band-syndrome#H296525661The physical examination test for Iliotibial band syndrome is called the Noble compression test, and would, of course, be positive if ITBS is indeed present! (Side note: couldn't find the NEW FACT button for "fact name" so please ignore)Clarification to current text09/16/19 5:28 PMMarkPilarskimarkdp21@yahoo.com
1177453Musculoskeletal, Skin, and Connective TissueAnatomyChildhood musculoskeletal conditionshttps://www.youtube.com/watch?v=imhI6PLtGLcThe text mentions "Ortolani and Barlow maneuvers" but by convention it is named "Barlow and Ortolani Maneuvers". The reason for specific order lies in fact that Barlow Maneuver is always performed before Ortolani maneuver to confirm the developmental dysplasia of hip. Also, this maneuver is usually performed at the age 0-3 months as it comes negative usually after the age of 3 months.Minor erratumReject The main comment is beyond the scope of USMLE step 1 (or two). I think the point is to know the maneuver and pick out that the clunk on exam is a dysplastic hip. The order of the name is pedantic for STEP 1 purposes. -AidaVerifiedText is fine as is, we don't go into detail on the specific maneuvers and age range for them, and I don't think we need to.
UTD seems to suggest that the Ortolani test is the most important, and that the Barlow maneuver can be helpful, and that the combination can have high specificity. I think it's okay to leave as is, but looking around online, it does seem that it is more common to refer to them as "Barlow and Ortolani."
I would be okay leaving as is, or just switching the names around. Deferring to editor!
-Connie
https://www.uptodate.com/contents/developmental-dysplasia-of-the-hip-clinical-features-and-diagnosis?search=ortolani&source=search_result&selectedTitle=1~4&usage_type=default&display_rank=1		Agree with Connie. Current text is fine as is. I found most reliable papers cite them as the "Ortolani-Barlow."

Few among others are:

1. https://www.ncbi.nlm.nih.gov/pubmed/7992611
2. https://www.aafp.org/afp/1999/0701/p177.html


- Vivek		Text is fine as is. In the peds world, we do both back to back, that the actual order of the name does not really matter. It is more important to know that those maneuvers exist rather than the nitty gritty. No changes recommended. -VVReject by 2 authors + 1 editor01/10/19 7:41 AMMurliMishramm.murli@gmail.com
1178453Musculoskeletal, Skin, and Connective TissueAnatomyChildhood musculoskeletal conditionshttps://orthoinfo.aaos.org/en/diseases--conditions/slipped-capital-femoral-epiphysis-scfeSlipped Femoral Capital Epiphysis indicates age as approximately 12 yo. and does not provide direction. Usually, the age of occurrence is 12-16 yo for Boys and 10-14 yo for girls. The Epiphysis is shifted downwards compared to femoral neck.Minor erratumreject Agree with Connie. This is not HY information for step 1. the major point of the "teenage" is to know that usually seen with periods of growths (ie don't think this in an adult). So knowing the age for girls/boys again is pedantic for step 1. -AidaVerifiedReject.
UTD says mean age of presentation is 12 for girls and 13.5 in boys, slightly more common in boys. I don't think we need to give specifics on the direction of epiphyseal shift, and we clearly have a tilde before the 12 years of age, "~ 12-year-old," which I think is sufficient.
-Connie
https://www.uptodate.com/contents/evaluation-and-management-of-slipped-capital-femoral-epiphysis-scfe?search=slipped%20capital%20femoral%20epiphysis&sectionRank=1&usage_type=default&anchor=H4&source=machineLearning&selectedTitle=1~35&display_rank=1#H4		Agree with authors. More important to know about the main concept and that one should never miss this diagnosis, rather than the actual age range. No change to the text. -VVReject by 2 authors + 1 editor01/10/19 8:05 AMMurliMishrammishra@sgu.edu
1179453Musculoskeletal, Skin, and Connective TissuePathologyChildhood musculoskeletal conditionsn/aOrtolAni – A in ortolAni comes later – takes away – Abducts hip joint Barlow is Bad – Adducts – promotes dislocationMnemonicVerified07/08/19 7:47 PMAPandeyaranikopandey@gmail.com
1180453Musculoskeletal, Skin, and Connective TissuePathologyCommon musculoskeletal conditionsnot neededthe phrase "Patellofemoral" is highlighted in yellow ,I suggested removing the highlight , It's not in the book style.Clarification to current textVerifiedReject. "Patellofemoral" is not highlighted in the text.
-Connie		Reject. -VVReject by 2 authors + 1 editor01/01/19 11:17 AMMoatasemAl-Janabiassoomi88@yahoo.com
1181453Musculoskeletal, Skin, and Connective TissuePathologyCommon musculoskeletal conditionshttps://orthoinfo.aaos.org/en/diseases--conditions/compartment-syndrome/ https://emedicine.medscape.com/article/307668-clinical#b3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3649580/In limb compartment syndrome , the text mension that "Presents with severe pain and tense, swollen compartments with limb flexion" and the references mension that the pain increases by stretching or using the involved muscles not by limb flexionMinor erratum06/26/19 6:20 AMRa'edAbabnehraedababneh@gmail.com
1182453Musculoskeletal, Skin, and Connective TissuePathologyFluid compartmentshttps://emedicine.medscape.com/article/307668-overview#a6Add in the section "Limb compartment syndrome" a cause of it is severe thermal burns, treated with fasciotomyHigh-yield addition to next year08/07/19 7:06 PMJudith A.Vásquezjudith.vasquez.11@gmail.com
1183454Musculoskeletal, Skin, and Connective TissuePathologyAchondroplasiahttps://www.ncbi.nlm.nih.gov/pubmed/24419316not only endochondral ossification but also membranous ossification is severely affected in achondroplasiaMinor erratum08/04/19 11:35 AMOsama NaserMagablehraedababneh@gmail.com
1184455Musculoskeletal, Skin, and Connective TissuePathologyNecrosishttps://www.uptodate.com/contents/overview-of-common-hip-fractures-in-adults?csi=460604c0-228b-4eef-9c7a-6c34ed932fc7&source=contentShareIn the text paragraph describing avascular necrosis of bone, you name the artery "medial circumflex femoral artery". But I'm the adjacent image, you name it "medial femoral circumflex artery". For continuity sake & to reduce potential confusion, I suggest both names be made the same. Moore Clinically Oriented Anatomy 7th Edition calls it "Medial Circumflex Femoral Artery" on page 555. On the other hand, the linked UpToDate article calls it "Medial Femoral Circumflex Artery". So either way name works, as long as they're both the same.Spelling/formattingWe could change this to keep consistency, but it is not urgent are it should not be part of the errata either. -Victor M.05/21/19 6:17 PMMatthewTaylormtaylor932@gmail.com
1185455Musculoskeletal, Skin, and Connective TissuePathologyOsteitis deformansIt's MnemonicPaget disease --> 4 H's : Hat size , Hearing loss , High-output cardiac failure , High risk of osteosarcomaMnemonicaccept. Suggest 4 H's however suggest incorporating the pathophys of each manifestation with the text so the student understand why each happens (ie: hat size(thickening of skull)..) -AidaVerifiedAccept. All four H's are high yield associations that frequently come up in practice questions. -ZanderAccept. Agree with other authors. -MA"High" risk is stretching the mnemonic a bit. It would be reasonable to include a mnemonic with 3 H's though. However, I'm inclined to reject, considering that this would mean that we need to reformat the entire fact in order to accomodate this mnemonic. It's easier to remember a mnemonic if there are just three words rather than sentences to remember. -VVReject by 2 authors + 1 editor01/22/19 1:47 PMMoatasemAl-Janabiassoomi88@yahoo.com
1186455Musculoskeletal, Skin, and Connective TissuePathologyOsteopetrosishttp://www.cda-adc.ca/jcda/vol-73/issue-9/839.htmlAlso known as "Marble Bone Disease". was a question about in UWorldHigh-yield addition to next yearaccept. since we have an alternative name for pages as well, might as well add this. -AidaVerifiedAccept. This was addressed in one of the above sections too. -ZanderDuplicate. -MAReject. Step 1 has been moving away from eponyms and "nicknames" for diseases, so it is unlikely that this would be tested on Step 1. More important to know the presentation of the disease rather than the other names. -VVReject by 2 authors + 1 editor03/01/19 7:59 PMAlaJamalala.aljamal@hotmail.com
1187456Musculoskeletal, Skin, and Connective TissuePathologyPrimary bone tumorsIt's MnemonicosteoBlastoma : verteBrae , Big size( > 2cm) , Bad response to NSAIDS.Mnemonicpartial. I think this mnemonic would need something like the "3B's" to work. -AidaVerifiedReject. I think the mnemonic below would be a better way to integrate both osteoblastoma and osteoid osteoma. -ZanderNot very good IMHO. -MAReject, not that great. -VV01/22/19 1:49 PMMoatasemAl-Janabiassoomi88@yahoo.com
1188456Musculoskeletal, Skin, and Connective TissuePathologyPrimary bone tumorshttps://emedicine.medscape.com/article/1255364-overviewThe Giant cell tumor is locally aggressive benign tumor in most cases but they have potential of metastasis (NCI as well as Robbins Pathology text book). The chances of metastasis to distant sites is 1-9% (Medscape)Minor erratumreject. Im unsure what the erratum is. Giant cell tumor is locally aggressive most commonly (what we currently have). a 1-9% chance is not most common aggressiveness. I think the HY information we have suffices for step 1 level of information. -AidaVerifiedReject. Right now, the information we have is both HY and correct. I don't think we need to add the detail of 1-9% of metastasis.

-Connie		Agree with authors. Reject -VVReject by 2 authors + 1 editor02/02/19 7:11 AMMurliMishramm.murli@gmail.com
1189456Musculoskeletal, Skin, and Connective TissuePathologyPrimary bone tumorsMyself.Osteoblastomas vs. Osteoid Osteomas. "osteoBlastomas are Bigger, Badder, and Backer than Osteoid Osteomas" Meaning= Bigger: Osteoblastomas (>2 cm vs. <2 cm=Osteois Os); Badder: OBs don't respond to Aspirin but OstOmas do respond; Backer: OsteoBs located in VertebraeMnemonicaccept partially. I like the bigger and badder, but the backer doesn't make sense right away. I think this mnemonic can be improved upon by the mnemonic team since its important to distinguish osteoid osteoma and osteoblastoma. Perhaps "The big, bad, osteoblastoma on the back". -AidaVerifiedPartial. Agree with Aida. The "backer" needs to be changed. Maybe "Bigger, Badder, in the Back". I think it could work if it is modified. It definitely helps differentiate two sometimes confusing bone tumors. - ZanderNot very good. Suggest rejecting. -MAReject. Not a fan. "Badder" and "Backer" are not really grammatically correct, and it probably would drive the OCD student insane lol. Would not recommend addition -VVReject by 2 authors + 1 editor02/17/19 6:54 PMAlecHastyalechasty2017@gmail.com
1190456Musculoskeletal, Skin, and Connective TissuePathologyPrimary bone tumorspage 638, table 24-1 , Rapid review Pathology (by Goljan) 4th editionGiant cell tumor is mostly occur on Females.Clarification to current textThis fact is not commonly tested. I wouldn't add. - Victor M.05/13/19 7:43 PMMuhanadShaibmohanad.shaib@gmail.com
1191457Musculoskeletal, Skin, and Connective TissuePathologyBone formationfirst AidPatrick Ewing plays for the Mesenchymal Magics, jersey number is 33(11+22), wears a small blue jersey and smells like onions after he playsMnemonicVerifiedPartial. There is another comment on annotate with a possibly pending mnemonic (Ew onion breath). This mnemonic incorporates the"small blue jersey" to indicate the small blue cells, which I like. -Zanderif we stick with the "patrick ewing's" jersey number mnemonic, I think this has potential.
-Connie		Agree that this could possibly work. Please migrate to annotate for further workup. -VVPrelim accept by 2 authors + 1 editor03/20/19 12:55 PMTimothyBlackwellblackwelt7@rowan.edu
1192457Musculoskeletal, Skin, and Connective TissuePathologyPrimary bone tumorsFA 2019 Page 457white arrow*s* in (F).Spelling/formattingAccept: Add "s" after arrows since there are many -AidaVerifiedAccept. Missing the pleural form in the text. -ZanderAccept.
Change "arrow" to "arrows," 3rd column of Ewing Sarcoma entry for image F.

-Connie		Replace "(white arrow in [F])" WITH "(white arrows in [F])"Prelim accept by 2 authors + 1 editor01/04/19 1:33 PMMoatasemAl-Janabiassoomi88@yahoo.com
1193457Musculoskeletal, Skin, and Connective TissuetruePathologyPrimary bone tumorshttps://www.ncbi.nlm.nih.gov/pubmed/27265835Ewing sarcoma was originally thought to be neuroectodermal in origin but is now believed to arise from a mesenchymal stem cell.Major erratumVerifiedAccept. This is true, origin was debated for a long time but it is believed to be mesenchymal in origin. Since we do include the origin, might as well make it correct. Change "neuroectodermal" to "mesenchymal."

-Connie
https://www.uptodate.com/contents/clinical-presentation-staging-and-prognostic-factors-of-the-ewing-sarcoma-family-of-tumors?search=ewing%20sarcoma&source=search_result&selectedTitle=1~93&usage_type=default&display_rank=1		Agree to change. Under the Ewing sarcoma section, replace "neuroectodermal origin" WITH "mesenchymal origin" -VVPrelim accept by 2 authors + 1 editorMaria Antonelliagree- mesenchymal origin is now most more accepted.Nathan SkelleyAgreeAccept02/04/19 3:16 PMRadMonamona.vahidirad@gmail.com
1194457Musculoskeletal, Skin, and Connective TissuePathologyPrimary bone tumorsUW question #15635Ewing Sarcoma is of mesenchymal stem cell origin (previously thought to be neuroectodermal in origin)Major erratumDuplicateRepeat02/05/19 2:43 PMManyleAhmedManyleAhmed@Gmail.com
1195457Musculoskeletal, Skin, and Connective TissuePathologyPrimary bone tumorsRobbins basic pathology 9th edition page 775In the Picture , it shows that osteoid osteoma in mainly located in the diaphysis area , although the most common location for it is the metaphysisMajor erratumIt could be present at both locations. I'd keep current illustration as is. "In long bones, osteoid osteoma is more often situated in the cortico-diaphyseal or metaphyseal regions, but other localizations such as intramedullary, subperiosteal, epiphyseal or apophyseal have also been noted.6 It is very rare to have two osteoid osteomas in the same patient..." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6187004/ - Victor M06/09/19 8:18 AMAhmad AlkhatibAhmad Alkhatibahmadkatib93@hotmail.com
1196457Musculoskeletal, Skin, and Connective TissuePathologyPrimary bone tumorsn/a“Evil Giant ShARk Drowns and DiEs” Epiphysis – Giant Cell Tumor Metaphysis – osteoSARComa, osteochonDROma Diaphysis – Ewing sarcomaMnemonicVerified07/08/19 7:49 PMAPandeyaranikopandey@gmail.com
1197457Musculoskeletal, Skin, and Connective TissuePathologyPrimary bone tumorsn/a“Evil Giant with Multiple eyes Rests Inside a Bubble” Evil – Epiphysis Giant Cell Tumor Multinucleated – Multiple eyed Rests – RANKL expression (Rests - Benign) Bubble – Benign, Soap Bubble Appearance. Bisphosphonates, pg 457 Adverse effects of “–dronates” -droNECK- Esophagitis OsteoNECrosis of jaw.MnemonicVerified07/08/19 7:51 PMAPandeyaranikopandey@gmail.com
1198458Musculoskeletal, Skin, and Connective TissuePathologyOsteoarthritis vs rheumatoid arthritishttps://www.uptodate.com/contents/hla-and-other-susceptibility-genes-in-rheumatoid-arthritisRheumatoid Arthritis is associated with HLA-DR4. However, it will be good to specify the gene locus HLA-DRB1 too. It will help reduce the confusion if question asks about gene locus.High-yield addition to next yearreject. This is way to out of scope and likely to overwhelm medical students. -AidaVerifiedReject. I think this is a little too much. I think, for the most part, when questions are asked about the HLA alleles, the HLA-DR4 is referenced. The RA section already has a lot of information and the extra tidbit is low yield. -ZanderReject. Agree with other authors that this is LY. -MAReject, LY for purposes of Step 1. -VVReject by 2 authors + 1 editor02/16/19 11:54 AMMurliMishramm.murli@gmail.com
1199458Musculoskeletal, Skin, and Connective TissuePathologyOsteoarthritis vs rheumatoid arthritisn/aHand joints affected by each type of arthritis: O, BRO starting from fingertips and moving proximally. DIP joints = O (osteoarthritis), PIP joints = B (both osteo and rheumatoid arthritis), MCP joints = R (rheumatoid arthritis), CMC joint of thumb = O (osteoarthritis). See figure for clarification.Mnemonicreject. since it requires explanation and not self explanatory with he suggested mneumonic. -AidaVerifiedAccept. I think this is better than the mnemonic that is currently in the text. The way you could write this out would be: "O, BRO to remember DIP, PIP, MCP, and CMC joints (distal --> proximal) affected by osteoarthritis, rheumatoid arthritis, or both." -ZanderReject. Agree with Aida that this is not a very good one. -MAReject, not a fan. -VVReject by 2 authors + 1 editor02/17/19 4:31 PMElizabethMurrayelizabeth.murray@downstate.edu
1200458Musculoskeletal, Skin, and Connective TissuePathologyOsteoarthritis vs rheumatoid arthritisnone neededPoDsteoarthritis = osteoarthritis affects the PIPs and DIPsMnemonicVerifiedReject. There was another mnemonic within the suggestions that was better. -ZanderReject. Agree with Zander. -MAReject, would not recommend addition -VVReject by 2 authors + 1 editor03/29/19 11:42 AMNatalieJansenjansen7@uic.edu
1201458Musculoskeletal, Skin, and Connective TissuePathologyOsteoarthritis vs rheumatoid arthritisn/a“Cycling and Smoking inside a 4-walled rheum, in the morning for >1 hr relieves her pain” Anti-cyclic citrullinated peptide antibodies Smoking – risk factor 4-walled: HLA DR-4 Morning stiffness lasting > 1 hr, improved with use Her – Female risk factorMnemonicVerified07/08/19 7:42 PMAPandeyaranikopandey@gmail.com
1202459Musculoskeletal, Skin, and Connective TissuePathologyGoutn/a"Get OUT is an INDY film" i.e. treat gout with indomethacinMnemonicreject. any NSAID is effective in treating gout, thus should not be distinguished. The exception is ASPRIN which should be avoided since its a salicylate and competes with uric acid for excretion. if we are to ad a mnemonic, suggest "Avoid Asprin in Acute Gout". -AidaVerifiedReject. Unless you've seen the film hard to connect. Wont help the majority of people that havent seen the movie. -ZanderReject. Agree with other authors. -MAReject. We do not use cultural references. Because of this, I had to reject a really good mnemonic about Harry Potter earlier, unfortunately. :( -VVReject by 2 authors + 1 editor02/17/19 4:26 PMElizabethMurrayelizabeth.murray@downstate.edu
1203459Musculoskeletal, Skin, and Connective TissuePathologyGouthttps://www.aafp.org/afp/1999/0401/p1799.htmlOverproduction of uric acid largely is idiopathic and it is most important cause as mentioned in u wolrd qustion id 1450Clarification to current text09/26/19 4:20 PMJamilNomanjamel.h2o.101@gmail.com
1204460Musculoskeletal, Skin, and Connective TissuePathologySystemic juvenile idiopathic arthritishttps://www.uptodate.com/contents/systemic-juvenile-idiopathic-arthritis-clinical-manifestations-and-diagnosis?search=juvenile%20idiopathic%20arthritis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1According to UpToDate and Robbins, Systemic Juvenile Idiopathic Arthritis is defined as systemic arthritis seen in <16 year olds, rather than <12 year olds.Minor erratumAccept. Both UpToDate and Medscape say 16 for the age. -ZanderAccept. Per UTD. -MAAccept. Please change "12" to "16" -VVPrelim accept by 2 authors + 1 editor04/25/19 8:34 PMValerieChenvalerie4@illinois.edu
1205461Musculoskeletal, Skin, and Connective TissuePathologySeronegative spondyloarthritisnot neededthe phrase "spondylarthritis" is highlighted in yellow ,I suggested removing the highlight , It's not in the book style.Clarification to current textVerifiedReject.
Nothing in this chapter is erroneously highlighted in yellow.
-Connie		Reject. -VVReject by 2 authors + 1 editor01/01/19 11:21 AMMoatasemAl-Janabiassoomi88@yahoo.com
1206461Musculoskeletal, Skin, and Connective TissuePathologySeronegative spondyloarthritishttps://www.uptodate.com/contents/heel-pain-in-the-active-child-or-skeletally-immature-adolescent-overview-of-causes; https://www.uptodate.com/contents/diagnosis-and-differential-diagnosis-of-axial-spondyloarthritis-ankylosing-spondylitis-and-nonradiographic-axial-spondyloarthritis-in-adultsadd that "Enthesitis presents as heel pain"High-yield addition to next year"reject. Enthesitis can lead to pain at the location at which the ligament or tendon is inflamed at its insertion point.So the only way this would make sense if we said Achilles enthesitis or plantar fascia enthesitis. Just associating enthesitis with heel pain is misleading bc if the student can't reason out that the term means pain at an insertion point (ie: heel pain or achilles aren't there), they may miss the question. another example is ankylosing arthritis and the SI pain because of enthesitis at the SI joint. -Aida"VerifiedReject. Enthesitis doesnt just refer to heel pain. -ZanderReject. Agree with other authors. -MAReject, text fine as is. -VVReject by 2 authors + 1 editor02/06/19 12:48 PMRalphZeitounriz07@mail.aub.edu
1207461Musculoskeletal, Skin, and Connective TissuePathologySeronegative spondyloarthritishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369321/ https://rarediseases.org/rare-diseases/reactive-arthritis/Reactive arthritis can cause Scaroiliitis in 20% of casesHigh-yield addition to next yearNot HY enough to be included. -Victor M.05/15/19 7:35 PMMuhanadShaibmohanad.shaib@gmail.com
1208462Musculoskeletal, Skin, and Connective TissuePathologySystemic lupus erythematosushttps://www.sciencedirect.com/science/article/pii/000991209290354U?via%3Dihub # https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3561694/drug induced lupus : autoantibodies to nuclear histone present in 95% of cases, less renal and neural symptomsHigh-yield addition to next yearaccept. We actually have this in the immune section, but suggest adding it to the SLE section too for reinforcement. -AidaVerifiedDefer to 2020.

- Vivek		Now 2020
Deferring to editor but leaning towards rejecting

I know this is important, but we cover autoantibodies in the immuno chapter page 115. Looking at the MSK chapter entry on lupus, we concentrate on msk findings, but we don't talk about the autoantibodies. I think drug-induced lupus is a very immunological phenomenon, and fits well in the immuno chapter. Here, we already don't talk about autoantibodies in specific, and we don't talk about drug-induced lupus at all, and I thinking pulling in drug-induced lupus anti-histone antibodies would just be out of place.

-Connie		Reject. The autoantibodies table is more appropriate for drug-induced lupus. The most important fact to know is that it is associated with anti-histone antibodies, which is covered in the immunoc chapter. Would not recommend discussing this in the SLE fact, which is already a pretty busy fact. -VVReject by 2 authors + 1 editor02/19/19 2:46 PMahamdObeidatobeidat.amd@hotmail.com
1209462Musculoskeletal, Skin, and Connective TissuePathologySystemic lupus erythematosusMnemonicLibman Sacks Endocarditis, LSE can stand for Lupus-Sterile EndocarditisMnemonicVerified05/12/19 3:04 PMAlecEganAlec.c.egan@gmail.com
1210463Musculoskeletal, Skin, and Connective TissuePathologyFibromyalgian/aPerimysial inflammation and atrophy with CD 4+ T cells (“D” for Dermatomyositis = 4)MnemonicVerified07/08/19 7:35 PMAPandeyaranikopandey@gmail.com
1211463Musculoskeletal, Skin, and Connective TissuePathologyNeuromuscular junction diseaseshttps://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwjx4_mah5HgAhUMTY8KHeDZC7wQFjAAegQIChAB&url=https%3A%2F%2Fwww.uptodate.com%2Fcontents%2Flambert-eaton-myasthenic-syndrome-treatment-and-prognosis&usg=AOvVaw3o4iXbgW-ZZND2oy_ugYdPFDA approved Amifampridine (oral potassium channel blocker) as the first drug for the treatment of Lambert Eaton syndrome.High-yield addition to next yearaccept. We would have to rework the entry to include treatments in addition to response to AchE inhibitor administration. I think we should also explain how it works because it has a tie with ach (K blocker--> prolonged membrane depol-->enhanced Ca -->released Ach) If we do , the student can reason out the answer choices if they don't see the drug name (ie pick answer choice that has K blocker, prolong membrane depol etc). -AidaVerifiedAccept. Although I wouldn't use Amifampridine, but instead, 3-4 diaminopyridine. I cant remember if this came up as an answer for step 1 studying, however, it was definitely a distractor. I think we could format it similar to the MG treatment. I.e under the "AChE inhibitor administration" section for LEMS put "Minimal effect (3-4 diaminopyridine for treatment" -ZanderAgree with other authors. -MA01/28/19 1:08 PMKirtiJunejaanil_kumarans@yahoo.co.in
1212463Musculoskeletal, Skin, and Connective TissuePathologyNeuromuscular junction diseasesFirst Aid 2019Myasthenia gravis is associated with Thymus (MYAsTHenia >> THYMus)MnemonicVerified05/09/19 12:45 PMFarisBinyouseffaris-v@hotmail.com
1213463Musculoskeletal, Skin, and Connective TissuePathologyNeuromuscular junction diseasesN/A(L)ambert-(E)aton = (L)ung cancer, pr(E)synaptic channelsMnemonicVerified05/19/19 1:50 PMAudreyHuntahunt01@nyit.edu
1214463Musculoskeletal, Skin, and Connective TissuePathologyPolymyositis/dermatomyositisFirst AidDermatomyositis is CD4 mediated. D is the 4th letter of the alphabet.Mnemonicreject. this isn't a mnemonic. -AidaVerifiedThis is already integrated into a note on annotate from last year. -ZanderI don't love it, but it's in a note on annotate and we can address it there.

-Connie		Already on annotate. Let's work up there. -VVPrelim accept by 2 authors + 1 editor03/04/19 7:51 PMMohammedVohrakehan.vohra@gmail.com
1215463Musculoskeletal, Skin, and Connective TissuePathologyPolymyositis/dermatomyositismayoclinic.org/diseases-conditions/polymyositisPoly and Jo sip on Mai Tais [polymyositis/dermatomyositis anti-Jo anti-SRP on anti-Mi-2]MnemonicVerifiedNot good. -MAReject. Not a big fan of this. -ZanderEh, not that great. -VVReject by 2 authors + 1 editor03/19/19 4:48 PMMyannaOlsenmyannaolsen@gmail.com
1216463Musculoskeletal, Skin, and Connective TissuePathologyPolymyositis/dermatomyositismederm4tomyositis ⇒ TCD4+ mediated damage vs p8lymyositis ⇒ TCD8+ mediated damage.MnemonicVerifiedPartial. Sometimes throwing numbers in words is surprisingly helpful to remember things. I could go either way on this. -ZanderNot inclined to accept. dermatomyositis also contains an "O" which in the state of taking the test, could lead to confusion. Would not recommend addition -VVReject by 2 authors + 1 editor03/24/19 8:22 PMNicolasCuri Gawlinskinicolascurii@gmail.com
1217466Musculoskeletal, Skin, and Connective TissueAnatomyDermatologic macroscopic termshttps://courses.washington.edu/hubio567/lang/vesicle.htmlThe text mentions vesicle<1cm and Bulla>1cm. However several references mentions Vesicle size < 0.5 cm and Bulla size > 0.5 cmMinor erratumagree with connie , in exam they are not testing exact size. but still it is controversial thing ( because according to harrison bar to differentiate is 0.5cm) ~ parthVerifiedReject.
The gold standard for derm (Bolognia, pg 4 in 2017 ed) agrees with us.

Also won't be testing to exact size on step 1, students just need to know that vesicles are small and bulla are larger to help them figure out the diagnosis (vesicles-herpes, bulla-pemphigoid)

-Connie		This is nitty gritty details that I highly doubt would be tested on Step 1. More important to know the difference between the two. Would not recommend changes to the text. -VVReject by 2 authors + 1 editor01/17/19 12:49 PMMurliMishramm.murli@gmail.com
1218466Musculoskeletal, Skin, and Connective TissueAnatomyDermatologic macroscopic termshttp://www.pathologyoutlines.com/topic/skinnontumoracanthosisnigricans.htmlOrthokeratotic hyperkeratosis (NOT ACTUALLY ACANTHOSIS ) and papillomatosis of stratum spinosumMinor erratumVerifiedDisagree. Text is fine as is. No change recommended. -VVReject by 2 authors + 1 editor02/13/19 7:26 PMrupkunrupayan.kundu1928@gmail.com
1219466Musculoskeletal, Skin, and Connective TissueDermatologyDermatologic macroscopic termshttps://www.uptodate.com/contents/image?imageKey=DERM%2F70809The image letter C seems to be referring to a nevus currently but the image shows an acne pustule (as seen in attached reference), so the letter C should be moved after acne.Minor erratumVerifiedAccept. I don't think the lettering needs to be moved, but possibly the image changed to a photo better representing a nevus..? I feel like it may be helpful to have a more classic appearing nevus instead of the picture that is currently there. -ZanderReject!

What? The picture we have is about as classic of a picture of an intradermal nevus on the face as you can find. It is most definitely not a comedone. This is a classic appearing nevus that fulfills the criteria of "papule" that we are trying to give an example of. Step1 isn't going to require students to differentiate between nevi subtypes, but they do need to know what a papule is, and this is a great example.

-Connie		Reject, image is fine as is. -VVReject by 2 authors + 1 editor03/04/19 6:21 PMAhmedNooraan10@duke.edu
1220466Musculoskeletal, Skin, and Connective TissueDermatologyDermatologic microscopic termshttp://www.pathwaymedicine.org/psoriasisAdd "psoriasis" to examples of acanthosis. This is a tested concept in UWorld question ID 15408Clarification to current textAccept. Under page 466 acanthosis nigrans is the only thing listed. We should add psoriasis. On page 468 of FA it even has acanthosis in the description. -ZanderAccept. Agree with user and Zander. -MASure. Please add "psoriasis" as an example of acanthosis. -VVPrelim accept by 2 authors + 1 editor03/20/19 11:15 AMCourtneyConnellycourtneyconnelly6@gmail.com
1221468Musculoskeletal, Skin, and Connective TissueDermatologyCommon skin disordersI have seen this mentioned in other resources including Pathoma and Boards & Beyond. I will include this paper from Nature as well as an earlier characterization of this association published in the American Journal of Human Genetics. (1) https://www.nature.com/articles/ng.694 (2) https://www.ncbi.nlm.nih.gov/pubmed/16642438Psoriasis has been found to be associated with HLA-CHigh-yield addition to next yearAccept. We already have HLA-C listed on page 100 in FA 2019 immune chapter(and we only listed psoriasis). However, suggest also listing HLA-C in the psoriasis entry in MSK chapter too for reinforcement. -AidaVerifiedAccept. I know the page is already cluttered, yet it may be nice to reinforce this HLA association again under the psoriasis section. -ZanderDefer to editor but leaning towards reject.

This page is SO cluttered, and we cover HLA associations so well in immuno.

-Connie		I'm inclined to reject. Honestly, the it's so cluttered, here and we have a nice table with such great mnemonics in the immuno chapter, that it is better suited to be addressed there rather than here. Would not recommend addition -VVReject by 2 authors + 1 editor01/24/19 10:13 PMMackenzieMadisonmadisonm@iu.edu
1222468Musculoskeletal, Skin, and Connective TissuePathologyCommon skin disordersnot neededUrticaria : Also known as HivesClarification to current text07/05/19 3:05 PMRaedAbabnehraedababneh@gmail.com
1223468Musculoskeletal, Skin, and Connective TissueDermatologyCommon skin disordersn/aeGGzema – mutations in filaGGrin gene. Psoriasis, pg 468 “SILVER Screening of Marilyn MUNRO’s – ‘PARAdise cove’ in AUStralia” SILVERy plaques Increased Stratum Spinosum MUNRO microabscesses PARAkeratosis AUSpitz sign.MnemonicVerified07/08/19 7:38 PMAPandeyaranikopandey@gmail.com
1224468Musculoskeletal, Skin, and Connective TissueDermatologyCommon skin disordershttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718124/Please consider adding that spicy food exacerbate rosacea symptoms. This is tested in Nbme.High-yield addition to next yearWe could add for the next edition. - Victor M.07/22/19 6:10 PMLeshlieDe la Torre Mendozaldelatorre28@hotmail.com
1225469Musculoskeletal, Skin, and Connective TissueDermatologyVascular tumors of skinhttps://rarediseases.info.nih.gov/diseases/6234/cystic-hygromacystic hygroma - cavernous lymphangioma of the neck,assoiated with turner syndromeMajor erratumAccept. Im not sure why this entry was removed?VerifiedReject. This entry was deleted based on studies showing that cystic hygromas are not technically a vascular tumor. It's been consolidated and included in the Turner syndrome page. Would not recommend readdition. -VVReject by 2 authors + 1 editorMaria Antonellithey are not really vascular tumors; they are a lymphatic collection. (a bit of semantics; where does one draw the line between vascular stuff and lymph stuff?!).Nathan SkelleyI have no input on this topic. I agree with Antonelli though--it's a fuzzy line.02/06/19 10:00 PMReenaMedicherlareena.medi@gmail.com
1226469Musculoskeletal, Skin, and Connective TissueDermatologyVascular tumors of skinn/a“ANGry Baby ShARk in SEA of VirginiA (VA)” ANGioSARcoma Breast – Chronic postmastectomy lymphadenopathy Sunexposed areas-Elderly-Aggressive Vinyl chloride - Arsenic.MnemonicVerified07/08/19 7:40 PMAPandeyaranikopandey@gmail.com
1227470Musculoskeletal, Skin, and Connective TissueDermatologySkin infectionshttps://emedicine.medscape.com/article/910570-workupThe histologic picture of Molluscum Contagiosum cytoplasmic bodies is very high yield to know for step1High-yield addition to next yearreject. IMHO the macroscopic and skin manefistation is more HY that histo. The diagnosis is based on clinical exam, and very rarely would you need biopsy/histo. I don't recall ever learning histo for MC like other virus (ex: owls eyes cytomegalovirus) -AidaVerifiedReject. Agree with Aida. If this were to be added, it should be put under the microbiology section if anything. -ZanderReject. Agree with other authors that this is likely LY. -MANah, not as HY. It's more important to recognize the image than the histology. Would not recommend addition -VVReject by 2 authors + 1 editor01/10/19 11:33 AMElmiraTaghi Zadehelmira.taghizadeh9@gmail.com
1228470Musculoskeletal, Skin, and Connective TissueDermatologySkin infectionshttps://emedicine.medscape.com/article/788199-overview ALSO SEE Vivian H Chu, MD, MHS. Staphylococcal toxic shock syndrome. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed on February 24, 2019.)The majority of clinically reported cases of Staphylococcal scalded skin syndrome are due to S. aureusMinor erratum?? Doesn't the name imply its by Staph? -AidaVerifiedPartial. This fact is already mentioned within the microbiology section. I understand they want to clarify SSSS is due to S aureus (instead of epiderm or sapro), however, not sure it needs to be reiterated. -ZanderReject. Agree with Aida. -MAGreat point Aida lol. Would not recommend addition -VVReject by 2 authors + 1 editor02/24/19 9:42 PMDianeVasquezdivasque89@gmail.com
1229470Musculoskeletal, Skin, and Connective TissueDermatologySkin infectionshttps://www.uptodate.com/contents/oral-leukoplakia?search=hairy%20leukoplakia&source=search_result&selectedTitle=2~138&usage_type=default&display_rank=2It is inferred that Hairy Leukoplakia is non-cancerous by the last sentence of "Contrast with thrush (scrapable) and leukoplakia (precancerous)", but it is not stated that hairy leukoplakia is not pre-cancerous, as it is stated that it cannot be scraped away. Possibly add after "cannot be scraped off", "not-precancerous". Then the last sentence would be more clear.Clarification to current textaccept. We do not mention that hairy leukoplakia(a subtype of leukoplakia which is benign and self limiting) is non-cancerous.-AidaVerifiedAccept, this entry could be clarified, it is extremely confusing right now.

Suggest some variation of:

"Irregular, white, painless plaques on lateral tongue that cannot be scraped off [J]. EBV mediated. Benign. Occurs in HIV-positive patients, organ transplant recipients. Contrast with thrush (scrapable) and leukoplakia (non-scrapable but precancerous).

-Connie		Agree, please add in per Connie. I just made some changes to fit the format of the text:

Benign. Irregular, white, painless plaques on lateral tongue that cannot be scraped off [J]. EBV mediated. Occurs in HIV-positive patients, organ transplant recipients (contrast with thrush [scrapable] and leukoplakia [non-scrapable but precancerous]). -VV		Prelim accept by 2 authors + 1 editor02/28/19 9:51 AMDylanErwinderwin@smu.edu
1230470Musculoskeletal, Skin, and Connective TissueDermatologySkin infectionsnot neededin Necrotizing fasciitis --> violaceous color of bullae *and* surrounding skinClarification to current text07/06/19 4:53 AMRa'edAbabnehraedababneh@gmail.com
1231471Musculoskeletal, Skin, and Connective TissueDermatologyAutoimmune blistering skin disordersFirst AidVulgar words come from the mouth so there's oral involvementMnemonicAccept! Thats very clever! Suggest something less wordy is possible. -AidaVerifiedAccept. The heading could highlight the vulgar in vulgaris red. Within the section we could add "Vulgar words come from the mouth = oral involvement" and again highlight the vulgar red. Although a little wordy it helps to remember one of the key differentiating factors between PV and BP. -ZanderAccept
I like Zander's shortening, it's much better.

-Connie		Please add Zander's shortened version to annotate. Highlight "vulgar" in red and in the next column say "Vulgar language = oral involvement" -VVPrelim accept by 2 authors + 1 editor01/11/19 2:56 PMHsinyuYinhsinyu94@hotmail.com
1232471Musculoskeletal, Skin, and Connective TissueDermatologyAutoimmune blistering skin disordershttps://www.uptodate.com/contents/pathogenesis-clinical-manifestations-and-diagnosis-of-pemphigus?search=pemphigus%20vulgaris&source=search_result&selectedTitle=1~43&usage_type=default&display_rank=1Pemphigus vulgaris always has desmoglein-3 antibodies with or without desmoglein-1. However, it cannot be desmoglein 1 without desmoglein 3 as that would be a different entity (pemphigus foliaceous)Minor erratumaccept. Currently we have ".. antibodies against desmoglein-1 and /or desmoglein 3." suggest instead reversing the two so it reads " desmoglein 3 and/or desmoglien-1" -AidaVerifiedAccept. Desmoglein-3 is the primary target antigen of pemphigus vulgaris. 1+3 is the mucosal form. Just 1 pemphigus foliaceous.

I think we can just include desmoglein-3, or change it to desmoglein-3 (and sometimes also desmoglein-1). Aida is correct but I don't think reversing 3 and 1 would be best, since the "and/or" still makes the possibility of desmoglein-1 antibodies to cause vulgaris.

-Connie		agree with Connie. Richard UsatineAgree can probably defer to main cycle but agree that the text needs to be modified. Replace "desmoglein-1 and/or desmoglein-3" WITH "desmoglein-3 (sometimes also desmoglein-1) -VVPrelim accept by 2 authors + 1 editorMaria Antonelliagree with the rewording DMG-3 (and sometimes DMG-1) rather than swapping and/or since it's technically not correct.Nathan SkelleyNot in my scope of practice.01/29/19 1:14 PMJulianMaamarijulian.maamari@lau.edu
1233471Musculoskeletal, Skin, and Connective TissueDermatologyAutoimmune blistering skin disordersMnemonicTo remember which skin blistering disorders stimulate specific IgG vs IgA antibodies, just look at the letters in the name of each disease. DermAtitis herpetiformis produces specific IgA antibodies, while bullous pemphiGoid and pemphiGus vulGaris both produce specific IgG antibodies (don’t let the lone “A” in “vulgaris” fool you; “pemphigus vulgaris” has two “G”s to emphasize production of IgG antibodies).Mnemonicpartial. I think had there been 2 A's in dermatitis herptiformis it would you reinforced it more (since the Pemphigoid and pemphigus Vulgars have the redundant G's). -AidaVerifiedReject. I personally think it's a bit of a stretch. -ZanderReject

The A in vulgaris not counting but the A in dermatitis herpetiformis counting throws it off completely for me. When it's arbitrary letters, might as well just memorize the fact over complicating it.

-Connie		Reject, the mnemonic is too complicated. -VVReject by 2 authors + 1 editor02/08/19 1:16 PMMatthew J.Christensenmattchristensen607@gmail.com
1234471Musculoskeletal, Skin, and Connective TissueDermatologyAutoimmune blistering skin disordersMnemonicIn order to remember characteristics about Pemphigus vulgaris, you can think "She 'said' it would be '2' 'vulgar' to wear 'fishnet tights' to the 'cemetery.'" This mnemonic allows you to remember that pemphigus vulgaris is a type II hypersensitivity reaction (2), it involves oral mucosa (said), it has a reticular/net-like pattern on immunofluorescence (fishnet tights), and that the acantholysis resembles a "row of tombstones" on H&E stain (cemetery).MnemonicVerifiedPretty good! it hits all the major HY points and puts it into a nice story. Especially if we still want the story mnemonics, I say, accept!

-Connie		Accept, please migrate to annotate. -VVPrelim accept by 2 authors + 1 editor03/23/19 6:46 PMAmerMohiuddinamemohiu@iu.edu
1235471Musculoskeletal, Skin, and Connective TissueDermatologyAutoimmune blistering skin disordersFA 19 p. 471, mnemonic*Vulgar* words come out of your *mouth*, pemphigus *vulgar*is may involve *oral* mucosaMnemonicVerified05/10/19 4:26 PMElanBaskirebask003@fiu.edu
1236471Musculoskeletal, Skin, and Connective TissueDermatologyOther blistering skin disordershttps://www.uptodate.com/contents/epidemiology-pathogenesis-classification-and-clinical-features-of-epidermolysis-bullosaInclude information about epidermolysis bullosa, which is one of the topics specifically mentioned in the USMLE content outline (https://www.usmle.org/pdfs/usmlecontentoutline.pdf, page 12). I think mentioning that the simplex type is the most common, involves blisters in areas of trauma or mechincal stress, and involves an autosomal dominant mutation in keratin genes.High-yield addition to next yearVerifiedPartial. I know the goal is to minimize very low yield info and I feel like this falls under that category. Although it isn't mentioned at all in the text (to my knowledge), so maybe a small section would be nice..? Interested to hear other thoughts on this. -ZanderThis is LY.

Looking at the PDF the student attached, it says, "This outline provides a common organization of content across all USMLE examinations. Each Step exam will emphasize certain parts of the outline, and no single examination will include questions on all topics in the outline." I've never seen this tested on Step 1, but if someone can find it in UW or NBME, we can add it.

-Connie		Reject. Epidermolysis is actually not really tested on Step 1. I remember being surprised by this fact, considering that it was frequently tested on my med school exams. I have never really seen it tested on Step 1. Would not recommend addition to the text. -VVReject by 2 authors + 1 editor03/10/19 8:26 PMMaxYudovichmax.yudovich@osumc.edu
1237471Musculoskeletal, Skin, and Connective TissueDermatologyOther blistering skin disordershttps://www.ncbi.nlm.nih.gov/pubmed/27656858Stevens-Johnson Syndrome + Nikolsky Sign occurs via different mechanism (necrosis of all epidermal layers, which causes dermal-epidermal detachment) than + Nikolsky Sign in Pemphigus Vulgaris (anti-desmeoglein), and - Nikolsky Sign in Bullous Pemphigoid (anti-hemidesmosome which causes dermal-epidermal detachment).Clarification to current textReject. LY for Step 1.

-MA		Reject. Agree that it's a little too in depth/low yield for step 1. -ZanderReject. Not HY for purposes of Step 1. -VVReject by 2 authors + 1 editor04/02/19 4:56 PMBenjaminSaracbsarac19@gmail.com
1238472Musculoskeletal, Skin, and Connective TissueDermatologyBurn classificationhttps://www.uptodate.com/contents/classification-of-burn-injuryBurns have largely been reclassified from first, second, third, and fourth degree to a system reflecting need for surgical intervention. They are now classified as: superficial (previously first degree), superficial partial-thickness, deep partial-thickness, full thickness, and fourth degree. The 2019 FA text does not differentiate superficial partial-thickness and deep partial-thickness burns (e.g., superficial partial-thickness does NOT scar where deep partial-thickness DOES scar) and does not mention fourth degree burns, which extend into fascia and/or muscle and never heal unless surgically treated. (See Table 1 and Figure 1 in source link for complete descriptions.)High-yield addition to next yearThis is a deferred comment already on annotate. I agree this is a change we need to make this year.

-Connie		Agree. Since it is already on annotate, not necessary to migrate this comment. Will reject, therefore. -VVReject by 2 authors + 1 editor03/23/19 11:00 AMJosephHuntleyhuntleyjh@gmail.com
1239472Musculoskeletal, Skin, and Connective TissueDermatologyMiscellaneous skin disordersn/aLichen grows on GRANite = Lichen planus results in increased thickness (growth) of the stratum GRANulosum.Mnemonicaccept. It makes sense. -AidaVerifiedNot very good. -MAReject, not really a fan. -VVReject by 2 authors + 1 editor02/22/19 10:20 AMElizabethMurrayelizabeth.murray@downstate.edu
1240472Musculoskeletal, Skin, and Connective TissueDermatologyMiscellaneous skin disordersn/aI believe a comprehensive table of the "erythemas" such as erythema migrans, marginatum should be included in the dermatology section. This would help put all of them in a concise place.High-yield addition to next year05/20/19 5:50 PMLexieGibsonlexiegibs@gmail.com
1241473Musculoskeletal, Skin, and Connective TissueDermatologySkin cancer-Basal cell carcinoma : rolled borders ( Ball-like), Telangiectasias ( Blood vessels), Palisading Nuclei ( Balisading), Bink+BearlyMnemonic10/07/19 1:05 PMAhmad Y.ObeidatObeidat.amd@hotmail.com
1242473Musculoskeletal, Skin, and Connective TissueDermatologySkin cancer-Squamous cell CA: Sunlight, Suppressed immunity, Sinuses, arSenicMnemonic10/07/19 1:09 PMAhmad Y.ObeidatObeidat.amd@hotmail.com
1243474Musculoskeletal, Skin, and Connective TissuePharmacologyArachidonic acid pathwaysMyselfNon-selective NSAID mnemonic: KIDIN i.e. Ketorolac, Ibuprofen, Diclofenac, Indomethacin, NaproxenMnemonicpartial. I think the mnemonic needs to be catchy. If the KIDIN was a phrase that would elude to the non-selective NSAIDS (similar to Hypertensive Moms Love Nifidepine..) then i could see it helping. Otherwise, the recall of KIDIN and association with Non-selective NSAIDs is not grossly apparent with the current state of the mnemonic. -AidaVerifiedNot very good. -MAReject, not really important to know the selective vs non-selective NSAIDs. Would not recommend addition. -VVReject by 2 authors + 1 editor02/02/19 8:28 PMMurliMishramm.murli@gmail.com
1244474Musculoskeletal, Skin, and Connective TissuePharmacologyArachidonic acid pathwaysNot neededall prostaglandin agonists have "PROST" in their name short for PROSTaglandin or PROSTacyclin; to make "prost" in RED. Same for "LEU" or "LUK" in LEUKotrienes antagonists. Makes it easier to rememberMnemonicreject. self explanatory and thus not needed. -AidaVerifiedReject, way too self explanatory to need mnemonic treatment.

-Connie		Reject, too much explanation needed. -VVReject by 2 authors + 1 editor03/01/19 6:50 PMAlaJamalala.aljamal@hotmail.com
1245474Musculoskeletal, Skin, and Connective TissuePharmacologyArachidonic acid pathwaysnot neededZileuton is Leukotriene synthesis inhibitorSpelling/formattingCurrent diagram is correct. -Victor M.07/13/19 8:10 AMRaedAbabnehraedababneh@gmail.com
1246474Musculoskeletal, Skin, and Connective TissuePharmacologyArachidonic acid pathwaysRX QID 1991.11 Prednisone-glucocorticoide complex recetorPrednisone is listed in the index (FA 2019) but it is not explained at all in the text under arachidonic pathway. Rx asked question (QID 1991.11)on this particular drug and explained as "Prednisone acts as an agonist, passing through the plasma membrane and binding to the intracellular glucocorticoid receptor. The prednisone-glucocorticoid receptor complex then travels into the nucleus, where it binds to inverted DNA repeats, causing activation or suppression of specific genes and leading to apoptosis of immature lymphocytes. The prednisone-glucocorticoid receptor complex also leads to the production of anti-inflammatory proteins and suppresses cytokine synthesis. Prednisone also suppresses neutrophil migration and inhibits the production of cyclooxygenase-2". Please just update this info under the Arachidonic pathwayClarification to current text08/18/19 11:39 AMUroosaMazharuroosam@auamed.net
1247474Musculoskeletal, Skin, and Connective TissuePharmacologyArachidonic acid pathwayshttps://www.sciencedirect.com/topics/medicine-and-dentistry/prostacyclinMnemonic: WIDE-Vasodilation is the Widening of blood vessels and PGI2, PGD2, and PGE2 are all prostacyclins and prostaglandins that promote vasodilation or "widening" of blood vessels. In red would be W from Widening, I from PGI2, D from PGD2, and E from PGE2.Mnemonic10/23/19 9:08 AMWilliamBloomwilliam.bloom3993@gmail.com
1248475Musculoskeletal, Skin, and Connective TissuetruePharmacologyAspirinhttps://www.ncbi.nlm.nih.gov/pubmed/8397891Under side effects of Aspirin, tinnitus is listed. In parenthesis it says CN 7. However, the tinnitus is due to CN 8.Minor erratumAccept Agree with Connie. I have listed another source that also says its due to CN VIII. source: https://www.ncbi.nlm.nih.gov/pubmed/8397891 -AidaVerifiedYes accept. Current text says CN VII which is incorrect. Source provided by reader is correct, and attaching another more recent source below. In brief, the motor part of CN VII controls facial muscles, and the sensory part conveys taste from the anterior 2/3 of the tongue. CN VIII is the vestibulocochlear nerve, and true to its name, it transmits sound and equilibrium information. CN VII does not have any functions in hearing or balance.

Suggest, "tinnitus (CN VIII)"

-Connie
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341117/		agree. Richard UsatineAgree. I changed to a minor erratum classification. Under Aspirin Adverse Effects section, replace "tinnitus (CN VI)" WITH "tinnitus (CN VIII)" -VVPrelim accept by 2 authors + 1 editorMaria Antonelliagree with change which is correct.Nathan SkelleyAgree with change.Accept12/22/18 9:46 PMJerrinBawajerrin.bawa@gmail.com
1249475Musculoskeletal, Skin, and Connective TissuePharmacologyAspirinhttps://emedicine.medscape.com/article/1948907-overviewin adverse effect part, after the word "tinnitus", CN VII should be corrected as: CN VIIIMajor erratumDuplicate01/02/19 10:30 PMElmiraTaghi zadehelmira.taghizadeh9@gmail.com
1250475Musculoskeletal, Skin, and Connective TissuePharmacologyAspirinN/Atinnitus would be caused by CN VIII instead of CN VIIMinor erratumDuplicateAlready addressed above, comment 15

-Connie		01/19/19 4:18 PMPrarthanaPateloprarthana@yahoo.com
1251475Musculoskeletal, Skin, and Connective TissuePharmacologyAspirinhttps://www.ncbi.nlm.nih.gov/pubmed/8397891under adverse effect of aspirin, there is tinnitus with CN VII inside bracket when infact it must be CNVIIIMajor erratumDuplicate- Victor M.Duplicate.
MA		05/16/19 10:14 AMManjilBasnetbasnetmanjil@gmail.com
1252475Musculoskeletal, Skin, and Connective TissuePharmacologyAspirinhttps://www.researchgate.net/publication/224899177_Salicylate_toxicity_model_of_tinnitusTinnitus experienced with high doses of Aspirin is mediated via CN VIII, not via CN VII as stated in the FirstAid 2019 EditionMajor erratumDuplicate.
-MA		06/27/19 10:19 AMMaximilianVettermaximilian.vetter@stud.pmu.ac.at
1253475Musculoskeletal, Skin, and Connective TissuePharmacologyBisphosphonatesFirs Aid itselftHighlight the suffix "dronate" as it is common suffix to bisphophonatesMnemonicreject. We don't always highlight repeating suffixes throughout the book. The times where we have done this is when its of utmost importance to distinguish classes of drugs as seen with the antiviral HIV protease inhibitors /integrase inhibitors.. etc. We don't really do this with for example, benzo's and "zepam" in the neurosection either. So unlikely to add to the MSK chapter since bisphosphonates names are so distinct from other MSK drugs. -AidaVerifiedReject. Doesn't adhere to standard formatting for this book.

-Connie		Reject. -VVReject by 2 authors + 1 editor02/02/19 9:01 PMMurliMishramm.murli@gmail.com
1254475Musculoskeletal, Skin, and Connective TissuePharmacologyDrug nameshttps://www.evenityhcp.com/?gclid=CjwKCAjw-ITqBRB7EiwAZ1c5UwliFfHEPH0EPv9lTNs1t3eUIkfQZI43VGF6jh48bi66arujwmsn-hoCBaMQAvD_BwE&gclsrc=aw.dsA new FDA approved drug to treat osteoporosis - Romosozumab (EVENITY). Mechanism: Romosozumab is a human monoclonal antibody that binds sclerostin. Clinical use: women with severe osteoporosis. Adverse effects: potential risk of MI, stroke and CV death.Clarification to current text07/31/19 8:28 PMPavelAksionavpavlusha_aksenov@mail.ru
1255475Musculoskeletal, Skin, and Connective TissuePharmacologyNonsteroidal anti-inflammatory drugsmyselftNSAID mnemonic: KID IN My Picture i.e. Ketorolac, Ibuprofen, Diclfenac, Indomethacin, Naproxen, Meloxicam, PiroxicamMnemonicreject. I think a mnemonic that has more information (ie: reversible NSAIDS and KIDIN) is more helpful than list of NSAIDS(similar to what we have Prevent a Painful Flare for "chronic gout drugs" Provenecid, Allopurinol, Pegloticase, Febuxostate). -AidaVerifiedReject. Not HY enough to warrant a mnemonic -VV02/02/19 8:49 PMMurliMishramm.murli@gmail.com
1256475Musculoskeletal, Skin, and Connective TissuePharmacologyPharmacokineticshttps://www.ncbi.nlm.nih.gov/pubmed/8397891in asprin side effects: tinnitus (CN VII) but it's VIII not VIIMinor erratumrepeat comment -AidaVerifiedDuplicate. -MAAddressed above already. -VVReject by 2 authors + 1 editor02/21/19 8:21 AMnehalkhalidnehalnasser55@gmail.com
1257476Musculoskeletal, Skin, and Connective TissuePharmacologyGout drugshttps://www.ebmconsult.com/articles/allopurinol-azathioprine-interaction-mechanism-wbcText says "increase concentrations of xanthine oxidase active metabolites, azathioprine, and 6-MP.". This text is confusing. It should be replaced by "Increases the concentrations of drugs metabolized by xanthine oxidase e.g. 6-MP (and it's prodrug Azathioprine) and increases the potential toxicity of these drugs if their concentration is not reduced"Clarification to current textreject This makes the text wordy and the text conveys the information well. -AidaReject.
The current text doesn't say either "increase" or "increases," it's an up arrow. The current text is correct, inhibiting xanthine oxidase increases its metabolites (azathioprine and 6-mp). The reader's suggestion implies that 6-mp and azathioprine are drugs metabolized by xanthine oxidase. The second part of the sentence is superfluous.

-Connie		Both are correct. However, I feel current text is slightly confusing at the first look. Because we are not illustrating here that these two drugs are metabolized by XO.

I recommend the following clarification to the text during FAS2020 revision:

[up arrow] concentrations of drugs metabolized by xanthine oxidase eg, azathioprine, and 6-MP.


- Vivek		Agree, not inclined to make any changes to the text. No changes recommended. -VVReject by 2 authors + 1 editor01/12/19 7:07 PMMurliMishramm.murli@gmail.com
1258476Musculoskeletal, Skin, and Connective TissuePharmacologyGout drugsMnemonicFebu-XO-STAT. - makes Xanthine Oxidase STATicMnemonicVerifiedAccept. I really like this one. Simple to understand and remember. -ZanderAccept, this definitely works.

-Connie		Accept, please add to annotate. -VVPrelim accept by 2 authors + 1 editor03/20/19 9:24 PMLokeshgoyallkh.lokesh@gmail.com
1259476Musculoskeletal, Skin, and Connective TissuePharmacologyGout drugs-PRobenecid : Prevent ReabsorptionMnemonic09/29/19 4:15 AMahmadObeidatObeidat.amd@hotmail.com
1260476Musculoskeletal, Skin, and Connective TissuePharmacologyTeriparatideMnemonicYou can remember that Teriparatide is a recombinant PTH analog by thinking, "Teri'PARA'tide is an analog of 'PARA'thyroid hormone (PTH)."MnemonicVerifiedAccept. Very simple addition to the text. Makes it easy to remember too. -ZanderIt's good but we cannot add mnemonic treatment to fact titles per FA style. -MAAgree, we can't add to the fact title. Would not recommend addition -VVReject by 2 authors + 1 editor03/20/19 10:59 AMAmerMohiuddinamemohiu@iu.edu
1261476Musculoskeletal, Skin, and Connective TissuePharmacologyTeriparatiden/aTo remember teriparatide is contraindicated in Paget disease, remember it its TERrible in Pagets (TERIPAratide)MnemonicVerified05/20/19 5:57 PMLexieGibsonlexiegibs@gmail.com
1262476Musculoskeletal, Skin, and Connective TissuePharmacologyTeriparatideMade this up myselfTeREPAIRaTIDE for REPAIRing bone(via osteoblasts) and TIDE for pulsatile fashion (like tides of an ocean)MnemonicVerified06/15/19 10:30 AMDannyIbrahimdsi00199@yahoo.com
1263476Musculoskeletal, Skin, and Connective TissuePharmacologyTNF-α inhibitorsnot neededit is easier to memorize them as "Infliximab, certolizumab, adalimumab, golimumab"Spelling/formattingIt does not add extra value. Keep as is. - Victor M.07/13/19 7:40 AMRaedAbabnehraedababneh@gmail.com
1264478Neurology and Special SensesEmbryologyRegional specification of developing brainN/A"Tell Diane, Messi met my mother." A mnemonic for Telencephalon, Diencephalon, Mesencephalon, Metencephalon, and myelencephalon.Mnemonic11/12/19 4:55 PMWenyuDengwenyu.deng128@gmail.com
1265479Neurology and Special SensesEmbryologyHoloprosencephalyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815046/Trisonomy 18 accounts for 1-2% cases of holoprosencephaly.High-yield addition to next yearVerifiedReject. This is true but not HY. Langman's Medical Embryology mentions only trisomy 13 and I have seen holoprosencephaly in a baby with trisomy 13 which is what we reference in FA.
-Kaitlyn		Agree to reject -YKAgree, not HY for purposes of Step 1. Reject. -VVReject by 2 authors + 1 editor02/14/19 9:32 PMJasonTegethofftegethoffjason@gmail.com
1266479Neurology and Special SensesEmbryologyNeural tube defectshttps://emedicine.medscape.com/article/311113-overviewIt says spina bifida occulta is failure of the caudal neuropore to close, however the defect is in the vertebral arches, not the neuropore. The most severe form of spina bifida (spina bifida with rachischisis) is caused by a failure of the caudal neuropore to close, not spina bifida occulta.Major erratum10/02/19 3:01 PMHaleeEinfeldraxorium@gmail.com
1267480Neurology and Special SensesEmbryologyPosterior fossa malformationsSelf-producedChiari 1 Malformation - Number '1' looks like a SYRINGE pointing up. It's associated with Syringomyelia. Also, usually symptomatic when you become '1' independent adult. // Chiari 2 malformation - 2 structures - vermis, tonsils + '2M's' MyeloMeningocele. // Dandy-Walker - Everything isn't 'fine and dandy' when you can't 'WALK' down cerebellar vermis path. Because it hasn't formed!Mnemonic10/27/19 6:57 AMKhalidAlattarkhalid_alattar@hotmail.com
1268480Neurology and Special SensesEmbryologyPosterior fossa malformations.Dany-(W)alker malformation : w = 2 v's - - - - - > ventricle, vermisMnemonic10/30/19 4:59 PMMaarouf GorraAlnafouriKaremgoora@gmail.com
1269480Neurology and Special SensesEmbryologySyringomyeliahttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2078323/As the disease progresses, syringomyelia can affect the anterior horns (LMN symptoms), which leads to SCOLIOSIS (due to paresis of paravertebral bodies). **"teenager w/scoliosis + loss of pain/temp in cape-like distribution" is a common presentation in board questionsHigh-yield addition to next yearThis is true and I agree high yield. we could write one sentence which should still fit on the page. The image will need to be modified to show expansion into the ventral horns.
-Kaitlyn		I was unaware of this association, but it makes sense! The more you know...Agree with Kaitlyn that the image should be updated to show involvement of the ventral horns. -Zander03/18/19 9:14 AMLisa-QiaoMacDonaldllm012@jefferson.edu
1270480Neurology and Special SensesEmbryologySyringomyeliaN/ASyringomyelia - 'syringe' that takes blood. Similarly, vampires run around with CAPES (CAPE-like loss of sensation) taking blood from people . They attack with both upper LATERAL limbs out trying to grab you as they don't feel pain in these limbs (lateral spinothalamic tracts affected in upper limbs, reducing pain and temperature sensation)Mnemonic10/27/19 7:05 AMKhalidAlattarkhalid_alattar@hotmail.com
1271480Neurology and Special SensesEmbryologySyringomyeliaSelfDifference between ALS and SyringomyeliaMnemonic11/18/19 1:57 PMUroosaMazharuroosam@auamed.net
1272481Neurology and Special SensesAnatomy and PhysiologyMicrogliamy own idea.what if you highlight the M letter in Microglia & Mesodermal with red colorMnemonicVerifiedIt already is under Embryology. I don't think it is necessary in this section. Reject -YK05/13/19 8:17 PMMuhanadShaibmohanad.shaib@gmail.com
1273481Neurology and Special SensesAnatomy and PhysiologyNeuronsFirst Aid 2018 vs First Aid 2019 (p. 481)In the index, you stated information on Wallerian degeneration was located on p. 481. It's missing in the new 2019 First Aid section.Clarification to current textVerifiedUser is correct. Index problem.

Wallerian degeneration fact is on page 483. Index should be corrected.
- Humood		Defer to index team. -AnupCorrect. I'll add a note to the index chapter. -VVPrelim accept by 2 authors + 1 editor01/20/19 7:54 PMBNguyenbrenda.m.nguyen@gmail.com
1274481Neurology and Special SensesAnatomy and PhysiologyNeuronsSelf-writtenNissl Stain = can be seen as "NISSERR/nicer" stain as it stains 'ERR' (Endoplasmic Reticulum Rough). You look 'nicer/NISSERR' to other people when you're NOT carrying an AXE. Meaning nissl/nice stain stains cell bodies and dendrites of neurones but NOT AXons.Mnemonic10/27/19 7:14 AMKhalidAlattarkhalid_alattar@hotmail.com
1275481Neurology and Special SensesAnatomy and PhysiologyNeuronsthis isn't a correction. Just a concern.In the index it says wallerian degernation can be found on page 481, but I do not see it anywhere.Clarification to current text11/27/19 3:41 PMSunnyGhotraghotram2@vcu.edu
1276481Neurology and Special SensesAnatomy and PhysiologySleep physiologyN3 has 3 major events that can happen in it, bedwetting, sleepwaking, and night terrors, so this updated mnemoic includes them all.Wee and flee in scary (night terrors) N3MnemonicVerifiedAccept. Simple addition and it includes all the components. -ZanderCan be added and opened for crowd suggestion. -Anup03/23/19 10:04 AMKatelynKlimowichklimowick0@rowan.edu
1277481Neurology and Special SensesAnatomy and PhysiologyTongue developmenthttps://www.optecoto.com/article/S1043-1810(15)00067-6/fulltext#s0015The tongue will form from two lateral lingual swellings and one median swelling all from the 1st pharyngeal arch. This will form the anterior 2/3rd of the tongue. A second median swelling, the copula (2nd pharyngeal arch) is overgrown by the hypobranchial eminence (3rd and part of the 4th arch). This will form the posterior 1/3rd of the tongue. The 4th arch contributes to the epiglottis and the laryngeal orifice is just posterior.Major erratumUser suggests no change, unclear what the erratum is. -YK03/20/19 10:28 PMPurnimaSharmapurnimasharma@students.rossu.edu
1278481Neurology and Special SensesEmbryologyTongue developmentn/aHyoglossus Hides tongue, Genioglossus Gives out tongue, Styloglossus Slides up tongue for Swallowing, and Palatoglossus elevates Posterior tongueMnemonicVerifiedI really like this, but the "Genioglossus Gives out tongue" could use some work. My only worry is it is rather long. -YK05/21/19 3:57 PMMeenhajKabirmkabir04@nyit.edu
1279481EndocrineAnatomy and PhysiologyTongue developmentn/aImagine tasting a dish and rating it with points for taste and sensation 10 points – Sensational taste that feels up to extreme posterior (Vagus – taste/sensation) 9 points – Sensational taste but, feels up to posterior 1/3rd (Glossopharygeal – taste/sensation) If you feel only in the anterior 2/3rd  7 points for taste (Facial – Taste)  V3 points for sensation (Trigeminal-maxillary – Sensation) 12 points – It’s a little too much and depressing – Hypoglossal depresses tongue 10 points – That’s a sensational taste to elevate your mood – Vagus elevates tongueMnemonicVerified07/08/19 7:17 PMAPandeyaranikopandey@gmail.com
1280482Neurology and Special SensesAnatomy and PhysiologySensory receptorsCurrent first aid 2019Instead of “pacinian corpuscle” call it a press-in-ian corpuscle, because its for pressure and vibrationMnemonicVerifiedI like this but I'm not sure if we have room on the page to add this to the table.
-Kaitlyn		Reject. I see where the "press" comes in, but "in" or "ian" may not be as clear regarding vibration. Would not recommend addition -VVReject by 2 authors + 1 editor02/12/19 4:23 PMAaronMilleraaronm314@yahoo.com
1281482Neurology and Special SensesAnatomy and PhysiologySensory receptorsn/a“Fine Miss with Hairless Skin in Dynamic Position” Fine touch, Dynamic and Position sensation Location – Hairless skin.MnemonicVerifiedLong, and not helpful. Reject -YK07/08/19 7:10 PMAPandeyaranikopandey@gmail.com
1282482Neurology and Special SensesAnatomy and PhysiologySensory receptorshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3508902/The sensory receptors lists "slippage of objects along surface of skin" for Ruffini corpuscles, but that is incorrect and slipping is felt by Meissner corpusclesMinor erratum08/28/19 9:08 PMGabrielaFridgabriela.frid@icahn.mssm.edu
1283482Neurology and Special SensesAnatomy and PhysiologySensory receptorsSelf-writtenPacinian Corpuscles - people use their deep ligaments and joints (pacinian corpuscles in these areas) to run at such a high PACE (PACEinian) it VIBRATES the floor (corpuscles sense vibration).Mnemonic10/27/19 7:37 AMKhalidAlattarkhalid_alattar@hotmail.com
1284482Neurology and Special SensesAnatomy and PhysiologySensory receptorshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2596705/Pacinian Corpuscles - Commonly tested in distal limbs (hands and feet) of diabetic patients. Diabetic neuropathy often leads to early loss in pacinian corpuscle function hence decreased vibratory sensation in periphery when assessing with a tuning fork. // Light/Fine Touch - commonly also assessed using 'Mono-filament' test in diabetics. (Although somewhat clinical information, would fit in well as an important small point here.High-yield addition to next year10/27/19 7:54 AMKhalidAlattarkhalid_alattar@hotmail.com
1285482Neurology and Special SensesAnatomy and PhysiologySensory receptorsSelf-writtenRuffini corpuscles - these corpuscles are 'ROUGH', tough and well built with a CAPSULE armouring them. The armour controls their body JOINT movement changes and protects them from potential SLIPS. The RUFF ruffinis are capsulated, in JOINTs, sense JOINT angle change and SLIPPage of objects.Mnemonic10/27/19 8:00 AMKhalidAlattarkhalid_alattar@hotmail.com
1286482Neurology and Special SensesAnatomy and PhysiologySensory receptorsmeto be in the (j)o(i)nts you should have two dots like in Ruff(i)n(i) and Pac(i)n(i)anMnemonic11/14/19 1:45 PMMaarouf GorraAlnafourikaremgoora@gmail.com
1287483Neurology and Special SensesAnatomy and PhysiologyNeurotransmitter changes with diseasehttps://accessmedicine-mhmedical-com.vcom.idm.oclc.org/content.aspx?sectionid=147035958&bookid=1969&jumpsectionID=147036058&Resultclick=2#1137636972In this section, the location of serotonin synthesis is written as Raphe Nucleus (medulla). I have found other resources that say that the raphe nuclei are located in both the medulla and the pons. In fact, some resources have said that they are more substantial in the pons.Clarification to current textVerifiedDefer to an expert.

I reviewed this new addition history on annotate. It was suggested by a crowdsourcer and was added without a reference.
- Humood		True. The raphe nuclei are throughout the brainstem (midbrain, pons, medulla). Text should be changed to say "Raphe nuclei (brainstem)"
-Kaitlyn		Agree to add, this can be deferred to the main cycle. Please add to parenthetical phrase: "(medulla, pons)" -VV https://www.sciencedirect.com/topics/neuroscience/raphe-nucleiPrelim accept but NOT publishable erratatrue01/16/19 7:48 PMAreekaMemonamemon@vcom.edu
1288483Neurology and Special SensesAnatomy and PhysiologyNeurotransmitter changes with diseasehttps://www.sciencedirect.com/topics/neuroscience/pontine-raphe-nucleusThe location of serotonin synthesis in the Raphe Nuclei occurs at the level of the medulla and the pons.Minor erratumToo detailed for Step 1. -AC06/26/19 3:27 PMShawnShohamshohams@acom.edu
1289483Neurology and Special SensesAnatomy and PhysiologyNeurotransmitter changes with diseasen/aAcetylcholine – Location of synthesis – “M” for Muscarinic (Meynert) GABA – nucleus accumBENs for BENzodiazepineMnemonicVerifiedCan be considered, but the table is too tight to add in mnemonics. -AC07/08/19 7:13 PMAPandeyaranikopandey@gmail.com
1290483Neurology and Special SensesAnatomy and PhysiologyNeurotransmitter changes with diseaseFirst Aid 2019In the 2019 release, the entry on schizophrenia (psychiatry section, p 548) added "increased serotonergic activity," along with the increased dopaminergic that was already stated in previous years. However, in the NT changes with disease table (neurology&ss section, p483) column for schizophrenia, there is an up arrow for dopamine, but nothing under serotonin.Clarification to current text10/19/19 9:22 PMAlyssaBarréabarre@email.sc.edu
1291483Neurology and Special SensesAnatomy and PhysiologyNeurotransmitter changes with diseasemwin (A)l(z)hemir disease (A)cetylcholine is going to sleep (zzzzzzz)Mnemonic11/14/19 1:48 PMMarrouf GorraAlnafourikaremgoora@gmail.com
1292484Neurology and Special SensesAnatomyMeningesN/ALayers of meninges from in to out: PAD P: pia mater A: arachinoid mater D: dura materMnemonicVerifiedThis is an old mnemonic that I used as well. -AC05/12/19 10:15 AMHaithamAlaithanhsaithan93@gmail.com
1293484Neurology and Special SensesAnatomy and PhysiologyVomiting centerN/AIt says that the nucleus tractus solitarius (NTS) receives information from the chemoreceptor trigger zone (CTZ), GI tract, vestibular system, etc. Many other sources and textbooks say that it's the other way around - that the NTS and vestibular nuclei project to the CTZ.Minor erratum10/15/19 1:58 PMHaleeEinfeldraxorium@gmail.com
1294485Neurology and Special SensesAnatomy and PhysiologySleep physiologyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC181172/According to Kaplan, Benzos only suppress REM sleep at very high (beyond clinical) doses and therefore are less likely to cause REM rebound. The article I linked seems to contradict this so I'm unclear. Regardless, would be great if you could include something in this section next year about REM rebound since it is a pretty testable concept.High-yield addition to next yearVerifiedDefer to 2020.

? HY new content. To be discussed by team next year.
- Humood		Can be discussed on annotate. -AnupReject. REM rebound is not really a topic that is tested on Step 1. It is more important to know about changes that occur due to depression and in the elderly, both of which are addressed. Would not recommend addition -VVReject by 2 authors + 1 editor02/03/19 10:39 AMLaurenAllenlaurenallen76@gmail.com
1295485Neurology and Special SensesAnatomy and PhysiologySleep physiologyhttps://www.uptodate.com/contents/behavioral-and-pharmacologic-therapies-for-chronic-insomnia-in-adults#H11Benzodiazepines should treat night terrors and sleepwalking by decreasing N3 sleep (which is the stage of sleep these occur in). Benzodiazepines are shown to reduce REM sleep in high doses, however inhibiting REM sleep, which promotes a state of paralysis would be detrimental in treating sleepwalking.Minor erratumReject. This submission makes a false assumption. Yes benzos are used for night terrors. Yes the reduce REM sleep. Reducing REM sleep doesnt necessarily promote the night terrors, however. Even when checking the supporting reference there isn't factual evidence to back up the claim this person is making. -ZanderAgree with rejection. -Anup03/25/19 11:56 AMJasonTegethofftegethoffjason@gmail.com
1296485Neurology and Special SensesAnatomy and PhysiologySleep physiologyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5689397/This page lists increased REM latency as a change in the elderly, but there's actually decreased REM latency as age increases.Minor erratumThis article does state that REM latency decreases with age. Would consider faculty input. -AC05/29/19 11:59 AMKesleyBrownkmbrown2@uams.edu
1297485Neurology and Special SensesAnatomy and PhysiologySleep terror disorderhttps://www.uptodate.com/contents/parasomnias-of-childhood-including-sleepwalkingThe phrase “night terror” is used several times in this section (also in pg 533 in the benzodiazapines box) as well as in the index. However, this was confusing because the term “sleep terrors” is also used in the Psychiatry section and in the index without any clarification indicating they were the same disorder. It would be helpful in future editions to use one singular term across sections or indicate they were identical.Clarification to current text10/20/19 9:55 PMJunuBaejunu.bae@osumc.edu
1298486Neurology and Special SensesAnatomy and PhysiologyHypothalamusN/AUpdate mnemonic to (L)ateral (L)esion makes you (L)ean. To avoid confusion with function vs pathology.MnemonicVerified05/26/19 4:07 PMAudreyHuntahunt01@nyit.edu
1299486Neurology and Special SensesAnatomy and PhysiologyHypothalamusSelf-created"She looked HOT from the back (posterior nucleus), but COLD-faced from the front (anterior nucleus)"MnemonicVerified08/29/19 5:56 PMKevinLandauklandau@sgu.edu
1300486Neurology and Special SensesAnatomy and PhysiologyThalamusFA page 486Mnemonic for the Ventral Posterior Lateral Nucleus: VPL: Vibration Pain/Pressure ceLciusMnemonicVerifiedNot a fan of this mnemonic. -AC05/08/19 2:38 PMLeeSeiferleeseifer16@gmail.com
1301487Neurology and Special SensesAnatomy and PhysiologyCerebellumhttps://radiopaedia.org/articles/cerebellar-nuclei?lang=usThe deep cerebellar nuclei are included under outputs of the cerebellum, this is somewhat misleading as these are anatomical structures and although they play a role in cerebellar outputs, they should be moved to their own subsection.Spelling/formattingAlthough I agree, I think that our current cerebellum entry is quite comprehensive and adequate for Step 1 exams. -AC06/01/19 12:47 AMAhmedNoorahmed.noor09@yahoo.com
1302487Neurology and Special SensesAnatomy and PhysiologyCerebellumhttps://nba.uth.tmc.edu/neuroscience/m/s3/chapter05.html"To maintain a BALANCED diet, Don't Eat Greasy Foods" (reminds that DEGF is for cerebellum)MnemonicVerified07/08/19 5:57 AMJustynaKacarowjustynakacarow@gmail.com
1303487Neurology and Special SensesAnatomy and PhysiologyLimbic systemn/aNeural structures involved in: Emotion, Behavior modulation, Olfaction, Long-term memory, ANS function. Mnemonic: EBOLA (first letter of each function)MnemonicVerifiedThis does not seem very testable to me and leaves out some less popular functions.
-Kaitlyn		Agree with Kaitlyn -- reject. -YKAgree, reject. -VVReject by 2 authors + 1 editor03/04/19 8:23 AMEliasAtrieatri001@fiu.edu
1304487Neurology and Special SensesAnatomy and PhysiologyLimbic systemi noted on my FA book but to be honest i don not know exactly from where i got it.what if you substitute the word Sex with Fornication. so mnemonics can fit the 5 F'sMnemonicVerifiedI think we have discussed this already in FA. -AC05/13/19 8:13 PMMuhanadShaibmohanad.shaib@gmail.com
1305488Neurology and Special SensesAnatomy and PhysiologyBasal gangliahttps://neurology.mhmedical.com/content.aspx?bookid=1049&sectionid=59138673The basal ganglia figure and text need to updated to reflect that the primary input to the striatum is cortical rather than from the SNc through the nigrostriatal dopaminergic pathway (see figure 43-2 in Principles of Neural Science 5th edition)Clarification to current textVerifiedReject.

I don't follow. The illustration shows that the striatum receives inputs from the motor cortex and SNc.

- Humood		Agree with Humood. No changes to the text. -VVReject by 2 authors + 1 editor02/01/19 6:24 AMNaylaMrouehnaylamroueh@gmail.com
1306488Neurology and Special SensesAnatomyBasal gangliahttps://www.uptodate.com/contents/etiology-and-pathogenesis-of-parkinson-disease?search=basal%20ganglia%20indirect%20pathway&sectionRank=1&usage_type=default&anchor=H3&source=machineLearning&selectedTitle=2~150&display_rank=2#H3In indirect pathway> SNc input to the striatum via the nigrostriatal dopaminergic pathway stimulates D2 receptors in striatum which in turn "SHOULD DECREASE" the release of GABA from striatum which further cannot inhibit the GPe resulting in continuous inhibition of STN resulting in NO inhibition of movements, It concludes the inhibition of inhibitory pathway via SNc. But its mentioned in FA19 in indirect pathway SNc input to the striatum would release GABA from striatum ( which is basically an Excitatory input that comes from Cortex which results in decreased movements) which in further would inhibit the GPe resulting in disinhibition of STN>stimulates GPi>inhibits thalamus>decreased movements. ( contrary to what's supposed to be the function of the D2 pathway that's stimulating the movements).Major erratumVerifiedEvery year we get errata regarding the text, which is more related to understanding than an actual error of the text. Based on the extensive review, the text is correct as is. Therefore, will reject without author input. -VVReject by 2 authors + 1 editor03/09/19 4:26 AMShamKumarkumarsham113@gmail.com
1307489Neurology and Special SensesAnatomy and PhysiologyCerebral perfusionThe graph below explains so.The third column says "CPP is directly proportional to Pco2 until Pco2 >90mm Hg." It should be <90 mm HgMajor erratumAccept need for clarification. The graph and words are correct. I think this person is confused by the wording "until". It is proportional while Pco2 is <90 meaning it is no longer proportional then Pco2 >90, which is what we said. We could change to " CCP is directly proportional to Pco2 while pco2 <90 mmHg"
-Kaitlyn		Can have an equation to correlate this data. -Anup03/24/19 6:24 AMShivaanshAggarwalshivaanshj96@gmail.com
1308490Neurology and Special SensesAnatomy and PhysiologyCerebral arteries—cortical distributionhttps://radiopaedia.org/articles/man-in-the-barrel-syndromeadd "if anterior cerebral/middle cerebral cortical border zone stroke" after "man-in-the-barrel syndrome"Clarification to current text09/04/19 9:56 PMAlsuZagorulkoalsu.zagorulko@gmail.com
1309490Neurology and Special SensesAnatomy and PhysiologyIschemic brain disease/strokehttp://revistaneurociencias.com.br/edicoes/2009/RN%2017%2002/10.pdfthere is NO lower extremity weakness in man in barrel syndrome. man-in-the-barrel syndrome” (MBS) is characterized by bilateral upper extremity paresis with intact motor function in the lower extremities. The patient is unable to move his arm to any stimulus, appearing as if the upper limbs are confined within a barrel. It was originally attributed to cerebral infarctions in the watershed zones between the middle and anterior cerebral artery distributions . [seen as the blue area in the first aid picture]Major erratumVerifiedReject.

Man in a barrel phenomenon is due to proximal weakness (shoulders and thighs). Our narratives is clear.

Per UTD, "The most severe ischemia may occur in border zone (watershed) regions between the major cerebral supply arteries since these areas are most vulnerable to systemic hypoperfusion. The signs that may occur with borderzone infarction include cortical blindness, or at least bilateral visual loss; stupor; and weakness of the shoulders and thighs with sparing of the face, hands, and feet (a pattern likened to a "man-in-a-barrel")."
https://www.uptodate.com/contents/etiology-classification-and-epidemiology-of-stroke?search=man%20in%20barrell&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
- Humood		Agree with Humood. No changes to the text -VVReject by 2 authors + 1 editor01/28/19 3:27 PMahmaddamlajahmaddamlaj@gmail.com
1310491Neurology and Special SensesAnatomy and PhysiologyCircle of Willishttps://emedicine.medscape.com/article/1877617-overview https://radiopaedia.org/articles/anterior-choroidal-artery?lang=usOn the Circle of WIllis diagram on page 491, the ant. choroidal A. comes from the MCA, but in reality it is a branch of the ICA.Minor erratumI agree with Humood. This is a controversial point and for clarification, we can delete the dashed line. - AlirezaVerifiedAs on radiopedia: "The AChA originates from the posterior wall of the ICA between the origin of the posterior communicating artery (PCOM) (which is 2-5 mm proximal to the AChA) and the internal carotid termination (which is 2-5 mm distal to the AChA). ". So, the submitter seems to be correct. And we do seem to have this art coming out from the MCA in the picture. Needs faculty review and illustration team review. I would also like to triage this as a major erratum. -AnupNo action needed, IMO. However, happy to defer to an expert.

Apparently, this is a controversial subject. All images of the circle of willis I found (Gross photos, and illustrations) have the anterior choroidal artery drawn after the ACOM takes off which makes it closer to MCA than ICA. Also, some resources keep it simple by saying "the anterior choroidal artery is the final branch of the internal carotid artery (or an early branch of the MCA)". Anyway, maybe it is better to delete the dashed line on our illustration which seems to be the dividing line between MCA and ICA.

Source: https://www.sciencedirect.com/topics/medicine-and-dentistry/circle-of-willis
Images: https://www.google.com/search?biw=2540&bih=1203&tbm=isch&sa=1&ei=IuU8XMWbKI6eUJ76m5AH&q=circle+of+willis+gross&oq=circle+of+willis+gross&gs_l=img.3..0.96591.98491..98581...0.0..0.199.961.0j5......1....1..gws-wiz-img.......0i67j0i8i30j0i24.i6ais60U-X4#imgrc=RbGFTxSFz-canM:

- Humood.		I'm inclined that no action should be taken IMHO. I highly doubt that Step 1 takers will be required to know whether the anterior choroidal artery is a derivative of the MCA or ICA. Let's defer to the main cycle and get expert review at that time. -VVDisagreement/need expertBrad ColeThe drawing is fine as is. I would only suggest changing the dashed line to the other side of the anterior choroidal artery. It is correct that the anterior choroidal artery is a branch of the ICA not the MCA*NEURO Brian WalcottFrom Dr. Walcott: Item #353, not controversial. The anterior choroidal artery is a branch off the internal carotid artery, not the middle cerebral artery. Not sure what the figure looks like in FA |||||||||||||||||| From Thomas A. Kosztowski, M.D, Neurosurgeon.: Agree with the corrections. Anterior choroidal should be coming off the ICA.
-Tom		Reject01/07/19 12:40 PMFARZINESHAGHIfarzin@uw.edu
1311492Neurology and Special SensesAnatomyVentricular systemtruehttps://emedicine.medscape.com/article/1898830-overview#a7 , https://www.sciencedirect.com/topics/neuroscience/ventricular-systemOn the lateral view of the ventricles (right side of diagram), the foramen of Magendie is mislabeled. It should be located INFERIOR to the foramina of Luschka. Overall the 4th ventricle is drawn weirdly on the lateral view; I would revise this diagram for the next edition.Minor erratumAgree. In most of the references, Luscka is above Magendie. https://radiopaedia.org/articles/lateral-apertures-of-luschka -AlirezaI agree this figure is not fantastic but I think this person is confusing magendie with the central canal of the spinal cord. luschka and magendie are nearly at the same level. I have an image in Blumenfeld that I cannot post but is most similar to this: https://image.slidesharecdn.com/patologaventricular-160927155238/95/patologa-ventricular-intracraneal-2-638.jpg?cb I can work with illustration team on fixing this.
-Kaitlyn		03/24/19 12:35 PMRebeccaXurebecca.xu@northwestern.edu
1312492Neurology and Special SensesAnatomy and PhysiologyVentricular systemtruehttps://www.sciencedirect.com/topics/agricultural-and-biological-sciences/ventricle-of-heartThe Figure on the right shows the wrong location of Foramina of Luschka, which should be located above the foramen of Magendie.Minor erratumAgree. In most of the references, Luscka is above Magendie. https://radiopaedia.org/articles/lateral-apertures-of-luschka -Alireza05/08/19 3:23 PMWeiyeDengvividengdeng@yahoo.com
1313492Neurology and Special SensesAnatomy and PhysiologyVentricular systemtruehttps://www.sciencedirect.com/topics/neuroscience/ventricular-systemlateral view of the ventricular system figure is mislabeled; foramen of Luschka and foramen of Magendie are labeled incorrectly with each others lable (reversed)Minor erratumAgree. In most of the references, Luscka is above Magendie. https://radiopaedia.org/articles/lateral-apertures-of-luschka -Alireza06/04/19 4:43 AMAwabElnaeemawab.kamal@gmail.com
1314492Neurology and Special SensesAnatomy and PhysiologyVentricular systemHigh Yield Neuroanatomy 5th edition, page 59 (Introduction) and Figure 7-1 in page 60Text says that "Factors of 12, except 1 and 2" referring to CNs from III to XII are derived from brain stem. It should also include CN XI which is not exclusively arising from medulla.Minor erratum12/13/19 1:18 AMRaulSalasrmsalas_b42@hotmail.com
1315493Neurology and Special SensesAnatomy and PhysiologyCranial nerve and vessel pathwaysFA 2019Mnemonic to remember that CN's 9,10, and 11 go through the jugular foramen: "Cop gets 9-11 call while drinking a Jug of coffee"MnemonicVerifiedSeems catchy. -AC05/17/19 11:21 AMJasminShahrestanijshahrestani@gmail.com
1316494Neurology and Special SensesAnatomyCranial nerveshttps://radiopaedia.org/articles/cranial-nerves-mnemonic?lang=usMnemonic: Oof, Oop, Ouch, Touch Try And Feel Very Good Velvet Accessing Heaven! Description: First 3 words are in alphabetical order and give idea of first 3 Cranial Nerves i.e. Oof (Olfactory), Oop (Optic), Ouch (Oculomotor) Next comes other nerves: Touch (Trochlear), Try (Trigeminal), Feel (Facial), Very (vestibulocochlear), Good (Glossopharyngeal), Velvet (Vagus), Accessing (Accessory), Heaven (Hypoglossal). This mnemonic is an improvisation of existing online mnemonic (that was confusing to most) Adding alphabetical order and caring for similar phonetics helped improve existing mnemonic. For your reference online mnemonic was " Ooh Ooh Ooh to touch and feel very good velvet! Such Heaven". You can notice the the difference and use whichever one you find better.MnemonicVerifiedI think that mnemonic is quite confusing. We can stick to the current one? Also, I am not sure we need one to remember the names. -AnupReject.

Reject for now as we are looking for Errata. We can defer suggestion to 2020.

- Humood		Reject, current mnemonic is better. -VVReject by 2 authors + 1 editor01/02/19 12:26 PMMurliMishramm.murli@gmail.com
1317494Neurology and Special SensesAnatomy and PhysiologyCranial nervesFirst Aid 2019First cranial nerve (number 01) is (olfactory > 01factory), and we can remember the function of the nerve by the bad SMELL of the FACTORY (olFACTORY)MnemonicVerifiedNot in favor of this mnemonic. -AC05/10/19 10:18 PMFarisBinyouseffaris-v@hotmail.com
1318494Neurology and Special SensesAnatomy and PhysiologyCranial nervesFirst Aid 2019The function of the 4th cranial nerve is the Superior Oblique (SO) muscle >> (SO + number FOUR)=> (So far)MnemonicVerifiedReject. A bit of a stretch IMO. -Zander05/10/19 10:26 PMFarisBinyouseffaris-v@hotmail.com
1319494Neurology and Special SensesAnatomy and PhysiologyVagal nucleiJust a mnemonic suggestion"In aMbiguus situations, be safe and call 9-11" --> Cranial nerves 9, 10, and 11 belong to the nucleus ambiguusMnemonicVerifiedThis is good. Not sure why the M is capitalized but we should use "In ambiguus situations, be safe and call 9-11"
-Kaitlyn		Agree with Kaitlyn -- nice mnemonic! -YKThis is a pretty decent mnemonic, but the problem we have run into in the past is that we usually only include only one mnemonic per row. Currently there is a pretty good mnemonic that compares the solitarus vs ambiguus nuclei that would be better to keep IMHO. Therefore, would be inclined to reject this mnemonic. -VVReject by 2 authors + 1 editor03/08/19 3:16 PMAzeemRathoreahrathore12@gmail.com
1320494Neurology and Special SensesAnatomy and PhysiologyVagal nucleiself-madeTo remember the cranial nerves in nucleus ambiguus: shrug your shoulders (CN XI) and say I don't know (ambiguus) what I just swallowed (CN IX, X)MnemonicVerifiedToo confusing. -AC05/14/19 5:29 AMTaliaKamdjoutaliakamdjou@mail.tau.ac.il
1321494Neurology and Special SensesAnatomyVagal nucleihttps://www-uptodate-com.proxy.lib.uiowa.edu/contents/evaluation-of-heart-rate-variability?search=nucleus%20ambiguus&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2This section falsely states that the Nucleus Ambiguus contains cell bodies of only branchial motor fibers of the Vagus nerve, while the Dorsal Motor Nucleus contains cell bodies of all parasympathetic fibers within the Vagus nerve. However, the Nucleus Ambiguus contains the cell bodies of parasympathetic fibers that lead to the heart. The DMN contains cell bodies of all other parasympathetic fibers found within the Vagus nerve, but NOT those that go to the heart.Major erratum10/19/19 3:49 PMShelbyBloomershelby-bloomer@uiowa.edu
1322495IndexAnatomy and PhysiologySpinal nervesFirst Aid 2019Index Indicates that "Vertebral Disc Herniation" is on page 495. However, there is nothing related to vertebral disc herniation on that pageMajor erratumVerifiedUser is correct. Index problem.

- Humood		02/04/19 10:14 AMMurliMishramm.murli@gmail.com
1323498Neurology and Special SensesAnatomy and PhysiologyClinical reflexeshttps://emedicine.medscape.com/article/1147993-overviewMnemonics are missing from reflexes.Spelling/formattingVerifiedI think we deliberately removed the mnemonics, as I can see changes made in the annotate doc. -AnupReject.

Yes, there were deleted during the revision process. Per Annotate, deletion requested by Christine.

- Humood		Agree that we removed last year, but it's a pretty good mnemonic that I frequently used while studying. Plus, there are multiple students that are requesting that it be added back in. Let's add back in this year. -VVPrelim accept by 2 authors + 1 editor12/30/18 12:13 PMIbrahimHyderibrahim.hyder@gmail.com
1324498Neurology and Special SensesAnatomy and PhysiologyClinical reflexesN/AI think the reflexes would still benefit from the old mnemonic (S1, S2 "buckle my shoe"; L3, L4 "kick the door"; C5, C6 "pick up sticks"). Obviously the old rhyme "lay them straight" wouldn't work for C6, C7 (which is correct at least according to Bates). My suggestion for C6, C7 is "now extend 'em." Not amazing but it's something!MnemonicVerifiedI guess this might be helpful to quickly remember. We have room to include it. Since above I suggested change C6,7 to C7,8 for tricep we can use the original version
-Kaitlyn		Agreed. -Anup03/25/19 12:14 AMRebeccaXurebecca.xu@northwestern.edu
1325498Neurology and Special SensesAnatomyClinical reflexeshttps://stanfordmedicine25.stanford.edu/the25/tendon.htmlTriceps reflex should be said to mainly involve C7, but that C6 and C7 can be involved based on what text book you are looking at. This note should be there in case, considering how much variation there is between different resources.Major erratumReject. The overlap of C6/C7 is mentioned in the current FA text, yet C7 is bolded as the main reflex. I think the current text illustrates this. -ZanderDuplicate suggestion as stated above. -Anup04/15/19 1:03 PMUsmanAlamualam@ucla.edu
1326498Neurology and Special SensesAnatomy and PhysiologyNeuronshttps://www.ncbi.nlm.nih.gov/books/NBK531502/Question banks are saying C7-C8 for triceps reflex, not C6-C7Clarification to current textI have always considered triceps purely C7. Blumenfeld Neuroanatomy book agrees. Source referenced by student says C7-8. I can say that amongst different practitioners, there is always disagreement about which roots is the dominant innervation of a muscle and clinically a C7 radiculopathy often affects multiple muscles. I think we should change to C7-8 to fit in with other resources but this is a bit of a moot point.
-Kaitlyn		I think there was this issue in the Flash Facts as well. Not sure if I have encountered this again, but there was definitely an issue some time ago. However, I do agree with Kaitlyn on the change. -Anup03/24/19 12:08 PMAnmolSinghanmol.singh@hotmail.com
1327499Neurology and Special SensesPathologyBrain stem—ventral viewMnemonicDecerebrate posturing has extension of both upper and lower extremities (dEcErebrate - two E's means double extension) while Decorticate has an E and an O with only extension of the lower extremitiesMnemonicVerifiedI know lots of people use this mnemonic and I think its better than the one we use.
-Kaitlyn		Can be added for crowdproofing. -AnupSure. Let's migrate to annotate and discuss there. -VVPrelim accept by 2 authors + 1 editor02/07/19 11:28 AMDanielLubarskydaniel.lubarsky@rockets.utoledo.edu
1328499Neurology and Special SensesPathologyCommon brain lesionsnot neededin frontal eye lid lesion, (or at the hemiplegia) should be changed into "away from the hemiolegia"Major erratumVerifiedWould recommend faculty review. -AnupText was edited based on input from faculty reviewers. Would not recommend changes to the text. -VVReject by 2 authors + 1 editor01/08/19 1:36 AMHangSonghuwanheng.pku@gmail.com
1329499Neurology and Special SensesPathologyCommon brain lesionshttps://www.uptodate.com/contents/internuclear-ophthalmoparesis?csi=4e09571d-2500-4a0e-b534-f89be1463f01&source=contentShareParamedian pontine reticular formation should read: Eyes looks AWAY FROM side of hemiplegia.Major erratumVerifiedReject.

Two reasons
1. Our faculty reviewers have already discussed this topic on Annotate (Dr. Cole and Dr. Beh). See screenshot attached (click on "attachments" icon on the left.
2. The UTD reference provided by the user talks about INO (?). Anyway, I did a quick search for the term "away" on this article. The word was used 3 times. None of which says.

Happy to be corrected

- Humood		I reviewed the points and agree with the Humood's suggestions.

In addition to that, we have already mentioned in the third column example- (inability to look toward side of lesion).


Reject- based on the commentaries.

- Vivek		Agree with authors. Corrections were made based on faculty input. Therefore, would not recommend any changes. -VVReject by 2 authors + 1 editor01/14/19 1:13 PMCarloCastroCastrotech2@gmail.com
1330499Neurology and Special SensesNeuropathologyCommon brain lesionsWithout errata, It is contradicting with the following describing in Paramedian pontine reticular formation-Eyes look toward side of hemiplegia. I got from Kaplan and UWorld that FEF control contralateral PPRF, so the consequences of both lesions should not be same.Frontal eye fields-Eyes look toward the side of lesion (or at the hemiplegia), Please revise "at" to "away from"Major erratumI addressed this in row 12 above. This student is correct, this is an erratum.
-Kaitlyn		03/18/19 2:40 PMShumanLiuShuman688@gmail.com
1331499Neurology and Special SensesPathologyCommon brain lesionshttps://en.wikipedia.org/wiki/Middle_cerebral_artery_syndrome signs and symptoms- 7th point says gaze towards the side of lesion and the 2nd point says hemiplagia contrlateral to the side of lesion, so the the gaze should be opposite to the side of hemiplagia.Destructive lesion such as an MCA stroke: eyes look toward the side of lesion (or at the hemiplegia). #error the bracket should be saying (or to the side opposite to hemiplagia)Major erratumI addressed this in row 12 above. It is an erratum that we need to fix.
-Kaitlyn		Repeat suggestion, so can reject this suggestion. -Anup03/21/19 11:39 AMVirajShahmbbs160147@kem.edu
1332499Neurology and Special SensesPathologyCommon brain lesionshttps://pubs.rsna.org/doi/pdf/10.1148/rg.331125033Lesion for the paramedian pontine reticular formation would cause the eyes to look AWAY from the side of hemiplegiaMajor erratum05/02/19 3:35 PMSwethaUppalapatisuppalapati87@midwestern.edu
1333499Neurology and Special SensesPathologyCommon brain lesionsFirst Aid 2019DeCORDicate (decorticate), the hands are near the cord (spinal cord) (midline of the body)MnemonicVerifiedNot in favor of addition. Would prefer a picture mnemonic instead. -AC05/09/19 12:58 PMFarisBinyouseffaris-v@hotmail.com
1334499Neurology and Special SensesPathologyCommon brain lesionsn/adEcErEBRatE: Extensor posturing - Below Red nucleusMnemonicVerifiedNot in favor of addition. Would prefer a picture mnemonic instead. -AC07/08/19 7:20 PMAPandeyaranikopandey@gmail.com
1335499Neurology and Special SensesPathologyCommon brain lesions* Kaplan Medical Lecture Notes Anatomy 2018 by Kaplan, Inc. Part III Neuroscience chapter 10 Cerebral Cortex page 364.Dominant parietal cortex: According to Kaplan, the disorientation in Gerstmann syndrome is from right to left (Not from left to right).Minor erratum08/12/19 11:58 AMStephanieDel Riostep.dt@outlook.es
1336499Neurology and Special SensesNeuropathologyCommon brain lesionshttp://www.psy.vanderbilt.edu/faculty/schall/pdfs/en2009FrontalEyeFields.pdfThere is a mistake on the second row (frontal eye field lesion); whenever there is a destructive lesion (e.g., MCA stroke), eyes DO look toward the side of lesion, which means they can NEVER look to hemiplagia side (hemiplegia is on the contralateral side) .. And what it says in text: "Destructive lesions such as an MCA stroke: eyes look toward the side of lesion (or at the hemiplegia).Major erratum10/09/19 2:08 PMKhalilSalmankhalilsalman97@gmail.com
1337499Neurology and Special SensesPathologyNeuronshttps://www.verywellhealth.com/what-are-the-effects-of-a-frontal-lobe-stroke-3146431frontal eye field lesion: eyes look toward the side of lesion (or at the hemiplegia) that's not right it looks at the opposite side of hemiplegiaMajor erratumVerifiedThis is a major erratum. FEF pull eyes contralaterally. So the R FEF pull eyes to left. If R FEF is ischemic, the eyes with favor a right gaze (toward the lesion), if the adjacent R motor strip is ischemic there will be a left hemiplegia (away from hemiplegia). Seizure on R hemisphere will pull eyes to left and have a left body seizure.
-Kaitlyn		Agree with Kaitlyn. Definitely had to brush up on this information, but the current wording in the text needs to be changed. So instead change "(or at the hemiplegia)" to "(away from the hemiplegia)". The section should then be correct. -Zander02/21/19 8:32 AMnehalkhalidnehalnasser55@gmail.com
1338499Neurology and Special SensesPathologyNeuronshttps://nba.uth.tmc.edu/neuroscience/m/s3/chapter08.html Neuroanatomy Through Clinical Caseslesion to frontal eye field will cause eye to look toward the lesioned side, which is the OPPOSITE side of hemiplegia. Opposite to the side of hemiplegia because a right sided lesion would cause the eyes to look toward the side of the lesion (toward the right) when damaging the frontal eye field and the LEFT side of the body will be affected. Pretty basic concept that any neurology textbook will demonstrate.Major erratum10/29/19 7:57 PMJamesGutchojamesgutcho@hotmail.com
1339500Neurology and Special SensesPathologyIschemic brain disease/stroken/aThe listed mnemonic for ischemic brain disease/stroke says "vulnerable hippos need pure water" for vulnerable regions hippocampus, neocortex, purkinje cells, and watershed areas. In the word "need," making the letters "n" and also "e" red (as opposed to just "n" as listed in the book) might more strongly reinforce the word "ne"ocortex.Spelling/formattingSeems like a valid suggestion. -AC06/15/19 12:52 PMLeylaClayli4321@yahoo.com
1340500Neurology and Special SensesPathologyIschemic brain disease/strokeWell known fact. Not needed. Also mentioned in the general pathology section of the First Aid 2019Under the histologic features of 24-74 hours since ischemic event column it would be beneficial to be more specific and mention 'Liquefactive Necrosis' rather than just 'Necrosis'.Clarification to current textCan be accepted if everyone agrees. -AC06/29/19 7:28 AMAhmed AliKhanahmedalikhanjr@gmail.com
1341500Neurology and Special SensesPathologyIschemic brain disease/strokeMnemonicTransient ischemic attack. Internal carotid vs. vertebrobasilar. "MD vs. DPM" Internal Carotid: MD: Monoocular blindness (amaurox fugax) Dominant hemisphere (aphasia). Vertebrobasilar DPM: Diplopia/Double blindness, Paralysis (quadriplesia), Motor weakness (ipsilateral)MnemonicVerifiedThese are common presentations and we have room to mention.
-Kaitlyn		07/30/19 2:27 PMPaolaDel Cuetopaoladelcueto@outlook.com
1342501PathologyPathologyIntracranial hemorrhageUworld. uptodate: treatment of cerebral aneurysmsRebleeding in Subarachnoid hemorrhage occurs within 24 hours. Whereas vasospasm only occurs on 3-10 days.Major erratum09/10/19 11:50 AMReemaAlRasheedreema.f.alrasheed@gmail.com
1343502Neurology and Special SensesPathologyEffects of strokesReferencing symptom from the PICA infarct 'symptom' columnThe addition of "wobbly (vertigo, ataxia)" to mnemonic about Lateral Medullary (Wallenberg) Syndrome: "Don' t pick a (PICA) wobbly (nystagmus, ataxia) horse (hoarseness) that can't eat (dysphagia)."MnemonicVerifiedReject or Defer to 2020.

Mnemonic.

- Humood		Agree with Humood. -Anup"Wobbly" makes the mnemonic kind of clunky. Would be inclined to reject. -VVReject by 2 authors + 1 editor01/23/19 3:33 PMJosephElphingstonejelphingstone@augusta.edu
1344502Neurology and Special SensesPathologyEffects of strokeshttps://onlinelibrary.wiley.com/doi/full/10.1111/j.1445-5994.2004.00732.x , Boards and BeyondThe "Rule of 4" method for localizing brainstem lesions/strokes is extremely useful and gives a systematic way for determining brain stem stroke syndromes -- MUCH EASIER than trying to remember all the individual characteristics of each brainstem stroke syndrome. I've included a picture of my notes that goes over the general strategy (I watched a Boards and Beyond video; he got it from a paper which I've also linked).High-yield addition to next yearPartial. I never used this as a way to remember the location of the different lesions, however, I know a lot of other students did. The only problem is this would take up quite a bit of space. The rule of 4's is also explained well when you watch videos of people walking through it - may be difficult to keep things clear and concise within the text. I think the existing information within FA is clear with great mnemonics, but maybe people think otherwise. -ZanderAgree with Zander that we do not have space to do this. We included the 3 most high yield brainstem strokes and have good mnemonics for them. This method doesn't help at all with the eponym or the vessel which is also important. I think our way of handling these strokes is appropriate.
-Kaitlyn		03/26/19 3:46 PMRebeccaXurebecca.xu@northwestern.edu
1345502Neurology and Special SensesPathologyEffects of strokesNone neededAnterior spinal artery infarctions can lead to medial medullary syndrome. Contralateral hemiparesis is a classic finding due to PYRAMIDAL TRACT/PYRAMID infarction, not lateral corticospinal tract as written. The lateral corticospinal tract is found post-pyramidal decussation, thus those lesions always lead to ipsilateral motor defects.Major erratum05/16/19 12:04 PMSohilDesaisohil94@gmail.com
1346502Neurology and Special SensesPathologyEffects of strokesn/aIt’s a SIN not to FEEL and HEAR the AMBIGUITY by PICA! SIN:  Sympathetic fibers (Horner’s Syndrome)  Inferior Cerebellar Peduncle (Ipsilateral ataxia/dysmetria)  Nucleus AMBIGUUS (CN IX, X, XI – Lateral Medullary Syndrome) FEEL:  Lateral Spinothalamic Tract (Contralateral Pain and Temperature)  Spinal Trigeminal Nucleus (Ipsilateral Pain and Temperature of Face) HEAR: Vestibular Nucleus (Vomiting, Vertigo and Nystagmus) Anterior Inferior Cerebellar Artery (Stroke), pg 502 But, AICA’s FACIAL Expression SIMs like she can FEEL and HEAR it! SIM:  Sympathetic fibers (Horner’s Syndrome)  Inferior Cerebellar Peduncle (Ipsilateral ataxia/dysmetria)  Middle Cerebellar Peduncle Facial Expression: Facial Nerve Palsy (LMNL) FEEL:  Lateral Spinothalamic Tract (Contralateral Pain and Temperature)  Spinal Trigeminal Nucleus (Ipsilateral Pain and Temperature of Face) HEAR:  Vestibular Nucleus (Vomiting, Vertigo and Nystagmus)  Labyrinthine Artery (Sensorineural Hearing LMnemonicVerified07/08/19 7:23 PMAPandeyaranikopandey@gmail.com
1347502Neurology and Special SensesPathologyEffects of strokeshttps://www.sciencedirect.com/topics/neuroscience/nucleus-ambiguusCN XI has no thing to do with nucleus ambiguusMinor erratum09/20/19 3:47 PMRa'edAbabnehraedababneh@gmail.com
1348502Neurology and Special SensesNeuropathologyIschemic brain disease/strokeNo dynamically updated web resources to support this, but many neuroanatomy sources (aged or new) should support this. Older source - p925 - Rostral medulla picture http://www.ajnr.org/content/ajnr/10/5/923.full.pdfUnder "ASA Stroke" - it says the caudal medulla is affected, resulting in a CN XII lesion. CN XII nucleus and nerve normally are found in the rostral medulla (CN XII nucleus on the dorsal part of rostral or "open" medulla, with nerve leaving between pyramid and inferior olivary nucleus). Not a major error - but might be better to keep consistent with most sources that show CN XII at level of rostral medulla.Minor erratumThe nucleus for XII runs throughout the medualla, rostral and caudal. The reason only XII is involved in this stroke (and spared in Wallenberg) is that the nucleus for XII is very medial. It would be more accurate for us to say "Medial medulla - hypoglossal nucleus and nerve" Reference - Blumenfeld
-Kaitlyn		04/05/19 5:35 AMAndrewKoandrewko@hawaii.edu
1349504Neurology and Special SensesNeuropathologyAneurysmsUpToDate and Boards and Beyond. UpToDate link: https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-aneurysmal-subarachnoid-hemorrhage?search=saccular%20aneurysm&source=search_result&selectedTitle=4~32&usage_type=default&display_rank=4Berry Aneurysms rupture hemorrhage DOES NOT cause focal neurologic symptoms except after several days when vasospasm occurs "Vasospasm and delayed cerebral ischemia".Major erratumVerifiedReject. The uptodate article does not say focal symptoms don't occur, it just doesn't mention them. MCA aneurysm rupture often causes subdural or intraparenchymal hemorrhage which both cause focal symptoms. For a reference: the hunt hess scale used to grade the severity of the rupture includes focal neurologic deficits in grade 3 and 4.
-Kaitlyn		Agree with Kaitlyn -- reject -YKAgree with Kaitlyn. Text is correct as is. -VVReject by 2 authors + 1 editor02/22/19 5:32 AMZaidR Najdawiznajdawi@hotmail.com
1350504Neurology and Special SensesPathologyAphasiahttps://www.uptodate.com/contents/approach-to-the-patient-with-aphasiaIn the 4th row in the table "Global" aphasia, the semicolon is confusing. Does it mean arcuate fasciculus is affected or not? I think it should read "arcuate fasciculus intact. Broca and Wernicke areas affected."Clarification to current textI'm not sure why we mention the arcuate fasciculus. It does not have to be involved in a global aphasia but a lesion large enough to hit brocas and wernickes normally takes it out too. I propose we just remove it from the line.
-Kaitlyn		Agree with Kaitlyn. Can defer to faculty for input. -Anup03/21/19 11:36 PMXiangGuodrguox@126.com
1351504Neurology and Special SensesPathologyAphasiawww.aphasia.orgupdate the figure and table to include global and anomic aphasiaClarification to current textNot needed. -AlirezaIt is impossible to put global aphasia on the figure. It is already in the table. Anomic aphasia is subtle expressive aphasia. It does not localize to a particular area of the brain but is seen in dementia, delirium, encephalopathy, etc. It is not HY in my opinion.
-Kaitlyn		I think we should not crowd out the existing details on the table. -Anup03/22/19 1:05 AMXiangGuodrguox@126.com
1352505Neurology and Special SensesPathologySeizureshttps://www.epilepsy.com/article/2016/12/2017-revised-classification-seizuresThe operational classification of seizure types on this page is outdated. As of 2017, according to the ILAE (International League Against Epilepsy), there is a new classification of seizure types (Focal, Generalized, Unknown) and a new set of features to focus on when differentiating between seizures (Onset, Awareness, and "other features" such as motor/non-motor onset). Both the organization and diagram needs to be updated to reflect this revision.Major erratumVerifiedDefer to 2020.

User is correct. The classification is outdated. I believe we had a discussion about this at some stage during the revision process. The current "traditional" classification is still HY on the boards. Anyways, we can consider replacing the illustration +/- narrative for 2020 edition.
- Humood		Agree with both, the user and Humood. We had agreed on replacing it with a newer classification.- AnupI remember that we had a discussion about this last year. Agree that we should consider changing but as Humood pointed out, the current traditional classification is pretty high yield, as Step 1 usually lags behind in terms of new classification until it becomes more mainstream. Defer to 2020. -VVPrelim accept but NOT publishable errata01/21/19 3:32 AMJulieTranjulietran@email.arizona.edu
1353505Neurology and Special SensesPathologySeizureshttps://www.uptodate.com/contents/convulsive-status-epilepticus-in-adults-classification-clinical-features-and-diagnosis?search=status%20epilepticus&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2Status epilepticus: continuous (>=5 min) or recurring seizures BETWEEN WHICH THERE IS INCOMPLETE RECOVERY OF CONSCIOUSNESSClarification to current textVerifiedAgree with the user. Clarification is warranted.

- Humood		Defer to 2020. -AnupDisagree. Incomplete recovery of consciousness is not necessarily required between recurring seizures in order to classify as status epilepticus. In fact the definition of ILAE does not mention this in the defintion. Would not recommend changes to the text. -VV https://onlinelibrary.wiley.com/doi/epdf/10.1111/epi.13121Reject by 2 authors + 1 editor01/30/19 2:25 PMHasanAlarourihassan.arouri@hotmail.com
1354505Neurology and Special SensesPathologySeizurestrueN/AWithin the figure, under tonic-clonic seizures, there is a spelling error. Alternating is spelt altenating. Missing the R.Spelling/formattingAccept. -AlirezaStaff acceptsAltenating should be changed to "Alternating"
-Kaitlyn		Agree. Defer to illustration team. -AnupAgree. Please add a note to change to "Alternating" -VVPrelim accept by 2 authors + 1 editor03/13/19 1:01 PMTaylerRosstaylerdeclanross@gmail.com
1355505Neurology and Special SensesPathologySeizureshttps://www.epilepsy.com/learn/types-seizures/focal-onset-aware-seizures-aka-simple-partial-seizuresThe classification of partial focal seizure under simple and complex is no longer used, the new classification defines it as: focal aware and focal impaired awareness. I think is important to update in recent terminology and put in parenthesis the old term used rather than all the way around. To avoid confusions and learn the correct term.Minor erratumThe nomenclature to describe seizure has changed. It is my understanding the the test is still reliant on the old nomenclature. I don't know this with any certainty as I took step 1 in 2015. I would defer to an editor about change this. The new terms are summarized here: https://www.epilepsy.com/learn/types-seizures/new-terms-seizure-classification
-Kaitlyn		03/26/19 5:29 PMDanielaCarralero Somozadanielacarralero@hotmail.com
1356506Neurology and Special SensesPathologyHeadachesIt's Mnemonic*T*ension ---> *Bi*lateral =Two lateral.MnemonicVerifiedNot quite fond of it. Would prefer mnemonics that deal with "band-like" distribution. -AnupReject.

Reject for now as we are looking for Errata. We can defer suggestion to 2020.

- Humood		Eh, not a fan. Reject. -VVReject by 2 authors + 1 editor01/04/19 6:56 AMMoatasemAl-Janabiassoomi88@yahoo.com
1357506Neurology and Special SensesPathologyHeadacheshttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2720121?guestAccessKey=dc65fc07-7bc7-4530-b864-94399937b0e7&fbclid=IwAR1JSsJK_PtyafnAnqJ6ipp8itIDNzeU_pP0vj0sgvZmLqBN_mwlPEBx-voFremanezumab and Erenumab, 2 newly FDA approved antimigraine CGRP monoclonal antibodies, should be reserved for patients with disabling high-frequency episodic migraine or Chronic migraine who have not benefited from or cannot tolerate 1st-line preventive treatments, like propranolol or topiramate (for episodic migraine) or botulinum toxin (for chronic migraine).High-yield addition to next yearVerifiedDefer to 2020.

? HY new content.
- Humood		May need expert review as well.-AnupReject. Both fremanezumab and erenumab were just accepted last year, so unlikely to be tested on Step 1. Would not recommend addition -VVReject by 2 authors + 1 editor01/19/19 11:08 AMAnilA Kumaranil_kumarans@yahoo.co.in
1358506Neurology and Special SensesPathologyHeadaches1. https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults 2. https://onlinelibrary.wiley.com/doi/full/10.1111/head.12835 (American Headache Society)Antiemetics acting as dopamine receptor antagonists are also among effective treatment options for acute migraine, particularly prochlorperazine (IV) and metoclopramide (IV). Both very commonly used in ERs, and their effectiveness are based on high quality of evidence (see references). Chlorpromazine also seems to be effective, although data are more limited compared to the other two drugs. These dopamine receptor antagonist antiemetics should be added to the text in the acute migraine rx table.High-yield addition to next yearVerifiedAgree. We need to specify these are IV meds. These are not first line for home management which the meds we already have listed are.
-Kaitlyn		Can be discussed on annotate. -AnupThis is something that needs to be known in the clinical setting rather than for purposes of Step 1. It is more important to know about the treatments mentioned in the table. Therefore, would be inclined to reject. -VVReject by 2 authors + 1 editor02/26/19 6:47 AMCemTuramcemturam@gmail.com
1359506Neurology and Special SensesPathologyHeadaches1. https://www.uptodate.com/contents/acute-treatment-of-migraine-in-adults 2. https://onlinelibrary.wiley.com/doi/full/10.1111/head.12835 (American Headache Society)When added to standard acute migraine therapy, parenteral treatment with dexamethasone reduces the rate of early headache recurrence (from 24 to 72 hours after treatment). Both UpToDate and American Headache Society recommend adjunctive therapy with parenteral dexamethasone for patients with acute migraine headaches, so it should be added to the acute migraine rx (note that even though it doesn't provide immediate pain relief).High-yield addition to next yearVerifiedAgree. We need to specify these are IV meds. These are not first line for home management which the meds we already have listed are.
-Kaitlyn		Can be discussed on annotate. -AnupThis is something that needs to be known in the clinical setting rather than for purposes of Step 1. It is more important to know about the treatments mentioned in the table. Therefore, would be inclined to reject. -VVReject by 2 authors + 1 editor02/26/19 7:06 AMCemTuramcemturam@gmail.com
1360506Neurology and Special SensesPathologyHeadacheshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100258/aimovig-erenumab-aooe-A novel and effective new treatment for migraine prophylaxis is (erenumab-aooe) a human monoclonal antibody that binds to the calcitonin gene-related peptide(CGRP) receptor and antagonizes CGRP receptor function.High-yield addition to next yearReject. I don't think this is HY.
-Kaitlyn		Not sure if it will get tested. Reject. -AC04/16/19 12:02 PMJan AndreGraumanjgrauman@gmail.com
1361506Neurology and Special SensesPathologyHeadachesself madeWhen describing cluster headache as more common in males and rest two in females. You can illustrate migraine and tension headache with picture of female rather than that of male. will give diagrmatic reprsentation and will be easier to learnMnemonic10/04/19 6:03 AMShreyaGulatigulatishreya23@gmail.com
1362507Neurology and Special SensesPathologyMovement disordersMnemonicTo remember asterixis is the “flapping” motion of uncontrollable repeating wrist and upper extremity extension, picture an asterisk and imagine it as a person flapping their arms like wings. Images attached.MnemonicVerifiedDefer to 2020. -AnupHelpful but will take up a lot of space. Also may confuse people because asterixis refers to the hands, not the whole arm.
-Kaitlyn		Agree with Kaitlyn. Would not recommend addition. -VVReject by 2 authors + 1 editor02/07/19 12:19 AMMatthew J.Christensenmattchristensen607@gmail.com
1363508Neurology and Special SensesAnatomyNeurodegenerative disordersFirst Aid 2019 + Pathoma for tau protein, Alzheimer’s sectionThe Senile plaques is composed of AB (amyloid-B)=> (A Blaques),,,,, while the Neurofibrillary tangles are composed of tau protein (TAUngles)MnemonicVerifiedNot in favor of addition. -AC05/10/19 10:47 PMFarisBinyouseffaris-v@hotmail.com
1364508Neurology and Special SensesPathologyNeurodegenerative disordershttps://parkinsonsdisease.net/symptoms/micrographia-handwriting/ https://bmjopen.bmj.com/content/2/3/e000628 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2169751/Adding Micrographia to Parkinson's disease paragraph as its strongly associated with it.Clarification to current textI am in favor of addition, as this is one of the first signs that may present in a patient with Parkinsons. -AC05/13/19 8:37 PMMuhanadShaibmohanad.shaib@gmail.com
1365508Neurology and Special SensesPathologyNeurodegenerative disordershttps://www.uptodate.com/contents/genetics-of-alzheimer-disease#H899448ApoE-4 makes you 4getMnemonicVerified06/11/19 4:33 PMKevinKronkevkron123@gmail.com
1366508Neurology and Special SensesPathologyNeurodegenerative disordersn/aApO E – 2: Smaller number – Decreased risk ApO E – 4: Larger number – Increased risk and later onset So many “P”s related with Alzheimer disease, including hyperPhosphorylated tau proteins.MnemonicVerified07/08/19 7:26 PMAPandeyaranikopandey@gmail.com
1367508Neurology and Special SensesPathologyNeurodegenerative disordershttps://www.uptodate.com/contents/clinical-features-and-diagnosis-of-dementia-with-lewy-bodies?search=lewy%20body%20dementia%20diagnosis&source=search_result&selectedTitle=1~111&usage_type=default&display_rank=1#H25The entry for Lewy body dementia states "Called Lewy body dementia if cognitive and motor symptom onset < 1 year apart, otherwise considered dementia 2° to Parkinson disease." I believe that it should be clarified to "Called dementia 2° to Parkinson disease if motor symptoms precede cognitive symptoms by > 1 year, otherwise considered Lewy body dementia." Per UpToDate "If parkinsonism is present for more than one year before the onset of dementia, it is officially classified as PDD."Clarification to current textThe student is technically correct but I think our current phrasing is fine
-Kaitlyn		07/21/19 1:36 PMDavidSindes144@case.edu
1368508Neurology and Special SensesPathologyNeurodegenerative disordershttps://www-uptodate-com.proxy.lib.uiowa.edu/contents/epidemiology-pathology-and-pathogenesis-of-dementia-with-lewy-bodies?search=lewy%20body%20dementia%20umbrella&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1"Lewy body dementia" should read "Dementia with lewy bodies," as LBD is an umbrella term that includes DLB and Parkinson disease. DLB refers to the the clinical syndrome with parkinsonism, visual hallucinations, etc.Major erratum10/20/19 10:17 PMRobThinnesrobert-thinnes@uiowa.edu
1369508Neurology and Special SensesPathologyNeurodegenerative disordersFA 2019neurofibrillary Tangles = Tau proteinMnemonic10/31/19 9:48 AMConnorLentzlentz.connor@gmail.com
1370510Neurology and Special SensesAnatomy and PhysiologyHypothalamusboards and beyonds , https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436859/ ; https://www.ncbi.nlm.nih.gov/pubmed/25560696 ;the effect on lateral and medial hypothalamic areas are mediated via orexigenic and anorexigenic neurons of arcuate nucleus respectively. These mediate their effects via NPY and POMC respectively. I am submitting an original simplified illustration showing the same. Also mentioned is the control of leptin and ghrelin on hunger and satiety . You are free to modify the illustration and use as per convenienceHigh-yield addition to next yearVerifiedDefer to 2020.

? HY new content.
- Humood		Can be discussed on annotate. -AnupThe current text is adequate for purposes of Step 1. Would not recommend addition or further clarification. -VVReject by 2 authors + 1 editor02/05/19 9:32 PManubhavsoodanubhavsood89@gmail.com
1371511Neurology and Special SensesPathologyMultiple sclerosishttps://www.dictionary.com/browse/spasticity6th line on this page (3rd bullet) I believe there is a spelling error. Instead of 'Spasticity', currently, the word is spelled as "spacticty."Spelling/formattingStaff acceptsNice catch. Agree that this needs to be changed and is a minor spelling error. -AnupAgree
-Kaitlyn		Accept. Please add a note to annotate to change to "spasticity" -VVPrelim accept by 2 authors + 1 editor02/06/19 3:08 PMHananQaqishhanan.qaqish@rockets.utoledo.edu
1372511Neurology and Special SensesPathologyMultiple sclerosisFirst Aid 2019The gold standard for Multiple sclerosis diagnosis is (MRI) (Multiple scleRosIs)MnemonicVerifiedNot necessary for addition. -AC05/10/19 10:55 PMFarisBinyouseffaris-v@hotmail.com
1373512Neurology and Special SensesNeuropathologyAcute inflammatory demyelinating polyradiculopathyhttps://www.uptodate.com/contents/guillain-barre-syndrome-pathogenesisCauses of Guillain-Barre: MC CHiVE Mycoplasma, Campylobacter jejuni, Cmv, Hemophilus influenzae, Varicella zoster virus, Epstein-barr virus.MnemonicVerifiedNot exactly causes, but rather precipitants [as per UTD]. However, not sure if all of these are important for Step 1. I would certainly expect the test to question on C jejuni, EBV, Mycoplasma at the most. So the mnemonic would just add extra info with no extra HY material. -AnupReject.

Reject for now as we are looking for Errata. We can defer suggestion to 2020.

- Humood		Reject. Not convinced that this is HY enough to warrant a mnemonic. Would not recommend addition -VVReject by 2 authors + 1 editor12/28/18 11:19 AMElanBaskirebask003@fiu.edu
1374512Neurology and Special SensesNeuropathologyAcute inflammatory demyelinating polyradiculopathyhttps://www.uptodate.com/contents/chronic-inflammatory-demyelinating-polyneuropathy-treatment-and-prognosis?search=Acute%20inflammatory%20demyelinating%20polyradiculopathy&topicRef=14174&source=see_linkThe last line of this passage says "No role for steroids.' While this is true for some forms of Guillain-Barre, glucocorticoids are a standard treatment for Acute inflammatory demyelinating polyradiculopathy.Minor erratumCan be put up for discussion, and may require faculty input. -Anup04/25/19 8:22 PMValerieChenvalerie4@illinois.edu
1375512Neurology and Special SensesPathologyAcute inflammatory demyelinating polyradiculopathyhttps://epomedicine.com/medical-students/guillain-barre-syndrome-gbs-mnemonic/Mnemonic: AIDP for management 1. Supportive: • Analgesia• Airway: ventilation• Autonomic• Antithrombotic: TED stockings, LMWH 2. IVIG 3. Dexamethasone (corticosteroid) 4. Plasma exchange (Plasmapheresis). Mnemonic: AIDP criteria 1. Areflexia 2. Include in differential and rule out other causes 3. Duration < 4 weeks 4. Progressive (Ascending weaknessMnemonicVerifiedManagement questions are mostly Step 2 CK, but we included this here as the concepts get tested. Not sure if adding a mnemonic would be HY. -AC06/06/19 9:36 AMMirInzamam Alimirinzamamali86@gmail.com
1376512Neurology and Special SensesPathologyOther demyelinating and dysmyelinating diseasesMnemonicCharcot-Marie-Tooth disease: Charcot-Marie-Foot associated with Foot deformities and Foot dropMnemonicVerifiedI prefer "C My Toes" for a CMT mnemonic.
-Kaitlyn		Not in favor of the proposed mnemonic. Kaitlyn's is better if we decide to add one. -YKRejecting this mnemonic, but accepting this comment so that we can add in Kaitlyn's suggestion to annotate. Please migrate "C My Toes" for CMT as a mnemonic with appropriate red text. We will have to do some reformatting to incorporate. -VVPrelim accept by 2 authors + 1 editor02/12/19 5:00 PMGenesisValenzuelagvalenzuelah@hotmail.com
1377512Neurology and Special SensesPathologyOther demyelinating and dysmyelinating diseasesn/aPEdMed.Coma PiloCYSTIC astrocytoma, Pinealoma EpenDymoma Medulloblastoma CraniopharyngiOMAMnemonicVerified07/08/19 7:28 PMAPandeyaranikopandey@gmail.com
1378512Neurology and Special SensesPathologyOther demyelinating and dysmyelinating diseasesn/a“Two PiMPs with Charcot and Marie” PMP 22 gene duplication Oncogenes, pg 225 CLaP and KRASh: K-RAS mutation in Colon, Lung and Pancreatic Ca. C comes after B. Hence, C-myc mutation for Burkitt Lymphoma.MnemonicVerified07/08/19 7:31 PMAPandeyaranikopandey@gmail.com
1379513Neurology and Special SensesNeuropathologyHerniation syndromeshttps://radiopaedia.org/articles/uncal-herniation-1?lang=usUncal herniation usually results in ipsilateral CN III palsy and contralateral hemiparesis. In rare cases of Kernohan's PHENOMENON, there will be contralateral CN III palsy and ipsilateral hemiparesis. This section isn't particularly clear on the difference between the common and rare manifestations of uncal herniation.Clarification to current text11/21/19 12:15 PMLeslieShangleslie.shang@gmail.com
1380513PathologyNeoplasiaNeoplasia and neoplastic progressionhttps://www.nature.com/articles/s41598-018-24310-5Neurofibromin (Ras GTPase activating protein) and in neurology section p 513 NF1 ((encodes neurofibromin, a negative RAS regulator )Clarification to current textVerifiedMentioned above. -ScottAgree with student. I see a similar comment on Annotate. Neurofibromin is an inhibitor of RAS/MAPK signaling. Robbins pathology, table 7-7. - MKDuplicate.

-Matt		Reject by 2 authors + 1 editor02/14/19 6:15 AMnehalkhalidnehalnasser55@gmail.com
1381513Neurology and Special SensesPathologyNeurocutaneous disordersFA 2019 Page 513Highlight the letter *T* and *S* in "Tuberous sclerosis" to match the mnemonic.MnemonicVerifiedI do agree, but we cannot highlight headings (if i recall correctly). So we can highlight the T and S in tuberous sclerosis immediately after rhabdomyoma. -AnupReject.

Reject for now as we are looking for Errata. We can defer suggestion to 2020.

- Humood		We removed this mnemonic last year, as we do not want multiple mnemonics, which would cause confusion. Additionally, we avoid including mnemonics in the header of the table. Reject. -VVReject by 2 authors + 1 editor01/04/19 9:22 AMMoatasemAl-Janabiassoomi88@yahoo.com
1382513Neurology and Special SensesPathologyNeurocutaneous disordersnilNF1 chromosome can be remembered as chr 17 by writing F1 as a mirror image (inverted). This is a better memory aid as no one will count the letters in von recklinghausen during examMnemonicVerifiedThis is good but requires a lot of explanation. Not sure how we could make it clear in text.
-Kaitlyn		Reject. Agree with Kaitlyn, this is too complicated -YKReject, too complicated. -VVReject by 2 authors + 1 editor02/12/19 1:47 AManubhavsoodanubhavsood89@gmail.com
1383513Neurology and Special SensesPathologyNeurocutaneous disordersGoljan- Rapid review of pathology. Also in https://emedicine.medscape.com/article/950151-overview#a1 NF1 is highly penetrant but not 100%. On the other end, NF-2 shows complete penetranceNF shows incomplete penetrance, not 100% penetranceMajor erratumReject. Some sources say it is highly penetrant, yet most suggest 100% penetrance. For simplicity sake I think it's acceptable to say 100% penetrance. UpToDate cites NF1 as being completely penetrant. -ZanderReject. Considered to have 100% penetrance. From genetics textbook dated 2018: https://www.ncbi.nlm.nih.gov/books/NBK1109/
-Kaitlyn		03/17/19 8:10 AMKetanDaymaketandayma77@gmail.com
1384513Neurology and Special SensesPathologyNeurocutaneous disordersn/a9 – 1 x 2 = 16 TS 1 mutation on chromosome 9 TS 2 mutation on chromosome 16MnemonicVerified07/08/19 7:30 PMAPandeyaranikopandey@gmail.com
1385513Neurology and Special SensesPathologyNeurocutaneous disordersSelf-writtenVHL Disease - some of these tumors found around HIP area/lower abdomen (von-HIP-Lindau). For example - RENAL cell carcinoma, PheochromocytomaMnemonic10/30/19 11:25 AMKhalidAlattarkhalid_alattar@hotmail.com
1386516Neurology and Special SensesPathologyChildhood primary brain tumorsI just tried to find a way to differentiate between Pilocytic astrocytoma and Medulloblastoma"Pilocytic" astrocytoma is Cystic+Solid (vs Medulloblastoma), just like a "Pillow" stuffed with cottons!MnemonicVerifiedThis is good but I don't think it would help on test day. Step 1 would never show an MRI and expect and MS2 to know JPA vs medullo. If they did, the answer would be JPA because JPA is more common. We should not incorporate this.
-Kaitlyn		Reject.

Reject for now as we are looking for Errata. We can defer suggestion to 2020.

- Humood		Reject. Agree with Kaitlyn. Would not recommend addition. -VVReject by 2 authors + 1 editor01/05/19 3:08 PMElmiraTaghi Zadehelmira.taghizadeh9@gmail.com
1387516Neurology and Special SensesPathologyChildhood primary brain tumorsN/AMedal (Medulloblastoma) for Homer who was (W)rightMnemonicVerifiedReject. Not sure how this helps to remember the Homer-Wright rosette association with medulloblastoma other than it restates the words together in a sentence. -ZanderAgree to reject. I don't get this at all.
-Kaitlyn		04/01/19 4:47 PMKellyLewkjl95@case.edu
1388516Neurology and Special SensesNeuropathologyNeuroblastomatruehttp://www.ajnr.org/content/27/3/488The histology picture of Homer-Wright Rosettes in the referenced picture in part D does not have an adequate depiction of what these structures look like in regards to a Medulloblastoma/PNET or a Pinealoma. When I researched a Homer Wright Rosette in the American Journal of Neuroradiology I came across an image that I feel would be a better representation.High-yield addition to next yearRefer to Kim. -AlirezaVerifiedDefer to 2020.

Defer suggestion to the images team next year.

- Humood		Agree with deferring. -AnupPlease add a note for Kim on annotate with the image included. -VVPrelim accept by 2 authors + 1 editortrue01/22/19 9:21 AMSamanthaFridaysfriday68993@med.lecom.edu
1389517Neurology and Special SensesPathologyHerniation syndromeshttp://www.uptodate.com.medproxy.hofstra.edu/contents/evaluation-and-management-of-elevated-intracranial-pressure-in-adults?search=kernohan+notch&sectionRank=1&anchor=H8&source=machineLearning&selectedTitle=1~1#H8You say Kernohan Phenomenon would lead to contralateral blown pupil. However it is still the ipsilateral blown pupil, and the side of hemiparesis flips only.Major erratumVerifiedReject.

The user might be confused here. Our narrative is consistent with the info on UTD.

Per UTD, "One notable false localizing syndrome seen following neurologic injury, referred to as Kernohan's notch phenomenon, consists of the combination of contralateral pupillary dilatation and ipsilateral weakness"
https://www.uptodate.com/contents/evaluation-and-management-of-elevated-intracranial-pressure-in-adults?search=Kernohan%20phenomenon&source=search_result&selectedTitle=1~1&usage_type=default&display_rank=1
- Humood		Agree. We has a discussion on this last year as well, if I remember correctly. -AnupText is correct as is. We made the distinction between late and early presentation with faculty approval. No change recommended. -VVReject by 2 authors + 1 editor01/27/19 5:00 PMDaveThomasdavethomas614@gmail.com
1390517Neurology and Special SensesPathologyHerniation syndromeshttp://www.uptodate.com/contents/evaluation-and-management-of-elevated-intracranial-pressure-in-adults?search=kernohanKernohan’s notch is not an anatomic structure that’s compressed against by the cerebral peduncle. Kernohan’s notch equals Kernohan’s phenomenon. It results from compression of contralateral cerebral peduncle against the free edge of the tentorium.Clarification to current textVerifiedThis is correct. Text should be changed to "Kernohan's notch phenomenon (misleading contralateral blown pupil and ipsilateral hemiparesis due to contralateral compression of cerebral peduncle against tentorial notch)"
https://www.ncbi.nlm.nih.gov/pubmed/15046669
-Kaitlyn		Can be discussed on annotate. -AnupMost of the sources I looked at call it Kernohan notch phenomenon. Please replace "Kernohan phenomenon" WITH "Kernohan notch phenomenon" -VV https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938049/ https://radiopaedia.org/articles/kernohan-phenomenon?lang=usPrelim accept by 2 authors + 1 editor03/08/19 8:12 AMXiangGuodrguox@126.com
1391518Neurology and Special SensesPathologySpinal cord lesionsFirst Aid 2019Amyotrophic lateral sclerosis (ALS) is combined upper & lower lesion, so (ALS= Apper Lower Symptoms)MnemonicVerified05/10/19 10:32 PMFarisBinyouseffaris-v@hotmail.com
1392518Neurology and Special SensesNeuropathologySpinal cord lesionshttps://www.christopherreeve.org/about-usAmylotrophic Lateral Sclerosis (ALS) - Christopher Reeves, who acted as SUPERman, used to fly around a lot. He has a charity foundation aimed to help people who can't fly at all due to both Upper and Lower Motor neuron disease. This disease is caused by SUPERoxide dismutase defect, that stops them from being SUPER like SUPERman.Mnemonic10/28/19 7:12 AMKhalidAlattarkhalid_alattar@hotmail.com
1393519Neurology and Special SensesPathologyBrown-Séquard syndromen/aThe diagram of the spinal cord segment indicates that the lesion is the blue section (the word "lesion" is below the blue half) but it should be under the red section in order to produce the symptoms noted in the diagram of the bodySpelling/formatting12/15/19 7:35 AMLaurenBenedettobenedetto@uchc.edu
1394519MicrobiologyVirologyPoliomyelitishttps://emedicine.medscape.com/article/1259213-overviewOPV is live attenuted so it goes in body just like live viruses( fecal-oral) while IPV is inactivted so it goes in the body by injectionMnemonicVerified05/30/19 6:53 PMAbdelrahmanAltaraziabodtaraze@gmail.com
1395520Neurology and Special SensesPathologyCommon cranial nerve lesionshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239699/#S11titlechange to "weak side of palate collapses" -- current language is ambiguous and makes it seem like weak side of uvula collapses, which would lead the uvula to deviate towards lesionClarification to current textVerifiedAgree. Change to "weak side of palate collapses"
-Kaitlyn		Agreed. -AnupAgree. Please replace "Weak side collapses" WITH "Weak side of palate collapses" -VV https://www.ncbi.nlm.nih.gov/books/NBK386/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239699/02/26/19 4:21 PMCarinPapendorpcpapendorp@gmail.com
1396520Neurology and Special SensesPathologyFacial nerve lesionshttps://www.uptodate.com/contents/bells-palsy-pathogenesis-clinical-features-and-diagnosis-in-adultswrite Bell's palsy instead of Bell palsySpelling/formatting08/01/19 9:56 AMAna LuizaMapurunga Goncalvesanaluizamapurunga@gmail.com
1397520Neurology and Special SensesPathologyFacial nerve lesionsNo reference.It says that "other symptoms" of a "Lower motor neuron lesion" of the facial nerve include "loss of taste sensation to anterior tongue". Indeed, taste can be lost when the facial nerve is damaged (since the nerve contains those sensory afferents), but a lesion at the facial nucleus (which contains the lower motor neurons and no sensory neurons) should not cause loss of taste. I suggest inserting a bracket after "loss of taste sensation to anterior tongue" to clarify that it occurs if it's specifically the facial nerve that is damaged.Clarification to current text09/19/19 3:06 PMHaleeEinfeldraxorium@gmail.com
1398520Neurology and Special SensesNeuropathologyMeningeshttps://www.uptodate.com/contents/clinical-features-and-diagnosis-of-acute-bacterial-meningitis-in-adultsAdd a new section on "Meningitis" in Neuropathology. Microbiology section covers common pathogens and lab findings but Neuropathology should cover clinical aspects of meningitis. I attached a picture of the information I added on my First Aid while watching Boards & Beyond Videos (by Dr. Jason Ryan).High-yield addition to next yearVerifiedWe are trying to work on this fact. -AnupReject.

Reject for now as we are looking for Errata. We can defer suggestion to 2020.

- Humood		01/08/19 12:09 PMRalphZeitounriz07@mail.aub.edu
1399520PathologyPathologyNeuromuscular junction diseaseshttps://www.nhs.uk/conditions/guillain-barre-syndrome/GBS can be read as goes from below superiorlly to remember that gullian barre is ascending paralysisMnemonicVerifiedReject. Scott05/30/19 7:04 PMAbdelrahmanAltaraziabodtaraze@gmail.com
1400520Neurology and Special SensesNeuropathologyNeuronshttps://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-SheetBell Palsy is incorrectly spelled. It is Bell's Palsy, named after Sir Charles Bell.Spelling/formattingAccept. -ZanderAgree
-Kaitlyn		04/19/19 2:07 PMJoshuaMorofgc7713@wayne.edu
1401521Neurology and Special SensesOtologyAuditory physiologyhttp://www.ncbi.nIm.nih.gov/books/NBK526135/BAd to the bone - conductive hearing loss (Rinne Bc > Ac, Weber localizes to BAD ear))MnemonicVerifiedReject. Although it does localize to the bad ear in conductive loss, I dont think the mnemonic really clarifies the concept well. -Zander04/18/19 9:56 AMAliciaMizesapm79@pitt.edu
1402521Neurology and Special SensesOtologyAuditory physiologyNone needed.Request to change "THIN and rigid" to "NARROW and rigid", since the purpose is to compare it to "wide and flexible". "Thin" is the opposite of "thick", "narrow" is the opposite of "wide".Clarification to current text10/18/19 1:38 PMHaleeEinfeldraxorium@gmail.com
1403522Neurology and Special SensesOphthalmology22q11 deletion syndromesIntra university exams;It wouldn't let me pick NEW FACT; but it is a high yield addition to add explanations of stye and chalazion to structural eye disorders. Especially since they are tested in normal in-medical school exams and are very common conditionsHigh-yield addition to next yearVerifiedI can't remember being tested on these but agree they are very common. I would like to know what other people think.
-Kaitlyn		Have never been tested on these for Step 1 prep. Agree they are common, not sure if it's a worthy addition -YK03/11/19 11:42 AMAbdul SattarRaslananr06@mail.aub.edu
1404522Neurology and Special SensesOphthalmologyVertigohttps://www.ncbi.nlm.nih.gov/books/NBK441861/need to differentiate the direction of nystagmus (horizontal vs any direction) associated with each kind of vertigo (peripheral vs central respectively). And also whether it occurs immediately (central vertigo) or delayed (peripheral). These facts are mentioned for central vertigo but have been skipped for peripheral vertigo. My proposal is to present them in a tabular format (see the file attachment). Also I am suggesting a mnemonic to remember the peripheral vertigo characteristics : PHD Peripheral Horizontal DelayedHigh-yield addition to next yearVerifiedPartial. Not sure if it's worth adding a whole table to the section, as I dont think it'd be a super high yield addition. The person that submitted this is right though, we are missing something about the type of vertigo under the peripheral section. Maybe add something like "Typically associated with a rotational nystagmus". -Zander02/25/19 3:56 AManubhavsoodanubhavsood89@gmail.com
1405522Neurology and Special SensesOtologyVertigoboards and beyond ; https://www.ncbi.nlm.nih.gov/books/NBK441861/Peripheral vertigo is associated with delayed nystagmus occuring in horizontal direction Mnemonic : PHD Peripheral Horizontal DelayedHigh-yield addition to next yearVerified02/25/19 4:04 AManubhavsoodanubhavsood89@gmail.com
1406524Neurology and Special SensesOphthalmologyAge-related macular degenerationnilto remember dry AMD is a/w gradual decrease in vision vs Wet AMD sudden ---- mnemonic 1 . Dry = graDual ; 2. It takes longer for clothes to DRY but get WET quicklyMnemonicVerifiedI like #2. it is sort of confusing but I can't think of anything better and I think it is helpful.
-Kaitlyn		02/24/19 5:55 AManubhavsoodanubhavsood89@gmail.com
1407524Neurology and Special SensesOphthalmologyUveitishttps://www.uptodate.com/contents/uveitis-etiology-clinical-manifestations-and-diagnosis?search=uvea&source=search_result&selectedTitle=1~16&usage_type=default&display_rank=1In the description of uveitis- there is discussion on what components make up the uvea (therefore it can somewhat be inferred that the iris, choroid, retina make up the uvea)- but there is no clarification of this saying exactly what is considered the uvea.Clarification to current textVerifiedAccept. Definitely a confusing point amongst medical students. I think instead of saying "specific name based on the location within the affected eye", we could say "Inflammation of the uvea. The uvea is the middle portion of the eye and consists of the iris, ciliary body, and the choroid". Or something similar so that it's clear. Most importantly, I think this could be shown in the diagram on page 522. The eye anatomy picture should delineate the structures of the uvea. -ZanderAgree with Zander. This was always a confusing point for me, I can see this being very helpful. -YK02/26/19 5:23 PMDylanErwinderwin@smu.edu
1408525Neurology and Special SensesOphthalmologyRetinal vein occlusionhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915868/It mentions that central or branch retinal veins are due to compression from nearby arterial atherosclerosis. Although this is true, that is the case mostly for branch retinal vein occlusions. As for the central vein occlusions the pathophysiology behind it is usually a primary thrombus disorder.Minor erratumAccept. It seems there isnt a definitive answer between AAO, UpToDate, NCBI, etc., but thrombus formation is definitely a cause of CRVO. The wording in FA currently groups central and branch occlusions together, but only mentions the atherosclerosis part. I think a small addition to the text could be "...due to compression from nearby arterial atherosclerosis or thrombus formation within the vessel". Ultimately I don't think it's super important to add, but it could be a small change. -Zander03/26/19 5:46 AMMaziadAl-Abdul Wahidmaziad_97@hotmail.com
1409525Neurology and Special SensesOphthalmologyRetinitishttps://nei.nih.gov/faqs/retina-cotton-wool-spotsCotton wool spots are found in diabetic retinopathy tooHigh-yield addition to next yearPartial. Under UpToDate (and various other sources) they are found in diabetic retinopathy. Not sure if it's a necessary add, however. -Zander03/16/19 10:02 PMManonmaniMurugappanmano96@gmail.com
1410526Neurology and Special SensesOphthalmologyRetinitisFirst AId 2018Entry on Retinitis excludedHigh-yield addition to next yearVerifiedWould need the X-ref team to have a look. -Anup01/07/19 6:08 PMDavidNwachukwudnjrocks@gmail.com
1411526Neurology and Special SensesOphthalmologyRetinitis pigmentosahttps://emedicine.medscape.com/article/1227488-overviewThere is currently no cure for RP; therefore, therapies are limited. Some pharmacological agents used in the management of RP include: Fat-soluble vitamins (eg, vitamin A, vitamin E), Calcium-channel blockers (eg, diltiazem) and Carbonic anhydrase inhibitors (eg, acetazolamide).Minor erratumWe have room to include this but I don't think it is HY. I would appreciate another authors opinion.
-Kaitlyn		Reject. RP is already pretty low yield and I think therapies are out of the scope of step 1 knowledge IMO. -Zander03/21/19 8:25 AMHusseinKhachfehussein.khachfe@gmail.com
1412527Neurology and Special SensesOphthalmologyMarcus Gunn pupilFirst AID 2019You really should talk about Argyll-Robertson pupil on the same page as Marcus-Gunn pupil as they are both common pupil disorders. It makes sense to put them next to each other.High-yield addition to next yearText authors should consider this addition. -AlirezaVerifiedAgree. We should add these two pupils to this page. We have room. I can draft the text when we transfer to annotate.
-Kaitlyn		Defer to illustration team. -Anup02/11/19 10:27 PMAdithyaNagarajaadityangrj776@gmail.com
1413527Neurology and Special SensesOphthalmologyMarcus Gunn pupilFirst AID 2019You should include Adie Pupil as a condition. Adie pupil is a unilaterally dilated pupil that reacts sluggishly to light, but better to accommodation. A result of ciliary ganglion lesion.High-yield addition to next yearText authors should consider this addition. -AlirezaVerifiedAgree. We should add these two pupils to this page. We have room. I can draft the text when we transfer to annotate.
-Kaitlyn		Defer to illustration team. -Anup02/11/19 10:39 PMAdithyaNagarajaadityangrj776@gmail.com
1414527Neurology and Special SensesOphthalmologyPupillary controlMnemonicTo remember miOsis is pupillary cOnstriction, think of how your mouth shrinks in size when pronouncing the letter “O”. Clarifying image attached.MnemonicVerifiedDefer to 2020. -AnupI don't like this. If you think about the O you think of the pupil being large.
-Kaitlyn		02/06/19 10:49 PMMatthew J.Christensenmattchristensen607@gmail.com
1415527Neurology and Special SensesOphthalmologyPupillary controlMnemonicTo remember that MYDRIasis is pupillary dilation, think “MY eye “dri”lates”. To remember that the sympathetic nervous system dilates the pupil (mydriasis) and decreases lacrimation, think “my dry eye dilates”. Clarifying image attached.MnemonicVerifiedDefer to 2020. -AnupI like the first part of this. We don't talk about lacrimation here so I don't think we should use that part.
-Kaitlyn		02/06/19 10:54 PMMatthew J.Christensenmattchristensen607@gmail.com
1416528Neurology and Special SensesOphthalmologyOcular motilityhttps://emedicine.medscape.com/article/1189759-overviewThe image on the right shows incorrect eye movements for SO, SR, IR, and IO. Both the superior and inferior rectus muscles adduct the eye, not abduct. Also, both the superior and inferior oblique muscles abduct the eye and not aduct. The image could also be demonstrating the torsion directions, but those would also be pointing incorrectly if that was the case.Major erratumDisagree, the current illustration is good enough for depicting the concept of ocular movements. -AlirezaVerified02/28/19 11:50 PMMaziarAminimaziaram@usc.edu
1417529Neurology and Special SensesOphthalmologyCN III, IV, VI palsiesI don't think a Mnemonic requires a referenceIn CN IV damage, the mnemonic would sound better and easier to memorize as: Can't see the floor without a healthy CN IV.MnemonicVerifiedAccept. I think this would be a good, simple change. -ZanderAgree. I use this mnemonic when I teach eye movements lecture. Students love it. I'm wondering if this is one of my students or if I'm just not creative as I thought.
-Kaitlyn		03/21/19 8:19 AMHusseinKhachfehussein.khachfe@gmail.com
1418529Neurology and Special SensesOphthalmologyCN III, IV, VI palsiesmnemonic, FA 19 p. 529*P*com aneurysm *p*ushes on *p*eripheral *p*arasympathetic fibers, *M*edial *M*otor, diabetes *M*ellitus (everything in ** highlighted in red)MnemonicVerifiedReject. The existing mnemonic is simple and clear compared to this suggestion. -ZanderI actually like this. We could add it just above the image, it would not add length to the fact.
-Kaitlyn		04/17/19 1:44 PMElanBaskirebask003@fiu.edu
1419530Neurology and Special SensesOphthalmologyCavernous sinusU world question where infection was related to old nasal tamponade, see also: https://en.wikipedia.org/wiki/Danger_triangle_of_the_facePlease add that the Cavernous Sinus Thrombosis if related to infections in the "triangle of danger" in the face! Maybe add that its not only eye and cortex veins but there is a connection between the V.angularis and V. Facialis so that infections in this area may lead to a sinus thrombosis!High-yield addition to next year06/07/19 10:44 AMNoamDegnernoam.degner@me.com
1420530PsychiatryPathologySchizophrenia spectrum disordersMyselfIncrease DOPamine = smoking "Dope"MnemonicVerifiedreject -YKReject - Rohan03/14/19 11:55 AMAbedaFarhatiabeda.farhati@gmail.com
1421530Neurology and Special SensesOphthalmologyVisual field defectshttps://www.uptodate.com/contents/homonymous-hemianopia?search=meyer%20loop&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2Meyer (SKYer's) loop for defect as "pie in the sky"; Dorsal (FLOORsal) optic radiation for defect as "pie on the floor"MnemonicVerified05/06/19 12:45 PMMichaelHagertymichaelhagerty1992@gmail.com
1422531Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/comtan.pdfFirst Aid states that Entacapone acts centrally and peripherally. However, my schools resources, Boards and Beyond, and Novartis (the company who makes the drug) state that it only acts peripherally. It is TOLCAPONE that acts both centrally and peripherally, NOT Entacapone.Major erratumVerifiedThis has been discussed during the 2019 crowdproofing. I think we can still have faculty input. -Anup03/03/19 7:08 PMMohammadSattarmo.sat92@gmail.com
1423531Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.uptodate.com/contents/tolcapone-drug-information?search=tolcapone&source=panel_search_result&selectedTitle=1~8&usage_type=panel&kp_tab=drug_general&display_rank=1#F228970Entacope is used for peripheral use of COMT inhibition. Tolcapone acts both centrally and peripherally for COMT inhibtion. both the picture and the text need to be correctedMajor erratum05/06/19 5:02 PMKinzaSultankinza.sultan@westernu.edu
1424532Neurology and Special SensesPharmacologyEpilepsy drugsnot neededvigabatrin = "Irreversible GABA TRansaminase INhibitor" (moa)MnemonicVerifiedDefer to 2020.
Mnemonic.

- Humood		I don't like it. Reject -YK01/14/19 2:51 PMNicholasYeisleynwygz4@mail.umkc.edu
1425532Neurology and Special SensesPharmacologyEpilepsy drugsFA 2019 chartTo remember that valproic acid and lamotrigine both treat all 3 types of seizures (excluding status epilepticus) you can remember them as vALLproic acid and lamictALL (brand name of lamotrigine).MnemonicVerifiedDefer to 2020.
Mnemonic.

- Humood		This is good, but I don't like that it excludes status. Also we should avoid relying on brand names. Reject -YK01/27/19 1:39 PMJonathanLeongjonathan.leong@downstate.edu
1426532Neurology and Special SensesPharmacologyEpilepsy drugshttps://www.uptodate.com/contents/drug-reaction-with-eosinophilia-and-systemic-symptoms-dressBesides Phenytoin, Carbamazepine and Lamotrigine are also important causes of DRESS syndrome.High-yield addition to next yearAccept. The AEDs are implicated and it's probably worth putting in DRESS as a complication under carbamzepine and lamotrigine. I know other step 1 resources mention these associations. Low yield, but could show up under any of this drugs -ZanderAgree. We do not have room to explain DRESS any in this table but we should include it under CBZ and LMG https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718748/
-Kaitlyn		03/21/19 3:08 AMNicolasCuri Gawlinskinicolascurii@gmail.com
1427532Neurology and Special SensesPharmacologyEpilepsy drugshttps://www.uptodate.com/contents/management-of-epilepsy-during-preconception-pregnancy-and-the-postpartum-periodLamotrigine and levetiracetam are the safest antiepileptics for pregnancyHigh-yield addition to next yearAccept. I have definitely had Uworld questions from both step 1 and 2 asking about AEDs in pregnancy. Currently there is nothing listed under the note section for both drugs. AED use and management is very complex, so I think having a simple statement would be best. Such as "Safer option during pregnancy" or "Minimal risk for teratogenicity in pregnant patients". -ZanderAgreed, and needs faculty review once on annotate. -Anup03/26/19 9:51 PMRebeccaXurebecca.xu@northwestern.edu
1428532Neurology and Special SensesPharmacologyEpilepsy drugsNoneVigabatrin - Blind as a batMnemonicVerified05/10/19 3:01 PMJulianMaamarijulien.maamari@gmail.com
1429532Neurology and Special SensesPharmacologyEpilepsy drugsn/aSide effects of Carbamazepine: "450 SAD SAD SleTs" (CYP450 induction; SIADH; Ataxia; Diplopia; SJS; Agranulocytosis/Aplastic anemia; DRESS Syndrome; SLE (drug-induced); Teratogen.Mnemonic10/05/19 6:49 AMMichaelMarkelmmarkel18@gmail.com
1430532Neurology and Special SensesPharmacologyEpilepsy drugsFirst Aid for the USMLE Step 1 2019, page 532Venn Diagram for mechanism of action of epilepsy drugsMnemonic10/30/19 8:43 AMHasanHammohahammo@gmail.com
1431533Neurology and Special SensesPharmacologyIntravenous anestheticsopinionEtomidate should be included in this listHigh-yield addition to next yearVerifiedDefer to 202.

? HY new content

- Humood		01/30/19 7:48 PMMatthewHm_r_hennessey@yahoo.com
1432534Neurology and Special SensesPharmacologySerotonin syndromehttps://www-ncbi-nlm-nih-gov.ezproxy.rosalindfranklin.edu/pubmed/29482205I think it' definitely worth mentioning how triptans can be safely co-prescribed with SSRI/SNRIs. A study published in 2018 concerning triptans and SSRI/SNRI co-prescription looked at nearly 48,000 patients between 2001 - 2014, with an incidence of 0.6 cases per 10,000 patients! The 2006 FDA alert seems unjustified, and probably invalid, given the mounting and contradictory evidence.Clarification to current text10/30/19 9:14 PMBenjamin A study published in 2018 concerning triptans and SSRI/SNRI co-prescription looked at nearly 48,000 patients between 2001 - 2014 and found only 0-4 cases per 10,000 patients! The 2006 FDA alert seems unjustified, and probably invalid, given the mounting contradictory evidence.Parkerbennparker123@gmail.com
1433534Neurology and Special SensesPharmacologyTriptanshttps://www.uptodate.com/contents/pathophysiology-clinical-features-and-diagnosis-of-migraine-in-children?search=sumatriptan%20mechanism&source=search_result&selectedTitle=5~25&usage_type=default&display_rank=5Under mechanism, it reads that triptans induce vasoconstrition, which is a typo meaning to say induce vasoconstrictionSpelling/formattingStaff acceptsCorrect, typo needs to be fixed.
-Kaitlyn		Agree. -YK02/12/19 8:43 AMAndreWakimandrewakim@creighton.edu
1434535Neurology and Special SensesPharmacologyDrug nameshttps://livertox.nih.gov/Entacapone.htm"Entacapone inhibits COMT activity only peripherally, unlike tolcapone which acts both peripherally and centrally."Major erratumVerifiedYou are right. Already addressed below. However, please consider acknowledgement and incentives for whoever suggested first.

- Vivek		Repeat suggestion, so will reject.Reject by 2 authors + 1 editor01/10/19 1:23 AMElanaMolchoelana.molcho@gmail.com
1435535Neurology and Special SensestruePharmacologyParkinson disease drugshttps://www.pdr.net/drug-summary/Tasmar-tolcapone-1605Entacapone does not inhibit central COMT. The current text states that it does under the heading 'Prevent dopamine breakdown.' This drug should be Tolcapone NOT Entacapone. The diagram is correct but the current text is not.Major erratumVerifiedThis is already being discussed in the text. -AnupThis student was first, so will give credit. Under the "Prevent dopamine breakdown" replace "Entacaptone--blocks conversion...by inhibiting central COMT." WITH "Tolcapone--blocks conversion...by inhibiting central and peripheral COMT."Prelim accept by 2 authors + 1 editorBrad ColeI agree that the diagram is correct and the first bullet point that says "Entacapone prevents peripheral...." is also correct. The second bullet under "prevent dopamine breakdown" however should be changed to "Tolcapone-blocks conversion of dopamine...". I would add that tolcapone is now so rarely used because of liver toxicity (I don't know a neurologist in our group who has prescribed this in more than 10 years) that a consideration would be to take tolcapone out entirely for the next edition.Accept12/23/18 4:57 AMJerrinBawajerrin.bawa@gmail.com
1436535Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.uptodate.com/contents/pharmacologic-treatment-of-parkinson-disease?search=entacapone%20peripheral%20COMT&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Under the strategy "Prevent dopamine breakdown," Entacapone is said to inhibit central COMT and block dopamine conversion to 3-MT. However, Entacapone works in the periphery and converts dopamine to 3-OMD. Instead of Entacapone, Tolcapone would be a more appropriate correction since this drug blocks the conversion of dopamine to 3-MT via inhibition of central COMT. Also, in another strategy on the same page, “increase L-DOPA availability,” Entacapone is already mentioned to prevent peripheral L-DOPA degradation, which is the correct mechanism of action.Major erratumDuplicate01/04/19 5:38 PMJulieTranjulietran@email.arizona.edu
1437535Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.uptodate.com/contents/pharmacologic-treatment-of-parkinson-disease?search=entecapone%20tolcapone&source=search_result&selectedTitle=4~8&usage_type=default&display_rank=4#H204803Under prevent dopamine breakdown it says entecapone works by inhibiting central COMT but only tolcapone inhibits central, entecapone just does peripheral (which is correct in the diagram)Minor erratumagree with vivek ~parthVerifiedAgree with change as per Vivek. -AnupThe student is correct.


entecapone is a preferential peripheral COMT inhibitor as supported by UTD and other references-

"Tolcapone is a mixed (peripheral and central) catechol-O-methyltransferase (COMT) inhibitor, whereas entacapone is a preferential peripheral COMT inhibitor." [1]


Recommendation:

1. Replace the drug name "Entacapone" to "Tolcapone" in the current text
2. Add at the end of same sentence "by inhibiting both central and peripheral COMT" OR "by inhibiting central COMT (also inhibits peripheral COMT).


Reference: 1. https://www.ncbi.nlm.nih.gov/pubmed/12573869


- Vivek		Reject, repeat suggestion.Reject by 2 authors + 1 editor01/10/19 5:55 PMAshleyKatzensteinashley.katzenstein@jefferson.edu
1438535Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.uptodate.com/contents/pharmacologic-treatment-of-parkinson-disease?search=entacapone&source=search_result&selectedTitle=1~3&usage_type=default&display_rank=1On prevent dopamine breakdown, entacapone is listed as a central COMT inhibitor but it should be peripheral COMT inhibitorClarification to current textVerifiedUser is correct. Text next needs to be changed.

We had discussed this on annotate earlier. The illustration was revised to say entacapone works peripherally while tolecapone works peripherally and centrally. Later on in the revision process, a crowdproofer suggested we revise the narrative as well but this suggestion was deferred.

- Humood		Reject, repeat suggestion.Reject by 2 authors + 1 editor01/18/19 4:03 PMCatherineGlossccg5z6@health.missouri.edu
1439535Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.uptodate.com/contents/pharmacologic-treatment-of-parkinson-disease?search=entacapone&source=search_result&selectedTitle=1~3&usage_type=default&display_rank=1On prevent dopamine breakdown, entacapone is listed as a central COMT inhibitor but it should be peripheral COMT inhibitor. I think FA meant to say Tolcapone in it's placeClarification to current textVerifiedDuplicate of above. Copying same response.

"User is correct. Text next needs to be changed.

We had discussed this on annotate earlier. The illustration was revised to say entacapone works peripherally while tolecapone works peripherally and centrally. Later on in the revision process, a crowdproofer suggested we revise the narrative as well but this suggestion was deferred.

- Humood"		Reject, repeat suggestion.Reject by 2 authors + 1 editor01/18/19 4:07 PMCatherineGlossccg5z6@health.missouri.edu
1440535Neurology and Special SensesPharmacologyParkinson disease drugsUworld and UpToDate - https://www.uptodate.com/contents/management-of-nonmotor-symptoms-in-parkinson-diseasePsychotic symptoms are a frequent complication in Parkinson disease (especially when dopaminergic drugs are used, which are first line for PD), and are the strongest predictor for nursing home placement of patients with PD. Drugs for psychosis in PD are Quetiapine, Clozapine and Pimavenserin (other antipsychotics worsen underlying Parkinson disease due to their extrapyramidal symptoms). Definitely high yield for what-drug-would-you-use kind of questions on the USMLE.High-yield addition to next yearVerifiedDefer to 2020.

? HY new content.
- Humood		01/20/19 5:56 PMAnilA Kumaranil_kumarans@yahoo.co.in
1441535Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.ncbi.nlm.nih.gov/pubmed/11440283Text is right in specifying "Entacapone- blocks conversion of dopamine to 3-methoxytyramine (3-MT) by inhibiting central COMT." Howver, it will be good to specify that Entacapone is only a weak inhibitor of COMT in CNS. Tolcapone is stronger inhibitor of COMT in CNS and hence can be used to produce effect both centrally as well as in periphery.High-yield addition to next yearVerifiedThis has been discussed during the 2019 crowdproofing. I think we can still have faculty input. -Anup02/14/19 8:28 AMMurliMishramm.murli@gmail.com
1442535Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.ncbi.nlm.nih.gov/pubmed/9917075Under the strategy "increase the L-DOPA availability," Tolcapone should be added as an agent that prevents peripheral L-DOPA degradation. It is added in the diagram but not the text.Major erratumVerifiedThis has been discussed during the 2019 crowdproofing. I think we can still have faculty input. -Anup02/26/19 7:17 PMSamanthaAbdallahsamantha.abdallah2@med.wayne.edu
1443535Neurology and Special SensesPharmacologyParkinson disease drugsmnemonicParkinson disease drug strategy "curb excess cholinergic activity"; mnemonic "Park your Mercedes-Benz". Suggestion: Add to existing mnemonic: " Mercedes-Benz by the CURB". (since the drug strategy is "Curb excess cholinergic activity"). May also add: "...Benz with TRIpointed emblem" in reference to TRIhexyphenidylMnemonicVerifiedI like both of these.
-Kaitlyn		03/06/19 5:03 PMM MarwanDabbaghdr.dabbagh@outlook.com
1444535Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.ncbi.nlm.nih.gov/pubmed/12573869 eMedicine mentions these drugs, but it does not mention peripheral vs central actions as this paper does.Under "Parkinson Disease Drugs", it mentions that Entacapone prevents peripheral break down of L-DOPA by inhibiting COMT (which is correct), but underneath that, it mentions entacapone as acting centrally to inhibit COMT as well. From my understanding, entacapone's effects are mostly limited to the periphery, while tolcapone is more noted for inhibiting both peripheral *and* central degradation of L-DOPA through inhibition of COMT. I hope I am not splitting hairs with this point, but I thought it may be worth reaching out and notifying you. Thank you for the great material!Minor erratumVerifiedThis has been discussed during the 2019 crowdproofing. I think we can still have faculty input. -Anup03/11/19 10:18 AMRoySmithBenjaminRoySmithJr@gmail.com
1445535Neurology and Special SensesPharmacologyParkinson disease drugshttps://www.ncbi.nlm.nih.gov/m/pubmed/9808337/Entacapone inhibit peripheral COMTMinor erratum05/23/19 9:09 PMSherifGuirguisSherif.guirguis@hotmail.com
1446536Neurology and Special SensesPharmacologyNeurodegenerative disease drugsMnemonicTetrabenazine for huntington disease. TETRAbenazine (4): Hunting 4 food, Chromosome 4MnemonicVerifiedThis is good except we don't mention chromosome 4 here so we shouldn't include that part.
-Kaitlyn		02/12/19 5:07 PMGenesisValenzuelagvalenzuelah@hotmail.com
1447537Neurology and Special SensesPharmacologyInhaled anestheticshttps://www.ncbi.nlm.nih.gov/pubmed/23324809 and https://www.openanesthesia.org/cbfcmro2_drug_effects/N20 does not cause an increase in cerebral metabolic demand, but it does cause an increase in cerebral blood flow. The fluorinated inhaled anesthetics (eg. halothane, desflurane) cause an increase in cerebral blood flow and a decrease in cerebral metabolic demand.Clarification to current textVerified02/18/19 6:48 PMBeth AnneGeorgeElisabeth_George@brown.edu
1448537Neurology and Special SensesPharmacologyLocal anestheticshttps://www.uptodate.com/contents/clinical-use-of-local-anesthetics-in-anesthesia?search=local%20anesthetics&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2Text states that "If allergic to esters, give amides." However, the opposite is true--typically if a patient is allergic to amides (first line, eg lidocaine or bupivacaine), then we move to esters.Major erratum09/19/19 3:23 PMSyedAdilsyedadil94@gmail.com
1449538Neurology and Special SensesPharmacologyBaclofenN/Ayou should highlight the B in Gaba B with red like you did with B in Baclofen for us to remember that it works on Gaba BMnemonicVerified05/12/19 6:47 PMOmairCochaudry19@gmail.com
1450538Neurology and Special SensesPharmacologyNeuromuscular blocking drugshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1760749/The current text says curare drugs are Ach antagonists, but they are actually Ach receptor** antagonists.Major erratumAccept. Definitely a receptor antagonist. -Zander04/21/19 12:03 PMShreyaReddysreddy000@citymail.cuny.edu
1451538Neurology and Special SensesPharmacologyOpioid analgesicshttps://reference.medscape.com/drug/sublimaze-fentanyl-343311In the index it is stated that the drug Fentanyl is on page 538 when it is not. It is a potent opioid which has a short duration but can also be used transdermally for chronic pain.Clarification to current textVerifiedUser is correct. Index problem.

Fentanyl was deleted from opioid fact on both 2018 and 2019 editions. We may need to add it back. Defer to 2020 team.

- Humood		Agree, it probably was deleted through the process of revamping this fact. Let's consider adding back fentanyl to the Opioid analgesics section under "Full agonist" line in the Efficacy section. -VVPrelim accept but NOT publishable erratatrue02/02/19 12:31 PMAlexandra & JoshuaMedeiros & Fowleralexkm1994@yahoo.com
1452538Neurology and Special SensesPharmacologyOpioid analgesicshttps://www.ncbi.nlm.nih.gov/pubmed/19435929 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2713087/ https://www.drugbank.ca/drugs/DB01183naltrexone and naloxone should be considered opioid inverse agonists as well as antagonists. Inverse agonist effect is used to treat overdoseMinor erratum10/10/19 2:55 AMjamesgutchojameskgutcho@gmail.com
1453538Neurology and Special SensesPharmacologyOpioid analgesicsN/ASide effects: MORPHINES Miosis, Orthostatic hypotension, Respiratory depression, Physical dependence, Histamine release, Increased intracranial pressure, Nausea, Euphoria, SedationMnemonic11/07/19 3:26 AMSaraCerasisara.cerasi@studio.unibo.it
1454538Neurology and Special SensesPharmacologySpasmolytics, antispamodicsIt's MnemonicTiz*a*nidine --> *α*2 *a*gonist .\highlight "a" in red color.MnemonicVerifiedCould be added in next year -AnupReject.

Reject for now as we are looking for Errata. We can defer suggestion to 2020.

- Humood		01/04/19 10:47 AMMoatasemAl-Janabiassoomi88@yahoo.com
1455538Neurology and Special SensesPharmacologySpasmolytics, antispamodicshttps://www.ncbi.nlm.nih.gov/books/NBK519505/ ,, https://en.wikipedia.org/wiki/TizanidineTizanidine is more Tolerable than baclofen .(*T*izanidine -->*T*olerable).MnemonicVerifiedCould be added in next year -AnupReject.

Reject for now as we are looking for Errata. We can defer suggestion to 2020.

- Humood		01/04/19 10:52 AMMoatasemAl-Janabiassoomi88@yahoo.com
1456542PsychiatryPsychologyEgo defensesNot needed.Under the 'Denial' heading, 'avoiding the awareness of some painful reality' can be replaced with 'avoiding the awareness of some unpleasant reality' as a better choice of words.Clarification to current textVerifiedReject. No change required. - RohanAgree with Rohan -YKI agree the current text is fine as is.

Sarah		Reject by 2 authors + 1 editor04/27/19 8:02 AMAhmed AliKhanahmedalikhanjr@gmail.com
1457545PsychiatryPathologyChildhood and early-onset disordershttps://www.uptodate.com/contents/attention-deficit-hyperactivity-disorder-in-children-and-adolescents-epidemiology-and-pathogenesis#H5ADHD has Oppositional defiant disorder (ODD) as a comorbidity (prevalence is very high at 50-80%). Can be listed as a comorbid association.High-yield addition to next yearaccept. agree with GS to list as comorbid condition. -AidaVerifiedI think we should list it as a comorbid association. -GSAgree with GS -YK01/20/19 7:12 PMAbhishekChhabraanil_kumarans@yahoo.co.in
1458545PsychiatryPathologyChildhood and early-onset disordershttps://www.cdc.gov/ncbddd/adhd/diagnosis.htmlIn order to diagnose Attention Deficit Hyperactivity Disorder six or more than six symptoms of inattentive and/or hyperactive/impulsive should be present. the no. of symptoms is not mention to make diagnosis.Major erratumVerifiedReject. This is too specific and not test-worthy on Step 1. -YKNot HY for Step 1. - RohanAgree- LY.

Sarah		Reject by 2 authors + 1 editor04/01/19 4:36 PMMuhanadShaibmohanad.shaib@gmail.com
1459545PsychiatryPathologyChildhood and early-onset disordershttps://www.sciencedirect.com/science/article/pii/S0925492715300573people suffering from autism have larger than normal head circumferences (macrocephaly), and have larger than normal brains. writing head/brain size can be misinterpreted as head to brain size. I think it would be clearer if it was rewritten head and brain sizeClarification to current textVerifiedAccept. Suggest changing to "head and brain size" -YKAccept. Change to Head and/or Brain size.- RohanMinor change but I agree this would make the text more accurate.

- Sarah		Prelim accept but NOT publishable erratatrue04/03/19 9:27 PMAwabElnaeemawab.kamal@gmail.com
1460545PsychiatryPathologyOrientationhttps://www.english.illinois.edu/-people-/faculty/debaron/essays/epicene.htmWording is "patient's ability to know who he or she is, where he or she is..." We should instead consider using less binary pronouns and having the text read, "patient's ability to know who they are, where they are..." as the use of singular "they" is now widely accepted and was even made word of the year in 2015 by the American Dialect Society.Spelling/formattingStaff rejects02/24/19 6:26 PMLoTamburrolo.tamburro@med.wmich.edu
1461546PsychiatryPathologyAmnesiashttps://www.uptodate.com/contents/overview-of-the-chronic-neurologic-complications-of-alcohol?search=korsakoff&source=search_result&selectedTitle=1~15&usage_type=default&display_rank=1Memory impairment correlates better with lesions in the anterior thalamus rather than mamillary bodies [13].Clarification to current textAgree. UpToDate mentions the role of anterior thalamus destruction is predominant in memory impairment. I suggest it should be changed to anterior thalamus and mamillary body destruction. - RohanI'm not sure about making the change. I think this all depends on who you ask. The paper UpToDate cites from the user-provided article is from 2000. In that same UpToDate article, it says mamillary bodies are specific for WE. In contrast, I found another UpToDate article (below) which mentions again that mamillary bodies are specific for WE (citing a paper from 1999), but does NOT mention the anterior thalamus. I think if we want to change anything, we need an EXPERT REVIEW. Otherwise I suggest no change. -YK


(source: https://www.uptodate.com/contents/wernicke-encephalopathy?search=korsakoff%20syndrome&source=search_result&selectedTitle=2~16&usage_type=default&display_rank=2#H13)		Being discussed on Annotate with faculty input.

- Sarah		Disagreement/need experttrue05/02/19 12:57 AMShichengSongnicksong66@gmail.com
1462547PsychiatryPathologyPsychosisShowed up on a few tests and Uworld.Impulse control disorders (specially Intermittent explosive disorder)High-yield addition to next yearIf we do add this, it should be under "Childhood and early-onset disorders" (not psychosis as suggested). I'm not aware of how commonly this is tested. I find it unlikely, would like further input. -YK06/10/19 7:39 AMAhmed AliKhanahmedalikhanjr@gmail.com
1463548PsychiatryPathologyDelusional disorderFirst Aid 2019at the end of first line there is two dots between the word symptoms and Daily.it suppose to be one dot only.Spelling/formattingAlready noted on Annotate. -KDAccept. - Rohan04/01/19 4:02 PMMuhanadShaibmohanad.shaib@gmail.com
1464548PsychiatryPathologyManic episodehttps://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t7/The requirements for Manic Episode is listed as ≥1 week. However, according to the DSM, the time requirement is ≥1 week OR any duration if hospitalization is necessary.Minor erratum11/08/19 12:07 AMHaziqSiddiqisiddiqi.haziq1@gmail.com
1465548PsychiatryPathologySchizophrenia spectrum disordershttps://www.ncbi.nlm.nih.gov/pubmed/25809850As risperidone is the first line treatment for Schizophrenia , Clozapine is the first line treatment for Resistant SchizophreniaClarification to current textVerifiedReject. This is mentioned under the pharma section for atypical antipsychotics. I do not think it is necessary here. -YKAgree with Yumi. Already covered in the chapter.

- Sarah		Reject by 2 authors + 1 editor04/20/19 1:47 PMMuhanadShaibmohanad.shaib@gmail.com
1466549PsychiatryPathologyMajor depressive disorderhttps://www.webmd.com/depression/guide/atypical-depression#1It is important to specify that Persistent Depressive Disorder (Dysthymia) need to be present only for 1 year in children for diagnosis. The adults patients need to have symptoms lasting 2 years or more.High-yield addition to next yearAccept. I dont think this is an errata more like a good addition to 2020 edition. Being able to diagnose Pediatric case of Dysthymia vs adult is important since it could mean misdiagnosis(and inappropriate next step in management) if you wait an additional year. I think it warrants adding and won't take too much space. -AidaVerifiedAccept. Agree with Aida. Can be added in as "lasting >= 2 years (>= 1 year in children)" -YK02/10/19 3:10 PMMurliMishramm.murli@gmail.com
1467549PsychiatryPathologyMajor depressive disorderhttps://sso.uptodate.com/contents/unipolar-depression-in-adults-course-of-illness?search=Persistent%20depressive%20disorder%20(dysthymia)&source=search_result&selectedTitle=1~60&usage_type=default&display_rank=1This section does not include Persistent Depressive Disorder (Dysthymic Disorder). I saw that someone submitted a suggestion, however, their source was WebMD which is not reliable. There is UpToDate information which will help include this into First Aid 2020.High-yield addition to next yearReject. The user is incorrect, FA2019 did have persistent depressive disorder present under the MDD section. -YKReject. The recommendation is already present in FA 2019, on page 549, MDD section - Rohan03/22/19 3:48 PMAntaraAfrinafrinant@msu.edu
1468550PsychiatryPathologyPeripartum mood disturbanceshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100364/zulresso-brexanoloneThe only drug specifically approved for post partum depression is brexanolone, a gamma-aminobutyric acid (GABA) A receptor positive modulatorHigh-yield addition to next yearAccept. FDA approved brexanolone as the first treatment specific for PPD. Although, it should be added after SSRIs, since it is still not considered the first line of treatment for PPD. - RohanI agree this information is correct, however this was a very recent change in medicine (March 2019). I'm not familiar with how soon we change the text with new advances. Will refer to editors. -YK04/16/19 11:42 AMJan AndreGraumanjgrauman@gmail.com
1469551PsychiatryPathologyAnxiety disorderNone needed. Just taking the symptoms and providing mnemonicMnemonic for the symptoms of Generalized Anxiety Disorder. CRIMES C- Concentration (decreased) R- Restlessness I-Irritability M- Muscle Tension E- Energy (decreased) S- Sleep (disturbance)MnemonicVerifiedReject. I don't find this necessary (most symptoms of anxiety are common knowledge, thus i don't see this being worth the extra space) -YKNot helpful in recollection - Rohan04/14/19 5:04 PMRabbi MichaelWeingartenweingarten.mj@gmail.com
1470553PsychiatrytruePathologyCluster A personality disordersSee First Aid 2018 - pg 549 which includes Paranoid personality disorder vs pg 553 First Aid 2019 does not include "paranoid"; however mnemonic on First Aid 2019 pg 553 still includes "Accusatory".Cluter A personality disorders - mnemonic includes Accusatory; however, "Paranoid personality disorder" has been removed in First Aid 2019 pg 553.Minor erratumVerifiedNot sure how this happened. Definitely need to update errata to include it. -GSIn response to Matt at right: we don't want to remove "Accusatory"; we want to put back paranoid PD which was erroneously deleted! -KDAgree, the "accusatory" part should be removed in light of removing paranoid personaltity disorder. Approve removal and reasonable to publish in the official errata.

Changed to a minor erratum, however, as it's hardly what I would call a major issue!

-Matt		Prelim accept by 2 authors + 1 editorRyan HallSounds goodAccepttrue12/30/18 4:37 PMMSathyanarayananmsgb289@gmail.com
1471553PsychiatryPathologyCluster A personality disordershttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639232/ ,,,First aid 2018you should put these paragraph "Paranoid Pervasive distrust (Accusatory) and suspiciousness of others and a profoundly cynical view of the world."High-yield addition to next yearIf the reader wants to place the comment's paragraph under Cluster A, then reject. As per psychology today the key words for all A's is "odd bizarre or eccentric". What the reader is describing sounds more like a paranoid PD. source: https://www.psychologytoday.com/us/blog/hide-and-seek/201205/the-10-personality-disorders -AidaVerifiedIs this related to the paranoid personality disorder or to all cluster A? I dont think it fits the general cluster A description. -GSI don't even understand what they're saying. Reject. -KD01/04/19 12:00 PMMoatasemAl-Janabiassoomi88@yahoo.com
1472553PsychiatryPathologyCluster A personality disordershttps://www.uptodate.com/contents/overview-of-personality-disordersThis year's version has missed explanation of "paranoid" concept in cluster A personality disorderHigh-yield addition to next yearVerifiedDuplicateRepeat - Rohan03/02/19 11:17 PMRunzheChenrunzhe.chen@outlook.com
1473553PsychiatryPathologyCluster A personality disordershttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992453/ ; https://www.uptodate.com/contents/overview-of-personality-disorders#H256374117Cluster A personality disorders: Paranoid was not included under Cluster A. I know this was submitted already; however, the source was not as authoritative; therefore, I thought I should re-submit.High-yield addition to next yearDuplicateRepeat - Rohan03/20/19 10:14 AMAntaraAfrinafrinant@msu.edu
1474553PsychiatryPathologyCluster A personality disordersN/AParanoid Disorder has been forgotten in the 2019 version, but the mnemonic(Accusatory) is the same in the 2018 edition and it is placed in the Cluster A personality disorders.Major erratumVerifiedDuplicateRepeated - RohanAgree - this has been highlighted on multiple occasions and has been published as part of the official errata.
The paranoid PD fact needs to be included again this year.

Sarah		Prelim accept by 2 authors + 1 editortrue03/26/19 7:21 PMDannyIbrahimdibrahim@sgu.edu
1475553PsychiatryPathologyCluster A personality disordershttps://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463The Index mentions that Paranoid personality disorder is at page 541 (which is just the introduction page to Psychiatry and still doesn't contain even the keywords). A paranoid personality disorder sub heading should be added to cluster A personality disorder on page 553.Major erratumVerifiedAgree. Requisite change should be done as per the suggestion. - RohanAgree - this has been highlighted on multiple occasions and has been published as part of the official errata.
The paranoid PD fact needs to be included again this year.

Sarah		Prelim accept by 2 authors + 1 editortrue04/28/19 8:22 AMAhmed AliKhanahmedalikhanjr@gmail.com
1476553PsychiatryPathologyCluster A personality disordersN/ASchizOID-- isolates oneself in a VOIDMnemonicVerifiednot a fan -YK05/30/19 2:04 PMHaleyD'Souzadsouzahs@evms.edu
1477553PsychiatryPathologyCluster A personality disordershttps://www-uptodate-com.proxy.lib.uiowa.edu/contents/overview-of-personality-disorders?search=personality%20disorders&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H256374117In the text, paranoid personality disorder was left out of the cluster A disorders and only schizoid and schizotypal are listed.High-yield addition to next year08/25/19 7:16 PMCassandraHardycassandra-hardy@uiowa.edu
1478553PsychiatryPathologyPersonalityFirst Aid 2018 has the disorderParanoid personality disorder omitted from the bookMajor erratumVerifiedSee comment above. -GSDuplicate.

-Matt		Reject by 2 authors + 1 editor01/02/19 12:19 PMDavidNwachukwudnjrocks@gmail.com
1479553PsychiatryPathologyPersonalityhttps://emedicine.medscape.com/article/294307-overviewParanoid Personality Disorder is missing from the Cluster A personality disordersMajor erratumDuplicateSee comment above. -GS01/18/19 1:15 PMChimmaNwobichimmaonyinye@gmail.com
1480553PsychiatryPathologyPersonalityhttps://emedicine.medscape.com/article/294307-overviewCluster A Paranoid Personality Disorder is missingMajor erratumDuplicate02/15/19 2:24 PMLiaDemchenkolia.demchenko@me.com
1481553PsychiatryPathologyPersonalityFA 2018Paranoid Personality Disorder was removedMajor erratumVerifiedDuplicateRepeat - RohanAgree - already added to AnnotatePrelim accept by 2 authors + 1 editortrue02/24/19 7:39 PMMatthewE.ehrlhoops@aol.com
1482553PsychiatryPathologyPersonalityhttps://www.uptodate.com/contents/overview-of-personality-disorders?search=personality%20disorder&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H256374117Paranoid personality disorderMajor erratumVerifiedAgree. Requisite change should be done as per the suggestion. - RohanAgree - this has been highlighted on multiple occasions and has been published as part of the official errata.
The paranoid PD fact needs to be included again this year.

Sarah		Prelim accept by 2 authors + 1 editortrue04/28/19 8:51 PMTomasReamtmream@utmb.edu
1483554PsychiatryPathologyMalingeringFAA 2x2 table comparing the disorders- malingering vs. factitious vs. somatic symptom would be useful in having a visual to aid with the new added bolded words- see attached pictureClarification to current textVerifiedNot a bad idea. I could see this being done with the 2 columns being "symptoms" and "motivation". However given that we're trying to save space this year, not sure if this is the best idea. This may be best to look further into for next year -YKAgree. A table would be better to compare Factitious disorder vs malingering vs somatic disorders. It would save the space and make the explanations more concise. - RohanExcellent idea! I am all for consolidating these facts and a comparison table would be great for that.
Let's migrate this suggestion to Annotate and work up the fact there.

- Sarah		Prelim accept but NOT publishable erratatrue02/27/19 10:00 AMDylanErwinderwin@smu.edu
1484554PsychiatryPathologySomatic symptom and related disordershttps://medlineplus.gov/ency/article/000954.htmConversion disorder are neurological symptoms that cannot be explained by neurological diagnosis. Later part is not there in First Aid 2019Clarification to current textreject. The definition we have hasn't changed at all since 2018. we currently mention that it's a "functional" neurological symptom disorder (where functional entails its subjective since physical exam is normal). If we want to improve the text, we should perhaps give an example. Example: patient saw something disturbing--> complains of not being able to see--> doctor finds normal HEENT exam -AidaVerifiedAgree, not incorrect or unclear, so no need to change. Open to considering the non-urgent "cosmetic" changes to the description, however.

-Matt		Reject by 2 authors + 1 editor02/10/19 12:17 PMMurliMishramm.murli@gmail.com
1485554PsychiatryPharmacologySomatic symptom and related disordershttps://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596"Most individuals with hypochondriasis are now classified as having somatic symptom disorder; however, in a minority of cases, the diagnosis of illness anxiety disorder applies instead." -DSM-5Major erratumNot clear what the suggested change is -YKI think the reader is suggesting that we should change hypochondriasis from being listed under illness anxiety disorder (as it was formerly classified) to now be included under somatic symptom disorder.
Migrated to Annotate for further discussion +/- expert input.

- Sarah		Disagreement/need experttrue07/09/19 3:02 PMJessicaLazarlazarjessa@gmail.com
1486555PsychiatryPathologyEating disordersLook at Previous Editions of First AidThe treatment for Anorexia nervosa, which was in past editions of First Aid was removed. Treatment is listed for Bulimia, but it is in a separate subsectionMajor erratumVerifiedAgreed. -KDAddition of "Treatment" subsection for Anorexia nervosa is required. Revision of treatment of anorexia and bulimia nervosa should be done accordingly. - Rohantrue04/14/19 4:58 PMRabbi MichaelWeingartenweingarten.mj@gmail.com
1487555PsychiatryPathologyEating disordersWHOUnder the Anorexia Nervosa heading, mentioning BMI less than 18.5 Kg per metre square can be helpfulHigh-yield addition to next yearAccept. BMI < 18.5kg/m2 is a defining feature, should be mentioned in the section. Also commonly presented in the question vignettes. - Rohan04/28/19 6:11 AMAhmed AliKhanahmedalikhanjr@gmail.com
1488555PsychiatryPathologyEating disordersUpToDate Uworld QbankUnder the binge eating disorder section and the opening sentence, kindly change 'without purging behaviors' to 'without compensatory behaviors' as the latter also includes restricting behaviors as well. This will avoid confusion. I got 2 questions wrong due to this.Clarification to current textAccept. Also, along this line we should also change "Bulimia Nervosa" in the first line to "Recurring episodes of binge eating with compensatory behaviors (eg, self-induced vomiting, excessive exercise, etc.)" -YK

Source: DSM 5		06/12/19 9:25 AMAhmed AliKhanahmedalikhanjr@gmail.com
1489555PsychiatryPathologySexual dysfunctionhttps://dsm.psychiatryonline.org/doi/10.1176/appi.books.9780890425596.dsm19Doesn’t have any information on paraphilias (aside from transvestic disorder above). Most paraphilias don’t constitute paraphilias disorders, however if the paraphilia causes distress or impairment to the individual by causing personal harm, or harm to (or risk of harm to) someone else. Treatment usually involves psychotherapy, however disorders that place public at risk (most commonly, pedophilic disorder) involves pharmacological therapy to suppress sexual drive (Eg: antidepressants, androgen antagonists).High-yield addition to next year08/08/19 7:50 PMBlairSchuchBlair.schuch@griffithuni.edu.au
1490556PsychiatryPathologyNarcolepsyhttps://www.medscape.com/viewarticle/910723Treatment: Additionally daytime Solriamfetol (the first and only dual-acting dopamine and norepinephrine reuptake inhibitor approved by the FDA )High-yield addition to next yearAccept. This is also found on UpToDate. Can be added in as "daytime stimulants (eg, amphetamines, modafanil, solriamfetol)" -YK

Source: https://www.uptodate.com/contents/treatment-of-narcolepsy-in-adults?search=narcolepsy&source=search_result&selectedTitle=2~120&usage_type=default&display_rank=2#H2955284314		Accept. Can be added to the examples in the narcolepsy section. However, this example is not HY since FDA approved it very recently. - Rohan03/21/19 11:26 AMDharmikPateldr.dharmik5995@gmail.com
1491556PsychiatryPathologyStages of change in overcoming addictionNone needed.To remember the stages, think "PCP Addicts Might Relapse"Mnemonic10/26/19 11:55 AMHaleeEinfeldraxorium@gmail.com
1492557PsychiatryPathologyNeuronsnoneUnder Neuroleptic Malignant Syndrome: (could not find proper Fact Name) NMS = Rigid State, Undo with a Dance with Dan(ce)troleneMnemonicVerifiedPage 557, under Psychiatric Emergencies. Interesting, but not sure how "Dance" is relevant here. Reject -YK05/26/19 9:08 AMNicolaDuzaknhampel@mail.sjsm.org
1493557PsychiatryPathologySerotonin syndromenoneSS = Hyperreflexes like a Pro, Tx: CyPROheptadineMnemonicVerifiedNot a fan -YK05/26/19 9:00 AMNicolaDuzaknhampel@mail.sjsm.org
1494559PsychiatryPathologyAlcoholismhttps://www.uptodate.com/contents/approach-to-treating-alcohol-use-disorder, UW Question ID 11577The listing order of the treatment for alcoholism should be reversed to reflect the clinically accepted first, second, and third line treatments. It's currently listed in the text as disulfiram first, acamprosate second, and naltrexone third, when clinically, according to UTD, the first line treatment in most cases is Naltrexone, second line Acamprosate, and third line Disulfiram. Reversing this order would provide better clarification for students on the order of treatment, even if the original listing of these drugs wasn’t necessarily a reflection of this order.Clarification to current textAccept/agree -YKAlready actioned during Pass 1Prelim accept but NOT publishable erratatrue06/07/19 4:55 PMYolandaZhangyolandazhang43@gmail.com
1495559PsychiatryPathologyPsychoactive drug intoxication and withdrawalhttps://jamanetwork.com/journals/archneurpsyc/article-abstract/652608 http://www.emcdda.europa.eu/publications/drug-profiles/lsdLysergic acid diethylamide intoxication can cause PUPILLARY DILATION.Clarification to current textVerifiedReject. Most resources including UpToDate don't mention pupillary dilation as a common presenting feature in LSD intoxication. - RohanAgree with Rohan. Seems LYReject by 2 authors + 1 editor04/26/19 4:24 PMMuhanadShaibmohanad.shaib@gmail.com
1496560.00PsychiatryPharmacologyCentral nervous system stimulantsCurrent First Aid Page 556.Addition of Modafinil as a nonamphetamine Psychostimulant as a first line pharmacotherapy option for Narcolepsy can be added. Also in the Index section 'Modafinil' is indexed at Pg 252 and Pg 556. I can confirm that there is no mention of Modafinil on pg 252.High-yield addition to next yearNot sure about this one. It's not clear if modafinil is classified as a "stimulant". Would require Expert Review. I added a note for the "Index" team on updating the page numbers. -YK06/22/19 8:18 AMAhmed AliKhanahmedalikhanjr@gmail.com
1497560RenalPathologyRenal clearanceN/a, this is tested even throughout USMLE-Rx relatively frequently. You could even make the First Aid as short as the one on this Rx question explanation (image attached, image belongs to USMLE-rx not me), with a quick list of expected lab findings.A few students and myself feel there should be, either in the renal or MSK section, a short outline of Rhabdomyolysis and expected findings. Aside from it's current and minimal mention in renal under "potassium shifts." This concept presents frequently and seems worth of its own short discussion.Clarification to current textVerifiedReject. Adequately covered in the renal pathology section, would seek the opinion from the authors of MSK section. - RohanDefer to 2020.

- Vivek		02/22/19 10:34 AMAshleyCohenashley.cohen@my.rfums.org
1498561PsychiatryPharmacologyAtypical antipsychotics1- https://www.ncbi.nlm.nih.gov/books/NBK459248/ . 2-http://www.differencebetween.net/science/health/disease-health/differences-between-dyslipidemia-and-hyperlipidemia/Replace "hyperlipidemia" with "dyslipidemia" , it is more accurate because dyslipidemia( abnormal amount, whether higher or lower, of lipids) associated with metabolic syndrome (elevated triglyceride level, low HDL level, and elevated low-density lipoprotein level) . Hyperlipidemia, on the other hand, is a condition wherein the level of fat and cholesterol in your body is too highMinor erratumaccept. As per up to date, they also use the term "dyslipidemia". source: "Weight gain, diabetes, and dyslipidemia are the components of metabolic syndrome usually associated with SGAs, ... disease". https://www.uptodate.com/contents/second-generation-antipsychotic-medications-pharmacology-administration-and-side-effects?search=antipsychotics&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H191681517 -AidaVerifiedI'm fine with this change. Change from "hyperlipidemia" to "dyslipidemia." -GSAccept -YKOK to make this change, but this need not be published in the official errata.

-Matt		Prelim accept but NOT publishable erratatrue01/22/19 9:54 AMMoatasemAl-Janabiassoomi88@yahoo.com
1499561PsychiatryPharmacologyAtypical antipsychoticsUWorld and First Aid page 557On page 557, Neuroleptic Malignant Syndrome is caused by "antipsychotics + genetic disposition". However, on page 561, Neuroleptic Malignant Syndrome is only listed for typical antipsychotics but not for atypical antipsychotics. Please add Neuroleptic Malignant Syndrome to the list of adverse effects for atypical antipsychotics. This was also a question on UWorld. Thank you.Clarification to current textaccept. atypical can still cause NMS, although less than typicals. We should explicitly mention. suggest " adding NMS along with "although typical>>atypical" -AidaVerifiedAccept - RohanAccept -YKAgree, add NMS to atypical antipsychotics for consistency. Minor and need not be published in the official errata, however.

-Matt		Prelim accept but NOT publishable erratatrue02/06/19 6:44 PMEstebanCasasolaecasasol@sgu.edu
1500561PsychiatryPharmacologyAtypical antipsychoticshttps://www.uptodate.com/contents/cariprazine-drug-information?topicRef=14776&source=see_linkCariprazine - a new atypical antipsychoticHigh-yield addition to next year10/21/19 11:12 PMPavelAksionavpavlusha_aksenov@mail.ru
1501562Neurology and Special SensesPharmacologyOpioid analgesicshttps://www.sciencedirect.com/science/article/abs/pii/S0955395914000887 (another: https://www.health.harvard.edu/blog/words-matter-language-addiction-life-saving-treatments-2016081510130)"Heroin addicts" is a stigmatizing term (see references below) that is generally not accepted by the harm reduction community as well as most people who use drugs. PWUD (people who use drugs) and PWID (people who inject drugs) are preferred alternatives.Major erratumVerifiedDefer to 2020.

Not a major erratum. UTD says "heroin addicts" in one of their articles.

Terminology change to be discussed by the team next year.

https://www.uptodate.com/contents/bone-and-calcium-disorders-in-hiv-infected-patients?search=heroind%20addicts&source=search_result&selectedTitle=5~8&usage_type=default&display_rank=5
- Humood		Let's defer to the main cycle. I would be inclined to reject, considering that it is important to know thtat the treatment used is specifically for heroin users, rather than all people who use or inject drugs. -VVPrelim accept but NOT publishable errata01/23/19 12:37 AMAdamBazariadam.bazari@ucsf.edu
1502563PsychiatryPharmacologyTricyclic antidepressantshttps://www.sciencedirect.com/topics/medicine-and-dentistry/tricyclic-antidepressantThe text indicates "3° TCAs (amitriptyline) have more anticholinergic effects than 2° TCA5 (nortriptyl ine)." It may be confusing for students and it would be better to clarify that Text is talking about tertiary (amitriptyline, doxepine, and imipramine) and secondary (desipramine and nortriptyline) amine respectivelyClarification to current textIs distinguishing secondary and tertiary amines even HY? I dont recall having to differentiate the two even in my pharm course... I think if we make this change its not as high yield as lets say knowing generations/classes of antipsychotics since it changes management and has prognostic implications (ie: atypicals AS are better for neg/pos symptoms). I highly doubt the student will be asked to chose tertiary or secondary TCA since they're not even first line drugs. -AidaVerifiedReject. I believe that additional examples of the drugs wouldn't be high yield, only representative drug examples suffice. - RohanEssentially,seems like the student wants us to list more of the examples from each class. This is a good situation where an "eg," before each drug name would work well. I propose just adding that to keep it simple.

I do not know how HY this is. Worthwhile to query our crowd/author team this year. I suspect it's reasonable to keep this in since the differences between the TCAs is higher yield clinically.

Accepting for credit and consideration, note that nothing here is published errata worthy.

-Matt		Prelim accept but NOT publishable errata02/10/19 2:59 PMMurliMishramm.murli@gmail.com
1503564PsychiatryPharmacologyAntidepressantstruehttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100364/zulresso-brexanolone, https://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100357/spravato-esketamine-nasal-spray,Probably need to update this diagram for esketamine and brexanoloneHigh-yield addition to next yearThe illustration team should look into the changes as per the editor's recommendation - RohanPer similar comment above: I agree this information is correct, however this was a very recent change in medicine (March 2019 for brexanalone). Also NOT sure how HY esketamine is currently for testing. I'm not familiar with how soon we change the text with new advances. Will refer to editors. -YK04/16/19 11:47 AMJan AndreGraumanjgrauman@gmail.com
1504564PsychiatryPharmacologyAtypical antidepressantshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100364/zulresso-brexanoloneShould add brexanolone for post partum depression as it uses a novel pathway: gamma-aminobutyric acid (GABA) A receptor positive modulatorHigh-yield addition to next yearAccept. FDA approved brexanolone as the first treatment specific for PPD. Although, it should be added after SSRIs, since it is still not considered the first line of treatment for PPD. - RohanPer similar comment above: I agree this information is correct, however this was a very recent change in medicine (March 2019). I'm not familiar with how soon we change the text with new advances. Will refer to editors. -YK04/16/19 11:44 AMJan AndreGraumanjgrauman@gmail.com
1505564PsychiatryPharmacologyAtypical antidepressantshttps://www.centerwatch.com/drug-information/fda-approved-drugs/drug/100357/spravato-esketamine-nasal-sprayShould add esketamine for treatment resistant depression as it uses a novel pathway: non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptorHigh-yield addition to next yearEsketamine is a new drug used in conjunction with an oral antidepressant in adults with treatment-resistant depression. FDA approved its use in early 2019. I feel it is not HY enough to be added to the section. - RohanAgree with Rohan as per above. Reject. -YK04/16/19 11:45 AMJan AndreGraumanjgrauman@gmail.com
1506564PsychiatryPharmacologyAtypical antidepressantsbecause the submission type is Mnemonics and its my own idea, so there is No reference!as Bupropion cause seizures in Bulimic patients what if you highlight B letter in red color on both words(bupropion & Bulimic)MnemonicVerifiedReject. Doesn't have an recollection value for the exam - RohanReject - agree with Rohan -YK05/13/19 7:17 PMMuhanadShaibmohanad.shaib@gmail.com
1507565RenalAbbreviations and SymbolsRenal clearancehttps://academic.oup.com/ajh/article/30/4/339/2623060 https://www.frontiersin.org/articles/10.3389/fphar.2018.00440/fullThroughout the renal section, the Term "AT-II Receptor Blocker" is used to denote Angiotensin II receptor blocker medications. However, although the term AT-II can imply Angiotensin II, to denote ARBs as AT-II Receptor Blocker is incorrect. This is because the notation “ATII-R” does not signify the only “Angiotensin II receptor blocker.” More-so, Angiotensin Receptor Blockers actually block AT1R bringing. This is a common misnomer, but is crucial in clarifying receptor binding, as new medications regarding which receptors bind are in clinical trials. Regarding the physiology, Angiotensin I is converted to Angiotensin II via ACE (and is inhibited by ACE-Inhibitors). Angiotensin II, however, binds to 2 receptors, AT1R (which is the target site of ARB’s), and ATIIR. The AT1R is actually the interaction targeted by ARBs. The notation “AT-II receptor blocker” denotes the incorrect binding, and as such, the common notation is rather: Ang-II receptor blocker. In summary: If you wish to denote Angiotensin II receptor blockers as ARB's, the abbreviation Ang-II must be used, rather than the misleading AT-II, as the latter denotes a separate entity Please reference Figure 1 in Carey, 2017, for visual clarification, as well as the distinction noted in Gebre et al., 2018.Clarification to current textVerifiedReject. ARB and ATII-RB are alternative acronyms used for the same group of drugs, and FA'19 clearly mentions the action of ARB/ATII-B is exclusively on AT1 (Page 596) No change required. - RohanReject, AKBReject by 2 authors + 1 editor01/08/19 1:02 PMJasonVadhanjv1015@mynsu.nova.edu
1508566RenalEmbryologyKidney embryologyhttps://en.m.wikipedia.org/wiki/Ureteric_budUreteric bud is a Mesonephric diverticulum (Metanephrogenic diverticulum) But in text , it is given as metanephric diverticulum.Major erratumReject. The mesonephric duct gives rise to the ureteric bud so that the ureteric bud can contribute to the metanephros.- Rohan Source: https://www.uptodate.com/contents/overview-of-congenital-anomalies-of-the-kidney-and-urinary-tract-cakut05/23/19 11:27 PMVigneshSundaramdr.vigneshsundaram@gmail.com
1509566.00RenalEmbryologyKidney stoneshttps://www.emjreviews.com/urology/article/renal-stones-a-clinical-review/Clarify that the ureteropelvic junction is the most common site of obstruction IN THE KIDNEY. The ureterovesical junction is narrower and a more common site of obstruction. "The three narrowest parts of the ureter are at the pelvo-ureteric junction, the mid-ureter, where the ureter crosses the iliac vessels, and the vesico-ureteric junction (VUJ). The VUJ is the most common site of obstruction."Spelling/formattingStaff acceptsDefer to expert, not sure about this.Disagreement/need expert*RENAL Adam WeinsteinI'm not certain what the suggested correction is. However, the text as is identifies three common spots for obstruction, and those are all accurate.soroushraisbahrami@gmail.comAgree with current wording that the three areas of ureteral obstruction secondary to urolithiasis passage are as stated: UPJ, ureter as it passes anterior to the iliac vessels, and the UVJ.Reject02/16/19 3:00 AMElanaMolchoelana.molcho@gmail.com
1510568RenalAnatomyAbdominal aorta and brancheshttps://www.ncbi.nlm.nih.gov/books/NBK538298/The cross-section of the kidney depicts the renal vein to be posterior to the artery. Anatomically, the renal vein is anterior/ in front of the renal artery. The renal pelvis remains the most posterior structure.Clarification to current text10/01/19 8:39 AMElizabethKasparovekasparov1@gmail.com
1511568RenalAnatomyKidney anatomy and glomerular structurehttps://www.ncbi.nlm.nih.gov/pubmed/29083626The lobar artery of the kidney is neither mentioned in the text nor shown in the picture: The text should change to read like this "Segmental artery -> lobar artery -> interlobar artery -> ..."High-yield addition to next yearVerifiedAgree to suggested change. This can also be added to image.

Yumi.		Nice addition-AKB01/07/19 4:14 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
1512568RenalAnatomyKidney anatomy and glomerular structuretruehttps://www.ncbi.nlm.nih.gov/pubmed/29494007 https://emedicine.medscape.com/article/1948775-overviewIn the figure showing a cross-section of the kidney, the renal vein is shown between the renal artery and renal pelvis. However, the renal vein should be the most anterior structure, with the renal pelvis most posterior and the renal artery traveling between the two.Minor erratumVerifiedAgree. This appears to be true. I believe this erratum came up during this last season of editing, however I suppose it was not addressed. This would require redrawing of the figure.

Source: https://www.ncbi.nlm.nih.gov/books/NBK459158/

Yumi		Nice addition-AKBIt wasn't accepted because it would require a revision to an illustration. Regardless, yes this should be changed in 2020.Prelim accept but NOT publishable errata*RENAL Adam WeinsteinYes, I agree this change would be the more accurate depiction.true01/24/19 12:42 AMEmmaSchnuckleems91261@creighton.edu
1513568RenalAnatomyKidney anatomy and glomerular structuretruehttps://www.ncbi.nlm.nih.gov/books/NBK459158/The image shown for the kidney anatomy and glomerular structure suggests that the renal artery is anterior to the renal vein. However, the correct anatomical position in the following order of anterior to posterior should be the renal vein, then the renal artery, and the renal pelvis as the most posterior. Since there is no text clarifying this, the image in First Aid makes it incorrectly seem that the renal artery is most anterior in terms of kidney anatomy.Minor erratumVerifiedAgree. Renal vein is indeed anterior to renal artery, and requires a change as per comment and the linked article. - RohanSame, agreed - AKBIt wasn't accepted because it would require a revision to an illustration. Regardless, yes this should be changed in 2020.Prelim accept but NOT publishable errata*RENAL Adam WeinsteinYes, same as above.true02/04/19 6:47 PMChristopherDeAngeloccd96606@creighton.edu
1514568RenalAnatomyKidney anatomy and glomerular structuren/aThe cross-section of a glomerulus has the Afferent arteriole labelled as Efferent arteriole, and vice versa. The opposite labelling has been used elsewhere. (Page 571) It would be better to stay with one standard labelling to avoid confusion.Major erratum11/12/19 3:44 PMMehreenAlidr.mehreenali@gmail.com
1515569RenalPhysiologyFluid compartmentshttps://hypertextbook.com/facts/1998/LanNaLee.shtml http://www.bloodjournal.org/content/bloodjournal/9/12/1205.full.pdf?sso-checked=trueBlood volume is given as 6L, though perhaps most sources list it as 4.7L or even less.Minor erratumI think this information will vary depending on the resource used. I'm inclined to leave it as is. -LilitAgree with Lilit. Addition not required, not a high yield info for the text. - RohanI agree with the authors. The exact numbers vary but approx. 5-6L is widely quoted. We mention it primarily for completion as knowing the exact blood volume is not particularly HY for Step 1.

- Sarah		Reject by 2 authors + 1 editor07/02/19 3:10 PMJosephYasmehjyasmeh@gmail.com
1516569RenalPhysiologyFluid compartmentsn/aGlomerular basement membrane is NEGATIVE about filtration of proteins.MnemonicVerifiedNot sure about this one. Doesn't seem like a good memory hook. Reject. -LilitLow recollection value. - Rohan07/10/19 1:05 PMAPandeyaranikopandey@gmail.com
1517569RenalPhysiologyGlomerular filtration barrierhttps://www.histology.leeds.ac.uk/urinary/renal_corpuscle.phpfiltration slits are only 20 to 30 nm wideMinor erratumI did stumble upon a few different resources with different size cutoffs for filtration slits. However, our text is stating size of molecules that cannot be filtered through the slits. Therefore, we don't really have an erratum here, so I would leave it as is. -LilitNo change required.I agree with Lilit. Knowing the exact width is not particularly HY for Step 1. It is more important to be aware of the molecules that cannot be filtered.

- Sarah		Reject by 2 authors + 1 editor06/02/19 6:40 AMRaedAbabnehraedababneh@gmail.com
1518570RenalPhysiologyGlomerular filtration rateMy recommendation + First Aid 2019The formula indicates P & pi value used for GFR. Even though most students understand what they are but it will be better to specify that they are hydrostatic and oncotic pressure. It will be helpful to save time for those students who do not remember itHigh-yield addition to next yearVerifiedAgree. P and π should be defined since it has not been done anywhere else in the chapter. - RohanFine to incorporate,AKB02/12/19 6:28 AMMurliMishramm.murli@gmail.com
1519570RenalPhysiologyGlomerular filtration rateMyselfHighlight CRE of Creatinine and secreted. It will help learn CREatinine is seCREted and hence overestimates GFR.MnemonicVerifiedReject. Basic physiological principle, rarely requires recall. - RohanReject, AKB02/12/19 6:40 AMMurliMishramm.murli@gmail.com
1520571RenalPhysiologyFiltrationmy self + First AidIn the diagram, the equation for net filtration pressure, It will be good idea to specify that P & pi are hydrostatic & Oncotic pressure respectively.High-yield addition to next yearVerifiedAgree. P and π should be defined since it has not been done anywhere else in the chapter. - RohanAs above - AKB02/12/19 7:12 AMMurliMishramm.murli@gmail.com
1521571RenalPhysiologyGlomerular filtration rateBoards and Beyond by Dr. Jason Ryan.It would be helpful to add an 'Afferent arteriole dilation' row in the 'Changes in glomerular dynamics' section at the bottom of the page. Here the both the GFR and RPF increase and FF remains the same. This may help further strengthen the concept.High-yield addition to next yearAccept.

Reasonable suggestion.

- Humood		accept, AKB03/18/19 6:35 AMAhmed AliKhanahmedalikhanjr@gmail.com
1522572RenalPhysiologyCalculation of reabsorption and secretion ratenot neededFiltered load = GFR x P, (((( If the substance is filtered freely )))Clarification to current textI don't think this addition in necessary. This information in parentheses should be intuitive. -LilitAgree with Lilit. This seems like an unnecessary LY addition.

- Sarah		Reject by 2 authors + 1 editor06/07/19 10:04 AMRaedAbabnehraedababneh@gmail.com
1523572RenalPhysiologyGlucose clearancenot neededon Diagram I suggest to add to Y axis parameter the "filtration load" to make it easier to understandMinor erratumVerifiedReject.Do not see the need to add the term, it will also overpopulate the diagram and make it difficult to understand. - RohanReject AKBAgree with the authors.

Sarah		Reject by 2 authors + 1 editor03/01/19 7:39 PMAlaJamalala.aljamal@hotmail.com
1524573RenalPhysiologyAcid-base physiologyhttp://eclinpath.com/chemistry/kidney/physiology/renal-acid-base/on p 573 on the collecting tubule diagram it looks like the HCO3- is getting excreted into the urine while the H+ is being reabsorbed; this is the opposite of the actual process, where H+ is excreted and bicarbonate is generated and reabsorbedClarification to current textVerifiedReject.- RohanReject. Sounds like this person is referring to the beta intercalated cells. Bicarb can be reabsorbed or secreted in the collecting tubule. Alpha and beta intercalated cells have opposing functions in this sense. -LilitAgree with Lilit's analysis. No change required.

- Sarah		Reject by 2 authors + 1 editor03/28/19 9:31 AMJessicaGeddesjessica.geddes@uky.edu
1525573RenalPhysiologyNephron transport physiologyNot neededA short note or a one-liner can or a pictorial representation can be made about Hartnup disease under early PCT. Would be a good tie in to biochemistry and the student can read it in more detail under the nutrition chapter on Pg.67.High-yield addition to next yearBorderline reject.

The idea itself is interesting. However, this is not the best page to place it in. The page is crowded already and there is no other disease tie-in on this page.

- Humood		Reject, AKB03/19/19 4:22 AMAhmed AliKhanahmedalikhanjr@gmail.com
1526573RenalPhysiologyNephron transport physiologyhttp://eclinpath.com/chemistry/kidney/physiology/renal-acid-base/on p 573 on the collecting tubule diagram it looks like the HCO3- is getting excreted into the urine while the H+ is being reabsorbed; this is the opposite of the actual process, where H+ is excreted and bicarbonate is generated and reabsorbedMinor erratumI believe this comment is describing the function of beta intercalated cells. Illustration looks good as is. No changes needed. -LilitNo change required. - RohanAgree with Lilit's analysis. No change required.

- Sarah		Reject by 2 authors + 1 editor05/22/19 10:11 AMJessicaGeddesjessica.geddes@uky.edu
1527573RenalPsychologyNephron transport physiologyBertram G. Katzung, Marieke Kruidering-Hall, Anthony J. Trevor - Katzung & Trevor’s Pharmacology Examination and Board Review (2019, McGraw-Hill Education)In the section of the Early DCT its stated that PTH increases the calcium/sodium exchange. However this is an action secondary to thiazide diuretics as they decrease the absorption of sodium into the DCT cell causing decreased sodium concentration inside the cell and inducing the movement of sodium into the cell from the interstitium/blood and calcium into the interstitium/blood by the calcium sodium exchanger. The binding of PTH to its receptor on the basolateral surface promotes the influx of calcium from the lumen/urine due to decreased intracellular calcium concentration due to the increased activity of the calcium/odium exchanger (that is not due to PTH but secondary tho thiazide diuretics). Lastly the increase in calcium in the serum is credited to Thiazide diuretics and not to PTH in the USMLE RX program.Major erratumReject. The calcium transport is actively regulated according to changes in calcium balance in the distal tubule and adjacent connecting segment. Parathyroid hormone (PTH) and calcitriol, the most active form of vitamin D, which may act in part by enhancing the activity of PTH, appear to stimulate this active process. - Rohan Source: https://www.uptodate.com/contents/diuretics-and-calcium-balanceI agree with Rohan.

UTD states: In addition, PTH increases the expression of the calcium transport proteins, TRPV5, calbindin-D28k, NCX1, and PMCA1b, in the distal nephron [4], which also enhances renal calcium reabsorption [19].

[NCX1 is a Ca2+/Na+ exchanger]



- Sarah		07/13/19 4:24 PMCindy MarielleSantana Perezcindysantanamd@gmail.com
1528574RenalPhysiologyRenal tubular defectsnot neededI think we don't need to highlight the letter "a" in "Fanconi" ,in red color, in the table and in the image.Spelling/formattingStaff acceptsAgree -- not sure why "a" in Fanconi was highlighted red. Also the red highlighting of "a" is inconsistent (not highlighted in description under "Renal tubulr defects", but is highlighted red in image and table.

-Yumi		Agreed - AKB01/03/19 3:50 PMMoatasemAl-Janabiassoomi88@yahoo.com
1529574RenalPhysiologyRenal tubular defectsnot requiredOrder of disorders: the FAN speed at the BAR GOT a LIDDLE EXCESSIVEMnemonicVerifiedAccept. Can replace the current mnemonic on the page. - RohanAgreed - AKB02/01/19 2:11 PMJoshuaLadellajosh.ladella@gmail.com
1530574RenalPhysiologyRenal tubular defectsnot requiredGitelman syndrome: GET ALL MEN DOWN to CAMP: levels of Calcium-Acid-Magnesium-Potassium go DOWNMnemonicVerifiedReject. Not much helpful in recall. - RohanReject - AKB02/01/19 2:13 PMJoshuaLadellajosh.ladella@gmail.com
1531574RenalPhysiologyRenal tubular defectsnot requiredAcid, Potassium, and Aldosterone levels go down to "just a LIDDLE bit"MnemonicVerifiedReject. Not much helpful in recall. - RohanReject - AKB02/01/19 2:16 PMJoshuaLadellajosh.ladella@gmail.com
1532574RenalPhysiologyRenal tubular defectsMyselfUnder the notes column(which is empty) of Fanconi syndrome, it would be beneficial to mention - May present similar to Diabetes Mellitus with polyuria and polydipsia secondary to osmotic diuresis from glucose. However, serum glucose level remains normal in contrast to DM.High-yield addition to next yearReject.

No source provided. While I do see the similarities between the two, Fanconi syndrome is more than just a glucose defect. If others feel strongly about this one, feel free to accept it.

- Humood		Reject, AKB03/19/19 4:51 AMAhmed AliKhanahmedalikhanjr@gmail.com
1533576RenalPhysiologyRenin-angiotensin-aldosterone systemMnemonicRAAS activation RAAiSes blood pressureMnemonicVerifiedReject. Basic physiological principle and mechanism, doesn't require a mnemonic. - RohanReject - AKB02/20/19 11:57 PMMariaGentrymg3w3@health.missouri.edu
1534576RenalPhysiologyRenin-angiotensin-aldosterone systemFirst Aid for the USMLE Step 1, 2019 editionRENAL - Receptor effects (angiotensin II receptor type I), Efferent arteriolar constriction, Na/H exchange, ADH secretion, "L"dosterone secretionMnemonicVerifiedReject. Basic physiological principle and mechanism, doesn't require a mnemonic. - RohanReject - AKB03/01/19 11:17 AMChristopherYangchristopher.yang@northwestern.edu
1535577RenalPhysiologyJuxtaglomerular apparatushttps://www.ncbi.nlm.nih.gov/pubmed/17686376The text mentions "In addition to vasodilatory properties, ~-blockers can decrease BP by inhibiting ~1-receptors of the JCA - I renin release." However, not all beta blockers cause vasodilation. It will be better to clarify that text is talking about Beta blockers with additional alpha blocking properties such as labetolol & CarvedilolHigh-yield addition to next yearVerifiedReject.The actions of different beta-blockers are well explained in the table on Page 245 (FA-19), not required to be repeated here - RohanReject - AKB02/12/19 10:37 AMMurliMishramm.murli@gmail.com
1536577RenalPhysiologyJuxtaglomerular apparatushttps://www.boardsbeyond.com/members/video.cfm?ID=6974CE5AC660610B44D9B9FED0FF9548&moduleID=29&subMod=30The current text states: Macula densa cells sense increased NaCl delivery to DCT -> increase renin release -> efferent arteriole vasoconstriction -> increase GFR. Clarification: The macula densa also constricts the afferent arteriole via tubuloglomerular feedback, to maintain GFR in hyponatremic states.Clarification to current textAgree. The tubuloglomerular feedback is an important of macula densa via the purinergic system. It should be included. - Rohan06/12/19 5:12 PMNoraMartininora.martini16@gmail.com
1537578RenalPhysiologyHormones acting on kidneytruehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116377/In addition to aquaporins, ADH increases apical expression of Urea transporters in the collecting duct, which are critical for maintaining the osmotic gradient used by the Loop of Henle throughout the renal medulla.High-yield addition to next yearAccept. Can be added to the figure labels, final word from illustration team. -Rohanok to incorporate, AKB03/14/19 1:30 PMMatthew J.Christensenmattchristensen607@gmail.com
1538578RenalPhysiologyHormones acting on kidneyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775849/ADH increases the expression specifically of Aquaporin 2, specifically on the apical side of the collecting duct. ADH does not increase aquaporin expression on the lumenal side of the collecting duct and does not affect expression of AQP 1, 3, or 4.Clarification to current textVerifiedReject. The figure in general doesn't have specific markings to highlight the location of channels/gates. Not high yield for Step 1. - RohanReject, AKBI agree with the authors. No change needed.

- Sarah		Reject by 2 authors + 1 editor03/14/19 1:35 PMMatthew J.Christensenmattchristensen607@gmail.com
1539578RenalPhysiologyHormones acting on kidneyFIRST AID pg 573 doesn't list it anywhere as functioning in those locations.you should remove the purple coloring on the thick ascending loop of henle and the DCT portion of the diagram as ANG2 doesn't act there.Major erratumI think the action of AT2 is much more complex than shown on pg 573. The text on said illustration, that is color coded according to hormone action, says that AT2 acts to increase Na reabsorption both proximally and distally. No changes needed. -LilitAgree with Lilit. The textbook focusses on high yield material with focus on the exam prep only. No change required. - RohanI agree with the authors. The current text contains all HY information. The text is not meant to be fully comprehensive or contain detailed physiology that is not tested on Step 1.

- Sarah		Reject by 2 authors + 1 editor05/14/19 3:10 PMKinzaSultankinza.sultan@westernu.edu
1540578RenalPhysiologyPotassium shiftsnot neededNice way to remember hyperkalemia states; Imagine a chronic Diabetic Heart Failure Hypercholestronemia patient; 1/ for HF: taking Beta blocker and Digoxin (both can increase serum K). 2/ DM: Low insulin high Glc cause high K, also Diabetic ketoacidosis, as acidosis causes high K, also in DKA there is high osmolarity which also causes elevated K. 3/ statins cause rhabdomyolysis which will remind you with cell lysis which in turn causes elevated K!High-yield addition to next yearVerifiedReject. The points have been well covered in the respective sections. Although can be added in the Rapid Review section. - RohanReject - AKB03/01/19 7:43 PMAlaJamalala.aljamal@hotmail.com
1541579RenalPhysiologyElectrolyte disturbancesIt's a mnemonic. Information taken from UWorld question bank, april 2018.Sodium = 6 Letters, Eq Na+ = +60 mV. Potassium = 9 letters, Eq K+ = -90 mV. Eq = Equilibrium potential.MnemonicVerifiedReject. Equilibrium potential amplitudes are not usually tested. - RohanReject - AKB02/25/19 10:58 AMEirikKragereirik.krager@outlook.com
1542579RenalPhysiologyRenin-angiotensin-aldosterone systemhttps://www.uptodate.com/contents/bartter-and-gitelman-syndromes#H53269181In the renal disorders table, there should be a column for urinary Magnesium. Both barter and gitleman syndrome have renal magnesium wasting. The urinary magnesium wasting column for gitleman can read 'severe', while that for bartter can read 'mild/moderate'. In addition, the serum magnesium entry for bartter can read 'normal or mildly reduced'. This can help people use just the urinary magnesium values when trying to differentiate between gitleman and bartter when the urine calcium is not given, and it also helps in understanding the pathophysiology behind bartter since it makes sense that it involves urinary magnesium wasting.High-yield addition to next yearVerifiedreject. I do not think this is high yield enough for step 1 to include as an entire column.

Yumi		Reject - AKB01/18/19 5:17 AMHasaanOmarkalimdor101@gmail.com
1543580RenalPhysiologyAcid-base physiologyhttps://www.uptodate.com/contents/simple-and-mixed-acid-base-disorders?search=acid-base%20physiology,%20metabolic%20vs%20respiratory%20acidosis%20vs%20alkalosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1CO2 + H2O <=> HCO3- + H+ (This is a very important equation that helps understand acid-base physiology. Could additionally include: CO2 is maintained by lungs, HCO3- is maintained by kidneys, and H+ determines pH)High-yield addition to next yearVerifiedReject. Basic equation, not high yield enough to find space on an already overcrowded page. - RohanReject - AKB02/18/19 9:16 AMNicoleDeMaraisnicole.demarais@my.rfums.org
1544580RenalPhysiologyAcidosis and alkalosisN/ACauses of Respiratory Alkalosis/Hyperventilation can be rearranged to spell "STAHP": Salicylates (early), Tumor, Anxiety/Panic Attack, Hypoxemia (e.g. high altitude), Pulmonary embolism. Causes of Metabolic Alkalosis can be abbreviated partially as VALHALLA: Vomiting, Antacid use, Loop diuretics, Hyper(AL)dosteronismMnemonic11/06/19 8:21 PMWenyuDengwenyu.deng128@gmail.com
1545581RenalPathologyNephritic syndromeUworldShould clarify that good pasture targets type IV collagen AND is a type 2 hypersensitivityClarification to current textVerifiedAgree. Under nephritic syndrome, states goodpasture's is a type II hypersensitivity (pg 585). Type IV collagen is not present from what I see. Agree this should be included, as it is a common + major fact. Source: Pathogenesis and diagnosis of anti-GBM antibody (Goodpasture's) disease, UpToDate.

Yumi		OK to incorporate - AKBAgree to discuss this in Annotate.But this seems like a HY addition rather than clarification.

Addendum: This is covered in the immunology and biochemistry chapters already. We don't have enough space on this page in the renal chapter to add the information (page already running long), therefore reject.

- Sarah		Reject by 2 authors + 1 editor12/26/18 1:50 AMMohammadHaidermomohaid@gmail.com
1546581RenalPhysiologyRenal tubular acidosisFA page 594RTA type 2 (Carbonic anhydrase inhibitor will alkalanize urine compared to other causes of RTA II)Minor erratumVerifiedReject. The secretion of HCO3- is clearly mentioned in the section and therefore the effect of the drug on urine pH is clearly understood. - RohanReject - AKBAgree with Rohan and Anup.

Sarah		Reject by 2 authors + 1 editor03/01/19 7:44 PMAlaJamalala.aljamal@hotmail.com
1547583RenalPathologyGlomerular diseasesMyself, First AidNephrItic syndrome mnemonic: MARIA: i.e. MPGN, Alport Syndrome, RPGN, IgA nephropathy, APSGN. Also, highlight I in NephrItic as well as MARIA for easy association.MnemonicVerifiedAccept. Can be added to the table/figure on page 583. - RohanAccept-AKB02/25/19 9:53 AMMurliMishramm.murli@gmail.com
1548583RenalPathologyGlomerular diseasesMyself, First Aid 2019NephrOtic Syndrome mnemonic: FOcus Minimum on Membrane in Diabetic Amyloidosis i.e. O is highlighted for Nephrotic. Conditions included are FSGN, MCD, MPGN, Diabetic glomerulonephropathy, AmyloidosisMnemonicVerifiedReject. Confusing, won't help recall. - RohanSame, not useful - AKB02/25/19 9:58 AMMurliMishramm.murli@gmail.com
1549583RenalPathologyGlomerular diseasesMyslef, FA2019Correction of mnemonic explaination for one I just submitted: NephrOtic Syndrome mnemonic: FOcus Minimum on Membrane in Diabetic Amyloidosis i.e. O is highlighted for Nephrotic. Conditions included are Focal segmental Glomerulosclerosis, MCD, Membranous Nephropathy, Diabetic glomerulonephropathy, AmyloidosisMnemonicVerifiedReject. Confusing, won't help recall. - RohanSame, not useful - AKB02/25/19 10:03 AMMurliMishramm.murli@gmail.com
1550583RenalPathologyGlomerular diseasesSelf-writtenPURE Nephritic Syndromes - The girl "ARIA" (Acute post-step, Rapid progressive, Ig-a, Alport) is always looking for more BLOOD to spill. (Nephritic syndromes associated with hematuria and RBC casts, the girl ARIA is also a character obsessed with hunting people down to make them BLEED in the tv-series 'game of thrones', if you want to include that.) /// possible MIXED Nephritic/Nephrotic - "DM" (Diffuse proliferative, Membranoproliferative). Both have "PROLIFERATIVE" in their names, they proliferate so much they can cause BOTH nephritic and nephrotic.Mnemonic10/30/19 8:27 AMKhalidAlattarkhalid_alattar@hotmail.com
1551584RenalPathologyNephritic syndromeHaving Nephiritic on the left on both pages would make recalling facts easier.Page 585 and 584 should be switched in order to match the position of Nephritic and Nephrotic syndromes in the diagram on page 583.Spelling/formattingStaff acceptsAccept. The change will make it easier to co-relate with the diagram on page 583. - RohanOk to incorporate - AKB02/01/19 5:25 PMDeliabellHernandezgi2336@wayne.edu
1552584RenalPathologyNephrotic syndromeMnemonicmInImal CHange disease - caused by "I"nfection or "I"mmune (-ization/stimulus) in "CH"ildren. (bold the I's and CH in minimal change disease)MnemonicVerifiedReject. Not of much help in recall. - RohanReject-AKB02/03/19 7:38 AMNathanielBorochovnateboro8@gmail.com
1553584RenalPathologyNephrotic syndromehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983022/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3818612/Membranous glomerulonephritis (Antibodies against phospholipase A2 receptor primarily IgG4Clarification to current textAntibodies against phospholipase A2 receptor primarily IgG - Rohan05/16/19 3:13 PMMuhanadShaibmohanad.shaib@gmail.com
1554584RenalPathologyNephrotic syndromehttps://www.merriam-webster.com/dictionary/compromiseThe line that explains why Nephrotic syndrome increases the risk for infection did not conjugate the word compromise to its past participle compromised therefore it's grammatically incorrect. The line is written as follows " ­ risk of infection (loss of immunoglobulins in urine and soft tissue compromise by edema)." Now if it were to be written as "­ risk of infection (loss of immunoglobulins in urine and soft tissue compromised by edema" although grammatically correct when reading it one can infer that soft tissue compromised by edema is also being lost in the urine. Therefore, by switching the order of the sentence to " ­ risk of infection (due to soft tissue compromised by edema and loss of immunoglobulins in urine)" there is no confusion while reading it and the word compromised is conjugated correctly. I believe this also eases the reader's understanding as he/she won't need to read it over and over to clarify what it is trying to explain.Spelling/formattingChange as per suggestion to - risk of infection (due to soft tissue compromised by edema and loss of immunoglobulins in urine). - Rohan07/12/19 8:01 PMCindy MarielleSantana Perezcindysantanamd@gmail.com
1555585RenalPathologyNephritic syndromeI just thought of it one day.ALPORT met his eX (-linked dominant) gf at a BASKET-WEAVING class in an IVy COLLAGEn.MnemonicVerifiedTentatively accept. Inadequate space for a long mnemonic in the Alport syndrome sub-section. - RohanNice mnemonic, ok to place -AKB02/01/19 12:06 PMEyalBenDavidbendavid.eyal@gmail.com
1556585IndexPathologyNephritic syndromeN/AAlport syndrome is not in the index at all; page 585 is the main entry. It is also mentioned in a couple other placesMinor erratumVerifiedDefer to 2020 revision.

- Vivek		02/15/19 2:15 AMRebeccaXurebecca.xu@northwestern.edu
1557585RenalPathologyNephritic syndromeSuggestionI think it would be helpful if abbreviations used on a page could be included on that page as a footnote in small font. On the page in question LM, IF, and EM are used frequently. It would be convenient for the reader to have quick access without having to flip to the back of the book to the acronym section.Clarification to current textVerifiedReject. The acronyms refer to different imaging techniques, very obvious from the features mentioned next to the acronyms itself. - RohanReject, AKBAgree with Rohan and Anup.

Sarah		Reject by 2 authors + 1 editor02/21/19 8:33 AMTayler DeclanRosstaylerdeclanross@gmail.com
1558585RenalPathologyNephritic syndromeNAFor both RPGN and IgA Nephropathy- the formatting for the microscopic findings if missing a tab down- as seen with the other disorders. Specifically, for both the LM findings are given, and then there is a semicolon and the EM findings are given in the same line- as opposed to their own new line as seen in the other disorders.Spelling/formattingStaff rejectsThe student is saying LM/IF/EM findings of RPGN/IgA nephropathy are arranged in the same line unlike in other disorders. I think this is done to save a line to accommodate all the disorders on same page.

- No errata.
- May be reformatted depending on space availability.


- Vivek		02/22/19 5:44 PMDylanErwinderwin@smu.edu
1559585RenalPathologyNephritic syndromehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175091/ https://www.researchgate.net/publication/7197534_Anti-streptococcal_antibodies_in_the_diagnosis_of_acute_and_post-streptococcal_disease_Streptokinase_versus_streptolysin_O_and_deoxyribonuclease_Bin PSGN there is increase anti-DNase B titers.Clarification to current text05/16/19 3:09 PMMuhanadShaibmohanad.shaib@gmail.com
1560585RenalPathologyNephritic syndromenot neededIn Diffuse proliferative glomerulonephritis, It is better to mensiion EM in Independant lineSpelling/formatting06/02/19 6:10 AMRaedAbabnehraedababneh@gmail.com
1561585RenalPathologyNephritic syndromeSelfAlport Syndrome = Al-four-t ("Alfort") since it involves type IV (4) collagenMnemonicVerified06/15/19 4:56 PMYogeshPatelyogesh.patel@downstate.edu
1562585RenalPathologyNephritic syndromeSee attachment for 2018 listing.In 2018, the types of Rapidly Progressive Glomerulonephritis were listed in order as type I: Linear; type 2: Granular; type 3: negative. This made much more sense listing them in numerical order. In 2019, it was changed to list them type 1: linear; type 3: negative; type 2: granular. It should change back to numerical listing.Spelling/formatting10/13/19 5:42 PMJuliaZautckej.zautcke@gmail.com
1563585RenalPathologyNephritic syndromeSelf-writtenAlport Syndrome - The couple usually have their picnic at the PORT (alPORT) that has 4-sides (Type 4 collagen defect). They take their picnic-BASKET (BASKET-weaving electron microscopy) and often SEE people PEEing and HEAR bees (eye problems, glomerulonephritis, sensory hearing loss). I hope they never SPLIT up (GBM-splitting).Mnemonic10/30/19 8:38 AMKhalidAlattarkhalid_alattar@hotmail.com
1564585RenalPathologyX-linked recessive disordershttps://ghr.nlm.nih.gov/condition/alport-syndrome#inheritance ;There are conflicting reports on whether the autosomal recessive or autosomal dominant form of Alport Syndrome is more prominent. The proposed change is to remove "most commonly X-linked dominant" to something along the lines of "inherited in either an X-linked recessive or dominant manner" or simply as an X-linked disorder to circumvent the presentation of currently debated information.Clarification to current textVerifiedAccept.

Alport inheritance can be X-linked, AR, or AD. The most common pattern is X-linked. Let's avoid saying XLD.

Revise to say "Most commonly X-lined"

- Humood
https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-treatment-of-alport-syndrome-hereditary-nephritis?search=alport&source=search_result&selectedTitle=1~40&usage_type=default&display_rank=1		accept, AKBText on p. 593 already states that it is "Most commonly X-linked."

- Sarah		Reject by 2 authors + 1 editor03/24/19 8:24 PMVincentSerapigliavserapiglia@neomed.edu
1565586RenalPathologyKidney stonesnot neededCalcium "PH"osphate and Ammonium magnesium "PH"osphate is precipitates with increased "PH"MnemonicVerifiedReject. Won't help in recollection, basic concept. - Rohan05/08/19 5:04 PMRaedAbabnehraababneh153@med.just.edu.jo
1566586RenalPathologyKidney stonesn/aUrine crystal shapes of kidney stones from top to bottom as given in page 586: Calcium – Ammonium magnesium phosphate – Uric acid – Cystine ENVELOPE with an invitation to attend the FUNERAL with a ROSE for the EX-army. Envelope shape = Calcium oxalate stones FUNERAL = Coffin lid shaped in Ammonium Magnesium Phosphate stones ROSE = Rosette shaped in Uric acid stones Ex = hEXagonal shaped in Cystine stones Calcium oxalate stone: Calcium and DUMBBELLS for body building. Cystine stone: Sodium Cyanide Nitroprusside test positive – He consumed sodium cyanide and Expired at 16 (HEXagonal shaped SIXtine stone)MnemonicVerifiedI like the idea of using a mnemonic for stones and their shapes. This is a catchy mnemonic, but I think it can be reworked into something that sounds better and more comprehensive. -Lilit07/10/19 1:07 PMAPandeyaranikopandey@gmail.com
1567586RenalPathologyKidney stonesFirst Aid page 586 image AoXalate stones look like an X (envelope shaped crystals)MnemonicVerified08/05/19 10:03 AMJulianMaamarijulian.maamari@lau.edu
1568587RenalPathologyAcute kidney injuryMy brainMnemonic for the causes of nephrotoxic acute tubular necrosis is CLEAR: Cisplatin, Lead, Ethylene glycol, Aminoglycosides, Radiocontrast agentsMnemonicVerifiedReject. Would be more appropriate under fact "acute tubular necrosis". I think this is a cool idea/mnemonic, but these nephrotoxic drugs are only examples and not all inclusive. So our mnemonic would be incomplete.

Yumi		Reject, AKB01/14/19 2:17 PMMariahGoslinggoslingm@hawaii.edu
1569587RenalPathologyRenal cell carcinomahttps://www.explainmedicine.com/article/General/VaricoceleSpecifying that occlusion of the left spermatic vein is the reason left-sided RCC may cause a varicocele. Suggested revision to current phrasing: "... may develop varicocele if left-sided; obstruction of left spermatic vein)..."High-yield addition to next yearAccept.

This is already mentioned on page 637. However, I suppose we can consolidate it here as well to say

"(may develop varicocele if left sided due to obstruction of left gonadal vein)"

- Humood		ok to incorporate, AKB03/15/19 11:32 AMMatthew J.Christensenmattchristensen607@gmail.com
1570587RenalPathologyRenal cell carcinomaFirst Aid 2019Paraneoplastic syndromes associated with RCC are mentioned on the right side. Similar to how secondary polycythemia is mentioned due to ectopic EPO production, hypercalcemia can also be added in the manifestations (due to PTHrP)High-yield addition to next yearReject.

I do not think this is necessary. The text already mentions PTHrP. No need to state the consequence of each paraneoplastic hormone, in my opinion.

- Humood		Reject, AKB04/02/19 7:11 AMAhmed AliKhanahmedalikhanjr@gmail.com
1571588RenalPathologyMultiple sclerosisUWorld Question ID : 11464FA says MS causes overflow incontinence (Detrusor Underactivity) but Uworld says that patients develop a spastic bladder and bladder hypertonia (Urge Incontinence)Major erratumDefer to expert.

Both are correct, based on UTD. On MS article, it says MS causes urge incontinence. On incontinence article, it says MS causes overflow incontinence and detrusor under-activity. I suppose it depends on where the lesion is located.

- Humood
https://www.uptodate.com/contents/clinical-presentation-course-and-prognosis-of-multiple-sclerosis-in-adults?search=multiple%20sclerosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.uptodate.com/contents/evaluation-of-women-with-urinary-incontinence?search=incontinence&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H21990073		ok to incorporate, AKBWorthwhile discussing further in Annotate, particularly as this point has been raised twice by different users.

It is probably best to include both types of incontinence as both can occur in MS.

- Sarah		Prelim accept but NOT publishable erratatrue03/17/19 9:45 AMJyothik VarunInampudijyothikvarun@gmail.com
1572588RenalPathologyNephroblastomaFirst AidAddition of W11ms tumor as a mnemonic (since i and l look like 1s). " "Loss of function" mutations of tumor suppressor genes WTJ or WT2 on chromosome 11 (W11ms tumor)"MnemonicVerifiedReject. Too complicated a mnemonic for the amount of information recall. -RohanReject, AKB02/24/19 11:09 AMJosephElphingstonejelphingstone@augusta.edu
1573588RenalPathologyNephroblastomaRobbins and Cotran Pathologic Basis of Disease, Chapter 10, 451-482. Wilms Tumor, under "Pathogenesis and Genetics." • A third group, that is clinically distinct from these previous two groups of patients but also with an increased risk of developing Wilms tumor are children with Beckwith-Wiedemann syndrome (BWS) , characterized by enlargement of body organs (organomegaly), macroglossia, hemihypertrophy, omphalocele, and abnormal large cells in the adrenal cortex (adrenal cytomegaly). BWS has served as a model for a nonclassical mechanism of tumorigenesis in humans— genomic imprinting. The chromosomal region implicated in BWS has been localized to band 11p15.5 (“WT2”), distal to the WT1 locus. This region contains multiple genes that are normally expressed from only one of the two parental alleles, with transcriptional silencing (i.e., imprinting) of the other parental homologue by methylation of the promoter region . Unlike WAGR or Denys-Drash syndromes, the genetic basis for BWS is considerably more heterogeneous in that no single 11p15.5 gene is involved in all cases. Moreover, the phenotype of BWS, including the predisposition to tumorigenesis, is influenced by the specific “WT2” imprinting abnormalities present. One of the genes in this region—insulin-like growth factor-2 ( IGF2 ) —is normally expressed solely from the paternal allele , while the maternal allele is silenced by imprinting. In some Wilms tumors, loss of imprinting (i.e., re-expression of the maternal IGF2 allele) can be demonstrated, leading to overexpression of the IGF-2 protein. In other instances there is a selective deletion of the imprinted maternal allele, combined with duplication of the transcriptionally active paternal allele in the tumor (uniparental paternal disomy) , which has an identical functional effect in terms of overexpression of IGF-2. Because the IGF-2 protein is an embryonal growth factor, it could conceivably explain the features of overgrowth associated with BWS, as well as the increased risk for Wilms tumors in these patients. Of all the “WT2” genes, imprinting abnormalities of IGF2 have the strongest relationship to tumor predisposition in BWS. A subset of patients with BWS harbor mutations of the cell cycle regulator CDKN1C (also known as p57 or KIP2 ); however, these patients have a significantly lower risk for developing Wilms tumors. In addition to Wilms tumors, patients with BWS are also at increased risk for developing hepatoblastoma, pancreatoblastoma, adrenocortical tumors, and rhabdomyosarcomas.WT2 is a loci, not really a "gene." I think it's better to word it as "... tumor suppressor gene WT1 or WT2 loci on chromosome 11."Clarification to current text10/05/19 7:16 PMHolyChouychou@student.uiwtx.edu
1574588RenalPathologyUrinary incontinencehttps://www.uptodate.com/contents/clinical-presentation-course-and-prognosis-of-multiple-sclerosis-in-adults?source=autocomplete&index=2~4&search=multiple%20sc ; https://emedicine.medscape.com/article/1146199-clinicalNeurogenic bladder with MS as an example is listed on page 588 under "Overflow Incontinence". Despite that MS patients can present with either type of neurogenic bladder (urge or overflow); it is well established that the majority of patients with MS are classically seen with an overactive bladder (urge incontinence) as typically seen with any upper motor neuron lesion (spasticity). If MS has to be listed as an example under one of the two, it should definitely be under "urgency incontinence" type as opposed to the overactive type. This is how we see it across the references.Major erratumAgreed. Urgency incontinence or Detrusor hyperreflexia is the most common presentation in MS. Therefore, the example should be moved to Urgency incontinence instead of overflow incontinence. Ref: https://doi.org/10.1016/S0090-4295(02)02243-4 - Rohanok to incorporate, AKBWorthwhile discussing further in Annotate, particularly as this point has been raised twice by different users.

It is probably best to include both types of incontinence as both can occur in MS.

- Sarah		Prelim accept but NOT publishable erratatrue03/14/19 5:41 PMM MarwanDabbaghdr.dabbagh@outlook.com
1575588RenalPathologyUrinary incontinenceN/AStress Sneeze Surgery Super active Stick Stream or Slow Sphincter Urgency UTI Ultra active bladder Overflow Obstruction OFF BladderMnemonicVerifiedReject. Too complicated for the recall value. - RohanReject, AKB03/14/19 6:22 PMNorikArmanidr.norayr@gmail.com
1576588RenalPathologyUrinary incontinenceUWorld QID: 15667Although diabetes can cause overflow incontinence with polyuria, it's important to note that diabetes mellitus can cause overflow incontinence through diabetic neuropathy. In diabetic neuropathy, diabetes mellitus can cause NEUROGENIC BLADDER as the peripheral nerve innervating the bladder is compromised. This leads to underactivity of the detrusor muscle, providing an explanation as to how NEUROGENIC BLADDER can be considered overflow incontinence. This is a HIGH YIELD ADDITION that should be made! It's important for students to remember that diabetic neuropathy can also cause neurogenic bladder, which is a different mechanism from the one that is currently written as "polyuria."High-yield addition to next year08/18/19 2:12 AMRyanLeeryanlee@gwu.edu
1577588RenalPathologyUrinary incontinencehttps://www.uptodate.com/contents/manifestations-of-multiple-sclerosis-in-adultsNeurogenic bladder (eg, MS) is most commonly an example of overactive detrusor muscle and should be under urgency incontinence and not overflow incontinence.Major erratum08/23/19 10:25 AMYaraJelwanyara.jelwan@lau.edu
1578589RenalPathologyAcute cystitisnot needed+nitrates (indicate gram - organisms). Surrgest changing it to + "N"itrates indicates gram "N"egative organismsMinor erratumVerifiedAccept. Change nitrites to nitrates and bold/highlight the first alphabet. - Rohan'nice addition - AKB03/01/19 7:41 PMAlaJamalala.aljamal@hotmail.com
1579590RenalPathologyAcute tubular necrosishttps://emedicine.medscape.com/article/238064-overviewBUN/Cr ratio increases in phase 2 of ATN and decreases in phase 3. The text has it as only decreased in phase 3 on page 591. The text also has it decreased in general on page 590 under intrinsic renal failure. This should be clarified that it is only phase 3 that the ratio decreases and it increases in phase 2.Spelling/formattingStaff acceptsReject. While this may be true, I don't believe the extra information is necessary. Also I think it can be inferred that the BUN/Cr does increase, and thus has room to decrease in the 3rd stage.

Yumi		Agree. reject.Reject by 2 authors + 1 editor12/27/18 4:56 PMAnthonyBitarabfy2@health.missouri.edu
1580590RenalPathologyConsequences of renal failureN/AWithin the mnemonic MAD HUNGER for the consequences of renal failure is uremia with its five clinical associations. The mnemonic BUN APPENtit helps to remember the signs and symptoms of uremia (Asterixis, Pericarditis, Platelet dysfunction, Encephalopathy, Nausea and anorexia).MnemonicVerified08/14/19 3:35 AMEun SungKimeunsung@berkeley.edu
1581591RenalPathologyAcute interstitial nephritisFirst Aid 2019Mnemonic has bolded "5 P's" and lists the drugs that involve the letter P but forgets to include the S that is bolded which should also include "sulfa drugs". This is done correctly on page 250 under "Drug reactions - renal/genitourinary". Just the way the mnemonic on page 250 has the use of P's and S's, on page 591 it's only P's and no S for Sulfa drug for the same mnemonicMinor erratumVerifiedReject. It is P's not Ps. - RohanI agree with the user that for consistency with the same mnemonic on p.252 we should include "sulfa drugs" in the mnemonic.

- Sarah		Prelim accept but NOT publishable erratatrue04/28/19 10:06 PMSahilZaveriszaveri@sgu.edu
1582591RenalPathologyAcute interstitial nephritishttps://emedicine.medscape.com/article/243597-workupWBC casts may be seen in acute interstitial nephritis. Although it was included on page 582, "WBC casts" should be added in into the "Acute Interstitial Nephritis" section as this is a very high yield association that students should be reminded of in the context of this specific pathology. Acute interstitial nephritis can also progress to renal papillary necrosis, which is also another high-yield association that students should know and should be added in.High-yield addition to next year08/15/19 2:07 AMRyanLeeryanlee@gwu.edu
1583591RenalPathologyAcute tubular necrosishttps://emedicine.medscape.com/article/238064-overviewThere is a loss of tubular cell polarity in ATN due to Na/K ATPase switching from basolateral side to lumenal side. This also increases sodium reabsorption which affects macula densa cells and further exacerbate constriction of afferent arteriole.High-yield addition to next yearVerifiedReject. Cool information, but too detailed for Step 1.

Yumi		Reject, AKB12/27/18 5:01 PMAnthonyBitarabfy2@health.missouri.edu
1584591RenalPathologyAcute tubular necrosisBased on information already in first aid but suggests a pneumonic that will make it easier for people to remember all the causes of ATN.Mnemonic for causes of nephrotoxic acute tubular necrosis: ATtentioN! Cancer LEADs to HAARM. Explanation of pneumonic: ATN! C in cancer refers to chemo drug Cisplatin, LEADs refers to lead, H- hemoglobinuria, A- aminoglycosides A- antifreeze (ethylene glycol), R- radiocontrast dyes, M-myoglobinuriaMnemonicVerified09/11/19 10:40 PMJulia GraceEpelbaumjepelbaum1@pride.hofstra.edu
1585591RenalPathologyDiffuse cortical necrosisno linkmisspeling the word CORTICAL, in the boook it's written as ORTICALSpelling/formattingLooked for it, but did not find any such spelling error?

- Vivek		must be an old mistake; no longer relevant - AKB01/13/19 3:52 AMahamedel azzihahamad.elazzih@gmail.com
1586591RenalPathologyRenal papillary necrosishttps://emedicine.medscape.com/article/439586-overview#a8Causes of renal papillary necrosis with the mnemonic POSTCARDS: Pyelonephritis; Obstruction of the urinary tract; Sickle cell hemoglobinopathies (including sickle cell trait); Tuberculosis; Cirrhosis of the liver, chronic alcoholism; Analgesic abuse; Renal transplant rejection, radiation; Diabetes mellitus; Systemic vasculitis.High-yield addition to next yearAccept.

Reasonable mnemonic. This would compete with our current "SAAD pappa" mnemonic. Let's discuss it on Annotate.

- Humood		accept, AKB03/21/19 3:00 AMNicolasCuri Gawlinskinicolascurii@gmail.com
1587591RenalPathologyRenal papillary necrosisNot neededAn easier and a more complete mnemonic for Renal papillary necrosis in my opinion can be - 'POSTCARDS' - Pyelonephritis, Obstruction of urogenital tract, Sickle cell disease or trait, TB, Chronic liver disease, Analgesics/Alcohol, Renal transplant rejection, DM, Systemic vasculitisMnemonicVerifiedDuplicate entry.
Delete row.

- Humood		duplicate, AKB03/28/19 7:47 AMAhmed AliKhanahmedalikhanjr
1588592RenalPathologyGenetic disorders by chromosomeMnemonicADPKD can be caused by a mutation in PDK1 (chromosome 16) or PKD2 (chromosome 4) - 4^2 = 16 and 16*1=16 allows you to remember the locations of PKD1 and PKD2MnemonicVerifiedReject. Too complicated for the recall value. - RohanReject, AKB02/07/19 11:34 AMDanielLubarskydaniel.lubarsky@rockets.utoledo.edu
1589592RenalPathologyRenal cyst disordershttps://www.uptodate.com/contents/diagnosis-of-and-screening-for-autosomal-dominant-polycystic-kidney-diseaseAutosomal dominant polycystic kidney disease is due to a mutation in PKD1 (on chromosome 16) or PKD2 (on chromosome 4) So, to remember the specific chromosomes 16^1= 16 and 4^2= 16MnemonicVerifiedAccept.

Reasonable mnemonic. Let's discuss on Annotate.

- Humood		accept, AKB03/17/19 6:28 PMAmerMohiuddinamemohiu@iu.edu
1590592RenalPathologyRenal cyst disordersFirst Aid 2019, USMLE World 2019In ADPKD microscopic cysts can be detected at birth but the disease process does not present until adulthood. Whereas ARPKD presents in infancy. In my opinion mentioning that 'ADULTS ARE DOMINANT' would serve as a helpful memory aid.MnemonicVerifiedReject.

No need, in my opinion.

- Humood		Reject, AKB03/28/19 8:54 AMAhmed AliKhanahmedalikhanjr@gmail.com
1591592RenalPathologyRenal cyst disordersNot neededIn ADPKD microscopic cysts can be detected at birth but the disease process does not present until adulthood. Whereas ARPKD presents in infancy. In my opinion, mentioning the first two letters i.e. AD of ADPKD in red along with the AD of ADult, would serve as a helpful memory aid.MnemonicVerifiedReject.

Not a big fan, sorry. If others feel otherwise, feel free to accept it.

- Humood		Reject, AKB04/10/19 5:03 AMAhmed AliKhanahmedalikhanjr@gmail.com
1592592RenalPathologyRenovascular diseaseIt's Mnemonic*F*ibromuscular dysplasia ---> *F*emales.MnemonicVerifiedReject. Yes more common in females, but not necessary to create a mnemonic.

Yumi		Reject, AKB01/04/19 6:21 AMMoatasemAl-Janabiassoomi88@yahoo.com
1593593RenalPharmacologyDiuretics site of actiontrueDude trust meChange "Thiazide" to "Thiazide diuretics".Spelling/formattingStaff acceptsAccept. Totally trust this dude. Illustration needs addition. - RohanAccept, AKB01/07/19 4:16 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
1594593RenalPharmacologyDiuretics: electrolyte changesFA p. 595 Mechanism of action for TZD and SketchyDiuretics site of action, it looks like you are showing normal electrolyte flow, yet in the DCT you show Ca2+ going into interstitium aka reabsorbed, under normal conditions, it is excreted. The TZD blocks NaCl & hence Na/Ca exchanger increases & that's how we reabsorb it.Minor erratum11/14/19 7:22 AMBeliceCabreracabreranena@gmail.com
1595594RenalPharmacologyDiuretics site of actionnot applicablewriting drug overdose before elevated intracranial/ intraocular pressure under clinical use of mannitol may confuse the reader that raised ICP or IOP can be due to drug overdose, I suggest writing elevated intracranial/intraocular pressure before drug overdoseSpelling/formattingI don't see this leading to confusion at all. If ICP was due to drug overdose the text would state that. I don't believe changing the order will do anything here. -Lilit06/13/19 1:52 AMAwabElnaeemawab.kamal@gmail.com
1596594RenaltruePharmacologyLoop diureticshttp://austinpublishinggroup.com/nephrology/fulltext/ajnh-v1-id1025.phpLoop diuretics do not cause PGE release, but rather prevent its degradation by inhibiting prostaglandin dehydrogenase. "Loop diuretics have been shown to decrease renal vascular resistance and therefore increase renal blood flow. This is likely due to the inhibition of prostaglandin dehydrogenase by loop diuretics, resulting in diminished breakdown of PGE 2 (a potent vasodilator), subsequently resulting in decreased renal vascular resistance and increased renal blood flow [17]."Major erratumVerifiedAgree. Not sure how well established this information is, but we can easily change the wording so it is less specific, such as: "Causes increased PGE". Specific mechanism is likely low yield, and not necessary to include in full.

-Yumi		Accept, AKBAgree change to: "Loop diuretics are associated with increased PGE"Prelim accept by 2 authors + 1 editor*RENAL Adam WeinsteinYes, I agree with the First Author's comment and suggestion to change this to be less specific. The specific mechanism is low yield, I agree. I might even suggest changing it to "Loop diuretics result in increased PGE" or "Loop diuretics are associated with increased PGE"--even more general statements.Accepttrue01/07/19 4:18 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
1597594RenalPharmacologyLoop diureticshttps://cjasn.asnjournals.org/content/early/2019/03/29/CJN.09630818 ; Uworld ID 684You guys accepted a suggested major erratum that loop diuretics do not stimulate PGE release but instead they prevent degradation of PGE by inhibiting prostaglandin dehydrogenase. However, both Uworld and the article from the "Clinical Journal of American Society of Nephrology" that was published this month states that loop diuretics stimulate PGE release and production.Major erratumVerifiedAccept. Loop diuretics indeed increase PGE, as per UpToDate (via citation : https://www.ncbi.nlm.nih.gov/pubmed?term=393525) - RohanAlready accepted, reviewed by Dr. Weinstein and implemented during Pass 1. Accepting for credit.

- Sarah		Prelim accept but NOT publishable erratatrue04/22/19 8:04 PMHeewonChoihxc326@case.edu
1598595RenalPharmacologyThiazide diureticshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142573/ https://en.wikipedia.org/wiki/Indapamideadding Indapamide drug to Thiazide diureticsClarification to current textReject. All drug names not required to be added. Single representative drug in section per standard procedure - Rohan."Agree with Rohan. The list is not meant to be inclusive or comprehensive. In addition, indapamide is not mentioned elsewhere in the book so I am reluctant to add it here. Reject.

- Sarah"		Reject by 2 authors + 1 editor05/16/19 3:23 PMMuhanadShaibmohanad.shaib@gmail.com
1599595RenalPharmacologyThiazide diureticshttps://www.uptodate.com/contents/effect-of-diuretics-on-magnesium-handling-by-the-kidney https://www.medscape.com/viewarticle/489521_5thiazide diuretics can cause Hypomagnesemia as well.Clarification to current textAgree. Add hypomagnesemia as well. - Rohan05/16/19 3:29 PMMuhanadShaibmohanad.shaib@gmail.com
1600596RenalPharmacologyAngiotensin II receptor blockershttps://orbi.uliege.be/bitstream/2268/228780/1/Angioedema%20a%20rare%20and%20sometimes%20delayed%20side%20effect%20of%20angiotensin%20converting%20enzyme%20inhibitors.pdf & First Aid For The USMLE Step 1The sentence "Effects similar to ACE inhibitors, but ARBs do not increase bradykinin." is misleading since ACE inhibitors do not directly increase bradykinin production but rather prevent their inactivation, which is mentioned in the previous section covering ACE inhibitors. It can be replaced with "ARBs do not prevent inactivation of bradykinin ".Clarification to current textAgree. Change as per suggestion. The sentence is indeed a little misleading - Rohan07/12/19 11:39 PMCindy MarielleSantana Perezcindysantanamd@gmail.com
1601597RenalPhysiologyNephron transport physiologyFirst Aid 2019Principal cells Pump Potassium into PeeMnemonicVerifiedReject. Basic physiological mechanism, doesn't require a mnemonic for recall. - RohanReject, AKB03/08/19 4:44 PMJosephElphingstonejelphingstone@augusta.edu
1602598ReproductiveEmbryologyEarly fetal developmenthttps://americanpregnancy.org/pregnancy-complications/early-fetal-development/Fetal cardiac activity visible by transvaginal ultrasound by the Fetal Age Week 4 (Gestational age: 6 weeks).Major erratum10/16/19 5:32 AMTareqAbabnehraedababneh@gmail.com
1603598ReproductiveEmbryologyImportant genes of embryogenesisnot requiredHCSAWD = HaCkSAWeD = Homeobox (craniocaudal axis), Sonic Hedgehog (anteroposterior axis), Wnt-7 (dorsal-ventral axis)MnemonicVerifiedReject. Don't quite follow. -GSThis seems too difficult to follow/remember. -MK01/29/19 7:11 PMJoshuaLadellajosh.ladella@gmail.com
1604598ReproductiveEmbryologyImportant genes of embryogenesishttps://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=PAX%206&source=search_result&selectedTitle=1~17&usage_type=default&display_rank=1 AND UWORLDADD--------->PAX GENE (PAX6): Key regulatory gene for gene of eye and brain development. Associated with ocular defects (aniridia) ------>Homeobox genes (HOXA 13) : Hand-foot -genital syndrome. Malformation of distal limbs(hypoplastic first digits), mullerian fusion anormalities (uterus didelfos)High-yield addition to next yearVerifiedWe already mention Hox genes in general, I do not think it would be HY to highlight one particular gene (HOXA13) from the whole group. As for PAX6 and its association with aniridia, I think this might be considered for Neuro chapter.

-Vasily		02/19/19 1:07 AMLissetteOrozcolissetteorozco_004@hotmail.com
1605598ReproductiveEmbryologyImportant genes of embryogenesisn/aWeek 6: Fetal cardiac activity visible by transvaginal USG – Sonography at Six.MnemonicVerified07/10/19 1:08 PMAPandeyaranikopandey@gmail.com
1606598ReproductiveEmbryologyImportant genes of embryogenesishttps://www.ncbi.nlm.nih.gov/gene/7476WNT-7- This gene is involved in the development of the anterior-posterior axis in the female reproductive tract, and also plays a critical role in uterine smooth muscle pattering and maintenance of adult uterine function. Mutations in this gene are associated with Fuhrmann and Al-Awadi/Raas-Rothschild/Schinzel phocomelia syndromes.Major erratum09/14/19 2:31 AMVamsiPeddintivamsi.dr@gmail.com
1607598ReproductiveEmbryologyNeural tube defectshttps://www.uptodate.com/contents/pathophysiology-and-clinical-manifestations-of-myelomeningocele-spina-bifida?sectionName=EMBRYOLOGY%20OF%20THE%20NEURAL%20TUBE&search=neural%20tube%20close&topicRef=460&anchor=H2&source=see_link#H2Neural tube being closed would be more helpful in the week 4 section than 3-8 weeksHigh-yield addition to next yearVerifiedDon't think this is necessary. Neural tube closing can remain in the 3-8 week section because it applies to the "susceptible to teratogens" comment. Also, the week 4 items make the mnemonic work, and adding neural tube closure would mean finding a way to include this in the mnemonic. - MK02/11/19 8:39 AMRaulOrozco Villalobosraul_ou_fan@yahoo.com
1608598ReproductiveEmbryologyTeratogensFirst AidCan spell Teratogens as T3r8ogens to remember that the embryonic period where a fetus is most susceptible to teratogens is from weeks 3-8.MnemonicVerifiedAccept. - MK03/23/19 1:02 PMAspinMakadiaaspinmak@gmail.com
1609599ReproductiveEmbryologyEmbryologic derivativesDon't have one, made it upSurface ectoderm mnemonic: GOOAALEE Glands (parotid, sweat, mammary), Oral cavity epithelial lining, Olfactory epithelium, Adenohypophysis, Anal canal below pectinate line, Lens of eye, Epidermis, Ear (sensory organs)MnemonicVerifiedReject. Too confusing to remember. -GSI don't think this addition is necessary. - MK01/18/19 1:45 PMAngelicaTrybulskaangietrybulska@gmail.com
1610599ReproductiveEmbryologyEmbryologic derivativesnot neededin "neural crest" subsection, "tracheal" lining" has been mentioned in the 2nd column as derivative of neural crest, which means tracheal epithelium , and that's incorrectClarification to current textVerifiedAccept. Should change tracheal lining to tracheal cartilage as one of the neural crest cell derivatives. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1352163/ - MKOK to migrate over for consideration. I am not sure this is incorrect, however, reasonable to clarify the text.

-Matt		Prelim accept but NOT publishable erratatrue03/06/19 9:26 PMghazalnaghibzadehghazal.naghibzadeh@gmail.com
1611599ReproductiveEmbryologyEmbryologic derivativesPunctuation ErrorParentheses are missing in the endoderm section: (eg, lungs, liver, gallbladder... [missing end parentheses].Spelling/formattingAgree. Add end parenthesis. -MK03/26/19 2:53 PMEmilyCokerecoker@mednet.ucla.edu
1612599ReproductiveEmbryologyEmbryologic derivativeshttps://jasperapi.kaptest.com/content/media/85/293785.22.ol314.anat.table.i_4_1.png ; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631767/It is stated in first aid that parafollicular (C) cells of the thyroid is derived from endoderm, however according to Kaplan it is actually derived from the NEURAL CRESTMajor erratumThis erratum submission is as certain as the sun sets in the west. We have had extensive discussion and will not be changing it further.

-Matt		Reject by 2 authors + 1 editor05/06/19 9:43 AMNiravShahniravs@health.usf.edu
1613599ReproductiveEmbryologyEmbryologic derivativesBRS Embryology 6th ed. Page 30 (Table 4.1 Germ Layer Derivatives)The text says that Tracheal lining is derived from Neural crest and Parafollicular (C) cells from Endoderm. Both are incorrect, the text should say: Tracheal lining is derived from Endoderm and Thyroid's Parafollicular (C) cells from Neural Crest.Major erratum11/29/19 11:35 PMRaulSalasrmsalas_b42@hotmail.com
1614599ReproductiveEmbryologyLung developmenthttps://opentextbc.ca/anatomyandphysiology/chapter/22-7-embryonic-development-of-the-respiratory-system/Tracheal lining is not one of the neral crest derivativesMajor erratumAccept. Should change tracheal lining to tracheal cartilage as one of the neural crest cell derivatives. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1352163/ - MKDuplicate.

-Matt		Reject by 2 authors + 1 editor03/27/19 7:25 AMRaedAbabnehraedababneh@gmail.com
1615599ReproductiveEmbryologySpleen1. UWorld Step 1 Question ID #2022 (citing Patterson KD, Drysdale TA, Krieg PA. Embryonic origins of spleen asymmetry. Development. 2000 Jan;127(1):167-75.) 2. NYU School of Medicine course notes, http://education.med.nyu.edu/courses/macrostructure/lectures/lec_images/gastrointest.html ("Unlike the liver, the spleen is not an outgrowth of the foregut. It develops coincidentally with the gut in the dorsal mesogastrium, but independently of the gut. However, its splenic artery is a branch from the celiac trunk.")"spleen (derived from foregut mesentery)" appears in the text. However, the spleen itself is NOT derived from the foregut mesentery, even though its vascular supply is from a branch of a celiac trunk.Major erratumSplenic embryological origins appear to be controversial. The student's source doesn't really answer the question and simply labels it as a vascular offshoot (?of the celiac trunk). Moreover, I cannot find any major references suggesting an alternative, high-yield embryological orgin.

For this reason, will flag for expert review before we make any decisions, as I would like their input on how to approach this.

-Matt		Disagreement/need experttrue07/05/19 6:17 PMZoëWarczakjwarczak1317@gmail.com
1616600ReproductiveEmbryologyEmbryologic derivativeshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614953/To remember that caudal regression syndrome (colloquially known as mermaid syndrome) is caused by maternal diabetes, use the mnemonic "Maternal diabetes Makes Mermaids"MnemonicVerifiedReject. I don't think this is a helpful mnemonic. -MK02/21/19 12:51 AMAdamRippetoeadam.rippetoe@yahoo.com
1617600ReproductiveEmbryologyLithiumYour text, this is just a minor contradiction by my understanding.Text states Ebstein anomaly is "apical displacement" of valves, when it's stated as a downward displacement on page 296.Minor erratumI believe FA is correct because the apex of the heart is the bottom of the heart. Thus apical displacement = downward displacement. We could consider choosing one term and staying consistent throughout the book, but sometimes I think it is better to hear the same disease described in 2 different ways. -MKAgree, two different ways of saying the same thing. I would propose standardizing between the two entries for the most clarity.

-Matt		Prelim accept but NOT publishable errata04/08/19 8:18 PMMarkMichaelMarkmichael8@hotmail.com
1618600ReproductiveEmbryologyTeratogenshttps://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020785s061lbl.pdf; https://en.wikipedia.org/wiki/Thalidomide#cite_note-UKlabel2017-7Thalidomide - Immunomodulatory Agent. Tx: CA/MM/LeprosyHigh-yield addition to next year05/24/19 8:26 AMNicola HelenDuzaknhampel@mail.sjsm.org
1619600ReproductiveEmbryologyTeratogenshttps://www.medicinenet.com/warfarin/article.htm#what_brand_names_are_available_for_warfarinWarfarin - bones, bleed, aBortion, blindMnemonicVerified06/13/19 8:30 PMChynnaSmithcs598711@ohio.edu
1620602ReproductiveEmbryologyTwinninghttps://www.uptodate.com/contents/monoamniotic-twin-pregnancy-including-conjoined-twinsLate division: monozygotic twins results in 1 amniotic sac and 1 chorionic sac.Major erratumI reviewed this fact in detail and I am pretty sure we clearly state that both in the text and the diagram. Not sure what needs to be corrected here. May be errata from an older edition?

-Matt		Reject by 2 authors + 1 editor07/10/19 12:56 PMJane-HweiLeedinwee@gmail.com
1621603ReproductiveEmbryologyPlacentan/asynCYTIOtrophoblast: SYN is outside (outer layer of chorionic villi) and CYTIO is inside (inner layer of chorionic villi).MnemonicVerified07/10/19 1:09 PMAPandeyaranikopandey@gmail.com
1622604ReproductiveEmbryologyEmbryologic derivativeshttps://emedicine.medscape.com/article/935618-overview#a12States that "in the 3rd week the yolk sac forms the allantois, which extends into urogenital sinus." In reality, the yolk sac and allantois are two distinct structures. Allantois is actually formed from the hindgut while the yolk sac is attached to the midgut. This is why a patent urachus connects bladder to umbilicus while vitelline duct connects midgut to umbilicus.Major erratumThis is way beyond my ability to interpret even using literature, so will ask for an embryological expert to take a look and comment. The student's linked reference does not really provide support for their submission.

-Matt		Disagreement/need experttrue07/28/19 11:11 AMTiffanyWangtwang19@pride.hofstra.edu
1623605ReproductiveEmbryologyAortic arch derivativeshttps://www.youtube.com/watch?v=XZNW3UnpQe8I came up with a way to memorize the key aortic arch derivations for the aorta, pulmonary arteries, ductus arteriosus, and common carotids, using a hand gesture. I've attached images to help explain what I mean, as well as some notes from an embryology video whose diagram was my inspiration (timestamp: 9:13).Mnemonic11/02/19 11:39 PMWenyuDengwenyu.deng128@gmail.com
1624606ReproductiveEmbryologyPharyngeal arch derivativesMnemonicTo remember that the GREATER horn of the hyoid is a derivative of the 3rd pharyngeal pouch and the LESSER horn of the hyoid is a derivative of the 2nd pharyngeal pouch: "3 is GREATER than 2"MnemonicVerifiedI don't think this is helpful. This could be difficult to understand in the current chart form. - MK03/04/19 10:45 PMSamanthaAbdallahfh3511@wayne.edu
1625606ReproductiveEmbryologyPharyngeal arch derivativesMnemonicTo remember that the GREATER horn of the hyoid is a derivative of the 3rd pharyngeal arch and the LESSER horn of the hyoid is a derivative of the 2nd pharyngeal arch: "3 is GREATER than 2"MnemonicVerifiedSame as above. - MK03/04/19 10:48 PMSamanthaAbdallahfh3511@wayne.edu
1626606ReproductiveEmbryologyPharyngeal arch derivativeshttps://embryology.med.unsw.edu.au/embryology/index.php/Neural_-_Cranial_Nerve_Development#CN_VII_FacialThe sensory nerves of the cranial nerves in the pharyngeal arches derive from neural crest cells (NCCs), not the neuroectoderm that the motor nerve portions derive from.Minor erratumVerifiedI agree with this student's suggestion according to the article cited. Need an expert's opinion on this. - MKYes, appears correct, but would want expert input as per MK's review to confirm. Can migrate for 2020 consideration.

-Matt		Prelim accept but NOT publishable erratatrue03/06/19 1:49 AMBenMeyersbsm010@jefferson.edu
1627606ReproductiveEmbryologyPharyngeal arch derivativeshttps://www.optecoto.com/article/S1043-1810(15)00067-6/fulltext#s0015The tongue will form from two lateral lingual swellings and one median swelling all from the 1st pharyngeal arch. This will form the anterior 2/3rd of the tongue. A second median swelling, the copula (2nd pharyngeal arch) is overgrown by the hypobranchial eminence (3rd and part of the 4th arch). This will form the posterior 1/3rd of the tongue. The 4th arch contributes to the epiglottis and the laryngeal orifice is just posterior.Major erratumYes, appears correct, but would want expert input as per MK's review to confirm. Can migrate for 2020 consideration.

-Matt		Prelim accept but NOT publishable erratatrue03/20/19 10:31 PMPurnimaSharmapurnimasharma@students.rossu.edu
1628606ReproductiveEmbryologyPharyngeal arch derivativeshttps://embryology.med.unsw.edu.au/embryology/index.php/Human_Embryology_and_Morphology_18All laryngeal cartilages are dervived from 4 and 6 pharngeal archesMinor erratumThe source provided does not discuss laryngeal cartilages. -MKAgree, reference not helpful. Can migrate over and see if crowdsourcing may help us find others.

-Matt		Prelim accept but NOT publishable erratatrue04/17/19 5:47 PMRaedAbabnehraedababneh@gmail.com
1629606ReproductiveEmbryologyPharyngeal arch derivativeshttps://www.researchgate.net/publication/259254315_On_the_Maxillary_NerveMaxillary and mandibular divisions of trigeminal nerve are in the 1 pharyngeal archMinor erratumReject. The maxillary division is derived from neural crest cells. The mandibular division (V3) is derived from the first arch, and this is already mentioned in the FA text. - MKReject.

-Matt		Reject by 2 authors + 1 editor04/17/19 6:01 PMRaedAbabnehraedababneh@gmail.com
1630606ReproductiveEmbryologyPharyngeal arch derivativesn/a4 – 6th Pharyngeal Arches: “4 + 6 = X” CNMnemonicVerified07/10/19 1:11 PMAPandeyaranikopandey@gmail.com
1631606ReproductiveEmbryologyPharyngeal arch derivativeshttps://emedicine.medscape.com/article/1923100-overview; http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/dissector/mml/lvp.htm;It says that the 4th arch derivatives are innervated by the superior laryngeal branch of CN X. This is true for the cricothyroid. The others (eg, levator veli palatini) are innervated mostly by other vagal branches (eg, levator veli palatini is innervated by the pharyngeal branch of the vagus nerve).Minor erratum09/19/19 4:25 PMHaleeEinfeldraxorium@gmail.com
1632608ReproductiveEmbryologyGenital embryologyhttps://www.uptodate.com/contents/congenital-uterine-anomalies-clinical-manifestations-and-diagnosis?csi=45478daa-d5ad-4757-89bf-174759e997dc&source=contentShareman is mesonephric; WOman is PARAmesonephric (Easy way to remember extremely high yield association that is easily confused)High-yield addition to next year08/16/19 7:19 PMBenjaminSwartbenjamin-swart@uiowa.edu
1633608ReproductiveEmbryologyMale reproductive anatomyhttps://www.sciencedirect.com/topics/neuroscience/paramesonephric-duct. and Dr Ryan from boards and beyondthe paramesonephric (female) remnant in males is the appendix testis and not gartner duct. the Mesonephric (male) remnant in females is gartner duct.they're switched in the bookMajor erratum10/18/19 9:40 AMMarianaHattarmaryanna21hattar@gmail.com
1634608ReproductivePathologySexual differentiationhttps://www.medscape.com/answers/252928-32489/what-is-the-pathogenesis-of-swyer-syndrome and Dr. Ryan of Boards and BeyondAbsence of Sertoli cells/lack of mullerian inhibitory factor is called Swyer Syndrome (or XY gonadal dysgenesis). The primary high-yield symptom is streak ovary.Clarification to current textVerifiedAccept this change. Absence of Sertoli cells/lack of mullein inhibitory factor -->develop both male and female internal genitalia ("streak gonads") and male external genitalia. -MKAgree with addition, and would migrate over for integration this year.

-Matt		Prelim accept but NOT publishable erratatrue03/01/19 8:23 AMNathanielBorochovnateboro8@gmail.com
1635608ReproductiveAnatomySexual differentiationhttps://www.ncbi.nlm.nih.gov/books/NBK29/box/&id/External female genital development is due to the absence of testosterone, and doesn't require estradiol. Clinical ex: lack of estrogen in XY Gonadal dysgenesis results in normal female genitalia (with no ovaries)Major erratum11/08/19 2:05 PMGIgindig@med.umich.edu
1636609ReproductiveEmbryologyMale/female genital homologsn/aGlans penis <---------GLANS------ Genital Tubercle--------GLANS-----> Glans clitoris Corpus cavernosum <------CAVE------ Genital Tubercle--------BULB-----> Vestibular bulbs Gland of Cowper <------COW------ Urogenital Sinus--------BARN-----> Gland of Bartholin Prostate gland <------PRO------ Urogenital Sinus--------SKIing-----> Gland of Skene Ventral shaft of penis <------DOWN/HYPO------ Urogenital Sinus------MINOR-------> Labia Minora Scrotum <-----SCORE------ Labioscrotal Swelling--------MAJOR----> Labia MajoraMnemonicVerified07/10/19 1:12 PMAPandeyaranikopandey@gmail.com
1637610ReproductiveAnatomyCongenital penile abnormalitiesmeWhen you have "H"ypospadias you pee on your "H"igh tops (shoes) or you pee down a "h"oleMnemonicVerifiedReject. I think the current mnemonic is more helpful. - MK02/16/19 12:20 PMChristianSchmidtschmidcm2@gmail.com
1638610ReproductiveAnatomyCongenital penile abnormalitiesmeH mnemonic for "h"ypospadias; "h"idden testes and bowels (cryptorchidism and inguinal hernia); "H"ooked shape penis (chordee); pee on "h"eelsMnemonicVerifiedHaving trouble following this. - MK02/16/19 12:30 PMChristianSchmidtschmidcm2@gmail.com
1639610ReproductiveAnatomyCongenital penile abnormalitieshttps://books.google.com.eg/books?id=20S0SYW9EScC&pg=PA553&dq=faulty+positioning+of+genital+tubercle+on+fifth+week+of+gestation&hl=en&sa=X&ved=0ahUKEwjcvs2L56DiAhVN46QKHWnCCNkQ6AEIJzAA#v=onepage&q=faulty%20positioning%20of%20genital%20tubercle%20on%20fifth%20week%20of%20gestation&f=false https://books.google.com.eg/books?id=BpOeBQAAQBAJ&pg=PA20&dq=faulty+positioning+of+genital+tubercle+on+fifth+week+of+gestation&hl=en&sa=X&ved=0ahUKEwjcvs2L56DiAhVN46QKHWnCCNkQ6AEILzAB#v=onepage&q=faulty%20positioning%20of%20genital%20tubercle%20on%20fifth%20week%20of%20gestation&f=false https://books.google.com.eg/books?id=aV6Pup1ZUoUC&pg=PA5&dq=faulty+positioning+of+genital+tubercle+on+fifth+week+of+gestation&hl=en&sa=X&ved=0ahUKEwjcvs2L56DiAhVN46QKHWnCCNkQ6AEINTAC#v=onepage&q=faulty%20positioning%20of%20genital%20tubercle%20on%20fifth%20week%20of%20gestation&f=falseIn Epispadias the faulty positioning of genital tubercle occurs on the fifth week of gestation.High-yield addition to next year05/16/19 3:46 PMMuhanadShaibmohanad.shaib@gmail.com
1640610ReproductiveAnatomyCongenital penile abnormalitiesn/aFemale remnant: Ovarian ligament + Round ligament “Use speculum in OR”MnemonicVerified07/10/19 1:14 PMAPandeyaranikopandey@gmail.com
1641610ReproductiveAnatomyGonadal drainageIt's MnemonicCerv*i*x* ---> *I*nternal and e*X*ternal iliac nodes.MnemonicVerifiedNot a fan. -GSReject - MK12/30/18 8:41 AMMoatasemAl-Janabiassoomi88@yahoo.com
1642610ReproductiveAnatomyGonadal drainageUWorld Q ID 2021Glans penis drains to deep inguinal nodes; Also "Clitoris" does according to UWORLD. which makes sense as they both originates from Urogenital TubercleHigh-yield addition to next yearVerifiedI have found several references which state that the clitoris drains to the deep inguinal nodes and the internal iliac nodes. I think we can leave this out. - MK03/01/19 7:54 PMAlaJamalala.aljamal@hotmail.com
1643610ReproductiveAnatomyGonadal drainagenot neededLymphatic drainage of clitoris is not mentionedHigh-yield addition to next year05/08/19 11:41 AMRaedAbabnehraababneh153@med.just.edu.jo
1644610ReproductiveAnatomyGonadal drainagen/aRight gonadal vein goes Right to the IVCMnemonicVerified08/21/19 4:40 PMJordanO'Steenjosteen441@gmail.com
1645611ReproductiveAnatomyFemale reproductive anatomyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103387/The diagram should be labeled Cardinal ligament AND Uterine artery. Previous editions only had the Uterine artery labeled, and only the artery was drawn in the diagram. The 2019 edition only has the cardinal ligament labeled, but the artery and the ligament are drawn (and now it doesn't label the uterine artery).Minor erratumAccept. I think the uterine artery should also be labeled in the diagram next to the label of the cardinal ligament. - MKAgree, good to label the item. Migrate over for consideration this year by the illustration team.

-Matt		Prelim accept but NOT publishable erratatrue03/25/19 12:27 AMRajverMannrajvermann@gmail.com
1646611ReproductiveAnatomyFemale reproductive anatomyn/aInfundibulopelvic ligament is aka Suspensory ligament of ovary: Ovaries SUSPENding IN-FUN.MnemonicVerified07/10/19 1:15 PMAPandeyaranikopandey@gmail.com
1647612ReproductiveAnatomyFemale reproductive epithelial histologyn/aUterus: Coiled glands in secretory phase - Secretory with the coiled hair.MnemonicVerified07/10/19 1:16 PMAPandeyaranikopandey@gmail.com
1648612ReproductiveAnatomyFemale reproductive epithelial histologyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1770692/In First Aid, the Transformation zone is defined as the "Squamocolumnar junction". This is incorrect. The correct definition for the Transformation Zone is the place where the squamocolumnar junction begins in fetal life to where it ends up as the body matures and the squamocolumnar junction moves upwards. As you can see in the article referenced, "The transformation zone is not the same as the squamo–columnar junction but the squamo–columnar junction is part of the transformation zone." I think wikipedia's definition is really good if you want more reading on this with sources: https://en.wikipedia.org/wiki/Cervix#HistologyMajor erratum10/02/19 4:59 PMAamerNaofalaamer.naofal@utsouthwestern.edu
1649612ReproductiveAnatomyMale reproductive anatomyMade-up MneumonicsCan point out that the first four letters in "SEVEN UP," so the "SEVE" = Seminal vesicles, epididymis, Vas deferens, and ejaculatory duct are the internal genitalia = derivates of the Mesonephric duct. For the external genitalia (pg 608), could say "boys like to play PSP OUTSIDE" for outside/external genitalia = Penis, Scrotum, Prostate.MnemonicVerified03/29/19 4:22 PMNankiHurananki.hura@gmail.com
1650613ReproductiveAnatomyUrethral injuryhttps://en.wikipedia.org/wiki/Extravasation_of_urineFor Anterior urethral injury location of blood accumulation section: blood accumulate within penis with intact Buck fascia, and leakage into scrotum if Buck fascia is torn.High-yield addition to next year08/03/19 6:04 AMSHICHENGSONGnicksong66@gmail.com
1651615ReproductivePhysiologyHuman placental lactogenhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233258/Maternal hyperglycemia from insulin resistance leads to lipolysisMinor erratumVerifiedReject.
There's no error in this entry. Metabolic changes such as increased lipolysis are now discussed under pregnancy on the previous page.

-MA		No actionable change to be made here, agree.

-Matt		Reject by 2 authors + 1 editor12/29/18 6:58 AMDr. KanchanGhimiredrkanchanghimire@gmail.com
1652616ReproductivePhysiologyEstrogenhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4397276/Estrogen causes closure of epiphyseal plates. This is mentioned under Testosterone on page 622 ("via estrogen converted from testosterone"), but not under Estrogen itself.High-yield addition to next yearVerifiedAgree with student. Closure of epiphyseal plates is due to estrogen and should be included under Estrogen section. - MK01/06/19 1:29 AMJerrinBawajerrin.bawa@gmail.com
1653616ReproductivePhysiologyEstrogenhttp://www.dynamed.com/topics/dmp~AN~T233179/EstradiolEstrogen promotes bone growth by decreasing osteoblastic apoptosis and stimulating osteoclastic apoptosis. This is not stated in this section and it would be of benefit for students to have that detail there.High-yield addition to next year06/18/19 6:14 PMYokairaCamiloyokacamilo@gmai.com
1654616ReproductivePhysiologyEstrogenn/aEstrogen, pg 616 Adipose – estrONE – Aromatization (Aromatase) granuloSa – fSh – eStrogen (Vs Sertoli cells in male – inhibin B  inhibit fSh) Progesterone, pg 616 PRO – GESTATION; NO – LACTATIONMnemonicVerified07/10/19 1:17 PMAPandeyaranikopandey@gmail.com
1655618ReproductivePhysiologyMenstrual cyclen/aFollicular phase comes First – Like Step 1 – Varies in duration Luteal phase comes Later – Like Step 2 – Does not vary in durationMnemonicVerified07/10/19 1:20 PMAPandeyaranikopandey@gmail.com
1656621ReproductivePhysiologyInfant and child developmentnoneUnder Toddler, it is listed: "200+ words by age 3." However, under the Preschool years, it is listed "1000 words by age 3"Clarification to current textI agree with the student. This can be confusing and I believe the text needs to be more consistent. - MKAgree. Let's rewrite this text this year.

-Matt		Prelim accept but NOT publishable erratatrue04/10/19 2:42 PMNankiHurananki.hura@gmail.com
1657621ReproductivePhysiologyInfant and child developmentN/Ain the section for Preschool, to remember that kids go down stairs with alternating feet at 4 years old, I use Four to the FloorMnemonicVerified05/16/19 7:21 PMOmairChaudryochaudry19@gmail.com
1658621ReproductivePhysiologyInfant and child developmentnot neededChild can have a vocabulary of up to 1000 words by age of 3 years and it is already mentioned in Preschool section. It is written as "200+ words by age 3" in toddler section which is not accurateMinor erratumAlready being addressed by submissions within Annotate, thus, this is a duplicate submission.

-Matt		Reject by 2 authors + 1 editor05/22/19 7:56 PMRaedAbabnehraedababneh@gmail.com
1659623ReproductivetruePhysiologyTanner stages of sexual developmenttruehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2020314/The first mound formation in females occurs in stage II NOT in stage III.Minor erratumVerifiedI think the student is correct. A small mound first appears in stage II. Would recommend faculty review.

Additional ref: Nelson essentials of pediatrics, 8e.

-MA		Agree with comment. Change from III to II. -GSReference and others seems to support mound formation being a stage II, as opposed to III, event. I am amenable to the change. Would like expert confirmation before approving change and publishing in official errata, however.

-Matt

UPDATE: per expert feedback ,we can change to stage II and publish in the errata.

-Matt		Disagreement/need expertsoroushraisbahrami@gmail.comI would be in approval with proposed change.Accept12/31/18 5:57 AMAbdulrhmanAlghamdiabdulalghamdi94@gmail.com
1660624ReproductivePathologySex chromosome disordersMnemonicMnemonic for Turner Syndrome - Tina Turner loves hugs and kisses (XO)MnemonicVerifiedI don't think a mnemonic is necessary for this condition. -MK03/14/19 10:54 AMAliJilania.jilani.77@gmail.com
1661624ReproductivePathologySex chromosome disordersFA 2019In Turner syndrome --> lymphedema in feet and hands instead of lymphedema in feet , handsClarification to current textThis doesn't seem necessary. - MKNot sure what purpose of this change is.

-Matt		Reject by 2 authors + 1 editor04/27/19 5:54 AMRaedAbabnehraedababneh@gmail.com
1662624ReproductivePathologySex chromosome disordershttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773039/50% of patients with Turner Syndrome have TPO autoantibodies, which could manifest as hypothyroidism.High-yield addition to next year09/04/19 4:32 PMJudithVasquezjudith.vasquez.11@gmail.com
1663626ReproductivePathologyPlacentahttps://www.uptodate.com/contents/placenta-previa-epidemiology-clinical-features-diagnosis-morbidity-and-mortality?search=partial%20placenta%20previa&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Placenta Previa: attachment of placenta OVER the internal cervical os. A placenta <2 cm away from the internal cervical os but NOT over it is now known as a "Low-lying placenta"Clarification to current textVerifiedAgree with student. Low-lying placenta is defined as < 2cm from, but not over, the internal os. Can be managed differently from placenta previa. https://www.uptodate.com/contents/placenta-previa-management. -MKOK to migrate over, would call more of a clarification than an erratum, however.

-Matt		Prelim accept but NOT publishable erratatrue01/29/19 11:04 AMHasanAlarourihassan.arouri@hotmail.com
1664626ReproductivePathologyPlacentaSelf-made mnemonicSeverity of different types of morbidly adherent placenta are in alphabetical order(first letter of each type). The deeper it invades - further the letters: Accreta->Increta->Percreta. A->I->PMnemonicVerified08/24/19 3:21 PMEduardKrishtopaytiskrishtopaitis@icloud.com
1665627ReproductivePathologyAmniotic fluid abnormalitiesmade this up"O"ligohydraminos=can't pee it "O"utMnemonicVerifiedAgree with this and think it's a helpful mnemonic. Oligohydramnios results from an inability to excrete urine. - MK02/16/19 12:14 PMChristianSchmidtschmidcm2@gmail.com
1666628ReproductivePathologyHydatidiform molehttps://www.ncbi.nlm.nih.gov/pubmed/20673583For the karyotypes for a complete mole, FA lists 46 XX and 46 XY as the main types which is partially correct. It should be both 46 XX and 46 YY. The reason being, If one sperm fertilize an empty ovum and the Paternal DNA is replicated twice it would only be XX or YY and not XY. If two sperm fertalize and empty ova then you can achieve an XX or XY karyotype but the text is unclear in this regard and this last from is much more rare.Clarification to current textVerifiedDisagree with student. According to https://www.uptodate.com/contents/hydatidiform-mole-epidemiology-clinical-features-and-diagnosis?search=complete%20mole&source=search_result&selectedTitle=2~44&usage_type=default&display_rank=2#H2161400197, karyotypes for complete mole are 46 XX and 46 XY. - MKAgree, the karyotypes we list are correct. No change needed here.

-Matt		Reject by 2 authors + 1 editor02/28/19 11:37 PMShivMisramisras0@rowan.edu
1667628ReproductivePathologyHydatidiform molehttps://emedicine.medscape.com/article/254657-overview#a4Complete mole can also be caused by 2 sperm into an enucleated eggHigh-yield addition to next yearAgree with student. Complete mole can result from an enucleated egg + single sperm OR enucleated egg + 2 sperm. - MK04/09/19 12:24 PMKatelynSturdivantksa.sturdivant@gmail.com
1668628ReproductivePathologyHydatidiform molehttps://www.ncbi.nlm.nih.gov/pubmed/23121032 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460560/in complete mole p57 marker is negative and in partial mole p57 marker is positiveClarification to current textUnless I am misreading, we already state this in the table explicitly? Not sure how to change this.

-Matt		Reject by 2 authors + 1 editor05/16/19 3:36 PMMuhanadShaibmohanad.shaib@gmail.com
1669629ReproductivePathologyHypertension in pregnancynot neededsuggest making this mnemonic "Hypertensive Moms Love Nifedipine" like this mnemonic ,in Page 312, "He likes my neonate" ,i think it's simpler .MnemonicVerifiedDisagree with student. Current mnemonic seems more helpful. -MK-01/01/19 1:52 PMMoatasemAl-Janabiassoomi88@yahoo.com
1670630ReproductivePathologyVulvar pathologyFA 2019In 'Lichen simplex chronicus' --> "no increased risk for SCC" instead of "no risk of SCC"Clarification to current textI'm not sure what the difference is. - MKNor am I. Seems like two ways of saying the exact same thing.

-Matt		Reject by 2 authors + 1 editor04/19/19 5:28 AMRaedAbabnehraedababneh@gmail.com
1671631ReproductivePathologyCervical pathologyhttps://www.uptodate.com/contents/cervical-intraepithelial-neoplasia-terminology-incidence-pathogenesis-and-prevention#H8037165Current First Aid text (2019) says that the #1 risk factor for cervical dysplasia is multiple sexual partners. Article from UptoDate and a question on another question bank indicates that the #1 risk factor is HPV infection with a high-risk serotype.Minor erratumVerifiedAgree with student. According to uptodate, "The two major factors associated with development of high-grade CIN and cervical cancer are the subtype of HPV and the persistence of the virus." However, I still think multiple sexual partners could be included. "HPV infection is endemic among sexually experienced individuals. The risk correlates with the lifetime number of sex partners, but is relatively high (4 to 20 percent) even in those with one partner." Therefore I think both statements can be correct as one relates to the other. Need expert advice. - MKMerits review. All are factors but which one is the "most important" can be studied more.

In general, in these cases, I find it easiest to just get rid of the hierarchy when it is not clear. So long as we list out the high-yield correct ones, I suspect the fact will be adequate.

Migrate over for consideration.

-Matt		Prelim accept but NOT publishable erratatrue01/21/19 9:34 PMNehaMylarapuneha.myamr@gmail.com
1672631ReproductivePathologyCervical pathologyhttps://ascopubs.org/doi/abs/10.1200/JCO.2017.35.15_suppl.e21627Postrenal renal failure is the most common cause of death in advanced cervical carcinomaHigh-yield addition to next yearWhile I can't find any definitive evidence that it is the MOST common cause of death, hydronephrosis with post renal failure is certainly a common cause of death in advanced cervical carcinoma. -MK04/19/19 2:05 PMRaedAbabnehraedababneh@gmail.com
1673631ReproductivePathologyFunctional hypothalamic amenorrheahttps://www.ncbi.nlm.nih.gov/pubmed/7114117Studies have failed to demonstrate a link between stressful life events and amenorrhoea of greater than 2 months . However, stress may lead to physical debility such as weight loss, which may then cause menstrual disturbance.Minor erratumDisagree with student. "Stress" in this case could mean stress to the body rather than one stressful life event. - MKAgree with MK, no erratum or need for change here. Text is clear as is.

-Matt		Prelim accept but NOT publishable errata04/22/19 1:15 PMRaedAbabnehraababneh153@med.just.edu.jo
1674631ReproductivePathologyPolycystic ovarian syndromeMade up.PCOS needs PCOS treatments oK. P=Playing/Weight reduction; C=Clomiphene citrate; O=OCPs; S=Spironolactone; K=KetoconazoleMnemonicVerifiedDon't think this is necessary. - MK02/15/19 1:07 PMAlecHastyalechasty2017@gmail.com
1675631ReproductivePathologyPolycystic ovarian syndromenot neededIt is not clear that clomiphene; spironolactone, finasteride and flutamide are used to treat hirsutism not PCOS itself ". It is better to mention that drugs in independent line.Clarification to current textWe could add clomiphene (ovulation induction); spironolactone, finasteride and flutamide to treat hirsutism. This should help clarify. -MKA similar suggestion is already on Annotate (defered from last year).

-Vasily		Reasonable proposal by MK. Can consider adding clomiphene for 2020.

-Matt		Prelim accept by 2 authors + 1 editor04/22/19 1:40 PMRaedAbabnehraababneh153@med.just.edu.jo
1676632ReproductivePathologyOvarian neoplasmsUWorld Question ID: 6441 (UWSA1)Mature cystic teratomas are derived from "totipotent germinal cells". That's why they can form meso/endo/ectodermal tissue.High-yield addition to next yearVerifiedThis seems repetitive as the text states that the tumor can contain elements from all 3 germ layers. But we could add derived from "totipotent germ cells". Need others' opinions. - MK02/08/19 10:54 AMemanuelgrantemanuelwgrant@gmail.com
1677632ReproductivePathologyOvarian neoplasmsMade upCystic teratoma-Struma Ovarii causes Over-yyy acting Thyroid hormone (Hyperthyroidism)MnemonicVerifiedHard to follow. Reject. - MK02/15/19 1:11 PMAlecHastyalechasty2017@gmail.com
1678632ReproductivePathologyOvarian neoplasmsBRS embryology, sixth edition , page 21CA 125 is a tumor marker for surface-drived overian cancers ( not all overian cancers)Minor erratumAccept. CA-125 is a useful serum marker to monitor treatment response and screen for recurrence in surface epithelial tumors. - MKSeems reasonable.

-Vasily		OK to consider this for 2020.

-Matt		Prelim accept but NOT publishable erratatrue04/25/19 4:13 AMRaedAbabnehraedababneh@gmail.com
1679632ReproductivePathologyOvarian neoplasmsNone needed.To remember that OCPs reduce the risk of ovarian cancer, remember OCP = Ovarian Cancer Protective.Mnemonic10/04/19 10:08 AMHaleeEinfeldraxorium@gmail.com
1680633ReproductivePathologyCancer epidemiologynoneYolk Sac tumors: SAC: S(Schiller-Duval), A (AFP tumor marker), C (children/young)MnemonicVerifiedAccept. I think this is a helpful mnemonic to remember 3 key facts about yolk sac tumors.- MK01/24/19 6:34 PMGraceGilbertgrace.v.gilbert@gmail.com
1681633ReproductivePathologyOvarian neoplasmsMade up(Alliteration) Young Yolk-sac tumor (=most common in young children)MnemonicVerifiedReject, not very helpful. - MK02/15/19 1:15 PMAlecHastyalechasty2017@gmail.com
1682633ReproductivePathologyOvarian neoplasmshttps://www.ncbi.nlm.nih.gov/pubmed/25605680Granulosa cell tumors will have "coffee bean nuclei" as seen with Brenner tumors.High-yield addition to next yearVerifiedAgree. "Histologically, granulosa cells of the adult subtype appear round, pale, with scant cytoplasm, and classic "coffee-bean" grooved nuclei."
https://www.uptodate.com/contents/sex-cord-stromal-tumors-of-the-ovary-granulosa-stromal-cell-tumors?search=granulosa%20cell%20tumor&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H11
-Vasily		03/06/19 7:40 AMMadhumitaGovindaswamymadhu.govindaswamy@gmail.com
1683633ReproductivePathologyOvarian neoplasmsN/A"Yo"(lk sac tumor) there's a glomerulus in this ovary!MnemonicVerifiedReject. - MK03/24/19 2:30 PMBenjaminSaracbsarac19@gmail.com
1684633ReproductivePathologyOvarian neoplasmsnone neededCurrently, "Primary dysmenorrhea" is placed under the Other (malignant) ovarian neoplasms heading. It should be moved to the next page where the section on "Uterine conditions" starts.Clarification to current textAgree. Primary dysmenorrhea should not be placed under the Other (malignant) heading. - MKOK to consider this for 2020.

-Matt		Prelim accept but NOT publishable errata03/25/19 1:36 PMNatalieJansenjansen7@uic.edu
1685633ReproductivePathologyOvarian neoplasmsRobbins Basic Pathology 10th Edition"may be metastatic from appenicial or other GI tumors" is not accurate since metastasis from appenicial or other GI tumors may cause pseudomyxoma peritonei not mucinous cystadenocarcinomaMajor erratumReject. Pseudomyxoma peritonei is a condition that can result from mucinous cysadenocarcinoma. Mucinous cystadenocarcinoma may be mets from appendiceal or other GI tumors. - MKAgree with authors to reject this one.

-Matt		Reject by 2 authors + 1 editor04/24/19 12:29 AMHalimaAloumraedababne@gmail.com
1686633ReproductivePathologyOvarian neoplasmshttps://emedicine.medscape.com/article/255771-overview#showallmetastasis from the GI tract does not result in Ovarian mucinous cystadenocarcinomaMajor erratumIt is not the exclusive cause of this pathology, but it can certainly be a cause of it. Student's own resource actually supports this notion, which is in line with what we state. No change to the text.

-Matt		Reject by 2 authors + 1 editor05/04/19 2:48 PMHalimaAloumraedababneh@gmail.com
1687633ReproductivePathologyOvarian neoplasmshttps://www.ncbi.nlm.nih.gov/pubmed/25608250For a granulosa cell tumor, there are different possible histologies that may present. The most common one is diffuse pattern, where the coffee-bean appearance is present ("sheets of small haphazardly oriented cells with scant cytoplasm and longitudinal nuclear grooves". Another HY pattern of granulosa cell tumors is Call-Exner bodies which are- unlike what FA 2019 has written- a microcystic space containing eosinophilic basement membrane material. It seems as though the 2 different patterns have been confounded.High-yield addition to next year12/13/19 10:13 AMMichaelMarkelmmarkel18@gmail.com
1688634ReproductivePathologyPregnancy complicationshttps://www-uptodate-com.library.iau.edu.sa/contents/unsafe-abortion?search=septic%20abortion&source=search_result&selectedTitle=3~28&usage_type=default&display_rank=3Septic abortion: Risk factors: pregnancy termination with retained products of conception. Microbiology: • G -ve bacilli • S. aureus. • Group B streptococci Presentation: • Fever, chills, and lower abdominal pain. • Bloody/ purulent foul-smelling vaginal discharge. • Tender uterus with a dilated cervix. Pelvic US: • Retained products of conception. • High vascularity. • Echogenic material in uterine cavity. • Thick endometrial stripe Management: broad spectrum antibiotics and surgical evacuation. Complications: sepsis, synechiae in the uterine cavity (Asherman syndrome).High-yield addition to next year05/14/19 1:59 PMAmnaAlsaihatiamna.saihati@gmail.com
1689634ReproductivePathologyTesticular non–germ cell tumorshttp://www.pathologyoutlines.com/testis.htmlThe information for Leydig cell tumors and Sertoli cell tumors are switched i.e. Sertoli cell tumors commonly present with gynecomastia and precocious puberty.Major erratumVerifiedReject. Leydig cell tumor usually produces androgen, causing precocious puberty in children or gynecomastia in adults. -MKReject.

I think we are correct. Leydig Cell Tumors- Prepubertal boys with androgen-secreting tumors may present with precocious puberty and Boys with estrogen-secreting tumors may present with feminizing symptoms such as gynecomastia, breast tenderness, and gonadogenital underdevelopment."

https://emedicine.medscape.com/article/437020-clinical#b1

- Vivek		Agree with authors to reject this one.

-Matt		Reject by 2 authors + 1 editor02/14/19 9:45 PMLillianZhengltzheng1@gmail.com
1690634ReproductivePathologyUterine conditionshttps://www.sciencedirect.com/topics/medicine-and-dentistry/ashermans-syndrome ; https://www.uptodate.com/contents/intrauterine-adhesions-clinical-manifestation-and-diagnosisCauses secondary amenorrhea. Loss of basalis layer (decreased regenerative capacity)High-yield addition to next yearVerifiedIs he suggesting that this should be added to Asherman Syndrome? If so, I agree. -MKDefer to 2020.

- Vivek		02/21/19 9:55 PMSejalShahsejalshah128@gmail.com
1691634ReproductivePathologyUterine conditionshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880005/Clinical manifestations of Asherman syndrome include amenorrhea and hypomenorrhea (not mentioned in the text of FA)High-yield addition to next yearAgree with student. Could include amenorrhea as a clinical manifestation of Asherman syndrome. - MK04/19/19 2:59 PMRaedAbabnehraedababneh@gmail.com
1692634ReproductivePathologyUterine conditionshttps://www.aafp.org/afp/2016/0315/p468.html#afp20160315p468-b2Most of the patients in both types of endometrial carcinoma diagnosed after menopauseClarification to current textReject. Endometrioid endometrial carcinoma is usually seen in perimenopausal women while serous type is more commonly seen in postmenopausal women. - MK http://ovidsp.tx.ovid.com/sp-3.33.0b/ovidweb.cgi?QS2=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 with authors to reject this one.

-Matt		Reject by 2 authors + 1 editor04/21/19 10:48 AMRaedAbabnehraababneh153@med.just.edu.jo
1693634ReproductivePathologyUterine conditionshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683444/Presentation lists HMB however abbreviation not defined as (Heavy Menstrual Bleeding)MnemonicVerified06/05/19 12:14 PMAndreaVictorioandrea.victorio@icloud.com
1694634ReproductivePathologyUterine conditionshttps://www.uptodate.com/contents/uterine-sarcoma-classification-clinical-manifestations-and-diagnosis?search=leiomyosarcoma&source=search_result&selectedTitle=3~87&usage_type=default&display_rank=3Per UptoDate: "Leiomyosarcomas and leiomyomas are independent entities. Leiomyosarcomas are rare and while they may coexist in the same uterus with benign leiomyomas (fibroids), they exhibit differing cytogenetic abnormalities [6-8], and leiomyomas do not appear to be the precursor to leiomyosarcomas." Also, per Pathoma: "Leiomyosarcoma arises de novo; leiomyosarcomas do not arise from leiomyomas."Minor erratumThank you for your suggestion. This issue has already been addressed on Annotate.

-Vasily		As per Vasily, already addressed on Annotate.

-Matt		Reject by 2 authors + 1 editor06/06/19 1:14 PMJuliaJacksonjajackson814@gmail.com
1695636ReproductivetruePathologyBreast cancerhttps://www.uptodate.com/contents/pathology-of-breast-cancerTubular & mucinous carcinomas are NOT subtypes of invasive ductal carcinoma, but rather subtypes of breast cancer (invasive carcinoma).Major erratumVerifiedAccept.

Both are included as seperate subtypes of invasive breast cancer in the 4th edition of the WHO classification of breast tumors. Older textbooks listed them as subtypes of IDC. IDC itself has been renamed to Invasive Breast Carcinoma of No Special Type.

I suggest deleting all the text in column 3 : "Subtypes: tubular—well-differentiated tubules that lack myoepithelium; mucinous—abundant extracellular mucin, seen in older women."

ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683948

- MA		Accept. I agree that we should delete the right-hand column under invasive ductal carcinoma. - MKI agree the classification needs to be updated. Tubular and mucinous are separate subtypes of invasive breast cancer. Invasive ductal carcinoma is also a subtype and is by far the most common. The current wording suggests that both tubular and mucinous are subtypes of invasive ductal carcinoma, which is somewhat inaccurate.

In truth, they need to be listed, perhaps as a footnote, as separate subtypes of invasive breast cancer, which we can work on for 2020.

We can update this and release an official errata publication making note of this, and for 2020 we can discuss how to best update the invasive breast cancer subentry to be most accurate.

-Matt		Prelim accept by 2 authors + 1 editorAccept01/07/19 4:21 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
1696636ReproductivePathologyBreast cancerhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628841/Inflammatory breast cancer usually presents with a palpable mass in at least 70% of cases. This contradicts what the text is saying ("usually lacks a palpable mass"). "Underlying tumour masses might be palpable in IBC, but up to 30% of patients will present with no underlying masses."Major erratumVerifiedReject.

UTD, dynamed and other references support our current text. Even the article provided by the user states the same :"Inflammatory breast cancer is a rare disease that typically presents with a rapidly enlarging erythematous breast, often with no discernable breast mass."

Additional ref: http://www.dynamed.com/topics/dmp~AN~T920656/Inflammatory-breast-cancer#General-Information

-MA		I also support the current text, most references cite that a palpable mass is less common than other features.

For example: https://www.cancer.gov/types/breast/ibc-fact-sheet

No change.

-Matt		Reject by 2 authors + 1 editor01/07/19 4:22 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
1697636ReproductivePathologyBreast cancermnemonic*C*omedocarcinoma has *c*entral necrosis and *c*alcificationsMnemonicVerifiedAccept. - MK03/29/19 2:03 PMConnorLentzlentz.connor@gmail.com
1698636ReproductivePathologyBreast cancerwww.uworld.com, www.ncbi.nlm.nih.gov/pubmed/11694790"HER2/neu negative form more aggressive" is mentioned. Its wrong. HER2/neu POSITIVE forms are MORE aggressive and indicate poor prognosis.Clarification to current textThank you for your comment! I agree, we need to make some changes to avoid confusion.

Current text can be misinterpreted the following way: "ER -ve breast cancer is associated with worse prognosis. PR -ve breast cancer is associated with worse prognosis. HER2/neu -ve breast cancer is associated with worse prognosis."

I think we should be more explicit in saying that "triple negative (ER -, PR -, HER2 -) breast cancer is associated with poor prognosis".

As for HER2 +ve breast cancers, they also have poor prognosis, especially in the absense of targeted therapy. On the other HER2 positivity is predictive of response to targeted therapy. But I do not think it is worth going into this kind of detail.

From UTD:
HER2 overexpression contends an unfavorable prognosis, particularly if patients are not treated with chemotherapy and HER2-directed agents. However, the added value of this information in clinical practice is questionable because outcomes are heavily influenced by the administration of therapy. In women with breast cancer, the main benefit of HER2 testing is its predictive value for appropriate candidates who should receive HER2-directed agents.

In the absence of systemic therapy, HER2 overexpression is a marker of poor prognosis in patients with pathologically node-positive and node-negative breast cancer. In addition, data suggest that HER2 retains prognostic value even in the presence of small tumors ≤1 cm.

https://www.uptodate.com/contents/prognostic-and-predictive-factors-in-early-non-metastatic-breast-cancer?search=breast%20cancer%20prognosis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H682639939

HER2 overexpression was associated with high rates of disease recurrence and death in the absence of adjuvant systemic therapy. However, the value of this prognostic information in clinical practice is questionable, particularly with the earlier use of HER2-directed agents in the neoadjuvant and adjuvant setting.

https://www.uptodate.com/contents/her2-and-predicting-response-to-therapy-in-breast-cancer?search=breast%20cancer%20prognosis&topicRef=782&source=see_link#H36

-Vasily		Not a major erratum. But agree that the current text is misleading and unclear. Triple negative breast cancer is extremely aggressive with a poor prognosis. Same with HER2-positive ones.

I think Vasily's clarification is best and I propose modifying the text to reflect that.

Accepting for credit, as Vasily has already migrated over to Annotate and a change has been implemented. Can certainly consider official errata addition.

-Matt		Prelim accept by 2 authors + 1 editortrue05/14/19 9:29 PMDr PriyaShenwaidrpriyashenwai@gmail.com
1699636RespiratoryPathologyEpistaxishttps://radiopaedia.org/articles/woodruff-plexusThe text says " Life- threatening hemorrhages occur in posterior segment (sphenopalatine artery, a branch of maxillary artery). " Specify that posterior bleeds occur in Woodruff's plexusClarification to current text07/27/19 5:05 PMJudithVásquezjudith.vasquez.11@gmail.com
1700637ReproductivePathologyPenile pathologyIts a mnemonic broPEyROUNDie: PEnis shaft curvature becomes more ROUNDedMnemonicVerifiedReject. Don't think this is necessary. - MK03/30/19 3:39 PMJoshuaLadellajosh.ladella@gmail.com
1701638ReproductivePathologyTesticular germ cell tumorsFirst Aid 2019, pg. 638SPAY - Seminoma, PALP, AFP, Yolk Sac tumor. Mnemonic to remember germ cell tumor hormone markers based on SPAY, which refers to removing reproductive organsMnemonic10/20/19 9:39 AMPhilipBrauerprb63@case.edu
1702639ReproductivePathologyBenign prostatic hyperplasiahttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762036/Characterized by non-nodular enlargement, in the book it states nodular enlargement, which is characteristic of tumor in 25-50% cases, and needs to rule out prostate cancer.Major erratumReject. "Nodular" here refers to the histology (hyperplasia in this case). A "nodule" detected grossly obviously raises concern for cancer. Different concepts. No change needed.

-Matt		Reject by 2 authors + 1 editor07/18/19 11:58 PMTemurDuschanovdnatima@gmail.com
1703639ReproductivePathologyTesticular non–germ cell tumorsMnemonic"Leydies dig crystals" mnemonic for Leydig cell tumor and Reinke CrystalsMnemonicVerifiedI like this mnemonic and think it is helpful. -MK03/27/19 5:16 AMNathanielBorochovnateboro8@gmail.com
1704640ReproductivePharmacologyControl of reproductive hormoneshttps://www.uptodate.com/contents/cyproterone-united-states-not-available-drug-informationDelete cyproterone. It is not mentioned anywhere else in the book. Also this drug is not available in the US. It is very unlikely that it will come up in the exam.High-yield addition to next yearVerifiedAccept. If the drug is not available in the US, I do not think it is high yield for the test. - MK01/07/19 4:25 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
1705641ReproductivePharmacologyEstrogenshttps://www.ncbi.nlm.nih.gov/pubmed/8732994Estrogens are associated with hypertension due to increased angiotensinogen synthesis by estrogen during first-pass metabolismHigh-yield addition to next year12/07/19 6:36 PMHadiSiddiquehadis@auamed.net
1706641ReproductivePharmacologySelective estrogen receptor modulatorshttps://www.uptodate.com/contents/abnormal-uterine-bleeding-and-uterine-pathology-in-women-on-tamoxifen-therapy?search=Tamoxifen+increase+the+risk+for+endometrial+polyp&source=search_result&selectedTitle=2%7E150&usage_type=default&display_rank=2Tamoxifen increase the risk for endometrial polypHigh-yield addition to next year05/08/19 11:19 AMHalimaAloumraababneh153@med.just.edu.jo
1707641ReproductivePharmacologySelective estrogen receptor modulatorshttps://www.mayoclinic.org/drugs-supplements/raloxifene-oral-route/side-effects/drg-20065760 https://www.mayoclinic.org/drugs-supplements/tamoxifen-oral-route/side-effects/drg-20066208Ovarian enlargement, multiple simultaneous pregnancies and visual disturbances are ‎basically ‎adverse effects for clomiphene not all of SERMs do thatMinor erratumAgree. A simple word change can actually fix that. Would just delete "SERMs" here to make this better. Note that the side effects can be caused by the other SERMs, but the current wording is confusing.

Will just deleted 'SERMs" from the clomiphene text. Not official errata worthy.

-Matt		Prelim accept but NOT publishable erratatrue05/09/19 10:58 PMRaedAbabnehraedababneh@gmail.com
1708641ReproductivePharmacologyTamoxifen, raloxifeneas per UworldTamoxifen causes hot flashes due to anti-estrogen effects on the anterior hypothalamus causing thermoregulatory dysfunction.High-yield addition to next yearVerifiedI think this can be inferred knowing that tamoxifen is a SERM. What do others think? -GSI agree with the student and think this should be included. I don't think this is necessarily "inferred" just by knowing that tamoxifen is a SERM. - MK01/19/19 9:55 AMYoseliVenturayoseli.ventura14@gmail.com
1709642ReproductivePharmacologyCombined contraceptionhttps://www.tandfonline.com/doi/pdf/10.3109/13625187.2010.513071Mestranol is the other form of estrogen that can be found in combined contraception. Only ethinyl estradiol is acknowledged. (Golan Pharmacology, pg. 516).Minor erratumMestranol is FDA approved, but marketing status is "discontinued". Likely LY.
https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=010976

-Vasily		Agree, likely LY.

-Matt		Reject by 2 authors + 1 editor07/01/19 3:01 PMJosephYasmehjyasmeh@gmail.com
1710643ReproductivePharmacologyAntiandrogensSelf-writtenSPIROnolactone - Sironolactone SPIRALS up and down to affect 2 levels of testosterone. First decreases testosterone PROUCTION higher up, then INHIBITS androgen-receptor complex lower down as well.Mnemonic10/30/19 8:58 AMKhalidAlattarkhalid_alattar@hotmail.com
1711643ReproductivePharmacologyPhosphodiesterase type 5 inhibitorshttps://en.wikipedia.org/wiki/Cyanopsiaone of the adverse effects of phosphodiesterase 5 inhibitors is Cyanopsia by s NOT Cynopia.Spelling/formatting08/13/19 5:03 AMMuhanadShaibmohanad.shaib@gmail.com
1712643ReproductivePharmacologyTestosterone, methyltestosteronehttps://www.uptodate.com/contents/overview-of-burn-injury-in-older-patientsI suggest deleting the phrase "stimulate anabolism to promote recovery after burn or injury" because neither testosterone nor methyltestosterone are indicated for the stimulation of the anabolism in catabolic conditions (eg, burn injuries). Oxandrolone is used instead for these conditions.Minor erratumVerifiedI disagree with this student. Testosterone can be used to increase protein synthesis as well as oxandrolone. - MKI disagree as well. Testosterone can be used for this purpose and merits testing/inclusion in the book.

-Matt		Reject by 2 authors + 1 editor01/07/19 4:27 AMPanagiotisKaparaliotispanagiotiskap@gmail.com
1713646ReproductiveEmbryologyCongenital lung malformationshttps://www.uptodate.com/contents/prelabor-rupture-of-membranes-before-and-at-the-limit-of-viability?search=pulmonary%20hypoplasia&source=search_result&selectedTitle=1~142&usage_type=default&display_rank=1In fact, pulmonary hypoplasia is associated with bilateral renal agenesis (triggering the Potter sequence). But I'd suggest swapping "bilateral renal agenesis" with "oligohydramnios (from any cause)". Potter's sequence is a SEQUENCE of events triggered by oligohydramnios that ultimately leads to pulmonary hypoplasia, a common cause of death in these patients. Bilateral renal agenesis is only one of the causes, but there are several other ones, like prelabor preterm rupture of membranes (e.g., rupture of membranes before 20w of GA) that are way more common clinically speaking.Minor erratum09/04/19 12:56 PMNicolasCuri Gawlinskinicolascurii@gmail.com
1714647RespiratoryPhysiologyLung and chest wallN/AThe description is redundant with "inward pull of lung is balanced by outward pull of chest wall, and system pressure is atmospheric" written twice.Clarification to current textVerifiedTM - Yes. Delete redundant statement.Agreed, it is verbatim written twice. Would delete the first time it is written. -MKAgree, delete redundant statement.Prelim accept but NOT publishable errataTisha Wangi agreetrue02/03/19 1:15 PMAngelaWangela.wu@som.umaryland.edu
1715648RespiratoryPhysiologyHemoglobin modificationshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1281520/Under Carboxyhemoglobin; Causes decrease in oxygen binding capacity with left shift in oxygen curve. I suggest modifying it to "for the reminder of Hb (not bound to CO) the affinity becomes higher to oxygen so the curve will shift to the Left in the presence of CO in blood". this will prevent confusion that might arise by the original parapgraphClarification to current textVerifiedSee below, this person is looking at the wrong page and more confusing.Reject by 2 authors + 1 editorTisha Wangprobably less wordy to just say "increased affinity to oxygen with left shift in curve"12/22/18 2:24 AMAlaJamalala.aljamal@hotmail.com
1716648RespiratoryAnatomyLung anatomyParagraph above, previous editions of First AidThe bronchioles are made up of columnar epithelium, not cuboidal epithelium. The text next to the illustration mislabels the illustration.Minor erratumVerified- Reject

We have correctly stated that the bronchioles are made of up cuboidal epithelium. (1)

Moreover, the entry is not supported by good supporting evidence.

1. https://www.sciencedirect.com/topics/medicine-and-dentistry/bronchiole

- Vivek		Agree, reject.Reject by 2 authors + 1 editor01/09/19 5:15 PMKatieLikatieli@umich.edu
1717648RespiratoryAnatomyRespiratory treen/aResistance is HI at broncHI Resistance in LO at bronchiOLesMnemonicVerifiedReject. Weak mnemonic. -MK07/10/19 12:46 PMAPandeyaranikopandey@gmail.com
1718648RespiratoryAnatomy and PhysiologyRespiratory treeBy definition in First aid gave it as a pseudo stratified ciliated columnar but in picture its represented as simple ciliated cuboidal.Simple ciliated cuboidal epithelium need to changes to pseudo stratified ciliated columnar epithelium in the picture next to bronchiole in respiratory tree picture.Minor erratum08/16/19 1:38 AMSathish kumarRamesh Babusathish_kumar@doctor.com
1719648RespiratoryAnatomyRespiratory treehttps://en.wikipedia.org/wiki/ObrOnchi: 1 "O" = gOblet , pseudOstratified // brOnchiOle: 2 "O" = smOOth cell, (cubOidal+squamOus) // bronChioLe=CL=CLub cellsMnemonic10/29/19 2:37 PMEsatGunaymd.esatgunay@gmail.com
1720648RespiratoryAnatomyRespiratory treehttps://www.histology.leeds.ac.uk/respiratory/respiratory.phpThere should be cilia on the cuboid cells on the picture where it shows respiratory bronchiolesMinor erratum10/30/19 11:38 AMEsatGunaymd.esatgunay@gmail.com
1721649RespiratoryAnatomyDiaphragm structuresIt's a mnemonic.The *C*ommon *C*arotid bi*four*cates at *C*4. • The *T*rachea bi*four*cates at *T*4. • The abdomina*L* aorta bi*four*cates at *L*4.MnemonicVerified*Reject. [~Accept. I think it would be a good, simple modification to the existing mnemonic. -Mitchell Katona~]

*I guess after thinking about the fact that it should already be obvious which vertebral region these three structures would be in, the value of the mnemonic is a lot less than I was originally considering. Agree with MA that may not be worth it, unless someone else thinks differently. -Mitchell Katona		I'm not a fan TBH. It's easy to figure out where theses structures are in relation to the spine. This would complicate our very simple mnemonic.

-MA		01/26/19 2:28 PMAbdulrhmanAlghamdiabdulalghamdi94@gmail.com
1722649RespiratoryAnatomyDiaphragm structuresNot needed.A mnemonic for "Structures perforating the diaphragm" could be: "I 8 (ate) 10 Eggs At 12" IVC at T8, Esophagus (Eggs) at T10, Aorta (At) at T12.MnemonicVerifiedReject. This mnemonic is already in the 2019 edition. -Mitchell KatonaReject.

Agree with MK
-MA		01/28/19 9:37 AMNajatFadlallahnajat.fadlallah@lau.edu
1723649RespiratoryAnatomyDiaphragm structuresNone needed.The mnemonic can be updated to help remember the vagus and phrenic nerve's passage through the diaphragm as well. The new mnemonic can be "I frenetically ate ten vulgar eggs at twelve." This will cover IVC, phrenic nerve at T8 (I, frenetically), esophagus and vagus nerve at T10 (vulgar, eggs), and aorta at T12 (at).Mnemonic11/25/19 11:01 PMAbhishekGamiagami@jhu.edu
1724649RespiratoryAnatomyLung anatomytruehttps://www.anatomyatlases.org/HumanAnatomy/Topography/Lungs.shtmlposterior border of the lung ends at the 10th rib not the 9th as illustrated in the diagramMinor erratumAgree. -AlirezaVerifiedAccept. This is a minor but not insignificant correction to an existing illustration. I confirmed with the Atlas of Human Anatomy by Netter and plate 194 does show the base of the lungs intersecting the 10th rib posteriorly. -Mitchell KatonaAccept.

Agree with MK.

-MA		Agree, the illustrating needs minor tweaking.

- Sarah		Prelim accept but NOT publishable erratatrue03/11/19 2:18 PMahamdObeidatobeidat.amd@hotmail.com
1725649RespiratoryAnatomyLung anatomyhttps://emedicine.medscape.com/article/353329-overviewIf you aspirate a peanut: - while supine: usually enters superior segment of right lower lobe "or posterior segment of right upper lobe"High-yield addition to next yearVerifiedLeaning towards accept. UpToDate (https://www.uptodate.com/contents/aspiration-pneumonia-in-adults?search=aspiration&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1) also mentions posterior segment of right upper lobe as being implicated in supine aspiration. On the other hand, I anecdotally recall superior segment being the "classically" affected segment. -Mitchell KatonaWe already discuss which lobes are more likely to be involved on p670 under lung abscess. I'm not really sure if it's HY to know the exact segment of each lobe though. I feel that it's LY for Step 1.

-MA		03/12/19 10:25 AMArpitJainarpitjaindr@gmail.com
1726649RespiratoryAnatomyLung anatomyhttps://emedicine.medscape.com/article/353329-overviewDue to gravity, SUPINE patients typically aspirate into the POSTERIOR SEGMENTS OF THE UPPER LOBE and SUPERIOR SEGMENTS OF THE LOWE LOBEHigh-yield addition to next year12/08/19 9:19 PMWindsor University School of medicineOkenabirhiegregory.okenabirhieMD@gmail.com
1727650RespiratoryPhysiologyLung volumeshttps://en.wikipedia.org/wiki/Tidal_volumeI think it would be better if arrange Tidal volume to be first in the column before Inspiratory reserve volume and writing the standard abbreviation between brackets on the same column for example: Tidal Volume (TV) Inspiratory reserve volume (IRV), Residual volume (RV)……etc.Spelling/formattingReject. The formatting is better in its current form with volumes in physiologic order. The abbreviations are obvious. -MK05/16/19 3:54 PMMuhanadShaibmohanad.shaib@gmail.com
1728651RespiratoryPhysiologyLung and chest wallthe information is correct, just duplicated.Inward pull of lung is balanced by outward pull of chest wall, and system pressure is atmosphere was duplicated in this section.Spelling/formattingStaff acceptsRepeat. -MK01/18/19 9:25 PMTinaNguyentina.on.earth@gmail.com
1729651RespiratoryPhysiologyLung and chest wallhttp://www.medicine.mcgill.ca/physio/resp-web/sect9.htmThe graph showing lung and chest wall compliance is labeled "transpulmonary static pressure" on the x-axis. However, transpulmonary pressure is defined as alveolar pressure minus intrapleural pressure. For the chest wall, this would not represent the pressure difference across it, which is more accurately the pressure at the body surface minus the pleural pressure. Therefore, I believe the label of the x-axis should read "transmural pressure," not transpulmonary static pressure.Minor erratumVerifiedReject. Transpulmonary pressure is merely one of three transmural pressures. Changing this would make the x axis vague and less accurate.

Need editor or expert input. -Mitchell Katona		I suggest changing "transpulmonary static pressure" to simply "Airway pressure".

Ref: Physiology by Constanzo 6e p 201

-MA		03/11/19 5:17 PMNidaBajwanab016@jefferson.edu
1730651RespiratoryPhysiologyLung and chest wallUworld and Dr. RyanCompliance is decreased w aging, written correctly under the Changes in elderly section but in the Lung/chest wall portion it says compliance is increased.Major erratum11/23/19 3:16 PMBeliceCabreracabreranena@gmail.com
1731651RespiratoryPhysiologyOxygen-hemoglobin dissociation curven/aTo remember right shift: "O2 falls right off"MnemonicVerifiedLeaning towards reject. There is nothing wrong with this suggestion, but it is a weak mnemonic for something that seems like it is relatively intuitive/does not require rote memory. -Mitchell KatonaNot a fan. Vote to reject.

MA		02/23/19 8:02 PMDouglasMossdouglas.moss@my.rfums.org
1732652RespiratoryPhysiologyCyanide vs carbon monoxide poisoninghttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1281520/Under Carboxyhemoglobin; Causes decrease in oxygen binding capacity with left shift in oxygen curve. I suggest modifying it to "for the reminder of Hb (not bound to CO) the affinity becomes higher to oxygen so the curve will shift to the Left in the presence of CO in blood". this will prevent confusion that might arise by the original parapgraphClarification to current textVerifiedNeed others input. The fact as written does seem ambiguous. A suggestion for a more clear version is now in Annotate. Need to make it clear that in carbon monoxide poisoning: 1) total oxygen bound to hemoglobin is low due to competition with CO, 2) the curve shifts to the left indicating a high affinity for oxygen. -Mitchell KatonaDuplicate. Already addressed in published errata. -MAtrue03/01/19 7:57 PMAlaJamalala.aljamal@hotmail.com
1733652RespiratoryPhysiologyCyanide vs carbon monoxide poisoningUWORLD, UptodateFirst row of the text mentions hypoxia unresponsive to supplement O2, but the treatment for CO poisoning is 100% O2/hyperbaric O2 (third row).Minor erratumVerifiedLeaning towards accept with qualifications. Both are true. Hypoxia will not correct with supplemental O2, yet it remains the treatment as it increases HbO2 in the setting of competitive inhibition with HbCO formation. I think we could consider changing "unresponsive to" to "does not correct with" to be more accurate, but even so this is not an erratum, only a clarification.

See below rows 35 and 36 for similar suggestions. This is clearly a point of confusion for some readers. I feel more strongly given three submissions of the same type that "does not correct with" would still convey the same information without suggesting that supplemental oxygen is entirely without benefit which seems to be some readers' interpretation of "unresponsive to". -Mitchell Katona		I actually agree with this. I think we should specify that it's the cyanide induced hypoxemia that would not correct with supplemental O2. High-flow O2 would help with CO poisioning and should be the first step in management after removing the source.

Ref: https://www.uptodate.com/contents/carbon-monoxide-poisoning?search=co%20poisoning&source=search_result&selectedTitle=1~80&usage_type=default&display_rank=1#H11
-MA		true03/23/19 1:38 AMSoon KhaiLowkhai50017@hotmail.com
1734652RespiratoryPhysiologyCyanide vs carbon monoxide poisoningInfo under column is correct but heading line gives counterintuitive infoThe first line in the heading says that both kinds of toxicities cause "hypoxia unresponsive to supplemental oxygen." However, this contradicts what is later written under the carbon monoxide heading - treatment is 100% oxygen. A friend of mine recently got a question wrong on an NBME due to the heading line, suggest changing or rephrasing.Major erratumVerifiedSee above row 32 and below row 36. Readers seem to interpret "unresponsive to" as meaning supplemental oxygen provides no benefit. Recommend rewording this phrase to "does not correct with" which still accurately conveys that hypoxia will still be present even with supplemental oxygen, but is less likely to be interpreted as contradicting the indicated treatment. Either way, not errata but rather a clarification. -Mitchell KatonaDuplicate. -MAtrue03/29/19 5:45 PMJerrinBawajerrin.bawa@gmail.com
1735652RespiratoryPhysiologyCyanide vs carbon monoxide poisoninghttps://www.uptodate.com/contents/cyanide-poisoning#H23For cyanide poisoning, the treatment should be clarified. Giving sodium thiosulfate is a totally separate step from inducing methemoglobinemia but the wording makes it sound like sodium nitrite plus sodium thiosulfate are both used for methemoglobinemia induction. Thiosulfate is a sulfur donor for the rhodanese enzyme which converts cyanide to thiocyanate, which is then renally excreted. FA 2018 explains it correctly (pg. 648).Clarification to current textVerifiedAccept. Student is correct as UpToDate confirms. Should clarify each of the three treatments, which have three MOAs. The 2018 edition had a wordier description but was more accurate. -Mitchell KatonaAgree. Let's bring back 2018 text. -MaAgree - it is somewhat confusing and should be clarified. Let's migrate this to Annotate to discuss further, ideally with crowdsourcer input. We should aim to keep the text as succinct as possible but without compromising clarity.

- Sarah		Prelim accept but NOT publishable erratatrue04/01/19 8:07 PMRebeccaXurebecca.xu@northwestern.edu
1736652RespiratoryPhysiologyCyanide vs carbon monoxide poisoninghttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5363978/This is a correction of a Major Errata approved here. Oxygen binding capacity in Carbon monoxide IS decreased as written in the book and shouldn't be changedMajor erratumAddressed already.

-Majed		true06/03/19 3:27 PMAhmadMashlaha7hmad@live.com
1737652RespiratoryPhysiologyCyanide vs carbon monoxide poisoningSelf-written'C'arb'O'xyhemoglobin loves 'CO' so binds it with much stronger affinity. Needs 'O'2 to fix issue.Mnemonic10/30/19 9:02 AMKhalidAlattarkhalid_alattar@hotmail.com
1738652RespiratoryPathologyOxygen content of bloodhttps://www.mayoclinic.org/diseases-conditions/carbon-monoxide/diagnosis-treatment/drc-20370646In the line cyanide vs CO poisoning it says that both unresponsive to supplemental O2. And straight after it is suggested to treat CO poisoning with O2.Major erratumVerifiedSee above rows 32 and 35. -Mitchell Katona-Duplicate. -MAtrue03/29/19 5:47 PMSergiiSakhnosakhnomd@gmail.com
1739652RespiratorytruePhysiologyOxygen-hemoglobin dissociation curvehttps://www.ncbi.nlm.nih.gov/books/NBK499818/Given as "decreased oxygen-binding capacity with left shift", but it should be "increased"Major erratumVerifiedSee above. -Mitchell KatonaChange " [down arrow] oxygen-binding capacity with left shift in
curve,  [down arrow] O2 unloading in tissues." to

[up arrow] oxygen-binding capacity with left shift in
curve, [down arrow] O2 unloading in tissues."		Prelim accept by 2 authors + 1 editorTisha Wangsee previous errata/comment on same sectionAccepttrue02/06/19 5:42 PMNikhilaGandrakotanikhila.gandrakota@emory.edu
1740652RespiratoryPhysiologyResponse to high altitudehttps://www.uptodate.com/contents/structure-and-function-of-normal-hemoglobins#H9"increased 2,3-BPG (binds to Hb causing left shift so that Hb releases more O2)" should be "increased 2,3-BPG (binds to Hb causing right shift so that Hb releases more O2)"Minor erratumVerifiedReject.Reject by 2 authors + 1 editorTisha Wangit already says rightward shift in the book that i have01/26/19 12:21 PMTiffanyWangtw8ee@virginia.edu
1741653RespiratoryPhysiologyOxygen content of bloodhttps://www.uptodate.com/contents/carbon-monoxide-poisoning% O2 Saturation of Hb is, of course, decreased in CO poisoning; however, in CO poisoning, this decrease in O2 saturation is not reflected in the pulse oximetry, which cannot be used for diagnosis of CO poisoning. Pulse oximetry can even be elevated in CO poisoning, because pulse oximetry cannot differentiate between Hb bound to O2 (oxyhemoglobin) and Hb bound to CO (carboxyhemoglobin). The chart reads that in CO poisoning there is a decrease in % O2 Saturation of Hb, which can mislead students to believing that this decrease would be revealed via pulse oximetry, the standard measure of O2 saturation. Suggestion/Correction to remove this misunderstanding: place a “*” or “a” in the chart that leads to a note below the chart that states: “This decrease in % O2 saturation is not seen via pulse oximetry, which cannot be used for diagnosis of CO poisoning, because pulse oximetry cannot distinguish between oxyhemoglobin and carboxyhemoglobin. An arterial blood gas sample is needed to confirm diagnosis of CO poisoning.”Clarification to current textVerifiedAgreed with student and Vivek. This is an important, high yield distinction (many CO poisoning vignettes will try to distract student with a pulse ox at 100%) but not errata. -Mitchell KatonaWhile the student is right, but the chart is not intended to discuss regarding pulse oximetry findings and not high yield IMO. We can take this discussion for the 2020 revision. No errata at this moment.

- Vivek		Agree to discuss in Annotate. Not errata.Prelim accept but NOT publishable erratatrue02/13/19 7:17 AMWarrenTeltserwkt5@georgetown.edu
1742653RespiratoryPhysiologyOxygen-hemoglobin dissociation curvehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195245/ ,, https://media.lanecc.edu/users/driscolln/RT127/Softchalk/Oxygen_transport_softchalk/Oxygen_Transport_Lesson4.htmlsuggest adding "HbS" in the column of "Right shift" .High-yield addition to next yearVerifiedReject. HbS has normal affinity at normal PaO2. It is only decreased when polymerization is significant, which only occurs in hypoxic conditions. Source: https://www.ncbi.nlm.nih.gov/pubmed/18249588 -Mitchell KatonaLY IMHO. The ones classically tested are all mentioned. If we receive more feedback that it's being tested then we may consider adding polymerized HbS -MA01/03/19 11:05 AMMoatasemAl-Janabiassoomi88@yahoo.com
1743653RespiratoryPhysiologyOxygen-hemoglobin dissociation curveIt's MnemonicLe*F*t shift = Hb*F* .MnemonicVerifiedReject. Weak mnemonic. -Mitchell KatonaAgree with MK.
-MA		01/03/19 11:07 AMMoatasemAl-Janabiassoomi88@yahoo.com
1744653RespiratoryPhysiologyOxygen-hemoglobin dissociation curveIt's Mnemonic*R*ight shift =*R*ise.MnemonicVerifiedReject. Weak mnemonic. -Mitchell KatonaAgree with MK. -MA01/03/19 11:08 AMMoatasemAl-Janabiassoomi88@yahoo.com
1745653RespiratoryPhysiologyOxygen-hemoglobin dissociation curveIt's MnemonicRight shift =Ri*S*e =Hb*s*MnemonicVerifiedReject. Weak mnemonic. Also, see row 12 regarding affinity of HbS for O2 in normoxic conditions. -Mitchell KatonaAgree with MK. -MA01/03/19 11:10 AMMoatasemAl-Janabiassoomi88@yahoo.com
1746653RespiratoryPhysiologyOxygen-hemoglobin dissociation curvemnemonicLeft shift: causes Loading of O2 in Lungs. Right shift: causes Release of O2 from Hb.MnemonicVerified07/30/19 2:38 PMPaolaDel Cuetopaoladelcueto@outlook.com
1747654RespiratoryPhysiologyAlveolar gas equation"PaCO2 is partial pressure of carbon dioxide in alveoli (in normal physiological conditions around 40 to 45 mmHg)." from https://www.ncbi.nlm.nih.gov/books/NBK482268/The Equation contains Pa Co2 wrongly, it should be PA Co2. Also in the right hand column. it must be PAco2= Alveolar Pco2 ( mmHg ) instead of wrongly printed Paco2=arterial Pco2.Minor erratumReject. Appears correctly written as is. - Mitchell KatonaCan't find an error either.
https://www.sciencedirect.com/topics/neuroscience/alveolar-gas-equation

- Sarah		Reject by 2 authors + 1 editor06/18/19 10:26 PMSukritiRanasukriti.rana@gmail.com
1748654RespiratorytruePhysiologyPulmonary circulationhttps://books.google.com/books?id=xZswDwAAQBAJ&pg=PA24&lpg=PA24&dq=diffusion+and+gas+%3D+A+x+D+X+p1-p2&source=bl&ots=jcKLyVYnCe&sig=NpTNtppgNg3Dzw4iz3aNVVv915w&hl=en&sa=X&ved=2ahUKEwiyhOL35NHfAhUHKuwKHehgCtYQ6AEwEnoECAgQAQ#v=onepage&q=diffusion%20and%20gas%20%3D%20A%20x%20D%20X%20p1-p2&f=falseReplace( *T* ↑ in pulmonary fibrosis )with (* ∆x * ↑ in pulmonary fibrosis ).Minor erratumVerifiedReplace( *T* ↑ in pulmonary fibrosis ) with "∆x ↑ in pulmonary fibrosis"Prelim accept by 2 authors + 1 editorTisha WangagreeCharles Dela CruzAgreeAccepttrue01/03/19 9:22 AMMoatasemAl-Janabiassoomi88@yahoo.com
1749654RespiratoryPhysiologyPulmonary circulationNot neededIn the explanation for diffusion equation, change T to delta X (T is not defined anywhere as thickness and may be misunderstood as tension, etc.)Spelling/formatting09/02/19 8:13 PMAbhishekGamiagami@jhmi.edu
1750654RespiratoryPhysiologyPulmonary circulationFirst Aid Usmle Step 1 2019 page 654"Alveolar thickness" in diffusion formula and its explanation could be replaced with letter "T" for convenience.Clarification to current text09/04/19 10:14 PMAlsuZagorulkoalsu.zagorulko@gmail.com
1751655RespiratoryPathologyPulmonary hypertensionhttps://www.uptodate.com/contents/clinical-features-and-diagnosis-of-pulmonary-hypertension-of-unclear-etiology-in-adults?search=pulmonary%20hypertension&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H3504609253The cutoff for Pulmonary hypertension is listed as >25 mmHg in First Aid, however this cutoff has been changed to >20 mmHg. "Hemodynamically, a mean pulmonary artery pressure (mPAP; supine and at rest) >20mmHg [37] is now considered diagnostic of PH based upon data measuring mPAP in healthy individuals, which confirmed that an mPAP of 8 to 20 mmHg at rest is normal [25]. While in the past, PH was hemodynamically defined by a mPAP ≥25 mmHg [38], this cutoff was somewhat arbitrary and targeted at avoiding the over-detection of PH."Major erratum11/06/19 10:25 PMGabrielaFridgaby.frid@gmail.com
1752655RespiratoryPhysiologyVentilation/perfusion mismatchhttps://www.uptodate.com/contents/image?imageKey=PULM%2F103089&topicKey=PULM%2F101436&search=physiologic%20dead%20space%22&source=outline_link&selectedTitle=1~150For blood flow obstruction the text parenthetical names the defect "physiologic dead space". Without clarification that this includes both anatomic and alveolar dead spaces this description is confusing. I propose that it should read "alveolar dead space" since this is more specific to the defect. Thank you for your consideration!Minor erratumVerifiedNot necessary, agree with Dr. Wang this is defined earlier in the chapter.Reject by 2 authors + 1 editorTisha Wangi think this is fine since physiologic dead space is defined earlier in the chapter01/02/19 7:41 PMJasrajMarjarajmarjara8@gmail.com
1753656RespiratoryPhysiologyCarbon dioxide transportn/aHaldane effect: HaLdane take H+ away in Lungs.MnemonicVerifiedReject. Weak mnemonic. -Mitchell Katona07/10/19 12:49 PMAPandeyaranikopandey@gmail.com
1754656RespiratoryPhysiologyResponse to high altitudewww.uworld.comIn the first line of the topic Response to high altitude, it says " decreased atmospheric oxygen (PiO2)". But there is a mistake in that sentence. PiO2 and atmospheric oxygen are not the same. The fraction of oxygen in the atmosphere (atmospheric oxygen) remains constant (21%) at different terrestrial elevations (it's the same atmosphere) but the barometric pressure drops with increasing altitude, leading to decrease PiO2 and therefore PaO2. For this reason I suggest to use " Decreased PiO2 (due to decreased barometric (atmospheric) pressure, normal FiO2)...Minor erratum05/07/19 10:52 AMGeorge AmauryLara Colladoamaurylarac@gmail.com
1755657RespiratoryPathologyEpistaxishttps://radiopaedia.org/articles/kiesselbach-plexusKiesselbach drives his Lexus with his LEGS: superior Labial artery, anterior and posterior Ethmoidal arteries, Greater palatine artery, Sphenopalatine artery. HERE , POSTERIOR ETHMOID ARTERY IS NOT A CONTRIBUTOR OF KIESSELBACH PLEXUSMinor erratumVerifiedAccept. Most sources seem to exclude the posterior ethmoidal including the one I have linked here. The illustration also seems to show that the posterior ethmoidal does not supply branches to Keisselbach plexus unlike the other four. This may be a good opportunity for a new illustration. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096213/ Here is another illustration from the Atlas of Emergency Procedures showing the exclusion of the posterior ethmoidal https://www.google.com/search?q=kiesselbach+plexus&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjbh4jJtP7hAhVHPK0KHevDCW8Q_AUIDigB&biw=1440&bih=789#imgrc=8xi8fcOt4NNtGM: -Mitchell KatonaClinically oriented anatomy 7e states that posterior ethomoidal participates in the anastamosis. Needs expert review. -MA01/27/19 3:27 PMRupKunrupayan.kundu1928@gmail.com
1756657RespiratoryPathologyEpistaxishttps://radiopaedia.org/articles/woodruff-plexusThe text says " Life- threatening hemorrhages occur in posterior segment (sphenopalatine artery, a branch of maxillary artery). " Specify that posterior bleeds occur in Woodruff's plexusClarification to current text08/26/19 6:02 PMJudithVasquezjudith.vasquez.11@gmail.com
1757657RespiratoryPathologyRhinosinusitishttps://www.uptodate.com/contents/acute-bacterial-rhinosinusitis-in-children-microbiology-and-treatmentIt has been mentioned on FA 2019 that S pneumoniae is the most common cause of Rhinosinusitis, but due to the replacement of PCV7 by PCV13 in 2010, it is no longer the leading cause. H influenza takes the first spot now as per new guidelines (Nov 18, UpToDate). H influenza (40-50%), S Pneumo (20-25%), M catarrhalis (25%). This is very high yield for most common organism type of questions on USMLE.Clarification to current textVerifiedAgree with Vivek. It is rare but not unheard of for USMLE to ask for most common organism without a contextual clue to distinguish between, for example, H influenzae and S pneumoniae. Not errata but worth reordering with H influenzae first. Don't think including the percentages is needed as the student includes. -Mitchell KatonaThank you for your updated reference. I agree with your statement.

But we did not rank S pneumoniae as the only most common cause of Rhinosinusitis.

However, I suggest aligning them as follow in order of high to low prevalence:

",most commonly H. influenzae, S. pneumoniae, M. catarrhalis."



Evidence (UTD): "It is estimated that in 2017, H. influenzae account for approximately 50 to 60 percent, S. pneumoniae for 15 to 25 percent, and M. catarrhalis for 12 to 15 percent of middle ear isolates in AOM"

Recommendation: Can be updated in 2020.


- Vivek		Agree, we don't say anything about which is more common. We can clarify to say "most commonly H influenzae, S pneumoniae, M catarrhalis."Prelim accept but NOT publishable erratatrue01/13/19 5:37 PMAnilA Kumaranil_kumarans@yahoo.co.in
1758657RespiratoryPathologyRhinosinusitishttps://radiopaedia.org/articles/sphenoid-sinusshenoid sinus drains into spheno-ethmoidal recess not superior meatusMajor erratum09/12/19 5:03 PMEtebongUdohetebong95@gmail.com
1759658RespiratoryPathologyFlow-volume loopshttps://obgynkey.com/respiratory-pathophysiology-and-regulation/Flow voume loop is correct but adding a directional arrow will be helpful to identify inspiration and expiration loop direction.Clarification to current textReject. Agree with MK. -AlirezaVerifiedLeaning towards reject. It seems the direction would be intuitive. Inspiration clearly would go right-to-left as lung volume increases and vice-versa. On the other hand, would be a small change and might help clarify for some. Can get illustration team input. -Mitchell KatonaAgree with MK. Deferring to illustration team. -MAReject by 2 authors + 1 editor03/07/19 10:58 AMMurliMishramm.murli@gmail.com
1760658RespiratoryPathologyFlow-volume loopsn/aRESTrictive lung disease = All DECREASED at REST and the loop shifts to the Right.MnemonicVerified07/10/19 12:50 PMAparanikopandey@gmail.com
1761658RespiratoryPathologyFlow-volume loopshttps://www.uptodate.com/contents/flow-volume-loops, https://www.jfmed.uniba.sk/fileadmin/jlf/Pracoviska/ustav-fyziologie/3ZH-Deter.oop.pdf, https://derangedphysiology.com/main/cicm-primary-exam/required-reading/respiratory-system/Chapter%20556/interpreting-shape-flow-volume, https://pdfs.semanticscholar.org/ea83/08837b1dd3ea002dc143116e874828427094.pdfAny flow-volume loop that demonstrates a "scoop/coved" shape should be considered representative of an obstructive lung disease until proven otherwise. Given how common obstructive lung disease is, it would make sense to add some descriptors to the flow-volume curve. Of course, in addition to an obstructive lung disease, the scoop shape could also represent a mixed obstructive/restrictive lung disease (though perhaps this is less high-yield)High-yield addition to next year08/27/19 6:09 AMAnthony MartinLimanthony.m.lim@gmail.com
1762658RespiratoryPathologyFlow-volume loopshttps://www.uptodate.com/contents/flow-volume-loops, https://www.jfmed.uniba.sk/fileadmin/jlf/Pracoviska/ustav-fyziologie/3ZH-Deter.oop.pdf, https://derangedphysiology.com/main/cicm-primary-exam/required-reading/respiratory-system/Chapter%20556/interpreting-shape-flow-volume, https://pdfs.semanticscholar.org/ea83/08837b1dd3ea002dc143116e874828427094.pd[SEE PREVIOUS SUBMISSION - just reclassified as "clarification to current text"; will re-add comments here: Any flow-volume loop that demonstrates a "scoop/coved" shape should be considered representative of an obstructive lung disease until proven otherwise. Given how common obstructive lung disease is, it would make sense to add some descriptors to the flow-volume curve. Of course, in addition to an obstructive lung disease, the scoop shape could also represent a mixed obstructive/restrictive lung disease (though perhaps this is less high-yield)Clarification to current text08/27/19 6:14 AMAnthony MartinLimanthony.m.lim@gmail.com
1763658RespiratoryPathologyPulmonary embolinot neededchange order of images from " A--C--B " to "A--B--C" in accordance with alphabet.Spelling/formattingStaff acceptsAccept; agree with Vivek and student. -Mitchell KatonaAgree that we need to re-arrange in-text figure numbers as well and re-sequence figure positions accordingly. Currently, C is coming in between A and B.

This can be deferred to 2020.

-Vivek		01/03/19 2:14 PMMoatasemAl-Janabiassoomi88@yahoo.com
1764658RespiratoryPathologyPulmonary emboliN/AS1Q3T3 -> "if you SQuaT 133 pounds, then you'lll get a PE" OR just "SQuaT 133 pounds"MnemonicVerifiedReject. Probably not HY enough to warrant a mnemonic and in any case this one does not help you remember that its 1-3-3 any more than rote memorizing S1Q3T3. -Mitchell KatonaReject. -MA03/09/19 12:05 PMSiamakKohanskhakshoor@mednet.ucla.edu
1765658RespiratoryPathologyPulmonary embolihttps://www.healio.com/cardiology/learn-the-heart/ecg-review/ecg-topic-reviews-and-criteria/pulmonary-embolism, https://emedicine.medscape.com/article/300901-workup#c20, https://litfl.com/right-ventricular-strain-ecg-library/While S1Q3T3 is "classic," it is rare, not particularly easy to find, and ignores the other more common ECG findings: sinus tachycardia + right heart strain pattern (e.g. right axis deviation, RVH V1-V2/3, ST depression/TWI in V1-3 and inferior leads).Clarification to current text08/27/19 6:41 AMAnthony MartinLimanthony.m.lim@gmail.com
1766659RespiratorySystemsMediastinal pathologyhttps://teachmeanatomy.info/thorax/areas/posterior-mediastinum/Middle mediastinal mass: esophegeal cancer !! esophegus located in posterior not middle mediastinumClarification to current textVerifiedDefer to expert, I am seeing middle in my research.Disagreement/need expertTisha Wangesophageal tumors are generally in the middle mediastinum - uptodate corroborates this as does https://www.pulmonologyadvisor.com/pulmonary-medicine/mediastinal-tumors/article/661072/Reject02/14/19 6:25 AMnehalkhalidnehalnasser55@gmail.com
1767659RespiratoryPathologyMediastinal pathologyUWORLD CK, Anatomy textbook.The image of mediastinal compartment in the first column is incorrect. Posterior mediastinum includes the part with esophagus and descending aorta. Thereby, the pathologies associated with esophagus and aorta should also be considered under posterior mediastinum mass, not middle.Major erratumVerifiedReject. Unable to review student's references. UpToDate confirms that esophagus and descending aorta are middle mediastinal and not posterior mediastinal structures. I do see some sources with illustrations that include esophagus in posterior, but most reputable sources put it in middle. Source: https://www.uptodate.com/contents/approach-to-the-adult-patient-with-a-mediastinal-mass?search=mediastinal%20mass&source=search_result&selectedTitle=1~128&usage_type=default&display_rank=1#H3598114789 -Mitchell KatonaI agree with Mitchell. Most sources I could find confirm that the esophagus and descending aorta are located in the middle mediastinum.

https://www.sciencedirect.com/book/9780323523578/iaslc-thoracic-oncology

https://www.sciencedirect.com/book/9781416058977/leibel-and-phillips-textbook-of-radiation-oncology

- Sarah		Reject by 2 authors + 1 editor03/23/19 1:33 AMSoon KhaiLowkhai50017@hotmail.com
1768659RespiratoryPathologyMediastinal pathologyhttps://emedicine.medscape.com/article/425308-overview#a10, https://emedicine.medscape.com/article/426659-overview#a12The anatomy of middle mediastinum does not include the esophagus and other structures that lie posterior to the heart. The diagram and written text in first aid about the middle mediatinum are incorrect.From emedicine: The posterior compartment, or posterior mediastinum, comprises the area posterior to the heart and trachea and includes the paravertebral sulci. It contains the descending thoracic aorta and ligamentum arteriosum, the esophagus, the thoracic duct, the azygos vein, and numerous neural structures (including the autonomic ganglion and nerves, lymph nodes, and adipose tissue).Major erratum05/10/19 8:47 AMDavidThomasdavidthomas708@gmail.com
1769660RespiratoryPathologyMesotheliomahttp://jpma.org.pk/full_article_text.php?article_id=741Nearly all mesotheliomas stain +ve for cytokeratin and may also stain +ve for calretininHigh-yield addition to next yearVerifiedReject. Cytokeratin is sensitive but not specific for mesothelioma because it is also positive in adenocarcinoma and SCC. The point of this the way it is written is to point out the distinguishing marker for mesothelioma. Calretinin is sensitive but also specific for mesothelioma. Source: https://www.ncbi.nlm.nih.gov/pubmed/11038661 -Mitchell Katona01/26/19 6:59 PMAISHAADIGUNtashadings@yahoo.com
1770660RespiratoryPathologyObstructive lung diseasesnot neededchange order of images from " D--A--B--C--E--F--G " to "A--B--C--D--E--F--G" in accordance with alphabet.Spelling/formattingStaff acceptsAccept; agree with student and Vivek.Agree that we need to re-arrange in-text figure numbers as well and re-sequence figure positions accordingly. Currently, D is coming before A.

This can be deferred to 2020.

- Vivek		01/03/19 2:32 PMMoatasemAl-Janabiassoomi88@yahoo.com
1771661RespiratoryPathologyRestrictive lung diseaseUWorld explanation Q. ID 7, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4925784/ "Pulmonary function test usually shows a restrictive pattern while DLCO is increased during the episodes of haemorrhage."Even though Goodpasture syndrome is a restrictive lung disease and DLCO decreases in restrictive lung diseases, in Goodpasture DLCO will increase during episodes of hemoptysis, due to alveolar hemorrhage. The hemoglobin in the alveoli will bind some CO, decreasing the amount expired during the test. So even though that amount of DLCO never diffused across the membrane, the decrease in the amount of CO expired will lead to an increased DLCO and not decreased.High-yield addition to next yearStudent is correct, their references as well as UpToDate confirm DLCO is increased in setting of alveolar hemorrhage 2/2 to Goodpasture syndrome. Source: https://www.uptodate.com/contents/pathogenesis-and-diagnosis-of-anti-gbm-antibody-goodpastures-disease?search=goodpasture%20dlco&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H5 Could consider adding this parenthetically in the bulletpoint for Goodpasture syndrome as an exception to decreased DLCO in restrictive disease. On the other hand, this may not be HY enough to include. Would like others' opinions. -Mitchell KatonaDifferential of increased DLCO is LY for Step 1 IMHO. For Step 1, Goodpasture = restrictive lung disease = ↓ DLCO -MA03/27/19 11:45 PMAntonisCosteastonis125@gmail.com
1772661RespiratoryPathologyRestrictive lung diseaseNo hyperlink neededMissing red arrow and blue arrow for picture A and picture B respectively for restrictive lung diseasesMinor erratum11/15/19 6:57 PMThoNguyentnguyen27@kumc.edu
1773661RespiratoryPathologySarcoidosishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521279/Sarcoidosis also has hepatic involvement including cirrhosis, granulomas in the liver and abnormal Liver function tests.High-yield addition to next yearVerifiedAccept. I agree with student that hepatic sarcoidosis is HY. Anecdotally, recall abnl LFTs in vignettes for sarcoidosis cases. Their source also indicates this occurs in 70% of cases. Would simply add one sentence to this fact describing hepatic sarcoidosis. -Mitchell KatonaAgree, let's consider adding this year. -MA02/08/19 3:59 AMRukminiKulkarnirukushammi.k@gmail.com
1774662RespiratoryPathologySarcoidosishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521279/Sarcoidosis is A Bad Harsh GRUELING Disease. A- African American women, elevated ACE enzymes. B- B/L adenopathy, Bells palsy. Harsh- Hepatic granulomas, cirrhosis. G- Gammaglobulinemia. U- Uveitis, E- erythema nodosum. L- Lupus pernio, I- Interstitial fibrosis. N- noncaseating, G- granulomas. D- increased Vit. DMnemonicVerifiedLeaning towards reject. I don't think this mnemonic adds much to the existing mnemonic and is more redundant (e.g. N for noncaseating granuloma, G for granuloma). Would like others' opinions. -Mitchell KatonaAgree with MK. -MA02/08/19 4:38 AMRukminiKulkarnirukushammi.k@gmail.com
1775662RespiratoryPathologySarcoidosishttps://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-pulmonary-sarcoidosis?csi=6a5e09dd-58eb-452f-8767-38ea380d40d8&source=contentShareACE has been found to be of unclear or limited use in Sarcoid diagnosis although helpful in disease progressionHigh-yield addition to next yearVerifiedLeaning towards reject. Student is correct, however it's unlikely a student would need to know this distinction for S1, so I think it's LY. Knowing the association is the HY fact, knowing how to utilize ACE for sarcoidosis is probably only useful for wards. -Mitchell KatonaAgree with MK. LY for Step 1.

-MA		03/02/19 11:03 AMRaulOrozco Villalobosraulcollege@gmail.com
1776663RespiratoryPathologyPneumoconiosesMnemonicAsbestosis affects the lower lobes because *F*erruginous bodies *F*allMnemonicVerifiedReject. Weak memory hook. Existing mnemonic is stronger. -Mitchell KatonaAgree with MK. -MA03/31/19 7:51 PMMariaGentrymg3w3@health.missouri.edu
1777663RespiratoryPathologyPneumoconiosesMade it up"ABC'S" of Pneumoconioses = Asbestosis, Berylliosis, Coal worker's pneumoconiosis, and Silicosis. Only "A" = Asbestosis is NOT in the upper lobesMnemonicVerifiedReject. I don't think the mnemonic helps students with difficult-to-remember facts. Which conditions are pneumoconioses does not seem to be something that needs a mnemonic in my opinion. -Mitchell KatonaReject. Agree with MK.
-MA		04/03/19 5:41 PMNankiHurananki.hura@gmail.com
1778663RespiratoryPathologyPneumoconioseshttps://emedicine.medscape.com/article/296759-clinicalBerylliosis is from space (beryllium exposure in aerospace) -> affects upper lobes.MnemonicVerified05/07/19 4:42 PMJasonSoaresjsoares@mail.sjsm.org
1779663RespiratoryPathologyPneumoconiosesNot RequiredBest Miso Soup= Asbestosis increases risk for mesothelioma, (Soup) Supradiaphragmatic PlaquesMnemonicVerified06/07/19 4:47 PMMirInzamam Alimirinzamamali86@gmail.com
1780665RespiratoryPathologySleep apneahttps://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-obesity-hypoventilation-syndromeIn Obesity Hypoventilation Syndrome the PaO2 can be decreased during the day when the patient is awake. This is unclear in the text as the introduction to Sleep Apnea section states "normal PaO2 during the day". Would be good to highlight that PaO2 can be low in Obesity Hypoventilation Syndrome.Clarification to current textVerifiedAccept; agree with student. Actually, low daytime PaO2 would be a useful distinction in a vignette between OHS and OSA. Would remove "Normal PaO2 during the day." from the "Sleep apnea" section and move it to OSA section. -Mitchell KatonaCorrect but not sure if HY for Step 1. This is more like Step 2 ck info.

-MA		I agree with the authors and UTD confirms the user's comment. This is definitely not an erratum but a helpful clarification and worthwhile implementing.

- Sarah		Prelim accept by 2 authors + 1 editortrue03/06/19 10:13 PMBeth AnneGeorgeElisabeth_George@brown.edu
1781665RespiratoryPathologySleep apneahttps://www.ncbi.nlm.nih.gov/pubmed/20116305 https://www.ncbi.nlm.nih.gov/pubmed/11587602electrical stimulation of hypoglossal nerve in obstructive sleep apnea can improve the situation.Clarification to current text05/16/19 4:02 PMMuhanadShaibmohanad.shaib@gmail.com
1782666RespiratoryPathologyAtelectasishttps://www.uptodate.com/contents/atelectasis-types-and-pathogenesis-in-adultsAtelectasis :Alveolar collapse, which can be due to multiple etiologies: • Obstructive -airway obstruction prevents new air from reaching distal airways, old air is resorbed (eg, foreign body, mucous plug, tu mor) • Compressive-external compression on lung decreases lung volumes (eg, space-occupying lesion, pleural effusion) • Contraction (cicatrization) -scarring of lung parenchyma that distorts alveoli (eg, sarcoidosis) • Adhesive-due to lack of surfactant (eg, NRDS in premature babies) Now I would like to suggest few changes in it. Instead of "ALVEOLAR COLLAPSE" it should be "LOSS OF LUNG VOLUME" because when there is external compression like pleural effusion it pushes the lung inside and due to that pressure alveoli collapse. What I mean to say is with alveolar collapse it could be either few alveoli or more the term gets generalised but what happens at the end is that lung loses its volume either one whole lobe or entire lung. Now coming to causes it could be Divided into: A) Obstructive Causes B) Non Obstructive Causes Compression Adhesive Cicatrization Relaxation : loss of contact between parietal and visceral tissue (Pneumothorax) C) Post-op Atelectasis: Most common cause within 48-72 hours post-op. D) Rounded Atelectasis: As in asbestosis, folding of lobe with fibrous band and adhesion there is loss of lung volume.High-yield addition to next yearVerifiedReject. There are two suggestions in this submission. First, changing the description of atelectasis from "alveolar collapse" to "loss of lung volume"; disagree with this as it is less specific than current description. Loss of lung volume occurs 2/2 to alveolar collapse, which is the important, HY concept to understand and already implies a loss of lung volume (student's source reflects this). Second, changing organization of etiologies; relaxation atelectasis is really a variant of compressive, it is the only one I would consider adding but still feel that it is LY and would make the distinction between PTX and most etiologies of atelectasis confusing; post-op atelectasis is not an etiology just a description of (usually) obstructive atelectasis from mucous plugging; rounded atelectasis is a LY etiology in my opinion. -Mitchell KatonaReject. Current text is accurate and I see no need to change it as proposed by user. -MA02/15/19 12:48 AMTirthPateltirthpatelb@gmail.com
1783668RespiratoryPathologyPneumoniaAspiration pneumonia develops commonly either in the posterior segment of the upper lung, or in superior segment of the lower lung. When you have pneumonia, you basically have pus (infection) in your lungs. Thus, In aspiration pneumonia there will be "PUS in the Lung" (=Posterior Upper and Superior Lower).Aspiration PneumoniaMnemonicVerified05/10/19 5:12 PMEliranDahanelirandah@hotmail.com
1784669RespiratoryPathologyLung cancermyselfSCLC characteristics mnemonic: SMALl Cell lung cancer: SIADH, c-Myc gene, ACTH, Lambert-eaton, Chromogranin AMnemonicVerifiedLeaning towards accept. Existing mnemonic for these HY associations is relatively weak. To make chromogranin A fit the suggested mnemonic, could make the mnemonic "SMAL Cell". With S = SIADH, M = myc, A = ACTH, L = Lambert, C = chromgranin. Would like others' opinions.

There are three suggestions regarding this fact and the mnemonic, which makes me feel stronger about making the above change. See below rows 33 and 42. -Mitchell Katona		I don't think it's a very good mnemonic. -MA03/15/19 10:03 AMMurliMishramm.murli@gmail.com
1785669RespiratoryPathologyLung cancerhttps://www.ncbi.nlm.nih.gov/pubmed/1656520Small cell carcinoma produces ADH, not SIADH. SIADH is a result of an increased production of ADH, just like ACTH causes Cushing syndrome for SCC.Minor erratumVerifiedSee above suggestion on row 29 and below row 42. Student is arguing semantics of what small cell carcinoma "produces", i.e. it produces ADH and causes SIADH. If we deicide to change the mnemonic per row 29, we can make this clarification there. If we decide to leave the mnemonic as is, we can format it so that it is consistent, i.e. "May produce ACTH (Cushing syndrome), ADH (SIADH),...". Either way this is a syntactical issue not errata. Would like others' opinions. -Mitchell KatonaDuplicate.
-MA		I can see why the user is taking an issue with this, even though it is a minor clarification. It is easy to implement as Mitchell suggested.

- Sarah		Prelim accept but NOT publishable erratatrue03/23/19 11:19 AMHeewonChoihxc326@case.edu
1786669RespiratoryPathologyLung cancerMnemonicsCuamous cell carcinoma - associated with Central location, Cavitations, Cigarettes and hyperCalcemiaMnemonicVerifiedLeaning towards reject. The existing mnemonic already includes all of this except for tying the C's to the phonetic misspelling of sCuamous. I don't really feel that tie in is necessary to be able to use the mnemonic. Would like others' input. -Mitchell KatonaReject.
Agree with MK. -MA		04/16/19 4:22 PMMuhammad DanyalAhsandanyalo.97@gmail.com
1787669RespiratoryPathologyLung cancerMnemonicSmall cell lung carcinoma associated with A's (ACTH, SIADH, Antibodies etc.) - read small cell as smaaaal cell or smAll cell carcinomaMnemonicVerifiedSee above rows 29 and 33. -Mitchell KatonaDuplicate - MA04/16/19 4:27 PMMuhammad DanyalAhsandanyalo.97@gmail.com
1788669RespiratoryPathologyLung cancern/aTake LUNGS to LABB and ADD C-PRO for BEST treatment to the LUNGS. Mets from LUNGS to Liver, Adrenals, Bone, Brain Mets to LUNGS from blADDer, Colon, PROstate, BrEaST.MnemonicVerified07/10/19 12:52 PMaPandeyaranikopandey@gmail.com
1789669RespiratoryPathologyLung cancerMnemonicTo remember that squamous cell cancer of the lung is the main lung cancer causing hypercalcemia, write it out as "SCa+mous" Cell Carcinoma. Small Cell Cancer on the other hand is already known to cause the other paraneoplastics like ACTH, SIADH.Mnemonic10/27/19 5:30 AMKhalidAlattarkhalid_alattar@hotmail.com
1790670RespiratoryPathologyPancoast tumorClarificationMentions that Pancoast tumor can cause "brachiocephalic syndrome (unilateral symptoms)" but doesn't explain what these symptoms are - this is also the only mention of "brachiocephalic syndrome" in the bookClarification to current textVerifiedLeaning towards accept. The unilateral symptoms would mostly be ipsilateral edema of arm, shoulder, breast, or neck with later complications of ulceration or infection. Source: https://www.uptodate.com/contents/thoracic-central-vein-occlusion-associated-with-hemodialysis-access?search=brachiocephalic%20syndrome&source=search_result&selectedTitle=2~56&usage_type=default&display_rank=2#H1234101750 Might be more clear without being too wordy by simply replacing "unilateral symptoms" with "ipsilateral arm edema". Would like others' input. -Mitchell KatonaReject.
Already covered on p670 under Pancoast tumor.
-MA		I agree with Majed. This information is covered in sufficient detail on p. 670. No need to repeat this information elsewhere in the chapter.

- Sarah		Reject by 2 authors + 1 editor04/03/19 10:10 PMNankiHurananki.hura@gmail.com
1791670RespiratoryPathologyPancoast tumorhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4930518/Pancoast tumors involves the following roots of brachial plexus = C8 - T2 ; mnemonic for this is its nice to have Tea(T) on the sea(C) coast (C8-T2)High-yield addition to next year11/23/19 9:22 AManubhavsoodanubhavsood89@gmail.com
1792670RespiratoryPathologySuperior vena cava syndromehttps://www.uptodate.com/contents/clinical-presentation-and-evaluation-of-goiter-in-adults?search=pemberton%20maneuver&sectionRank=1&usage_type=default&anchor=H6514249&source=machineLearning&selectedTitle=1~150&display_rank=1#H6514249The Pemberton maneuver is a physical examination tool used to demonstrate the presence of latent pressure in the thoracic inlet. The maneuver is achieved by having the patient elevate both arms until they touch the sides of the face. A positive Pemberton's sign is marked by the presence of facial congestion and cyanosis, as well as respiratory distress after approximately one minute. A positive Pemberton's sign is indicative of superior vena cava syndrome (SVC), commonly the result of a mass in the mediastinumClarification to current textThis was discussed on Annotate and deemed LY for Step 1.

- Sarah		Reject by 2 authors + 1 editor07/31/19 8:49 PMPavelAksionavpavlusha_aksenov@mail.ru
1793671RespiratoryPharmacologyPulmonary hypertension drugshttps://www.uptodate.com/contents/treatment-of-pulmonary-hypertension-in-adults?search=pulmonary%20htn&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3#H167513175Pulmonary hypertension drugs should be edited to Pulmonary arterial hypertension (group 1) drugs, as other causes of pulmonary hypertension are treated by treating the underling causeClarification to current textVerifiedAccept, partially. Very minor clarification, but student is technically correct. Would just add the word "arterial" before "hypertension" and not include "group 1" as this would only muddy the waters and is not used in the "Pulmonary hypertension" section on p665 to describe PAH. -Mitchell KatonaAgrre with MK. Let's add "arterial". -MAtrue03/21/19 8:05 AMHasanAlarourihassan.arouri@hotmail.com
1794672RespiratoryPharmacologyAsthma drugshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269605/ https://www.cochrane.org/CD001490/AIRWAYS_magnesium-sulfate-treating-exacerbations-acute-asthma-emergency-departmentMagnesium sulfate can be used for AsthmaClarification to current text05/16/19 4:11 PMMuhanadShaibmohanad.shaib@gmail.com
1795677Rapid ReviewRapid ReviewPlatelet disordershttps://www.uptodate.com/contents/evaluation-of-adults-with-cutaneous-lesions-of-vasculitis?search=petechiae&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Petechiae misspelled as "Petichiae"Spelling/formatting10/30/19 6:57 AMHasanAlarourihassan.arouri@hotmail.com
1796681Rapid ReviewLaboratory TechniquesSclerodermaFirst Aid Usmle Step 1 2019 page 464put "anti-Scl-70 antibody (anti-DNA topoisomerase-I antibody) and anti-RNA polymerase III" to table near "diffuse scleroderma"Clarification to current text09/04/19 6:15 PMAlsuZagorulkoalsu.zagorulko@gmail.com
1797682Rapid ReviewRapid ReviewVasculitidesn/aOn page 682, the index references page 585 for Wegener granulomatosis but page 585 is on renal pathologyMinor erratumVerifiedIndex is already being fixed.Reject by 2 authors + 1 editor02/18/19 2:18 AMJumokeDicksondrfierce12@gmail.com
1798684Rapid ReviewRapid ReviewClostridiahttps://www.uptodate.com/contents/clostridioides-formerly-clostridium-difficile-infection-in-adults-treatment-and-preventionMetronidazole is no longer recommended as any initial treatment of Clostridium Difficle. Recommended first line treatment for C. Difficile is now oral vancomycin or fidaxomicin for both severe and non-severe CDIMinor erratumVerifiedChange to "oral vancomycin, metronidazole,
or fidaxomicin, recurrent cases-repeat prior regimens or fecal microbiota transplant" per Microbio chapter.		Prelim accept by 2 authors + 1 editor01/01/19 3:19 PMFaresAniFares.Ani.SIA@gmail.com
1799685Rapid ReviewRapid ReviewHeparinhttps://www.uptodate.com/contents/venous-thromboembolism-initiation-of-anticoagulation-first-10-days?search=anticoagulation%20renal%20failure&sectionRank=1&usage_type=default&anchor=H1225023498&source=machineLearning&selectedTitle=2~150&display_rank=2#H1225023498 https://www.uptodate.com/contents/venous-thromboembolism-anticoagulation-after-initial-management?search=anticoagulation%20renal%20failure&source=search_result&selectedTitle=5~150&usage_type=default&display_rank=5Drug of choice for anticoagulation in renal failure is not LMWH. Instead, unfractionated heparin is preferred for initiation of anticoagulation, and warfarin is the drug of choice for long term anticoagulation.Major erratum05/05/19 11:18 AMAlannaHickeyalanna.hickey@umassmed.edu
1800685Rapid ReviewRapid ReviewNeural tube defectshttps://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/folic-acid-for-the-prevention-of-neural-tube-defects-preventive-medicationPrevention of neural tube defects requires preconceptional rather than prenatal folic acid supplementation. The USPSTF recommends that all women who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400 to 800 µg) of folic acid.Major erratum11/09/19 2:20 PMAliIbrahimaokamal@gmail.com
1801685Rapid ReviewRapid ReviewSpinal cord lesionsNot applicable"Degeneration of dorsal column fibres" is erroneously placed under the "Classic/relevant treatments" section. It should be listed under the "Key associations" section.Minor erratum08/08/19 8:09 PMMehreenAlidr.mehreenali@gmail.com
1802685Rapid ReviewRapid ReviewSyphilisn/aPage 685 Under the Heading condition: Degeneration of dorsal column Fibers Under the heading Common Treatments: Tabes dorsalis.... This point should probably be under Disease/finding and Most common/important associations insteadClarification to current textVerifiedAgree. The entire row belongs to Lab/diagnostic findings-diagnosis/disease rapid review table.

- Vivek		02/18/19 1:39 AMJumokeDicksondrfierce12@gmail.com
1803685Rapid ReviewRapid ReviewWarfarinhttps://www-uptodate-com.ezproxy.lib.utah.edu/contents/reversal-of-anticoagulation-in-warfarin-associated-intracerebral-hemorrhage?search=warfarin%20reversal%20pcc&sectionRank=1&usage_type=default&anchor=H168423846&source=machineLearning&selectedTitle=1~100&display_rank=1#H168423846In addition to reversing warfarin with FFP and vitamin K. Reversal also includes administration of prothrombin complex concentrates (PCC) for immediate reversal.High-yield addition to next yearVerified01/29/19 1:17 PMNicholas T.Gamboanicktgamboa@hotmail.com
1804690Rapid ReviewRapid ReviewChildhood primary brain tumorsSee UWORLD and pg 516 of First AidPage 690 says that the most common supratentorial brain tumor in kids is a medulloblastoma, but both page 516 and UWORLD say that the most common tumor of childhood is the pilocytic astrocytomaClarification to current textVerifiedIn both page 690 and 516, we have correctly mentioned that in kids most common infrantentorial (cerebellum) tumor is medulloblastoma (not supratentorial).

According to UTD, the most common CNS tumor types in children include medulloblastomas (63.7%) and pilocytic astrocytomas (15.5%).

Ref: UTD- epidemiology of central nervous system tumors in children.


I think it is slightly confusing for the reader to read different versions around this particular epidemiological aspect that:

- most common 1° brain tumor in childhood is pilocytic astrocytonomas. (which is benign)
- most common malignant brain tumor in childhood. is medulloblastoma
- the most common infratentorial brain tumor in childhood is a medulloblastom


Final comment:
- no errata
- may need clarification during 2020 revision.


- Vivek		02/22/19 6:01 PMAreekaMemonamemon@vcom.edu
1805702Abbreviations and SymbolsAbbreviations and SymbolsChromatin structurehttps://www.google.com/search?client=firefox-b-d&q=euthrochromatinE* presently 'euthrochromatin' should be 'euchromatin'Minor erratum11/12/19 3:56 PMKellyRoeemail@kellyroe.org
1806702Abbreviations and SymbolsAbbreviations and SymbolsSclerodermahttps://rarediseases.info.nih.gov/diseases/12430/crest-syndromeThe "S" in CREST syndrome stands for "sclerodactyly," not "sclerosis"Minor erratum06/15/19 6:34 PMYolandaZhangyolandazhang43@gmail.com
1807704Abbreviations and SymbolsAbbreviations and SymbolsHeart failurehttps://www.google.com/search?client=firefox-b-d&q=HFpEFHFpEF entry should have 'fraction' rather than 'fracture'Minor erratum11/12/19 4:01 PMKellyRoeemail@kellyoe.org
1808716Section IV Top-Rated Review ResourcesPathologyVasculitidesClarification of textI would like clarrification regarding the text on pages 310/311 ; their corrisponding alphabetical images, and the extended information provided about the images on page 716. For example "polyateritis nodosa" on page 310 is linked to image F in column 3 (page 310) , but on page 716 "vasculitides: Image F. Gangrene as a consequence of Buerger disease" is discused. this is noted for all of the images in this section.Clarification to current textThis is a section IV issue that we should address after revisions are completed. I do see this discrepancy in the 2019 edition. -LilitAgreed, this is a section IV issue that should be addressed once revisions are completed. - Huzaifa06/30/19 3:37 AMMishalBawamishalbawa@gmail.com
1809731IndexIndexIntussusceptionFA 2019Intussusception is misspelled as "intussussception" under the sub-entry, "Abdominal pain"Spelling/formatting07/13/19 1:54 PMYolandaZhangyolandazhang43@gmail.com
1810732IndexIndexAcute pericarditisN/AListed in the index to be on page 314 but is found on page 308.Spelling/formattingStaff accepts01/04/19 7:32 PMHalleyAlbertshalley8236@yahoo.com
1811732IndexIndexHeart embryologySee FA 19 textbook, page 273.The contents incorrectly labels section III as starting on page 269, when it actually starts on page 273. Approaching the organ systems starts on page 274, and cardiovascular starts on page 277. These 3 contents are listed with incorrect page numbers.Spelling/formattingAgree with the student, listing of pages, section and chapters are not correct. -Victor MartinezStaff acceptsAgree, in the contents (Page VI), Section III should be 273 not 269. Approaching organ systems should be page 274 not 270. Cardiovascular should be 277, not 273.Prelim accept by 2 authors + 1 editorReject12/24/18 3:25 PMSarah KiranGrewalsa178658@atsu.edu
1812733IndexIndexα1-antitrypsin deficiencyclarificationalpha1-antitrypsin deficiency is noted as being on page 51 - it isn't. Also, perhaps it doesnt need to be listed twice?Minor erratum07/16/19 4:10 AMMishalBawamishalbawa@gmail.com
1813734IndexIndexAndrogensPage 644 in First Aid 2019 is a notes pageAndrogenetic alopecia is indicated in the revised index to be on page 644 when it is actually on page 643.Spelling/formattingStaff accepts03/03/19 9:55 AMMaxYudovichmax.yudovich@osumc.edu
1814734IndexIndexAromatase inhibitorsn/aThe index says anastrozole is referenced on page 642. Anastrozole is referenced on page 641.Spelling/formatting03/24/19 11:00 AMLisa-QiaoMacDonaldllm012@jefferson.edu
1815734IndexIndexAromatase inhibitorshttps://firstaidteam.com/wp-content/uploads/2019/01/fas1_2019_index_revised_january2019.pdfIn the index, Anastrozole is listed as page 642 when in the 2019 book it is on page 641Clarification to current text07/23/19 4:01 PMFatimaSiddiquifatima_aman_97@hotmail.com
1816734IndexIndexDrug namesN/AAmlodipine is listed to be on page 319. This is incorrect. Amlodipine is on page 313.Minor erratum06/03/19 4:28 PMMarcoLawandymlawandy@student.touro.edu
1817734IndexIndexTrimethoprimFA 2019"Trimethoprim" is misspelled as "trimethroprim" on page 734 (under "Anemia"), page 765 (under "Leukopenia"), and page 785 (under "Sulfonamides")Spelling/formatting07/02/19 11:46 PMYolandaZhangyolandazhang43@gmail.com
1818736IndexIndexAortic dissectionno reference neededThe wrong page number is listed in the index for aortic dissection. The main "aortic dissection" section is on page 301, but in the index it is listed as 306. However, there is no mention of "aortic dissection" on page 306.Spelling/formattingStaff accepts01/19/19 2:45 PMCorinnaFukushimacorinna_m_fukushima@rush.edu
1819736IndexIndexHereditary hemorrhagic telangiectasiaN/ATwo issues. 1) In the index, "hereditary hemorrhagic telangectasia" is written twice under Arteriovenous malformations (AVM). 2) The reference page number is wrong, it should be to page 312 instead of page 319.Spelling/formattingStaff accepts01/13/19 7:29 PMJulieTranjulietran@email.arizona.edu
1820737IndexIndexAtrial natriuretic peptideN/AANP is listed as being on page 298, when it is actually on page 294.Spelling/formattingStaff accepts03/04/19 1:12 PMJacobSiegerjsieger93@gmail.com
1821737IndexIndexAutoregulationFirst Aid 2019 pg. 295Every time autoregulation of blood flow appears in the index (737, 739, 740, 752, 757) it is listed as pg. 300, however it is actually on pg. 295Spelling/formattingStaff accepts01/18/19 2:14 AMAlitaTeitzalita.teitz@gmail.com
1822737IndexPhysiologyECG tracingsIndexAtrial fibrillation is listed as page 297. This is wrong; it should be listed as page 293.Minor erratum06/10/19 7:38 PMMagdaAzizmarcolawandy@gmail.com
1823737IndexIndexSyphilishttps://www.uptodate.com/contents/syphilis-screening-and-diagnostic-testing?search=syphilis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Syphilis is spelled "syphillis" in the indexSpelling/formattingStaff accepts01/27/19 4:56 PMChelseaHAymanchelsea.hayman@yahoo.com
1824738IndexMiscellaneousDiffuse axonal injuryFirst AID 2019Axonal Injury, Diffuse is actually talked about on page 503Spelling/formattingStaff accepts02/10/19 6:06 PMAdithyaNagarajaadityangrj776@gmail.com
1825738IndexIndexVasculitidesNoneBehcet syndrome is on page 310, not 317.Spelling/formatting04/17/19 9:55 PMJohnDoeaction-reaction@rakuten.jp
1826739IndexPathologyCongenital cardiac defect associationshttps://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-turner-syndrome?search=turner%20syndrome&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1Under the Bicuspid aorta valve-->Turner syndrome sub-listing page 303 is one of the pages listed but should be replaced by 298Spelling/formattingStaff accepts03/11/19 3:08 PMDavidSindavidesin@gmail.com
1827741IndexIndexCalcium channel blockersnot applicableeffect of calcium on myocardial action potential and effect on pacemaker action potential should be corrected from P 295 to the corresponding page on the next edition p 290 in the current editionSpelling/formatting04/05/19 4:55 PMAwabElnaeemawab.kamal@gmail.com
1828741IndexIndexCardiomyopathiesN/AThere are many errors in page numbering for the index. This is particularly true for pages in the Cardiovascular section. For example, in the index "Cardiomyopathy" is listed as page 310 but the entry for cardiomyopathy is on page 305. There have been several similar errors of incorrect page numbering in other sections as well, including microbiology.Spelling/formattingStaff accepts02/26/19 12:08 PMJamesHunkerjimh3472@gmail.com
1829742IndexIndexAcute inflammatory demyelinating polyradiculopathyhttps://www.uptodate.com/contents/guillain-barre-syndrome-in-children-epidemiology-clinical-features-and-diagnosis?search=cerebrospinal%20fluid%20albuminocytologic%20dissociation&sectionRank=1&usage_type=default&anchor=H603783422&source=machineLearning&selectedTitle=1~150&display_rank=1#H603783422Currently is spelled "Cerebrospial fluid (CSF) albuminocytologic dissociation" but should be "Cerebrospinal fluid (CSF) albuminocytologic dissociation"Spelling/formattingStaff accepts03/05/19 4:02 PMDavidSindes144@case.edu
1830742IndexIndexBaroreceptors and chemoreceptorsN/ACarotid Massage is listed as being on page 299, when it is actually on page 294.Spelling/formattingStaff accepts03/04/19 1:10 PMJacobSiegerjsieger93@gmail.com
1831743IndexIndexBaroreceptors and chemoreceptorsN/AChemoreceptors are listed in the index as being on page 299. This section is actually found on papge 294Spelling/formattingStaff accepts01/12/19 11:38 AMJasminShahrestanijshahrestani@gmail.com
1832744IndexIndexSympatholytics (α2-agonists)Not requiredClonidine can be found on Page 242 and under Tourette syndrome on Page 545 but not on Pages 240 and 244Spelling/formattingStaff accepts12/31/18 8:45 AMMuhammad FaizanAlifaizanali.93@hotmail.com
1833744IndexIndexSympathomimeticsN/ACocaine's sympathomimetic action is listed as being on page 243 but is actually on page 242Clarification to current text03/14/19 11:05 AMJacobSiegerjsieger93@gmail.com
1834744IndexIndexVasculitidesn/aPage 744 Churg-Strauss syndrome index notes page 317 but page 317 is on cardiovascular pharmacology.Spelling/formattingStaff acceptsDefer to 2020.

- Vivek		02/18/19 1:46 AMJumokeDicksondrfierce12@gmail.com
1835746IndexIndexCystic fibrosisFA page 437Cystic hygroma is not on page 437 as indicated * it was not available in the drop down menu to choose from*Spelling/formattingStaff accepts02/28/19 5:10 PMFARZINESHAGHIfarzin@uw.edu
1836747IndexIndexDanazolwww2.usmle-rx.com/proposed-errata-and-suggestions-fa-step-1The page number for Danazol should be 642. This typo is also on pages 731, 750, 751, 758, 759, 791.Spelling/formatting03/26/19 4:00 PMDavidSindavidesin@gmail.com
1837748IndexPharmacologyCardiac glycosidesFirst Aid hard copyDigoxin for dilated cardiomyopathy is referenced in the index on page 311, however in the 2019 edition it is found on page 305. I also think it should be indexed to include page 316 as it is the main drug listed under cardiac glycosides.Spelling/formatting08/15/19 4:26 PMSavinaReidreidsa93@rowan.edu
1838748IndexIndexDermatologic microscopic termsFA 2019There is no mention of "Desmoplakin" on page 465Spelling/formatting06/20/19 9:42 PMYolandaZhangyolandazhang43@gmail.com
1839751IndexIndexSympathomimeticsN/AUnder Epinephrine it states "for anaphylactic reaction, 114" but there is no mention of epinephrine's use in anaphylaxis on that page.Spelling/formattingStaff accepts03/05/19 12:56 PMJacobSiegerjsieger93@gmail.com
1840752.00IndexIndexSeizuresFA 2019"Ethosuximide" is incorrectly spelled as "Ethosuxamide" on pages 752 and page 789 (sub-entry under "Urticaria")Spelling/formatting06/21/19 3:01 AMYolandaZhangyolandazhang43@gmail.com
1841753IndexIndexFibromyalgianone (index error)"Fibromuscular dysplasia, 303" does NOT appear on page 303Spelling/formattingStaff accepts02/06/19 9:34 PMClaireDonnelleyclairedonnelley@gmail.com
1842755IndexOphthalmologyGlaucomaIndexIndex for glaucoma displayed wrong page number. FA2019 version should be 524 for glaucoma, not 242. On the same note, in terms of one-angle and close-angle, it should be 524.Minor erratum10/09/19 11:58 PMThoNguyentnguyen27@kumc.edu
1843758IndexIndexHepatitis virusesPage 683: Chronic hepatitis B or CHepatitis B treatment is referenced to page 684, when it is actually on page 683Spelling/formattingStaff accepts03/05/19 12:53 PMMaraBezerkomarabezerko@gmail.com
1844758IndexIndexHereditary hemorrhagic telangiectasiaNot neededHereditary hemorrhagic telangiectasia is put as P.319 in the index when it should be P.312. And 676 should be added to HHT in the index as it is a rapid review case of HHT (check P.751 and notice how only Osler-Weber-Rendu syndrome is put there, whereas in P.773, OWR syndrome is referred back to HHT)Minor erratum04/18/19 4:02 AMAbdulrahmanAl Kotobabdulrahman.alkotob@lau.edu
1845758IndexIndexVasculitidesFirst Aid pg. 676Henoch-Schonlein purpura is erroneously listed as pg. 318, however it is actually on pg. 311Spelling/formattingStaff accepts01/13/19 7:10 AMAlitaTeitzalita.teitz@gmail.com
1846760IndexIndexHydralazineNoneOn p 760 within the index, under "Hydralazine", it says p. 311 and 319 however there is no mention of the drug on either of those pages, instead "Hydralazine" can be found on p. 313Spelling/formattingStaff accepts02/26/19 3:52 PMRichDowdjrdowd4@gmail.com
1847763IndexIndexTorsades de pointesnoneThe index states that Jervell and Lange-Nielsen syndrome is on page 297, when it is actually on page 292.Spelling/formattingStaff accepts01/11/19 3:29 PMKellyOlsenkelly_olsen@med.unc.edu
1848763IndexSystemsVasculitidesnafix page number for kawasaki disease to 310 and also rheumatic fever to 308Spelling/formattingStaff acceptsDefer to 2020.

- Vivek		02/17/19 5:09 PMSabrinaTabonesdtabone1@gmail.com
1849767IndexIndexPolymyositis/dermatomyositisFA 2019Even though there are 2 index entries for "Mechanic's hands," there is no mention of it in the textSpelling/formatting06/21/19 6:16 AMYolandaZhangyolandazhang43@gmail.com
1850768IndexIndexHypertension treatmentn/aThe index says that Minoxidil is on page 644 (respiratory notes page). I can't find minoxidil anywhere.Spelling/formatting03/21/19 10:07 AMLisa-QiaoMacDonaldllm012@jefferson.edu
1851772IndexIndexRNA virusesN/AIn the index under "Norovirus" in the first column, "medical importance" is spelled incorrectly. It is spelled "medical improtance"Spelling/formattingStaff accepts03/10/19 8:36 PMCoriFukushimacorinna_m_fukushima@rush.edu
1852774IndexPathologyPersonality-On page 774, the index references "Paranoid Personality Disorder" as being on page 541, which is the title page for the Psychiatry section. From looking at the edition, I see that the "Paranoid Personality Disorders" section has been completely omitted, hence the index reference is quite misleading. I even checked the newer published index with corrections and it was still showing that said entry can be found on page 541. It took me some time of scouring around the section and book to realize there is no such entry, hence I would like to formally request you to remove it from the index. Thank you!Spelling/formattingStaff accepts03/12/19 3:30 PMParidhiGhaiparidhighai94@gmail.com
1853774IndexIndexPhosphodiesterase type 5 inhibitorsN/APDE-5 inhibitors are listed as being on page 644 on multiple occasions in the index, when they are really on page 643.Clarification to current text03/24/19 4:07 PMJacobSiegerjsieger93@gmail.com
1854775IndexIndexDrug reactions—musculoskeletal/skin/connective tissuen/aPage 775 Penicillamine related myopathy is listed as page 250 but it's 249Spelling/formattingStaff accepts03/06/19 8:05 AMJumokeDicksondrfierce12@gmail.com
1855775IndexIndexPseudomonas aeruginosaFirst Aid 2019This entry for Pseudomonas aeruginosa is not listed alphebetically (it is between "Pes cavus" and "Petechiae"). It should be with the other Pseudomonas aeruginosa entry in the index on page 778. Also the sub-entry of "splenic dysfunction and, 98" may need to be removed because page 98 does not mention Pseudomonas aeruginosa explicitly.Spelling/formatting03/24/19 11:02 AMDavidSindavidesin@gmail.com
1856778IndexIndexProtein synthesishttps://opentextbc.ca/anatomyandphysiology/chapter/24-4-protein-metabolism/Under the category of protein synthesis, "metaboilic site" is listed, this should be spelled correctly as metabolic siteSpelling/formattingStaff accepts01/09/19 1:17 AMAlitaTeitzalita.teitz@gmail.com
1857778IndexIndexβ-blockershttps://www.uptodate.com/contents/search?search=Propanolol (link shows no results for "propanolol"; instead redirects to results for "propranolol")The index has an entries for both "propanolol" and "propranolol"; however, the former appears to be a misspelling of the latter. This error is also present in older versions of First Aid as well as the revised index found online.Spelling/formatting09/01/19 1:01 AMJunuBaejunu.bae@osumc.edu
1858779IndexIndexReceptor bindingNot neededon page 779, it says receptors are on page 231 but they are actually on page 238Spelling/formattingStaff accepts01/05/19 7:47 PMJankiPanchmatiajpanchma@nyit.edu
1859780IndexIndexHeart failureits on bookin index there is regadenoson, 307 but it should be 301 as the drug is on page 301Minor erratum05/22/19 8:25 AMManjilBasnetbasnetmanjil@gmail.com
1860780IndexIndexParamyxovirusesNoneUnder the entry for “Respiratory syncytial virus (RSV)” in the index, under its sub-entry “paramyxovirus," the correct page numbers should be 167, 169 (not 170)Spelling/formatting06/12/19 12:27 AMYolandaZhangyolandazhang43@gmail.com
1861781IndexIndexRheumatic fevern/aThe page reference for rheumatic fever says 314, it should be 308.Spelling/formatting07/05/19 11:36 PMAlexMeilechmeilecha@email.arizona.edu
1862781IndexIndexUrinary tract infectionsNoneIndex says Sabouraud agar is found on pg 153 but there's no mention of this on pg 153.Spelling/formattingStaff accepts02/10/19 2:12 AMMaxShengmms199@case.edu
1863785IndexIndexSyphilitic heart diseaseN/AListed to be on page 315 in index but is found on page 309.Spelling/formattingStaff acceptsAlready addressed in index errata report.

-Vivek		01/04/19 7:31 PMHalleyAlbertshalley8236@yahoo.com
1864785IndexIndexTriptansNoneOn p 785 within the index, under "Sumatriptan", "coronary vasospasm with" reads p 248 and it should be p 247Spelling/formattingStaff accepts01/07/19 1:32 PMRichDowdjrdowd4@gmail.com
1865788IndexIndexCongenital cardiac defect associationsN/AIn the index, Turner's Syndrome cardiac association is said to be found on page 303 but it is found on page 298.Spelling/formattingAgree with the student, the congenital cardiac defect associated with Turner's syndrome is found on page 298 instead of 303. -Victor MartinezStaff acceptsAlready addressed in index errata report.

-Vivek		01/11/19 3:36 PMHalleyAlbertshalley8236@yahoo.com
1866789IndexIndexAuscultation of the heartnot neededValsalva maneuver is not in page 293 as it mentioned in the indexSpelling/formatting06/29/19 3:28 PMRa'edAbabnehraedababneh@gmail.com
1867790IndexIndexVasculitidesnaVasculitis is listed to be found in pag 315 and 316; while they are actually in pg 310 and 311. It should also be changed to ''Vasculitides" in the index for consistency with how it's acknowledged in pg 310.Spelling/formatting08/06/19 6:15 PMFranciscoDuenasfrancisco.duenasmd@gmail.com
1868791IndexIndexChromatolysiscorrected page numberWallerian degeneration mention as page number - 481 to be corrected to 483 ( correct page number)Major erratum10/04/19 11:28 AMAshwiniMahadevaiahashwini_mahadev@yahoo.co.in
1869791Neurology and Special SensesAnatomy and PhysiologyNeuronsFirst Aid 2019Information on Wallerian degeneration is actually on page 483, not 481 as implied by the 2019 indexSpelling/formattingStaff acceptsUser is correct. Index problem.

- Humood		Yes agree, we can address it in 2020 revision.

- Vivek		Correct. Definitely needs to be addressed during 2020 cycle.Prelim accept but NOT publishable errata01/20/19 8:01 PMBNguyenbrenda.m.nguyen@gmail.com
1870791,756.00IndexPathologyGranulomatous inflammationUSMLErx.comWegener granulomatosis is listed on pages 218 and 317. It is actually on page 311, not 317. This is a mistake on both pages 791/756. If you search wegeners (791) or granulomatosis with polyangitis (wegener) (756)Spelling/formatting07/07/19 1:47 AMShelbieScharfShelbie828@hotmail.com
1871305 (it's in the 2018 version but the fact probably has not changed)CardiovascularPathologyBacterial endocarditishttps://www.uptodate.com/contents/culture-negative-endocarditis-epidemiology-microbiology-and-diagnosis?search=culture%20negative%20endocarditis&sectionRank=1&usage_type=default&anchor=H6&source=machineLearning&selectedTitle=1~43&display_rank=1#H6If culture negative most common are Coxiella and Bartonella. HACEK, however, do grow in cultures and don't cause culture negative IF..Major erratum09/23/19 2:05 AMGideonLindengideon.linden@gmail.com
1872319-3CardiovascularPharmacologyIvabradineI thought of this mnemonic myself.IvaBRADIne affects FUNNY channels. BRADY Bunch is a FUNNY show.MnemonicVerifiedI like out IVabradine = phase "IV" much better than this. -LilitReject. Hard to remember. - Huzaifa07/05/19 9:18 PMSinaMoridzadehsinamorid91@gmail.com
1873336 (2018 edition)EndocrinePathologyHypothyroidismFirst Aid 2018 (2019 is in the mail now)Riedel Thyroiditis presents with rock-hard goiter. I have always remembered this because of the movie, “Grease.” They rock at Riedel High. I have told this to multiple other students at my school and it has really seemed to help them. Figured I would let you all know and see if it could help other students out there. It would be a pretty quick one-liner to help remember the pathology.MnemonicVerified09/05/19 1:28 PMZacharyJodoinzacharyjodoin@yahoo.com
1874IndexIndexIndexCardiomyopathiesnot neededI think the whole book's Index needs to be re-made, I've recorded too many errors to keep submitting errata.Spelling/formattingStaff acceptsCVS is already addressed in index errata report and other section can addressed in 2020 revision.

-Vivek		01/11/19 8:04 PMJankiPanchmatiajpanchma@nyit.edu
1875IndexIndexIndexHeart failuren/aThe page numbers in the index are grossly incorrect -- often off by 6 or more pages. Which makes the entire index difficult to use. For instance paroxysmal nocturnal dyspnea is listed as page 312 but it on page 306.Spelling/formattingStaff acceptsAlready addressed in index errata report.

-Vivek		01/16/19 7:08 PMElizabethAlbertElizabeth.beatrice@gmail.com
1876n/aImmunologyImmune ResponsesImmunodeficienciesn/aTo remember the x-linked immunodeficiencies more common in boys (Hyper IgM, Wiskott-Aldrich, CGD, Bruton's agammaglobulinemia ): Boys are Hyper When it Comes to ButtsMnemonicVerified09/13/19 1:04 AMNicoBivonanico.bivona@gmail.com
1877P 48BiochemistryCellularMicrotubulehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972880/Dynein carries to the DNAMnemonicVerified09/14/19 9:26 AMAna LuizaMapurunga GoncalvesAnaluizamapurunga@gmail.com
1878p. 203MicrobiologyAntimicrobialsHIV therapyuptodate.com/contents/treatment-of-hiv-2-infection#H356294 "On p.203, it is mentioned that "All ARTs are active against HIV-1 and HIV-2 with the exception of of NNRTIs", however, HIV-2 viruses are intrinsically resistant to both NNRTIs and Fusion inhibitorsMajor erratumAdded as major erratum to annotate. Will likely eligible for acknowledgement.

- Vivek		09/25/19 4:12 PMSallyEl Sammaksjs24@mail.aub.edu
1879p. 594RenalPharmacologyLoop diureticshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117548/Loops are the BeFT to tx CHF symptomatology! (Bumetanide, ethacrynic acid (?), Furosemide, Torsemide)MnemonicVerifiedCHF drugs are discussed in great detail in the cardiovascular chapter. No need for a mnemonic in this chapter. -Lilit07/20/19 11:05 AMNicolaDuzaknhampel@mail.sjsm.org
188003/08/19 11:49 PM
1881536Neurology and Special SensesPharmacologyParkinson disease drugsFA 2019, UWORLD QBANK, USMLE RX QBANK, KAPLAN QBANK, NBMEs, USMLE MEDBULLETS, WIKIPEDIAAmantadine (↑ dopamine release, ↓ dopamine reuptake, NMDA-receptor antagonism); toxicity = peripheral edema, livedo reticularis, ataxia. Formerly prescribed as an antiviral medication against Influenza A (inhibits viral uncoating by binding to the M2 protein).High-yield addition to next year12/16/19 1:04 AMVirginiaAlvarado-Jonesvalvara2@gmail.com
1882564PsychiatryPharmacologyOpioid analgesicsFA 2019, UWORLD QBANK, USMLE RX QBANK, KAPLAN QBANK, NBMEs, USMLE MEDBULLETS, WIKIPEDIAMethadone Long-acting oral opiate used for heroin detoxification or long-term maintenance therapy. Additional NMDA-receptor antagonism effective for central, chronic, and neuropathic pain.High-yield addition to next year12/16/19 1:11 AMVirginiaAlvarado-Jonesvalvara2@gmail.com
1883559PsychiatryPharmacologyPsychoactive drug intoxication and withdrawalFA 2019, UWORLD QBANK, USMLE RX QBANK, KAPLAN QBANK, NBMEs, USMLE MEDBULLETS, WIKIPEDIAPhencyclidine (PCP) Violence, impulsivity, psychomotor agitation, nystagmus, tachycardia, hypertension, analgesia, psychosis, delirium, seizures. Trauma is most common complication. NMDA-receptor antagonist.High-yield addition to next year12/16/19 1:13 AMVirginiaAlvarado-Jonesvalvara2@gmail.com
1884308CardiovascularPathologyAcute pericarditishttps://www.uptodate.com/contents/etiology-of-pericardial-disease?search=acute%20pericarditis%20causes&source=search_result&selectedTitle=1~93&usage_type=default&display_rank=1#H2638284Listed causes of Acute Pericarditis: Radiation therapy, Idiopathic, Infectious, Neoplasm, Uremia, and Cardiovascular (Post-MI) could be remembered as RAIIN Umbrella/CoatMnemonic12/16/19 2:14 AMSkylerHarrisonSharr013@ucr.edu