2016 FA Step 1 Proposed Errata

2016 FA Step 1 Proposed Errata & Suggestions
Page
Chapter
Supporting Reference(s)
Main Comment
Section I
Supplement
(on FA Team
blog)
IMED has been replaced by the World Directory of Medical

Schools
Section I
http://www.ecfmg.org/news/2014/
12/16/world-directory-medicalschools-replace-internationalmedical-education-directoryimed-2015-purposes-determiningeligibility-ecfmg-certification/
http://www.usmle.org/announcem
ents/
Section I
60/44
1 question per 78 seconds should be 82 seconds
Section I
ents/default.aspx?ContentId=166
one question per 90 seconds
33
Behavioral
Science
First Aid for Step 1, page 33
34
Behavioral
Science
N/A
34
Behavioral
Science
https://www.ncbi.nlm.nih.gov/pmc
/articles/PMC522855/
36
Behavioral
Science
https://en.wikipedia.org/wiki/Type
_I_and_type_II_errors
36
Behavioral
Science
"Crush Step 1: The Ultimate

USMLE Step 1 Review" by Ryan
A Pedigo, Theodore X. O'Connell,
and Thomas E. Blair
37
Behavioral
Science
First Aid book for Step 1, page 37
38
Behavioral
Science
http://www.uptodate.com/contents
/proof-p-values-and-hypothesistesting?source=see_link&section
Name=CONFIDENCE+INTERVA
LS&anchor=H8#H8
39
Behavioral
Science
NA
39
Behavioral
Science
N/A
Raising the cut-off point makes it close to Positive (increased

PPV/sPecificity), lowering the cut-off point makes it closer to
Negative (more NPV/seNsitivity).
Current explanation of Odds ratio is the non-intuitive explanation.
Intuitive explanation: Odds that the group exposed to a risk factor
have the disease (a/b) divided by the odds that the group not
exposed to a risk factor have the disease (c/d).
"Number needed to hARm: NNH = 1/AR" *make the AR in
"hARm" both capitalized and in red, and also make the "AR" in
the equation in red, to emphasize that NNH = 1/AR, and AR is in
the correct spelling of "harm," to distinguish from 1/AR from
1/ARR, which is used in NNT equation*
The mnemonic for Beta (type 2 error) should be corrected to say
"Blind TO the truth" since you did not see an association that was
truly there.
The "Hawthorne Effect" is listed as a type of measurement bias in
which people change their behaviors in a study. Example:
Participants in a medication trial to treat hypertension are more
likely to adopt a healthy lifestyle if they know they are being
studied. A decrease in blood pressure then occurs because of
lifestyle changes, but is attributed to the medication. Solution: Use
placebo group.
Following the alphabetical order for the negative and positive
skewness. If positively skewed then start from A-->Z, ie. mEAnmEDian-mOde. if negatively skewed then the opposite, from Z-->
A, ie. mOde-mEDian-mEAN.
The proper interpretation of a 95% confidence interval is that if the
experiment were repeated an infinite number of times, the true
value would be contained within the confidence interval 95% of
the time. This is different from saying that there is a 95% chance
that the true value is contained within a 95% CI because once an
experiment has been conducted and once a confidence interval
has been calculated, there are only 2 possibilities: either the
confidence interval contains the true value or it does not. The real
utility of the confidence interval is to provide information about the
precision of the point estimate (based on the width of the CI).
In Justice, last sentence states: "This does not always imply
equally." English is not my first language but I feel that it should
be "equality" sine equally is an adverb and the verb imply is
commonly a transitive verb. Justice does not imply equality. (at
least it's easier to understand even if the current sentence is
grammatically true).
The algorithm attached wil help in selecting a suitable statistical
test in different common situations.
40
Behavioral
Science
First Aid for the USMLE Step 1,

2016
40
Behavioral
Science
Crush Step 1
May 2016 Changes: 280 Questions. Blocks of 40 questionss. 90

seconds at most per question
Current sentence structure is unreadable... Perhaps shift

sentence 3 into a bullet point format? "A minor is generally any
person < 18 years old. Parental consent laws in relation to health
care vary by state. In general, parental consent should be
obtained unless emergent treatment is required (eg, blood
transfusion) even if it opposes parental religious/cultural beliefs,
or if a minor is legally emancipated (eg, is married, is self
supporting, or is in the military)."
Procedural information that should be included in informed
consent discussion: BRAIN; B=Benefits, R=Risks, A=Alternatives,
Submission
type
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41
Behavioral
Science
/confidentiality-in-adolescenthealth-care
45
Behavioral
Science
46
Behavioral
Science
http://www.cdc.gov/women/lcod/2
013/womenall_2013.pdf
http://www.cdc.gov/men/lcod/201
3/allagesmen2013.pdf
No reference have
48
Biochemistry
https://en.wikipedia.org/wiki/CpG_
site#Methylation.2C_silencing.2C
_cancer.2C_and_aging
49
Biochemistry
First Aid 2016, p. 49
51
Biochemistry
N/A
51
Biochemistry
53
Biochemistry
http://oregonstate.edu/dept/bioch
em/hhmi/hhmiclasses/bb451/lectn
otesgdp/DNAI.html
Own idea, and reference is text
itself
53
Biochemistry
A mneumonic.
54
Biochemistry
previous page (53) states mRNA

start codon as AUG
54
Biochemistry
54
Biochemistry
https://en.wikipedia.org/wiki/Start
_codon;
http://www.ncbi.nlm.nih.gov/pubm
ed/15531618
FA2016page 54
54
Biochemistry
n/a
54
Biochemistry
N/A
55
Biochemistry
See any recent authorative text

such as Albert et al. Molecular
Biology of the Cell or Lodish et al.
Molecular Cell Biology or Plopper
et al. Lewins's Cells
54
Biochemistry
UWorld question ID 2025
55
Biochemistry
N/A
57
Biochemistry
https://www.nobelprize.org/educat
ional/medicine/dna/a/translation/i
nitiation.html
56
Biochemistry
First Aid 2016
57
Biochemistry
https://books.google.com.do/book
s?id=6FQtBgAAQBAJ&pg=PA57
&dq=the+small+ribosomal+subun
it+kaplan+biochemistry&hl=en&sa
=X&ved=0ahUKEwjTyr73jKXKAh
I=Indications, N=Nature of procedure. WIPE mnemonic for

exceptions to informed consent: W=Waiver, I=Incompetence,
P=therapeutic Privilege, E=Emergency i.e. implied consent
The physician's good judgement "SAVED" the day: Suicidal
(and/or homicidal), Abuse (of child and/or elderly), Victim
(Tarasoff decision), Epilepsy (and other driving impairments),
Disease (transmittable, including STIs, TB, hepatitis, food
poisoning)
Should break this out into male and female as they are different.
In latent error section under type of medical errors there is need

of grammatical correction of the line "Occurs in processes indirect
from operator but impacts patient care". Please notice the
"indirect" word. This should be "indirectly" and after impact there
can be written "Impact on patient care"
Methylation of CpG sites within the promoter of genes can lead to
their silencing, a feature found in many human cancers. In
contrast, hypomethylation of CpG sites is associated with
overexpression of oncogenes within cancer cells. Methylation
levels are a highly accurate biological clock (epigenetic clock).
To remember if sugars or bases come first for pyrimidine
synthesis, I made the mnemonic "the PYRamids were built from
the BASE UP", meaning that PYRimidines first have bases built,
then sugar attached.
There are two spaces between the words DNA and polymerase in
the header "(G) DNA polymerase III" but only one space in "(H)
DNA polymerase I"
DNA polymerase I has exonuclease capabilities in both the 3 to 5
and 5 to 3 directions.
"You lose NER (nucleotide excision repair) in XER(oderma
pigmentosum)"
Think it is easier to remember like this: UGA: "U ! Go Away",
UAG: "U Are.... Going", UAA: "U Are Away!". Was easier for me to
remember this anyways.
Typo. Start codon listed as "ATG" instead of AUG
The figure on page 54 shows that the start codon is ATG (ATG=
start codon). This an error. The start codon is acutually AUG
IIIIII are numbered in the same order that their products are
used in protein synthesislarge ribosomal RNAmRNAthen
small RNAsShould be changed to tRNAnot small RNA
"Rifampin inhibits RNA Polymerase in Prokaryotes" should be
placed in the column next to the Prokaryotes section instead of in
column next to the Eukaryotes section
To remember that Rifampin inhibits RNA polymerase in
prokaryotes, you should bold the following R's: "Rifampin inhibits
Rna polymerase in pRokaryotes."
The term "exon" refers to any region of a gene that becomes part
of the final mature RNA. The definition "Exons contain the actual
genetic information coding for a protein" is incorrect. Exons
include not only the protein coding regions of an mRNA, but also
the 5" and 3' UTRs in mRNA. Exons may refer to regions that
encode functional non-coding RNAs such as miRNAs, ribosomal
RNAs and tRNAs.
The text currently says enhancers bind transcription factors.
UWorld says "activator proteins that facilitate DNA bending" -maybe consider changing the wording for clarification next year.
To remember the function of miRNA ( mRNA function), I use the
letters "mi" from the name as an abbreviation for "mRNA
inhibitors" (the 'm' and 'i' should be in red).
Although the facts are true as written ATP is also used to "going
places" as the originally scanning of the mRNA by the ribosome
requires ATP to get to the Kozak sequence/start site.
In the tRNA structure near the D-arm, there is a U and a G
connected to each other. That base pairing is incorrect.
Initiation factors (eukariotic IFs) help assemble the 40s ribosomal
subunit with the mRNA (not tRNA as stated in the FA book).
Small ribosomal subunit binds to mRNA
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XEWx4KHXXIB3UQ6AEIGzAA#v
=onepage&q=the%20small%20ri
bosomal%20subunit%20kaplan%
20biochemistry&f=false
Harper Biochemistry text
57
Biochemistry
58
Biochemistry
59
Biochemistry
59
Biochemistry
N/A
59
Biochemistry
http://emedicine.medscape.com/a
rticle/945460-clinical#b4
59
Biochemistry
60
Biochemistry
"Two steps forward one step

back..." is a catchphrase
reflecting on an anecdote about a
frog trying to climb out of a water
well; for every two steps the frog
climbs, it falls back by one step,
making its progress arduous.
https://en.wikipedia.org/wiki/Ciliu
m
60
Biochemistry
/primary-ciliary-dyskinesiaimmotile-cilia-syndrome
60
Biochemistry
N/A
60
Biochemistry
https://en.wikipedia.org/wiki/Signa
l_transduction
60
Biochemistry
Already in FA
61
Behavioral
Science
fadem biostats book
61
Biochemistry
https://en.wikipedia.org/wiki/Ouab
ain
61
Biochemistry
rticle/1114004-overview#a5
61
Biochemistry
N/A
63
Biochemistry
http://www.ncbi.nlm.nih.gov/book
s/NBK1244/
63
Biochemistry
http://ghr.nlm.nih.gov/condition/m
Rubin, Emanuel. Essentials of

Rubin's Pathology. 5th ed.
Philadelphia: Wolters Kluwer
Health/Lippincott Williams &
Wilkins, 2009. 48. Print
Ross histology 6e. page 48,
figure 2.28
Error : assemble the 40s ribosomal subunit with the initiator t RNA
and are released when the m RNA and the 60s subunit assemble
with the complex. Suggestion : Initiation involves the small subunit
of the ribosome binding to 5' end of mRNA with the help of
initiation factors.
Book incorrectly states that "Permanent cells regenerate from
stem cells". Permanent cells are not able to regenerate. Rubin's
Pathology 5ed page 48 states "Permanent cells, are terminally
differentiated, have lost all capacity for regeneration"
COPI is referred to as retrograde when (mainly) it is between the
cis-golgi and ER. the (retrograde) should be moved forwards
instead of where it is now ( after golgi -> golgi)
To remember that the peroxisome does -oxidation, you should
bold the 'oxi' in perOXIsome and in -OXIdation.
I-Cell can be remembered with a simple mnemoic that almost
exists in the text: I-CELL. I for Eyes (corneal clouding, puffy
eyelids), C (Coarse face), E (elevated Enzymes), L (Limited Joint
movement), L (Lysosomal storage disease, mucoLipidosis II)
2 (II) steps forward (anterograde): COP2 (II); 1 (I) step back
(retrograde) COP1 (I) OR simply- 2 steps forward (COP2) one
step back (COP1)
Minor
erratum
The cilia structure is positively updated in 2016 version. However

I would recommend adding a figure to clarify the structure of
doublets and triplets (in basal body). Additionally the cilia is
consisted of 9 doublet + 2 singlets (the 2 central microtubules are
not doublet). So 9+2 doublets as indicated in the text is not
precise. There is a great figure in wikipedia.
In Kartagener syndrome, "female infertility" is not a precise notion.
Female subfertility is a more correct based on current evidence
since <50% of females with kartagener still have normal fertility
(so they are not infertile). Please see UpToDate link, section on
fertility.
Emphasize the "me" in "Vimentin", "Mesenchymal", "endometrial
carcinoma" and "meningiomas" to help students associate them
with each other. (There's an existing mnemonic that highlights the
"M" in "Desmin" and "Muscle," which is arguably a weaker
mnemonic than the one I'm suggesting.)
During my studies , I looked up on cellular transduction pathways
and kinda compilated the ones that looked important to me in a
single simplified chart. I am attaching a photo of it so you can
have a look and maybe add it to next year's FA if you deem it
important . Thanks for you amazing product!
For dynein which transports substances from + to - end write
dynein as dyNEIN . towards negative as NEIN = negative ( - ive)
in German
for the CI got OR and RR includes 1, h0 is not reject and theres is
NO SIGNIFICANT DIFFERENCE
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Ouabin, a plant toxin inhibiting NA-K-ATPase, is derived from a

plant known as "arrow-poison tree" since it was used in Africa as
a component of arrow poison. I think it worth adding the "arrow
poison" in parentheses after Ouabin. It will greatly help students
to remember the function of the substance despite the odd name
of Ouabin!
In the table for collagen types, I would recommend adding
collagen type V because it's the most common affected type in
Ehlers-Danlos. It's good to add a note that other types of collagen
also exist because the table implies that there are only 4 types
and a couple of pages later Collagen type V is mentioned as the
most common type in EDS.
To remember what Type III collagen does, I use the rhyme "type
tHREE is stretcHEE (pronounced "stretch")". This is because type
3 is all the stretchy stuff - skin, blood vessels, uterus, fetal tissue.
Classic form has COL5A1 or COL5A2 mutations = collagen type
V mutation => hypermobility of joint, widened scars,
hyperextensible skin.
An interesting fact that I learnt is the similarity of genetic defects
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enkes-syndrome
63
Biochemistry
My mnemonic
64
Biochemistry
http://ghr.nlm.nih.gov/gene/FBN1
66
Biochemistry
FA2016 p 66
68
Biochemistry
https://en.wikipedia.org/wiki/Gene
_knockdown
68
Biochemistry
http://ghr.nlm.nih.gov/handbook/ill
ustrations/codominant
68
Biochemistry
n/a
69
Biochemistry
http://www.firstaidteam.com/updat
es-and-corrections
69
Biochemistry
https://ghr.nlm.nih.gov/condition/a
ngelman-syndrome
70
Biochemistry
rticle/916377-overview#a4,
/rett-syndrome
70
Biochemistry
N/A
70
Biochemistry
71
Biochemistry
http://www.genetics.edu.au/Public
ations-and-Resources/GeneticsFactSheets/FactSheetXLRInheritance
https://www.nlm.nih.gov/medlinep
lus/ency/article/002051.htm
http://www.genetics.edu.au/Public
ations-and-Resources/GeneticsFactSheets/FactSheetXLRInheritance
FA 2016
71
Biochemistry
Blanching telangiectasia
71
Biochemistry
Blanching telangiectasia
71
Biochemistry
Myself
in Menkes Disease and Wilson's Disease (ATP7A and ATP7B,

respectively). I would recommend adding a note to one of these
entities because both are related to Copper problems and that
would help to remember the genes in both of them by connecting
the genetic similarity and the metal ion involved.
S/S of Osteogenesis Imperfecta: They can't [ BITE ] => B
(BONES = Multiple Fractures), I (EYE = Blue Sclera), T (TEETH =
Dental imperfections), E (EAR= Hearing loss).
Should revise writing to read: caused by a defect in fibrillin, a
extracellular matrix glycoprotein. vs a glycoprotein.
In the entry for "Flow cytometry", there is a minor formatting error
in the right column. Examples of uses for flow cytometry are
given. There should be a change to the parentheses
encompassing the list. The current sentence says, Commonly
used in workup of hematologic abnormalities (e.g., paroxysmal
nocturnal hemoglobinuria, fetal RBCs in mothers blood, and
immunodeficiencies (e.g., CD4 cell count in HIV). Maybe change
to, (e.g., paroxysmal nocturnal hemoglobinuria, fetal RBCs in
mothers blood, and immunodeficiencies [eg, CD4 cell count in
HIV])."
Add in the concept of knock-down (vs knock-out) = expression of
gene is reduced.
In the examples for the definition of Codominance, it states that
Blood groups A and B are examples of codominance but this is
not precise as only phenotypes A-A or B-B can be considered
examples of codominancy. Phenotypes of type A A-O and type B
B-O are not examples of codominancy.
All the genetic terms are formatted or described by how the
genotype effects the phenotype except for variable expressivity,
where its flipped. Please change in order to maintain consistency
and avoid confusion.
"Heterod-'i'-somy" has one "i" therefore it indicates meiosis I error,
whereas, 'I'-sod-'i'-somy has two "i"'s, indicated meiosis II error.
OR 1 Head ("H"-eterodisomy) and 2 Eyes ("I"-sodisomy)
Angelman Syndrome and the maternal deletion can be easily
remembered by thinking of "Mommy's Little Angel"
In 2016 edition Rett syndrome is added to X-linked Dominant
examples. Although the defective mutation is on the X-chromose,
nearly all cases of Rett syndrome are females and almost all
mutations are sporadic with very low inheritance in families
(although some cases are inherited and mosaicism also plays a
role). Overall it's not a good example of X-linked dominant at all
because one would expect both males and females to be affected
with high rates of inheritance. Please see Medscape and
UpToDate topics on Rett Syndrome.
From reading through your examples of Autosomal Dominant and
Recessive disorders on pages 71 and 72, it seems like all the
cancer-causing genetic diseases are Autosomal Dominant (FAP,
Li-Fraumeni, MEN, Neurofibromatosis 1/2, tuberous sclerosis, von
Hippel-Lindau). This could be mentioned as a general rule of
thumb. "If it causes cancer, it's most likely AD."
Sons of heterozygous mothers have a 25% chance of being
affected, not 50% as stated in the book
I think it's easier to remember NF-1 as chromosome 17 because if

you write: NF-1 = 17 the F1 looks like a mirror image of the
number 17.
Hereditary hemorrhagic telangiectasia. Findings: blanching skin
lesions (telangiectasias). (It should say "blanching" instead of
"branching")
Hereditary hemorrhagic telangiectasia. Findings: blanching skin
lesions (telangiectasias). (It should say "blanching" instead of
"branching")
To remember Marfan syndrome just think of "MISS FE is only 15."
The 'MISS' reminds you that its a MISSense mutation and the 'F'
stands for FBN1 mutation / Fibrilin mutation and the 'E' for
addition to
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71
Biochemistry
71
Biochemistry
na
72
Biochemistry
mnemonic : GF BOLD SHOW for

X-linked inheritance in page 72.
72
Biochemistry
/cystic-fibrosis-overview-of-thetreatment-of-lung-disease
72
Biochemistry
Its a mnemonic of own creation.
73
Biochemistry
ed/12893528
73
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rticle/1259041-workup
73
Biochemistry
73
Biochemistry
for #1 big Robbins 8e page1268.

for #2
ed/17162189
73
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rticle/289117-overview
74
Biochemistry
none
74
Biochemistry
This is just a minor errata.
abnormal elastin. 15 for chromosome 15.

"LI"-Fraumeni = chromosome "17" If you rotate "Li" 180 degrees
it looks like a "17"
Dominant Hunting MEN FAP their Tubes and Spheres in Hip
Cafs and get Tele Chols from Li about Marfans: Huntingtons
Multiple Endocrine Neoplasia FAP Tuberous Sclerosis Hereditary
Sphereocytosis von Hippel-Lindau Cafe = Neurofibromatosis type
1 (NF2 is also dominant but doesn't have cafe au lait spots)
familial hyperCHOLesterolemia Li-Fraumeni Marfans
The Mnemonic for X-linked inheritance is changed in the 2016
edition and improved but I still think it's a very long sentence to
remember. I have used my mnemonic that I think is easier to
remember and also relevant! I recommend using "ex-GF BOLD
SHOW" as ex stands for X-linked and in the same order of the
current text: G6PD def, Fabry, Brutons, Ocular albinism, LeschNeyhan, Duchenne, Syndrome Hunter, OTC def, Wiskott-Aldrich.
However the last W also helps me to remember M for Menkes but
it's a bit of stretch ! Hope the mnemonic helps! It is shorter and
more relevant and easier to remember.
I suggest adding ivafactor (a CFTR modulator) to the treatment
options of CF. Although it should be noted that only a small
proportion of CF patients that harbor a particular mutation benefit
from Ivafactor, but it's a prototype of CFTR modulators and the
only drug that targets the underlying problem in CF. However I
don't know how high-yield it is but I think it definitely worth
mentioning.
Under the Autosomal Recessive diseases the pathology's are:
Albinism, autossomal recessive polycystickidney dissease, cystic
fibrosis, glycogen storage disseases, hemocromatosis,
Kartagener syndrome, mucopolysaccharidosis, phenylketonuria,
sickle cell, sphingolipidosis, thalassemias and Wilson disease.
From all those options only Albinism, Mucopolisacharidosis and
Hemocromathosis share a letter with the Dominant disorders. So
the mnemonic i figured out is that if it starts with any of these
letters is Recesive. Soldiers Can Get Kronic Post Traumatic
Stress After War. Although there is a dominant with A, its
autosomal dominant kidney disease. Wich pretty much says what
you need to know. I think these mnemonic helps to remember the
diseases but also during a test to easily clear options just by the
starting letter having only to remember muchopolisaccharidosis
and hemochromatosis. Thanks.
COP II is anterograde movement, COP I is retrograde movement,
therefore a good mnemonic is "2 steps FORWARD, 1 step
BACK". COP 2 goes forward, COP 1 goes back
FA2015 says increase "CPK" whereas FA2016 says increased
"CK". there should be an increase in creatinine phosphokinase
Duchenne MD is typically attributed to a complete lack of
dystrophin protein, whereas Becker MD is attributed to truncated
or partially functional (but still present) dystrophin protein.
Currently, FA 2016 states that truncated dystrophin protein is
present in Duchenne MD and partially functional dystrophin is
present in Becker MD.
the pathogensis of Duchenne is not in that absence of dystrophin
inhibits muscle regeneration as stated right after the 2nd arrow.
Absence of dystrophin causes damage to the cell -> necrosis and
because these are the skeletal and cardiac muscles that are
mainly affected -> no regeneration. As to how the myocytes are
actually damaged there are two hypotheses. 1) "The role of this
complex of proteins in transferring the force of contraction to
connective tissue has been proposed to be the basis for the
myocyte degeneration that occurs in the absence of dystrophin"
2) dystrophin is thought to be strongly involved in the regulation of
intracellular calcium and its absence will lead to a leaky
membrane to calcium -> cell damage and necrosis
Fragile X syndrome is the most common inherited form of
intellectual disability but the second most common genetic form of
intellectual disability (after Down syndrome)
Mnemonic for Edwards Syndrome: Big headed politicians with
clenched hands are dumb, lower their ears and jaw, and rock their
feet to special interests during election season.
PAPP-A is not defined in the "Abbreviations" section!
74
Biochemistry
Current text states that trisomy 21 due to mosaicism have no
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ed/22903903
74
Biochemistry
N/A
74
Biochemistry
N/A
74
Biochemistry
http://ojrd.biomedcentral.com/artic
les/10.1186/1750-1172-7-81
74
Pharmacolog
y
s/NBK21710/
75
Biochemistry
n/a
76
Biochemistry
76
Biochemistry
FA
77
Biochemistry
N/A
77
Biochemistry
N/A
78
Biochemistry
N/A
78
Biochemistry
78
Biochemistry
ed/3556611
ed/830875
ed/1567934
not needed
79
Biochemistry
N/A
79
Biochemistry
N/A
79
Biochemistry
UpToDate http://www.uptodate.com/contents
/folic-acid-supplementation-inpregnancy?source=machineLear
ning&search=folate+pregnancy&s
electedTitle=5~150&sectionRank
=1&anchor=H7#H7
81
Biochemistry
na
82
Biochemistry
83
Biochemistry
/malnutrition-in-children-inresource-limited-countriesclinicalassessment?source=search_resu
lt&search=Kwashiorkor&selected
Title=1~14#H4
NON
maternal association. However, mosaic trisomy 21 is

multifactorial, with advanced maternal age being associated with
67% of cases.
You should bold the fact that Down syndrome has inhibin A on
quad screen, whereas Edwards has or normal inhibin A. This is
the only lab value on quad screen that sets them apart, making it
important to take note of. Both have the same AFP, -hCG,
and estriol.
There was an error in my last submission. I meant to say that both
-hCG and inhibin A levels are different. Both are in Down
syndrome and both (or normal for inhibin) in Edwards. Sorry!
Eighteen (trisomy) Digit overlapping flexion Wide head Absent
intellect (mentally retarded) Rocker-bottom feet Diseased heart
Small lower jaw
Kinesin moves anterograde to microtubule, or towards the cell
surface. Mnemonic: "Kinesin to the Korners"
Williams syndrome- Robin WILLIAMS was a "COMIC" "C"ommunicative "O"-pen (friendly) "M"-icrodeleton of long arm of
chromosome 7 "I"-ntellectual disabilty "C"-ardiovascular problems
Due to aberrant development of 3rd and 4th "branchial pouches",
should be 3rd and 4th "pharyngeal pouches."
Easy to remember these in terms of 3's. 1-2-3, 5-6-7, 9 and 12.
Then to remember the vitamins in order "The Really Naughty
Puppy Punched Big Fat Cats
The existing mnemonic for vitamin A is "Retinol is vitamin A, so
think retin-A (used topically for wrinkles and Acne)." An improved
mnemonic is "Retinol is vitamin A, so think retin-A (used topically
for Aging and Acne)."
To reflect current WHO classification and to maintain consistency
with Heme/onc section on leukemias, "AML subtype M3" should
be replaced with "APL" ( "formerly AML-M3").
Remember symptoms of Vitamin B5 deficiency: DEAL
(Dermatitis, Enteritis, Adrenal insufficiency, aLopecia)
phototherapy for neonatal janudice causes B2 deficiency.
Phototherapy deactivates B2..
to current
text
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Clarification
to current
text
Mnemonic
Mnemonic
Spelling/for
matting
Mnemonic
High-yield
addition to
next year
Vitamin B3 (Niacin) synthesis requires vitamins B2 and B6. 6 / 2 =

3
The existing mnemonic for Vitamin B7 (biotin) is "Avidin in egg
whites avidly binds biotin," with the "avid"s bolded in red lettering.
I recommend that you also bold the "bi" in "binds" and "biotin," to
help students remember that association. Remembering that
"avidin in egg whites avidly binds...somethingorother" is less
useful.
To remember that phenytoin and sulfonamides cause folate
deficiency, I think of phenytoin as spelled Fenytoin and
sulFOnamides with the FO in red (for FOlate). It's a bit of a
stretch, but I personally also remember methotrexate by
pronouncing it meFOtrexate.
Supplemental folic acid should be started prior to becoming
pregnant, instead of in early pregnancy. "Because neural tube
development/closure occurs within the first four weeks of
embryonic life (ie, by six weeks of gestation) and before many
women know they are pregnant or meet with a clinician, folic acid
supplementation should be started at least one month prior to
conception and continue throughout the first trimester."
You have to FIGHT to end a WAR. FIGHTonadione given to
reverse Warfarin
Adding an "S" to the "MEAL" mnemonic so that it is "MEALS" may
be useful to remember the skin lesions seen in Kwashiorkor. Skin
changes such as hyperpigmentation are often mentioned in
clinical vignettes
Mnemonic
For Ethanol metabolism the 2 enzymes used are: Alcohol

Dehydrogenase and Acetaldehyde (Aldehyde) Dehydrogenase.
My mnemonic to easy remember which goes 1st is C before D.
alC then alD. For pharm, you used Disulfiram for Acetaldehyde
(Aldehyde) Dehydrogenase blockade. Mnemonic is D for D =
Disulfiram blocks alDehyde dehydrogenase.
Mnemonic
Mnemonic
Mnemonic
Clarification
to current
text
Mnemonic
Mnemonic
84
Biochemistry
es-and-corrections
84
Biochemistry
N/A
85
Biochemistry
This is a popular Mnemonic
85
Biochemistry
86
Biochemistry
https://vpn.tufts.edu/+CSCO+1h7
56767633A2F2F6A6A6A2E6863
6762716E67722E70627A++/cont
ents/overview-of-hemolyticanemias-inchildren?source=machineLearnin
g&search=triosephosphate&selec
tedTitle=1%7E4&sectionRank=1&
anchor=H5# OR TRY THIS
WEBSITE
http://pubs.acs.org/doi/abs/10.102
1/bi00238a002 OR TRY THIS
WEBSITE one
http://rarediseases.org/rarediseases/triosephosphateisomerase-deficiency/ OR TRY
THIS WEBSITE
http://ghr.nlm.nih.gov/condition/tri
osephosphate-isomerasedeficiency
http://www.csun.edu/~jm77307/F
atty%20Acid%20Biosynthesis.pdf
87
Biochemistry
The Lovely Coenzymes For

Nerds. Page 87 mnemonic
87
Biochemistry
https://www.rpi.edu/dept/bcbp/mol
biochem/MBWeb/mb1/part2/kreb
s.htm
87
88
Biochemistry
A mneumonic.
Biochemistry
http://www.valuemd.com/biochem
istry.php
88
Biochemistry
NA
88
Biochemistry
https://en.wikipedia.org/wiki/Nicoti
namide_adenine_dinucleotide
88
Biochemistry
http://chemistry.elmhurst.edu/vch
embook/612citricsum.html
89
Biochemistry
https://en.wikipedia.org/wiki/Hepa
tic_stellate_cell
89
Biochemistry
Page 89 typo.
89
Biochemistry
es-and-corrections
89
Biochemistry
ed/21739343 |
http://www.ncbi.nlm.nih.gov/pmc/
articles/PMC3048933/ |
http://bja.oxfordjournals.org/conte
nt/102/4/566.long
90
Biochemistry
https://www.rpi.edu/dept/bcbp/mol
biochem/MBWeb/mb2/part1/pent
in FA2015 positive regulators of gluconeogenesis are ATP and

acetyl-CoA
A common enzyme name that could be added is "synthase/
synthetase," as in glycogen synthase and Caramel phosphate
synthetase I/II.
VOMIT pathway: Propionyl-CoA is generated from 5 different
components: V-valine;O-Odd chain carbon fatty acids;Mmethionine; I-Isoleucine; T-Theronine. I think that it would be
useful to include this mnemonic for a better understanding and
memorization of the right lower green quadrant of this figure.
"Triose phosphate isomerase" or "Triosephosphate isomerase"
should be added as the enzyme that takes DHAP to
Glyceraldehyde-3-P. It is not only a proven functional enzyme
here, but interestingly there is also a deficiency associated with it
leading to severe anemia. I am suggesting that this enzyme be
added to the pathway because currently First Aid does not
recognize the "Triose phosphate isomerase" enzyme at all. I have
inserted 4 websites for reference in the "supporting reference(s)"
spot below separated by "OR TRY THIS WEBSITE". I have
provided the uptodate.com reference first, which was logged in
through a school VPN. If you go into uptodate and search
"Triosephosphate" alone it will pull up "overview of hemolytic
anemias in children", if you click on that, and then on your
keyboard hit control+find or go to the search within this topic
"triosephosphate" it will yield 3 found results.
Minor
erratum
High-yield
addition to
next year
Mnemonic
As correctly mentioned in the text NAPDH is mainly the product of

HMP shunt. However another high-yield source for NAPH
production during lipid synthesis is the Citrate shuttle and the
Malic enzymes involved. I would recommend adding this fact
either in page 86 or 101 in the lipid metabolism section.
I think the new mnemonic TLC For Nancy is great. However I
have used another one that thought that might be also useful and
easy to remember. I use "The Lovely Co-enzymes For Nerds" !
Thiamin, Lipoid acid, Co-A, FAD, NAD.
The fifth cofactor listed for the pyruvate dehydrogenase complex
is NAD, but it should be NAD+.
High-yield
addition to
next year
ARsenic poisoning and association with gARlic odor

Can I Keep Selling Sex For Money Officer? C- Citrate; I-Isocitrate;
K-Alpha-Ketoglutarate, S-Succinyl CoA; S-Succinate; FFumarate; M-Malate; O-Oxaloacetate. This mnemmonic is easier
and more fun to remember than the actual one.
The cycle illustrated for TCA cycle indicates that the conversion
from pyruvate to acetylCoA has "- NADH." This seems confusing
since NADH is PRODUCED in this reaction. This "-" could signify
a lot of things... and appears to signify that NADH is being lost in
this reaction!
There are two places on the pyruvate metabolism picture where
the conversion of NAD+ to NADH are not showing a balanced
reaction. On the pyruvate dehydrogenase line (3) it should read
NAD+ + H+<>NADH. On the lactate dehydrogenase line (4) it
should read NADH <>NAD+ + H+.
FA 2016 mentions 10 ATP/acetyl CoA , while its 12 ATP per
acetylCoA or we can write it like 10 ATP (form 3 NADH+1
FADH2) and 2 GTP to be more precise
Vitamin A is stored in Ito Cells in the liver.
I think there is a typographical error in the figure. The substance
should read 2,4 Dinitrophenol not "2,3". The text in uncoupling
agents is correct though as 2,4 DPG.
in the diagram, it says 2,3-Dinitrophenol but that should be 2,4Dinitrophenol like in the following section. see FA2015
In the diagram of the electron transport chain, it lists '2,3Dinitrophenol' as one substance that can cause uncoupling. In the
section below it then lists '2,4-Dinitrophenol' a substance for
uncoupling the electron transport chain (used for illicit weight
loss). It seems that both should read '2,4-Dinitrophenol' as '2,3Dinitrophenol' doesn't seem to be listed in the medical literature
for achieving this effect, while '2,4-dinitrophenol' is abundant.
The diagram at the bottom of the page shows G6PD converting
glucose-6-phosphate into 6-phosphogluconate. The product
High-yield
addition to
next year
Mnemonic
Clarification
to current
text
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Spelling/for
matting
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erratum
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to current
text
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matting
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erratum
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erratum
ose.htm
91
Biochemistry
/galactosemia-clinical-featuresanddiagnosis?source=search_result&
search=galactosemia&selectedTit
le=1%7E47
92
Biochemistry
FA 2016 p. 92 (just a mnemonic)
92
Biochemistry
https://en.wikipedia.org/wiki/Esse
ntial_amino_acid
92
Biochemistry
ed/6782033
92
Biochemistry
https://en.wikipedia.org/wiki/Gluco
genic_amino_acid
92
Biochemistry
NA
92
Biochemistry
N/A
92
Biochemistry
N/A
92
Biochemistry
First Aid
93
Biochemistry
One Can Consume Amino Acids

For Abrupt Urination. mnemonic
for Urea cycle
93
Biochemistry
/urea-cycle-disorders-clinicalfeatures-and-diagnosis
93
Biochemistry
93
Biochemistry
rticle/941090-overview#a4 In
previous copies of FA it is listed
as an "required cofactor"
http://accessmedicine.mhmedical.
com/content.aspx?sectionid=732
44375&bookid=1366&Resultclick
should be 6-phosphogluconolactone (which is subsequently

converted to 6-phosphogluconate by 6phosphogluconolactonase).
Under Galactokinase deficiency it says that "Symptoms develop
when infant begins feeding (lactose present in breast milk and
routine formula)." This is actually more consistent with classic
galactosemia, which presents with vomiting, lethargy, and failure
to thrive after beginning breastfeeding. Galactokinase deficiency
more commonly presents only with cataracts without any other
symptoms. The idea is that accumulation of Galactose-1-P leads
to the symptoms that are seen in classic galactosemia, while
galactitol only results in cataracts.
I have a mnemonic to remember which tissues have an
insufficient amount of sorbitol dehydrogenase and are thus at risk
for intracellular sorbitol accumulation and osmotic damage, as
noted on p. 92 of the 2016 edition. Sorbitol LRKS (lurks) in tissues
that dont have enough of the enzyme, which are Lens, Retina,
Kidney, and Schwann cells. This mnemonic has gotten me a few
questions correct in Q banks, so I thought it might be helpful to
share.
For the essential Amino Acids, I have always used the mnemonic
which sounds like someone's full name: WHILT V. KMF which
stands for the one letter symbol for each amino acid (eg W = Trp).
The glucogenic amino acids from this list can be remembered by
Motor Ve-Hicle since cars require Gas (Glucose) to run.
Lens does contain a significant amount of sorbitol dehydrogenase
that facilitates conversion of sorbitol into fructose. The current text
implies lens is lacking in this enzyme and that it cannot
breakdown sorbitol. In reality, in healthy individuals trace amounts
of glucose is trapped in the lens by aldose reductase and
converted to sorbitol by sorbitol DH. In hyperglycemic states, the
amount of glucose simply overwhelms the capacity of lens sorbitol
dehydrogenase.
glucogenic Amino Acids includes methionine, Histidine and
Valine. So i remembered it as MET HIS VALENTINE she is so
SWEET(glucogenic), Met (methionine) His (Histidine)
Valentine(valine,) she was so SWEET (as valentine is a sweet
day) hence it can easily be remembered which amino acids are
are glucogenic.
Glucogenic amino acids : met (methionine) his (histidine)
valentine (valine) [sweet thing :glucogenic] Ketogenic amino
acids: i (isoleucine) 3 (threonine) free( phenylalanine) trips
(tryptophan)
To remember the basic amino acids, I use "His Lies Are basic" to
stand for histidine, lysine, and argentine. Also, this mnemonic
puts them in order of increasing pH. Argenine is the most basic,
and histidine has no charge (per your text).
Someone submitted a mnemonic to help remember the essential
amino acids, but it was more confusing and less commonly used
than PVT TIM HALL (Private Tim Hall, like a Private in the
military). That's the one a majority of students already know and
should probably be included in FA2017.
Glucogenic amino acids: "Val Met His Sugar" (amino acid
abbreviations, sugar = glucogenic)
Well honestly I don't like the current mnemonic for urea cycle! It's
very hard to remember and with big words! I remember the same
substances with this mnemonic: One Can Consume Amino Acid
For Abrupt Urination! In the same order as in the text: Ornithine,
Carbamoyl phosphate, Citrulline, Aspartate, Argininosuccinate,
Fumarate, Arginine, Urea. It contains Amino Acid and Urination
and makes sense to be related to Urea cycle!
To remember that: disorders of the urea cycle can result from
defects in these 6 enzymes (CPS, OTC, AS, AL, AG, NAGS):
Odysseus The Clever (OTC) and the Argonauts (argi- enzymes
AS, AL, AG) encounter OROTIC sirens (elevation of orotic acid)
between Cyprus (CPS) and their NAGging wives (NAGS) back
home (which are not orotic; i.e. dont elevate orotic acid)
N-acetylglutamate is an obligate activator of carbamoyl phosphate
synthetase I. In the text it is labeled as an allosteric activator.
The current discussion of the urea cycle/ammonia transport is
illogically presented. The transport of ammonia should come
Clarification
to current
text
Mnemonic
Mnemonic
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erratum
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erratum
Clarification
to current
=2
93
Biochemistry
No reference needed.
93
Biochemistry
FA 2016, Kaplan Biochemistry

videos and textbook, FA 2015.
ed/8663466
93
Biochemistry
articles/PMC3977640/
95
Biochemistry
FA 2016
96
Biochemistry
96
Biochemistry
uworld.com
96
Biochemistry
96
Biochemistry
/overview-ofhomocysteine?source=machineL
earning&search=homocystinuria&
selectedTitle=1%7E45&sectionRa
nk=1&anchor=H16#H16
N/A
97
Biochemistry
s/NBK22429/
99
Biochemistry
Not needed
99
Biochemistry
mnemonic
99
Biochemistry
non
99
Biochemistry
N/A
100
Biochemistry
FA2016 pg.100
before the urea cycle, as that is the source of the ammonia that
feeds into it. Also, an essential step is missing in both diagrams the conversion of glutamate to ammonia in the mitochondria by
glutamate dehydrogenase. This is an essential preparatory step
for the urea cycle, and links the two diagrams.
In the entering of hyperammonemia, forget to add neomycin to
the list. In the GI section, it is added. So please add neomycin to
the biochem section.
N-acetylglutamate is listed as an "allosteric activator". Typically
allosteric activator refers to one that enhances enzyme function
but is not required. FA2015 lists N-acetylglutamate as "required
cofactor". FA2016 page 94 lists N-acetylglutamate as a "required
cofactor" under "N-acetylglutamate deficiency". Kaplan
Biochemistry videos specifically state "required activator, not
allosteric activator". Linked PubMed abstract calls it a "required
allosteric effector". Perhaps because you've already rejected
someone else's submission, a proper compromise would be
similar to the PubMed abstract by calling it a "required allosteric
activator". This would help clarify that even if the effects are
mediated allosterically, the enzyme is required.
Benzoate and other drugs don't bind directly to NH4 to promote
excretion. The drugs bind to glycine creating a new compound,
which is then excreted. In this way, these drugs promote the
indirect elimination of nitrogen by depleting the body's stores of
glycine, diverting free nitrogen into glycine synthesis thereby
decreasing ammonia. Sodium benzoate is thought to be a
metabolically active agent in which benzoate is first conjugated by
coenzyme A to form benzoyl CoA, which then conjugates with
glycine in liver and kidney mitochondria to form hippurate
(hippuric acid, N-benzoylglycine), which, in turn, is rapidly
excreted by the kidneys via glomerular filtration and tubular
secretion. . . One mole of hippurate contains one mole of waste
nitrogen. Thus, 1 mole of nitrogen is removed per mole of
benzoate when it is conjugated with glycine (one half as much
nitrogen as is excreted in urea).
In order to remember the cofactors required for catabolism of
tyrosine and catecholamine synthesis, the mnemonic "44 sexy
Sam" may help. This can be derived from 4, 4, 6, C, SAM", so
BH4, BH4, B6, Vitamin C and SAM. Also might be easier placed
on page 94 with Amino Acid Derivatives.
I would recommend adding "ear lobe pigmentation" or "ear
cartilage discoloration" to alkaptonuria since it seems to show up
in questions as a clue.
uworld says that it's cystathionine-"beta"-synthase that converts
homocysteine to cystathionine
HOMOCystinuria Head not right (intellectually disable)
Osteoporosis, kyphosis Marfanoid habitus Ocular (lens
subluxation) CV
text
To remember that cystinuria is treated with urinary alkalization, I

remember that COLA (your acronym for this disease) is acidic, so
you counteract it with base. Makes sense because soda really is
acidic.
The image indicates that glucagon activates adenylate cyclase
through the glucagon receptor and ATP. However, glucagon
activates adenylate cyclase through the glucagon receptor by
GTP.
Under Pompe disease the word 'findings' has been shortened to
'finds.'
Very Potent acid Causes Major Hallucinations. Capitalized letters
represent the Glycogen Storage Diseases in order (V = von
gierke, P = pompe, C = cori, M = mcardle) with the H standing for
the unmentioned GSD VI (Her's disease). The lowercase "acid"
(aka LSD) reminds you which one is also a lysosomal storage
disease (LSD). Potent-Acid = Pompe-LSD.
For Pompe Disease the easier way to remember Lysosomal 1,4-glucosidase and that it affects the heart by knowing this:
Mnemonic = We have 1 Heart and it has 4 Chambers.
Dr. LUTHor Von Gierke = Lactate, Urate, Triglycerides,
Hepatomegaly (due to increased glycogen)
The letter G for Gaucher Disease can be written in bold/different
color to help remind of both the deficient enzyme
Mnemonic
Clarification
to current
text
Minor
erratum
Minor
erratum
Mnemonic
High-yield
addition to
next year
Minor
erratum
Mnemonic
Major
erratum
Spelling/for
matting
Mnemonic
Mnemonic
Mnemonic
Mnemonic
100
Biochemistry
Mnemonic-reference not needed
100
Biochemistry
100
Biochemistry
FA 2016 pg. 100
100
Biochemistry
Robbins & Cotran 9th Edition pg.

154
100
Biochemistry
n/a
101
Biochemistry
s/NBK21528/
101
Biochemistry
Kaplan Biochemistry 2016 page

242
101
Biochemistry
s/NBK26904/
101
Biochemistry
s/NBK26904/
101
Biochemistry
/energy-metabolism-in-muscle
101
Biochemistry
103
Biochemistry
http://www.biocyc.org/META/NE
WIMAGE?type=PATHWAY&object
=PWY-6285&detail-level=3
Lippincott's Illustrated Reviews
Biochemistry, 6th Ed. p.329,
"Liver In Fasting"
104
Biochemistry
N/A
104
Biochemistry
N/A
105
Biochemistry
FA 2016
106
Biochemistry
108
108
Biochemistry
n/a
Microbiology
NA
108
Microbiology
108
Microbiology
/microbiology-and-epidemiologyof-qfever?source=search_result&sear
ch=coxiella&selectedTitle=3~33
N/A
(Glucocerebrosidase) and the accumulating substance

(Glucocerebroside), which both start with the letter G as well.
Mnemonic for features of Gaucher Disease: GAUCHer=Gaucher
cells, AUsteoporosis/bone crises, Cytopenia (pancytopenia), and
Hepatosplenomegaly
Mnemonic for features of Gaucher Disease: GAUCHer=Gaucher
cells, AUsteoporosis/bone crises, Cytopenia (pancytopenia), and
Hepatosplenomegaly
To remember that Fabry disease and Hunter syndrome are Xlinked recessive, you can use the phrase "Fabulous Hunters are
XLR".
Hurler Syndrome: Deficient Enzyme: Alpha-L-Iduronidase.
Robbins & Cotran mentions MPS I is characterized by Alpha-1iduronidase deficiency on page 154 of the 9th edition.
to help remember what Gaucher disease affects- " GOUCHer- if
you get an "ouch", you sub out and sit on the side
(GlucocerebroSIDE) OR " if all your players keep getting an
"ouch" (gOUCHer), you will accumulate players on the SIDE
(glucocerebroSIDE)
Rhyme mnemonic for the order of the Electron Transport Chain.
"1, 2, Coenzyme Q. After 3, Cytochrome C"
In the degradation of FA, it is a bit confusing because FA CoA
synthase is listed, but FA CoA synthethase is left out in the next
step.
These substances RACC (wreck) the Electron transport Chain:
Complex I-Rotonone Complex III-Antimycin A Complex IVCyanide , CO
Previously submitted a mnemonic. here is an alteration on the
one I submitted to see if this one is preferred.these substance.
The capital letters are part of the mnemonic. RACC Oxidative
phosphorylation: complex I-Rotonone complex III-Antimycin A
complex IV-Cyanide , CO complex IV-Oligomycin
The diagram for fatty acid degradation shows that the first step in
activating the fatty acid involves the enzyme fatty acid synthase.
However, up-to-date refers to this enzyme as acyl-CoA
synthetASE. Taken from the section beta-oxidation of long chain
fatty acids: "In the muscle cytoplasm, long-chain fatty acids are
first activated by long-chain acyl-CoA synthetase to their CoA
thioesters." .
Does fatty acid synthesis begin with citrate or Acetyl CoA?
In starvation days 1-3, hepatic glycogenolysis is not a significant

contributor to blood glucose levels, as it is nearly exhausted after
18 hours of fasting.
To remember that apolipoprotein A-I Activates LCAT, you could
bold the 'A' in 'A-I' and 'Activates'. That helps me remember it.
To remember that apolipoprotein C-II is a cofactor for Lipoprotein
Lipase, I underlined the 'II' in 'C-II' since it looks like 2 'L's. 2 L's
for "Lipoprotein Lipase"
To remember that LDL transports cholesterol from the liver to
peripheral tissues, one can use the mnemonic Leaving Da Liver.
Similarly, for HDL taking cholesterol from the periphery to the
liver, the mnemonic is Headed to Da Liver.
Melanin should not be marked as a derivative of DOPA. There are
conflicting sources that indicate that melanin is derived from
tyrosine by the work of tyrosinase. This would also have to be
corrected in the biochemical pathway diagram on pg 107 in FA
2015 under the section "Catcholamine synthesis/catabolism
Please see attached document
Under Spore, I think there is ";" instead of "," in the paragraphe
"Keratin-like coat; dipicolinic acid; peptidoglycan, DNA."
Text states that only Gram + organisms have spores, but one
notable exception to this rule is Coxiella burnetii, which is
considered Gram-negative.
There's a typo in the section about the Outer Membrane: The text
erroneously has two spaces between the words "component" and
"antigenic" in the line that reads "O polysaccharide component
antigenic." I wonder if it was meant to say "O polysaccharide
component is antigenic."
Mnemonic
Mnemonic
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erratum
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to current
text
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erratum
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erratum
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erratum
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erratum
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to current
text
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erratum
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to current
text
109
Microbiology
/mycoplasma-pneumoniaeinfection-inadults?source=search_result&sea
rch=mycoplasma&selectedTitle=1
~110#H325624843 and
/mycoplasma-hominis-andureaplasma-urealyticuminfections?source=preview&langu
age=enUS&anchor=H35510070&selecte
dTitle=1~31#H35510070
https://en.wikipedia.org/wiki/Fuso
bacterium
109
Microbiology
110
Microbiology
N/A
110
Microbiology
www.uptodate.com/contents/appr
oach-to-gram-stain-and-cultureresults-in-the-microbiologylaboratory
110
Microbiology
N/A
111
Microbiology
Medical Microbiology (Jawetz),

27th edition, Chapter 11
111
Microbiology
personal mnemonic
111
Microbiology
N/A
112
Microbiology
112
Microbiology
/bacterial-adherence-and-othervirulence-factors-for-urinary-tractinfection?source=search_result&s
earch=proteus+mirabilis&selected
Title=1~59
/pasteurella-infections
113
Microbiology
Personal mnemonic
115
Microbiology
https://en.m.wikipedia.org/wiki/Tu
mor_necrosis_factor_alpha
117
Microbiology

117
Microbiology
ed/9216123
Mycoplasma and ureaplasma are listed in the Gram Positive

column of this table, but they belong in the Gram Negative
column.
Major
erratum
In gram negative table, I think you should add "Fusobacterium" as

it similar to Bacteroides. which is mentioned in Pages 111, 162
and 624. and you can add it also to anaerobes that treated by
Metronidazole (Page 178) and Clindamycin (Page 175).
The existing mnemonic for gram negative bacteria is "These
Microbes May Lack Real Color," but it can be expanded to "These
Little Microbes May Unfortunately Lack Real Color, But Are
Everywhere," for Treponema, Leptospira, Mycobacteria,
Mycoplasma, Ureaplasma, Legionella, Rickettsia, Chlamydia,
Bartonella, Anaplasma, and Ehrlichia (i.e. the new mnemonic
would include all of the examples given in this section of the text).
MacConkey agar is an excellent medium to select for gram
negative bacteria and inhibit gram positive growth. It also has a
second use for distinguishing lactose fermenters from non lactose
fermenting enterics. The text should add this high yield fact and
make it clearer also under selective media and indicator
(differential) media. From uptodate: "MacConkey agar is a
selective medium designed to detect gram-negative bacteria. Bile
salts in MacConkey agar inhibit growth of gram-positive bacteria.
Lactose-fermenting organisms produce pink colonies when grown
on this media; nonlactose-fermenting organisms produce
colorless colonies (picture 36). Lactose-fermenting organisms
include E. coli, Enterobacter, and Klebsiella. Nonlactosefermenting organisms include Pseudomonas, Proteus,
Salmonella, Shigella, and Citrobacter."
"PASs the sugar and whipped cream" to remember PAS is used
to diagnose Whipple disease in addition to its function of staining
glycogen.
I suggest also adding Bacillus to Aerobe section. It's a high-yield
characteristic of Bacillus and also a distinguishing factor between
Bacillus and Clostridium (both spore-forming gram positive bacilli,
but the former Aerobe and the latter Anaerobe). Also it will help
your mnemonic too! The current one in "Nagging Pets Must
Breathe" and both M and B come from Mycobacterium! You can
simply add Bacillus and relate the B to it! Could it BE any better!?
Either change the existing mnemonic to "Some (fungi) are odd" Sounds like Sabouraud - easier to remember than Sab's a fun
guy. Or slightly alter it to "Saab's a fun drive."
"Someone has Eaten Mycoplasma's cell wall!" (Eaton agar for
Mycoplasma pneumoniae)
Proteus causes infectious struvite stones, because if you
rearrange the letters of Proteus, you can spell PETROUS, which
means stone.
Clarification
to current
text
Pasteurella is a catalase-positive organism as well
High-yield
addition to
next year
Mnemonic
GN bugs that use TIII secretion system: SHigella, E.coli,

(injectisome- NEEDLE like), SAlmonella,
Pseudomonas.......SHaring Every NEEDLE = not SAfe Practice.
Endotoxin induces "TNF-a, (listed as TNF)" IL-1, and IL-6. This
chart leaves off the "a." While it is not technically inaccurate, it is
inconsistent with the chart on page 117 which lists "TNF-a." I
found the inconsistent terminology between the two charts
confusing. Perhaps there could be a notation elaborating on the
multiple names for TNF-a.
I suggest adding mannitol fermentation to S.aureus
characteristics since it's the only staph fermenting mannitol and
it's a high-yield fact.
A fact that is emphasized in the banks is that Strep pyogenes
(and also enterococci) is Pyrrolidonyl Arylamidase positivePYR+. This is a reliable why to differentiate them from other
Mnemonic
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
Mnemonic
Mnemonic
Mnemonic
Minor
erratum
High-yield
addition to
next year
High-yield
addition to
next year
118
Microbiology
FA 2016
118
Microbiology
118
Microbiology
/image?imageKey=ID/57140&topi
cKey=ID%2F1280&source=outlin
e_link&search=listeria+beta+hem
olysis&selectedTitle=1~145&utdP
opup=true
N/A
119
Microbiology
First Aid 2015, First 2014, First

Aid 2013
119
Microbiology
http://link.springer.com/article/10.
3758/BF03337426
119
Microbiology
ed/874458
119
Microbiology
http://www.microbiologyinfo.com/
haemolysis-of-streptococci-andits-types-with-examples/
120
Microbiology
https://en.wikipedia.org/wiki/Virida
ns_streptococci#Identification
120
Microbiology
/pneumococcal-vaccination-inadults?source=search_result&sea
rch=strep+pneumoniae+vaccine&
selectedTitle=1~150
120
Microbiology
Mnemonic-
121
Microbiology
/microbiology-pathogenesis-andepidemiology-ofanthrax?source=search_result&s
earch=bacillus+anthracus+lethal+
toxin&selectedTitle=1%7E150
122
Microbiology
no reference needed.
123
Microbiology
ed/16582679
123
Microbiology
123
Microbiology
124
Microbiology
124
Microbiology
/epidemiology-and-pathogenesisof-listeria-monocytogenesinfection?source=search_result&s
earch=Listeria+at+4+degrees&sel
ectedTitle=3~150
ed/17115379 Robbins
Pathological Basis of Disease,
9e, pp. 98
http://www.archivesofpathology.or
g/doi/10.1043/00039985(2001)125%3C1261:AFSCO
M%3E2.0.CO;2?url_ver=Z39.882003&rfr_id=ori%3Arid%3Acrossr
ef.org&rfr_dat=cr_pub%3Dpubme
d&
124
Microbiology
ed/17115379
streps.
Bacitracin sensitivity is tested in organisms that show Betahemolysis. The two are linked by B. Growth in NaCl is tested for
organisms that show Gamma-hemolysis. The two are linked by
G. Helpful for remembering some of the tests for classification.
Listeria has weak beta-hemolytic activity on sheep blood agar
plate
The algorithm seems to state that all alpha-hemolytic streptococci

are optochin sensitive and bile soluble. Instead, to maintain
consistency with the other branch points in the algorithm, the text
should read, "Optochin sensitivity and bile solubility" instead of
"Optochin sensitive and bile soluble."
In the section of Beta-hemolytic bacteria, listeria monocytogenes
is no longer listed as in previous versions. Is this a mistake or an
actual update?
You should write the name of each bacterium in purple font (if it's
Gram +) or pink font (if it's Gram -). Simple visual cues like this
lead to higher retention. The current standard color font does not
help for these bugs.
You should add that S. epidermidis does not ferment mannitol,
since this is a great laboratory method of differentiating it from S.
aureus.
The green color associated with alpha hemolysis is caused by the
oxidation of hemoglobin to methemoglobin; it is valuable to clarify
the phrase "partial reduction of hemoglobin" to avoid confusion.
Viridan streptococci is bile insoluble
You need to discuss the 2 pneumococcal vaccines. Adults get the
23-valent polysaccharide vaccine which makes IgM, giving
shorter immunity (that fact not included anywhere in FA2016).
Kids get the 13-valent vaccine conjugated to a protein so they
make IgG for longer lasting immunity (that fact also missing from
FA2016).
Use mnemonic MOPS to remember the four common diseases
caused by Strep Pneumo: M eningitis O titis Media P neumonia,S
inusitis
There is no mention of Bacillus anthracis's Lethal Toxin (LT). This
is extremely important, as it is what causes the necrosis that
creates the characteristic black eschar of anthrax. It's odd that this
was omitted, as you guys included the lower-yield Edema Factor
(EF) toxin. Please add LF.
"Toxin A, enterotoxin, binds to the brush border of the gut. Toxin
B, cytotoxin, causes cytoskeletal disruption via actin
depolymerization diarrhea pseudomembranous colitis B" Both A
and B can contribute to diarrhea. Maybe make it more clear. The
current text confuse me for a while since diarrhea is after toxin B.
In the column under Nocardia this line "Causes pulmonary
infections in immunocompromised (can mimic TB but with
PPD); cutaneous infections after trauma in immunocompetent"
should be clarified more by putting "Patients" or "Hosts" after
immunocompromised and immunocompetent word.
Brain abscess associated with nocardiosis.
Growth of Listeria monocytogenes can occur at temperature as

low as 4 degrees celsius
Mnemonic
Major
erratum
Clarification
to current
text
Clarification
to current
text
Spelling/for
matting
High-yield
addition to
next year
Clarification
to current
text
Major
erratum
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
next year
"Langerhans" giant cells is spelled incorrectly; the correct spelling

is "Langhans"
Spelling/for
matting
Mycobacteria Tuberculosis cord factor, in addition to it's

macrophage inhibitory properties, is also responsible for TB
"serpentine" growth, which is specific for the tuberculosis species
and is also a virulence factor. The unique serpentine growth
should be emphasized as a differentiating factor between
mycobacteria species.
Caption above picture erroneously spells Langhans giant cell as
"Langerhans giant cells".
High-yield
addition to
next year
Spelling/for
matting
124
Microbiology
N/A
124
Microbiology
124
Microbiology
/natural-history-microbiology-andpathogenesis-oftuberculosis?source=search_resu
lt&search=mycobacteria+tubercul
osis&selectedTitle=1%7E150
124
Microbiology
Copyright (c) UWorld, Please do

not save, print, cut, copy or paste
anything while a test is active.
124
Microbiology
125
Microbiology
None, this is a consistency and

formatting submission.
125
Microbiology
N/A, formatting
125
Microbiology
UpToDate (under multiple

sections, specifically "approach to
gram staining");
Sketchymedical.com
125
Microbiology
126
Microbiology
/clinical-manifestations-diagnosisand-treatment-of-plague-yersiniapestisinfection?source=preview&search
=yersinia+pestis&language=enUS&anchor=H8&selectedTitle=1~
83#H1
126
Microbiology
N/A
126
126
126
Microbiology
Personal mnemonic
Microbiology
FA 2016 P. 126
Microbiology
/microbiology-and-pathobiology-
King Baldwin IV (the lepromatous form is a Type IV

hypersensitivity reaction) had leprosy, and covered his head in
cloth (clofazimine is added to the lepromatous form, which he
had).
Langerhans giant cells should be Langhans. U-world specifically
states not to misinterpret Langhans as Langerhans
There is a ton of high-yield info missing from mycobacteria.
Diagnostic info - its an obligate aerobe and facultative
intracellular within macrophages, which are important descriptors
that would be given in a question stem. Clinical info is also
severely lacking. Primary TB causes middle or lower lobe
caseating granulomas with hilar lymphadenopathy, called a Gohn
complex. Secondary TB takes 3 forms. First and most commonly,
it may go latent. Second, it can go systemically and cause multiorgan failure (miliary TB). Third, and rarely, it can reactivate if pt
becomes immunosuppressed. This reactivation TB affects the
upper lobes, which is key in differentiating it from primary TB.
Reactivation can lead to CNS granulomas or Pott disease
(vertebral granulomas).
Under the text for primary and secondary tuberculosis, Langhans
cells are referred to as "Langerhans cells". LangERhans cells are
dermal dendritic cells that contain Birbeck granules. Langhan
cells are the horeshoe-shaped multinucleated giant cells present
in granulomas, such as those seen in tuberculosis.
On the right, the text refers to "Langerhans giant cells" as
characteristic of secondary TB, but they are actually called
LANGHANS giant cells, not Langerhans. Langerhans cells are
mononuclear epidermal dendritic cells. In the Medscape link,
under "TB Lesions," you will see them correctly referred to as
Langhans giant cells. Also, though not authoritative, Wikipedia
notes Langhans/Langerhans cells shouldn't be confused with
each other on their respective pages.
The Gram-negative algorithm should have "Shape" listed right
under the "Gram (-) (pink) title" before it subdivides into the 4
major shapes like the Gram-positive algorithm has. The Grampositive algorithm already does this, but not the Gram-negative
algorithm. This is for consistency.
In the gram-positive lab algorithm, you have each positive result
(ex: catalase positive) going to the right and each negative result
(ex: catalase negative) going to the left. This is logical. For the
gram-negative lab algorithm, however, it appears totally random,
which is extremely confusing hard to remember. For example, you
have maltose positive branching to the left, and lactose positive
branching to the left, but then oxidase positive branching to the
right. Please choose one convention and stick with it for both
diagrams. I think positive results should go to the right and
negative results to the left. That will make it much easier to
remember.
In the Gram-negative lab algorithm you have Camylobacter jejuni,
Vibrio cholera, and Helicobacter pylori all grouped under
Comma-shaped rods. The term Comma-shape is high yield
specifically for Vibrio cholerae and not the other two. Instead, they
should all be listed under Curved-shaped rods with a denotation
for Vibrio cholerae being the only one of the 3 that is specifically
comma shaped.
Yersinia is classified as coccobacillus, not bacillus. It should be
moved in the diagram.
Mnemonic
I think it worth mentioning the term "satellite phenomenon" in

parentheses in clarification of growth of H.influenza in the
presence of S.aureus (lines 10-11 in fact H.influenza)
In the chart of Gonococci vs Meningococci, the 5th fact under the
Meningococci column states "Waterhouse-Friderichsen Syndrome
(adrenal insufficiency, fever, DIC, shock) syndrome" The word
"syndrome" has been listed twice, before and after the
parenthesis. One of them should be removed.
A Nickel (NAD) is worth 5 (V) cents
highlight tin in hemaTIN to associate it with factor X
It is important to add that Neisseria is Oxidase positive. This is
Clarification
to current
text
Spelling/for
matting
Spelling/for
matting
High-yield
addition to
next year
Minor
erratum
Minor
erratum
Clarification
to current
text
Clarification
to current
text
Minor
erratum
Minor
erratum
Mnemonic
Mnemonic
High-yield
of-neisseriameningitidis?source=search_resu
lt&search=neisseria+oxidase&sel
ectedTitle=1%7E150
/microbiology-and-pathobiologyof-neisseriameningitidis?source=search_resu
ectedTitle=1%7E150
ectedTitle=1%7E150
126
Microbiology
126
Microbiology
126
Microbiology
ectedTitle=1%7E150
126
Microbiology
/chlamydia-trachomatisinfections-in-thenewborn?source=search_result&
search=neonatal+conjunctivitis&s
electedTitle=1%7E6
127
Microbiology

127
Microbiology
rticle/363083-overview , Uworld
Qbank id: 8257 (546041)
128
128
128
Microbiology
First Aid 2016 p. 128
Microbiology
Microbiology
128
Microbiology
/microbiology-pathogenesisepidemiology-and-prevention-ofenterohemorrhagic-escherichiacoliehec?source=search_result&sear
ch=e+coli+catalase&selectedTitle
=1%7E150
/pathogenic-escherichiacoli?source=search_result&searc
h=ETEC&selectedTitle=1%7E31
129
Microbiology
rticle/785774-clinical
129
Microbiology
129
Microbiology
129
Microbiology
/infections-due-to-serratiaspecies?source=search_result&s
earch=serratia+motile&selectedTi
tle=1%7E101
/pathogenesis-of-salmonellagastroenteritis?source=search_re
sult&search=salmonella+macroph
age&selectedTitle=1%7E150
/shigella-infection-clinicalmanifestations-anddiagnosis?source=search_result&
search=shigella+dysenteriae&sel
ectedTitle=2%7E17
129
Microbiology
/epidemiology-ofyersiniosis?source=search_result
&search=yersinia+cold&selected
Title=4%7E150
easy to forget, since gram negative oxidase positive organisms

are classically Pseudomonas, Campylobacter, Vibrio, and H.
pylori. This makes for a very testable fact
N. meningitidis produces and IgA protease. This is an important
virulence factor, as it allows the bug to more easily invade
mucosal linings (like the vaginal wall).
addition to
next year
N. meningitidis has lipooligosaccharide (LOS). This is extremely

high-yield, as it is analogous to the more well-known LPS on
enteric gram negative bacteria and causes much of the pathology
associated with this disease. From UpToDate: "The symptoms of
meningococcal sepsis are typically caused by LOS acting as an
endotoxin"
There was an error in my last submission about N. meningitides
producing an IgA protease. It should read: Neisseria (both
gonorrhea and meningitidis) produces an IgA protease. This is an
important virulence factor, as it allows the bug to more easily
invade mucosal linings (like the vaginal wall and nasopharyngeal
mucosa, respectively).
You should add that the neonatal conjunctivitis caused by
Neisseria gonorrhea presents within the first week of life. This is
extremely high-yield, because it is one of the main ways to
differentiate this from neonatal conjunctivitis caused by
chlamydia, which presents at 1-2 weeks postnatally.
Among virulence factors of B.pertussis, three might be most
important: Pertussis toxin (classic AB toxin, inhibits Gi, increase
cAMP), Adenylate cyclase toxin (increase cAMP by mechanism
similar to Edema Factor of Bacillus anthraces) and tracheal
cytotoxin. Additionally it is important to note that pertussis toxin
mediates the lymphocytosis and also increased insulin secretion.
So I think it's better to correct the last line and relate the
lymphocytosis to pertussis toxin rather than just "immune
response".
under Legionnaires pneumonia must change unilateral to bilateral
lobe Since both lobes are commonly effected. As mentioned in
Uworld
For EIEC, highlight in red the "I" in "intestinal" mucosa
For EPEC, highlight in red the "P" in "prevents" absorption
E coli is catalase positive. This is important, as catalase is usually
associated with Staphylococcus. This is a good opportunity for
exam writers to trip up students, so it should be included in
FA2017.
High-yield
addition to
next year
The high-yield toxins of ETEC should be elaborated on, since the

boards love drawing connections between bugs (multilevel
questions). The heat-labile toxin is of the same family as the
cholera toxin and increases cAMP. The heat-stable toxin
increases cGMP.
A unique characteristic of the diarrhea in Salmonella typhi
infection is described as "pea soup" diarrhea
High-yield
addition to
next year
Salmonella is the #1 cause of osteomyelitis in sickle cell disease

patients. This is a quick but high-yield fact to add in. From
UpToDate: "Osteomyelitis in the United States in Europe is
usually due to Salmonella or other gram-negative organisms"
Both salmonella types (typhi and non-typhi) are facultative
intracellular within macrophages. This is high-yield and should be
added tot eh table for next year.
It is high-yield to know that Shigella dysenteriae can lead to
Hemolytic-Uremic Syndrome. Since HUS is usually associated
with E. Coli, this rare exception makes for a great board question.
From UpToDate: "Ninety percent of cases of HUS in children
follow a diarrheal prodrome; it is most often due to infection with
enterohemorrhagic Escherichia coli (particularly type O157:H7),
but may also be induced by infection with S. dysenteriae"
It is important to know that Yersinia enterocolitica is resistant to
cold, like listeria. This is clinically significant because the bug can
multiply in refrigerated RBC's. From UpToDate: "Yersinia
organisms are ferrophilic and capable of multiplying at cold
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
Mnemonic
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
130
Microbiology
FA. 2016 p. 130
130
Microbiology
rticle/1146903-differential
130
Microbiology
/bacteriology-and-epidemiologyof-helicobacter-pyloriinfection?source=search_result&s
earch=h+pylori&selectedTitle=3%
7E150
130
Microbiology
FA 2016
130
Microbiology
https://en.wikipedia.org/wiki/Lepto
spira_interrogans
132
Microbiology
N/A
132
Microbiology
132
Microbiology
132
Microbiology
/epidemiology-microbiology-andpathogenesis-oftularemia?source=search_result&
search=francisella+tularensis&sel
ectedTitle=2%7E60
/clinical-manifestations-diagnosisand-treatment-oftularemia?source=search_result&
search=francisella+tularensis&sel
ectedTitle=1%7E60
/pasteurellainfections?source=search_result&
search=pasteurella+encapsulated
&selectedTitle=1%7E150
132
Microbiology
FA 2016
133
Microbiology
Refer epidemiology section :

/epidemiology-microbiology-anddiagnosis-of-culture-negativeendocarditis?source=outline_link
&view=text&anchor=H4#H4
133
Microbiology

133
Microbiology
/clinical-manifestations-anddiagnosis-of-rocky-mountainspottedfever?source=search_result&sear
ch=rickettsia&selectedTitle=2%7
E61
134
Microbiology
http://www.medicinenet.com/chla
mydia_in_women_overview/page
3.htm
134
Microbiology
135
Microbiology
/treatment-of-chlamydiatrachomatisinfection?source=search_result&s
earch=chlamydia+treatment&sele
ctedTitle=1%7E150
https://en.wikipedia.org/wiki/Urea
se
135
Microbiology
Personal mnemonic
temperatures prior to transfusion"

Bold type Stage 1, Stage 2, Stage 3
Add 'bilateral bell's palsy' to indicate that lyme presents with
bilateral paralysis of the facial nerve. It is a very rare presentation
of Bell's palsy.
H pylori is motile, which is important as this fact is often
mentioned in question stems and can differentiate it from other
organisms. From UpToDate: "The organism's urease, motility,
and ability to adhere to gastric epithelium are factors that allow it
to survive and proliferate in the gastric milieu"
Leptospirosis is caused by water contaminated with animal urine.
LEPtosPirosis caused by LEoPard Pee.
Leptospira interrogans We need to interrogate who peed in the
pool
A mnemonic to remember that fleas transmit Rickettsia typhi is to
think of it as "Rickettsia ty*phlea*".
Francisella tularensis - It is high yield to know that it causes
caseating granulomas within lymph nodes. I've gotten a question
about that before.
Spelling/for
matting
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
Mnemonic
Mnemonic
High-yield
addition to
next year
Francisella tularensis - Treatment is classically streptomycin
High-yield
addition to
next year
Pasturella multocida - Lots of high-yield facts missing here. It's

encapsulated, which is important since asplenic patients are at
higher risk. It's oxidase and catalase positive, exhibits bipolar
staining, and grows on sheep's blood agar. These are important
key words that can be mentioned in a question stem. Treatment is
usually with penicillin. Please add in all these high-yield facts.
For Chlamydophila psittaci, highlight the p in psittaci,
psittacosis, and parrots to help association between the three.
The most common cause of culture negative endocarditis may not
be Q fever. The local prevalence of the pathogen varies
geographically. The study that claims c. Burnetii as the most
common cause, was done in southern France, where the
incidence of Q fever is very high.
Both in pages 132 and 133 amniotic fluid is mentioned as the
source of Coxiella infection. However, in addition to amniotic fluid,
other tissues might be infected and handling of those tissues
might lead to infection in those handling infected animal tissues
(so a male animal can also be infected and infective!). Also sheep
feces and urine is an important source of soil contamination in the
US. So I would recommend changing the transmission to
contaminated tissues (e.g amniotic fluid) or feces. Also I don't
know why Coxiella is omitted from spore-forming organisms in
page 114 while in page 133 spores are mentioned (and it's true
that at least endospore-like structures are involved in infectivity of
Coxiella)
There are quite a few high-yield facts missing about the rickettsia
genus: The rash is due to vasculitis. The Weil-Felix Agglutination
Test can be used for diagnosis. It's obligate intracellular since it
needs host CoA and NAD+. It's technically gram negative,
although it takes up gram stain quite poorly. It's coccobacillary in
shape. These are all important facts that can be given in a
question stem.
Add NAAT (Nucleic Acid Amplification Tests) as one of the
methods of diagnosis
High-yield
addition to
next year
The treatment of Chlamydia should include ceftriaxone, since coinfection with Gonorrhea is so prevalent. You guys included
treatment for chlamydia under the Neisseria gonorrhea section,
but not vice versa
Urease Positive CHUNKS (P=Proteus, C=Cryptococcus,
H=H.Pylori,U=Ureaplasma,
N=Nocardia,K=Klebsiella,S=S.Epidermidis,S=S.Saprophyticus
The dimorphic fungi are often described by their size relative to an
RBC. The size of Histoplasma can be remembered by creative
capitalization "HistoplaSMa are SMaller than an RBC." The size
Mnemonic
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
Mnemonic
135
Microbiology
135
Microbiology
http://1.bp.blogspot.com/-SpZ1_LW1y0/U2586ok7gI/AAAAAAAAKlQ/lTRirAV
AcWc/s1600/Maps_of_Fungi_Infe
ctions.jpg
135
Microbiology
N/A
135
Microbiology
135
Microbiology
135
Microbiology
/diagnosis-and-treatment-ofpulmonaryhistoplasmosis?source=search_r
esult&search=histoplasmosis&sel
ectedTitle=1%7E150
/pathogenesis-and-clinicalmanifestations-of-disseminatedhistoplasmosis?source=search_r
esult&search=histoplasmosis&sel
ectedTitle=4%7E150
/clinical-manifestations-anddiagnosis-ofblastomycosis?source=search_re
sult&search=blastomycosis&selec
tedTitle=1%7E78
135
Microbiology
135
Microbiology
136
Microbiology
emedicine.medscape.com/article/
1091575-overview
136
Microbiology
/tinea-versicolor-pityriasisversicolor?source=search_result&
search=tine+versicolor+stratum+c
orneum&selectedTitle=1%7E150
136
Microbiology
136
Microbiology
137
Microbiology
/dermatophyte-tineainfections?source=search_result&
search=dermatophytes&selected
Title=1%7E25
/dermatophyte-tineainfections?source=search_result&
search=dermatophytes&selected
Title=1%7E25
rticle/215354-treatment
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http://www.medscape.com/viewar
ticle/827307_5,
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n/a
/clinical-manifestations-anddiagnosis-of-chronicparacoccidioidomycosis?source=
search_result&search=paracoccid
ioidomycosis&selectedTitle=2%7
E21 and
/clinical-manifestations-anddiagnosis-of-acute-subacuteparacoccidioidomycosis?source=
search_result&search=paracoccid
ioidomycosis&selectedTitle=1%7
E21
FA 2016
of Blastomyces can be remebered with the following alliterative

slang "Blastomyces are 'bout [about] the same size as an RBC"
Blastomycosis is endemic to the central and southeastern United
States, as well as central america.
It would be great if you added a simple map showing the
geographic distributions of the various systemic mycoses, since
question stems almost always include geography in these cases.
A map would really help us visual learners. Here's an example of
what I mean: http://1.bp.blogspot.com/-SpZ1-_LW1y0/U2586ok7gI/AAAAAAAAKlQ/lTRirAVAcWc/s1600/Maps_of_Fungi_Inf
ections.jpg
For blastomycosis, your mnemonic of Blasto Buds Broadly should
be expanded to "Blasto Buds Broadly, goes to Bones." That helps
us remember that it causes osteomyelitis when it disseminates to
bone.
For histoplasmosis, it is important to know that diagnosis is done
either by visualizing the infected macrophages or, more
commonly, via serum and urine testing. From UpToDate: "The
highest sensitivity is obtained by testing both urine and serum."
Minor
erratum
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An important manifestation of systemic dissemination of

histoplasmosis is hepatosplenomegaly. This makes sense, since
histo infects macrophages, which are found in high concentration
in the spleen and liver.
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Diagnosis of blastomycosis can be done either by visualization

(included in FA2016) or by antigen detection in urine. This is
important to include, as it is easier and faster than culturing the
fungus. From UpToDate: "The sensitivity of this assay is 89
percent in disseminated blastomycosis and 93 percent overall.
Sensitivity is higher in urine than in serum."
For paracoccidioidomycosis, the 2 most important clinical
symptoms are muco-cutaneous ulcers (usually in the mouth) and
lymphadenopathy (as it invades the reticuloendothelial system).
High-yield
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To remember the two forms of dimorphic fungi, you could add

Yeast in the beast, mold in the cold.
Tinea versicolor can produce hypopigmented or hyperpigmented
macules and patches. The text only makes reference to
hypopigmented or pink patches.
For tine versicolor, you mention that the pathology is due to
degradation of lipids. It is important to add that this happens in the
stratum corneum. This is important as it accounts for the lack of
itching since the stratum corneum is denervated (vs other
cutaneous mycoses, which are itchy).
All the dermatophyte diseases involve pruritus (vs tinea
versicolor, which does not itch). I'm shocked this isn't already
FA2016, as the intense itching is one of the biggest reasons
people with this infection seek treatment.
Treatment for dermatophytes is oddly missing from this section.
Initial treatment is with topical azoles. Severe infections or
onychomycosis are treated with systemic terbinifine.
Mnemonic
I recommend adding the treatment of cryptococcosis as a highyield fact and also to be consistent with other entities. It seems to
be the only one that lack a line about treatment. Treatment is with
Amphotericin B +/- Flucytosine followed by fluconazole (CNS
penetration) for at least 8-10 weeks.
The First Aid text indicates that latex agglutination is more specific
than india ink in diagnosis of Cryptoccus neoformans. While latex
agglutination may be more specific than india ink (this is
consistent with many but not all studies), the value of latex
agglutination in diagnosis is also due to it significantly greater
sensitivity.
I would strongly suggest changing the picture depicting Mucor
and Rhizo histology on page 137 Figure H. Since the current
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personal mnemonic
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/clinical-manifestations-oforopharyngeal-and-esophagealcandidiasis?source=search_result
&search=thrush&selectedTitle=2
%7E150
/candidavulvovaginitis?source=search_res
ult&search=candida+vulvovaginiti
s&selectedTitle=1%7E150
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FA2016, page 112
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/epidemiology-and-clinicalmanifestations-of-invasiveaspergillosis?source=search_res
ult&search=aspergillus&selectedT
itle=1%7E150
/epidemiology-and-clinicalmanifestations-of-invasiveaspergillosis?source=search_res
itle=1%7E150
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/the-role-of-fungi-molds-inhumandisease?source=search_result&s
earch=aspergillus+aflatoxin&sele
ctedTitle=1%7E150
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/treatment-and-prevention-ofinvasiveaspergillosis?source=search_res
itle=2%7E150
N/A
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Microbiology
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/intestinal-entamoeba-histolyticaamebiasis?source=search_result
&search=entamoeba+histolytica+i
nfection&selectedTitle=1%7E44#
H13
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/toxoplasmosis-in-hiv-infectedpatients?source=search_result&s
earch=toxoplasmosis&selectedTit
le=1%7E150
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/treatment-of-cryptococcusneoformans-meningoencephalitisand-disseminated-infection-in-hivseronegativepatients?source=search_result&s
earch=cryptococcus+neoformans
http://reference.medscape.com/m
edline/abstract/22684277
/treatment-and-prevention-ofcryptosporidiosis?source=search
_result&search=cryptosporidium&
selectedTitle=1~78#H13465782
/epidemiology-clinicalmanifestations-and-diagnosis-ofgiardiasis?source=search_result&
search=giardia&selectedTitle=2%
7E99
version does not display the Broad or wide angles thus is

misleading or confusing.
Treatment for a candida infection in A NYC Fashion week CAF
topical Azoles-for vaginal Nystatin, Capsofungin, Flucanozole-for
esophageal/oral Capsofungin, Amphotericin B, Fluconazole-for
systemic
Candida albicans - It is important to describe that the oral thrush
can be scraped off with a tongue depressor, since this is the most
common way of differentiating candida thrush from leukoplakia
(which can't be scraped off).
next year
Candida albicans - it is important to mention that the discharge of

vulvovaginitis caused by candida has a normal pH (vs the
discharge of bacterial vaginosis and trichomonas). This is
mentioned of page 164 of FA2016, but should also be mentioned
here.
Candida and aspergillus are both catalase positive, as you guys
mention on page 112 under the category "Catalase-postive
organisms." It would be great to mention this under the Candida
and Aspergillus categories, since it indicates a predisposition to
these infections in Chronic Granulomatous Disease patients.
Aspergillus fumigatus - transmission is via inhalation of conidia.
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Aspergillus fumigatus - none of the symptoms of invasive

aspergillosis are mentioned. This is a high-yield fungi, so we
should at least mention some of the important symptoms: kidney
failure, endocarditis, ring-enhancing brain lesions (causing
neurological symptoms), and paranasal sinus necrosis.
Aspergillus fumigatus - It is important to mention that the
Aflatoxins that aspergillus produces are pre-formed (i.e., it does
not make these inside of us). The most common way humans
ingest aspergillus-formed Aflatoxins is via staple crops, like
peanuts, rice, and wheat.
Aspergillus fumigatus - Nothing is mentioned about the treatment
of aspergillus, which is fairly high-yield. Mild infections are treated
with voriconazole. Severe (invasive) infections are treated with
amphotericin B.
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ASpergillus = Acute & Septate. This differentiates it from nucor

and rhizopus, which has wide-angled branching and is nonseptate (as is mentioned on p137).
Cryptococcus neoformans - Treatment of crypto is curiously
missing form this section. Initial therapy is with amphotericin B +
flucytosine, then maintenance therapy is with fluconazole.
Mnemonic
Mucormycosis gain access to the brain through the cavernous

sinuses.
Text states that to treat cryptosporidium, nitazoxanide is used in
immunocompetent host. Should say that it is used only in children
and immunocompromised with severe disease. HIV patients
should be started on HAART as first line of treatment.
The diagnosis of Giardia can be made through ELISA looking for
stool antigens. I suspect USMLE will start testing this, as many
recent studies have shown that ELISA has better sensitivity than
microscopy. Please add "ELISA for stool antigens" under
Diagnosis.
Treatment of Entamoeba histolytica should involve Paromomycin,
a luminal agent to kill cysts. From UpToDate: "nvasive colitis is
generally managed with metronidazole (alternative therapies
include tinidazole, ornidazole, and nitazoxanide), followed by a
luminal agent (such as paromomycin, diiodohydroxyquin, or
diloxanide furoate) to eliminate intraluminal cysts."
Toxoplasma gondii - You should add the word "multiple" in front of
"ring-enhancing lesions," since a solitary lesion would be highly
unlikely to be toxoplasma (more likely to be CNS lymphoma).
That is a very important way distinguishing the pathology behind
ring-enhancing brain lesions.
Toxoplasma gondii - The mnemonic you have for the treatment is
Minor
erratum
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erratum
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/toxoplasmosis-in-hiv-infectedpatients?source=search_result&s
earch=toxoplasmosis&selectedTit
le=1%7E150
FA 2016
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Mnemonic- No reference needed
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http://www.cdc.gov/parasites/trich
inellosis/biology.html
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microbiology kaplan
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/strongyloidiasis?source=search_
result&search=strongyloides&sele
ctedTitle=1%7E80
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/toxocariasis-visceral-and-ocularlarvamigrans?source=search_result&s
earch=toxacara+canis&selectedTi
tle=2%7E33
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/clinical-manifestations-anddiagnosis-ofechinococcosis?source=search_r
esult&search=echinococcus&sele
ctedTitle=1%7E24
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/intestinaltapeworms?source=search_result
&search=taenia+saginata&select
edTitle=1%7E7
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http://www.cdc.gov/parasites/clon
orchis/faqs.html
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See Page 132 FA2016 Zoonotic

bacteria (epidemic vs endemic
typhus, Louse vs Flea,
R.prowazekii vs R. typhi)
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Microbiology
way too long to be helpful. A better and shorter one I use is: I
SURe am MELlow when Im SLEEPING
To remember that P. vivax and P. ovale are the two Plasmodia
that have a dormant form in the liver, you could call out the v in
each bug and in liver. "P. ViVax and P. oVale dormant in liVer."
Enterobius vermicularis (pinworm): "Enterobius" = "Enter your
butt" (mnemonic for the anal associations of Enterobius: anal
pruritis and anus tape test diagnosis)
Trichinella spiralis is transmitted only by eating encysted larvae in
meat, NOT fecal-oral. For this reason, it is only a disease of
carnivores.
ascaris eggs description text : bile stained knobby eggs. depicted
in picture but not described in tex
A unique (and thus highly testable) feature of Strongyloides is that
its larvae are detected in feces (vs all the other intestinal
nematodes, where you find eggs in feces). From UpToDate: "The
rhabditiform larvae are generally passed in the feces."
The most important and testable symptom of Toxocara canis is
missing from FA2016, and it really should be added. It's
blindness. To show how important this symptom is, the title of the
UpToDate article on Toxocara canis is titled "Toxocariasis:
Visceral and ocular larva migrans." If that hasn't convinced you
that this fact 100% needs to be added, here's the relevant line
from the UpToDate article: "The most serious consequence of
infection is invasion of the retina with granuloma formation in the
periphery or posterior pole, leading to dragging of the retina and
eventual retinal detachment, which can lead to blindness."
I think most med students have a hard time remembering which
common worm name goes with which proper helminth name, so I
came up with this mnemonic: "RN's get FTR (pronounced
"future") CT's" RN = Round worms, Nematodes. CT = Cestodes,
Tape worms. FTR = Flukes, TRematodes.
The text states that Tania solium is transmitted by "ingestion of
eggs contaminated with human feces," but perhaps it should read
that transmission occurs by ingestion of eggs within human feces
or by ingestion of human feces contaminated with eggs. Basically,
the eggs are not contaminated by the feces, but rather the eggs
are contained within the feces, which then contaminates food/is
ingested.
The high-yield buzzword associated with the Echinococcus
hydatid cysts on CT is "egg-shell appearance." This descriptor
should be added in, since it appears in question stems. From
UpToDate: "Cysts with a calcified rim may have an "eggshell"
appearance."
The only cestode in the Taenia family FA2016 mentions is Taenia
solium. T. saginata is just as important and should also be
mentioned. The differences between the two are the animal they
infect (solium is pig, saginata is beef) and the presence of rostral
hooks on imaging (solium has them, saginata does not). From
UpToDate: "There are two main species of Taenia for which
humans are the only definitive hosts. These are Taenia saginata,
the beef tapeworm, and Taenia solium, the pork tapeworm."
It may be helpful to mention that "Clonorchis sinensis" is the
Chinese liver fluke.
In the Lice segment and disease transmitted by lice, for Rickettsia
prowazekii please add "epidemic" to typhus (should read
"epidemic typhus") to differentiate it from the Flea-born disease
from Rickettsia typhi (endemic typhus). It would be more precise
and will avoid misunderstanding this way.
I would recommend adding Paragonimus westermani (lung fluke)
as a high-yield topic either to flukes or to parasite hints.
P.westermani is unique in being a lung fluke that can cause
pulmonary nodules and hemoptysis and mimic symptoms of TB.
People can get infected by eating freshwater crab and the
treatment is Praziquantel like other flukes.
in the entry for scabies, third column, first paragraph, it says that
transmission is through fomites, but actually the main mode of
transmission is prolonged skin contact, transmission through
fomites is uncommon and mainly occurs in the crusted type of
Mnemonic
Mnemonic
Minor
erratum
Clarification
to current
text
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Clarification
to current
text
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to current
text
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to current
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erratum
http://sklice.com/head-licefacts.html?gclid=CjwKEAiAmNW2
BRDL4KqS3vmqgUESJABiiwDT
m0HGVis2_xken8XI5uyDFw0wR
xaQwtKruOGtrI6FRoCgNLw_wcB
http://www.cdc.gov/vaccines/sche
dules/hcp/child-adolescent.html
scabies.
the third paragraph lice the first line says : blood -sucking insects
that prefer to live on clothing . I do not think that is right, as they
can't survive on clothing. Lice need human blood to live.
145
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N/A
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Same information as First Aid

2016, just a new mnemonic
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FA 2016
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Myself
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148
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/clinical-manifestations-anddiagnosis-of-bk-virus-inducedpolyomavirus-inducednephropathy-in-kidneytransplantation?source=search_r
esult&search=JC+virus&selected
Title=1%7E91
N/A
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149
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articles/PMC474073/pdf/jclinpath
00380-0073.pdf
149
Microbiology
Firecracker and
149
Microbiology
Add that HSV-1 Encephalitis is usually localized to the temporal

lobe
149
Microbiology
A commonly-tested clinical manifestation of HSV-1 is Erythema

Multiforme. From UpToDate: "HSV-1 infection may be associated
with the onset of erythema multiforme"
149
Microbiology
/clinical-manifestations-anddiagnosis-of-herpes-simplexvirus-type-1infection?source=search_result&s
earch=herpes+simplex&selected
Title=1%7E150
/infectious-mononucleosis-inadults-andadolescents?source=search_resu
lt&search=infectious+mononucleo
sis&selectedTitle=1%7E150
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/molluscumcontagiosum?source=search_res
ult&search=poxvirus&selectedTitl
e=1%7E12 and
/the-epidemiology-pathogenesisand-clinical-manifestations-ofsmallpox?source=search_result&
search=guarnieri+bodies&selecte
dTitle=1%7E1
/epidemiology-pathologicfeatures-and-diagnosis-of-
Minor
erratum
( No booster needed for live attenuated vaccines ). this is not right

as all live vaccines need a second or a third dose or a booster .
"SABIN ROde IN SMALL YELLOW Volkswagen MMRs" => Sabin
(polio); ROtavirus; INfluenza; SMALLpox; YELLOW fever; Vzv
(chickenpox); Measles, Mumps, Rubella
In Phenotypic mixing, last sentence, fourth line, it's written
"However, the progeny from this infection have type A coat that is
encoded by its type A genetic material." according to the given
example of the same section, it should be type B coat that
encoded by type A genetic material
Music and LYRICSS are best enjoyed Live (Music=MMR, L=live
vaccines, Y=Yellow fever, R=rotavirus, I=intranasal influenza,
C=Chickenpox, S=Smallpox, and S=Sabin polio vaccine. The
second Live is again, for Live vaccines)
Remember that poxvirus is the exception to the "all DNA viruses
replicate in the nucleus" with the mnemonic "Think outside of the
pox!" (sounds like box, see?)
To remember that polyoma and papilloma are circular DNA, call
out the o in each of them, as that is a circle. PolyOma and
papillOma.
An alternative (arguably faster) mnemonic for remembering that
parvovirus is a ssDNA virus is: "parvovirus is So Small that it's
Single Stranded".
BK virus also causes hemorrhagic cystitis, which is high-yield
since Step 1 will use this fact to try to make you think it's
Adenovirus. From UpToDate: "BK virus primarily causes
tubulointerstitial nephritis and ureteral stenosis in renal transplant
recipients and hemorrhagic cystitis in bone marrow transplant
recipients."
Minor
erratum
Mnemonic
To remember that Adenovirus causes sore throat, I remember

"ADENOvirus infects the ADENOids."
There are quite a few high-yield facts missing from Poxvirus. It's
the only DNA virus that replicates in the cytoplasm (so it brings its
own RNA polymerase), specifically in Guarnieri bodies which can
be seen on biopsy as CYTOPLASMIC inclusion bodies. Its
envelope is often described in question stems as "box shaped"
(mnemonic: pOX in a bOX). Slightly less high-yield, but questions
stems can describe a dumbbell-shaped core.
Mnemonic
Please add hairy leukoplakia (in AIDS patients, not precancerous)

in associations of EBV. In the current text only Burkitt and
nasopharyngeal carcinoma are mentioned.
The Monospot test specifically refers to agglutination of Horse
RBCs only. The distinction is important because agglutination of
Sheep RBCs is the Paul Bunnell Test, which is replaced by the
better Monospot test (easier and faster, and more sensitive).
Esophagitis should be placed as clinical significance under
Herpes Simplex Virus-1
High-yield
addition to
next year
Minor
erratum
For Epstein-Barr virus, I have gotten many questions on the fact

that a rash develops after administration of amoxicillin (ex:
physician misdiagnoses it as strep throat). This is very high-yield
and should be included in this section. From UpToDate: "A
maculopapular rash almost always occurs following the
administration of ampicillin or amoxicillin"
For Epstein-Barr virus, you need to add the high-yield fact that
EBV leads to Hodgkin lymphoma (in addition to the Burkitt
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Mnemonic
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classical-hodgkinlymphoma?source=search_result
&search=mixed+cellularity+hodgk
in&selectedTitle=1%7E5
149
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/clinical-manifestations-andtreatment-of-epstein-barr-virusinfection?source=search_result&s
earch=epstein+barr+virus&select
edTitle=1%7E150
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/clinical-manifestations-andtreatment-of-epstein-barr-virusinfection?source=search_result&s
earch=epstein+barr+virus&select
edTitle=1%7E150
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/clinical-manifestations-ofvaricella-zoster-virus-infectionherpeszoster?source=search_result&se
arch=herpes+zoster+ophthalmicu
s&selectedTitle=1%7E16
/classic-kaposi-sarcomaepidemiology-risk-factorspathology-and-molecularpathogenesis?source=search_res
ult&search=kaposi+sarcoma&sel
ectedTitle=4%7E150
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/classic-kaposi-sarcomaepidemiology-risk-factorspathology-and-molecularpathogenesis?source=search_res
ult&search=kaposi+sarcoma&sel
ectedTitle=4%7E150
N/A
http://www.uptodate.com.ezproxy.
uthsc.edu/contents/herpessimplex-virus-type-1encephalitis?source=preview&se
arch=temporal+lobe+encephalitis
&language=enUS&anchor=H11&selectedTitle=1
~150#H8
uthsc.edu/contents/asepticmeningitis-inadults?source=machineLearning
&search=viral+meningitis&selecte
dTitle=1~150&sectionRank=1&an
chor=H3#H3
uthsc.edu/contents/herpessimplex-virus-type-1encephalitis?source=preview&se
arch=temporal+lobe+encephalitis
&language=enUS&anchor=H11&selectedTitle=1
~150#H8
uthsc.edu/contents/asepticmeningitis-inadults?source=machineLearning
&search=viral+meningitis&selecte
chor=H3#H3
N/A
https://www.google.com.sa/url?sa
=t&rct=j&q=&esrc=s&source=web
&cd=1&cad=rja&uact=8&ved=0ah
UKEwir6dDPo4fLAhXLvBoKHexz
AtcQFggbMAA&url=http%3A%2F
%2Fwww.ncbi.nlm.nih.gov%2Fpu
bmed%2F8211117&usg=AFQjCN
Fr1oimfEjKU4LnXGsMnipdl35zcg
; and
https://en.wikipedia.org/wiki/Sialic
_acid .
lymphoma that you mentioned). Specifically it's the mixed

cellularity and lymphocyte-deplete subtypes. From UpToDate:
"EBV is found infrequently in nodular sclerosis HL, whereas it is
detected in about 40 percent of lymphocyte rich HL, 70 percent of
mixed cellularity HL, and close to 100 percent of lymphocyte
depleted HL (LDHL)"
For Epstein-Barr virus, you mention that nasopharyngeal
carcinoma is a potential consequence. You should elaborate that
this is often in Asian patients. It has been in all the question stems
I've seen about it, and UpToDate confirms this: "Nasopharyngeal
carcinoma is relatively rare in most populations. However, it is
one of the most common cancers in southern China"
For Epstein-Barr virus, it should be added that EBV can cause
Oral Hairy Leukoplakia in HIV patients. This is high-yield because
examiners try to confuse you into thinking you're dealing with
candida oral thrush. The difference is that Oral Hairy Leukoplakia
is can NOT be scraped off. Also, it is importantly not
premalignant.
A quick line should be added about VZV reactivation possibly
causing Herpes Zoster Ophthalmicus. It has a unique
presentation, making it very testable. It occurs when VZV affects
the V1 branch of trigeminal nerve, leading to a rash in the
ophthalmic area with unilateral blindness.
next year
For HHV-8, the pathogenesises of Kaposi sarcoma is partially due

to dysregulated VEG-F production, leading to uncontrolled
angiogenesis. This is high-yield due to its biochem tie-in. From
UpToDate: "viral genes expressed during the lytic cycle may be
particularly important in increased expression of growth factors,
such as vascular endothelial growth factor (VEGF)"
For the purposes of Step 1, the classic patents who get Kaposi
sarcoma are eastern european men (they commonly pick
Russians) and African Americans. UpToDate supports this: " the
disease is most often diagnosed in individuals from the
Mediterranean basin and Central and Eastern Europe"
High-yield
addition to
next year
"Fever first, ROSie LAter" (Rosela -fever followed by rash

Bolding, color coding, and highlighted juxtaposition would greatly
clarify that "herpetic encephalitis or *HSV-1 ENCEPHALITIS* is
nearly *EXCLUSIVELY* due to HSV-1 and correlates with
*temporal lesions* whereas herpetic meningitis or *HSV-2
MENINGITIS* is more commonly HSV-2 than HSV-1 and does
not correlate with temporal lesions. Although covered, these
distinctions are neither well emphasized nor juxtaposed in the
current text. The lone comparison of HSV-2>HSV-1 meningitis is
confusing and overshadows HSV-1 predominance in encephalitis.
Mnemonic
Clarification
to current
text
A helpful mnemonic for herpetic neuropathology and herpetic

vesicle affinity include HSV*1Encephalitis* and HSV*2Meningitis*
[1&E before 2&M] and HSV-*1* for *one mouth* [orifice], and
HSV-*2* for *two genitals* [anal & urethral orifices] to remember
that HSV-1 is more commonly oral and HSV-2 more commonly
genital.
Mnemonic
The existing mnemonic for HSV identification is "Tzanck heavens

I do not have herpes," with Tzanck emphasized. I recommend
that this be amended so that the "he" in "heaven" and "herpes" is
also emphasized/bolded, to help the student establish the
connection between Tzanck and herpes.
Please include the following two additions along with the current
text. Influenza virus -> binds to sialic acid using hemagglutinin.
Parvovirus -> binds to blood group p antigen globoside.. It is also
worth mentioning (somewhere near the table so others dont have
to anotate it from qbanks) that duffy antigen is used by p vivax,
hiv/cmv/vaccina incorporate host CD59 (to avoid MAC attack)
and, also, cmv uses heparan sulfate to enter the cells. Its worth
mentioning that diptheria toxin resuts in the generation of
molecular mimicry against the same heparan sulfate (see ref) . it
Mnemonic
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
150
Microbiology
UKEwj34oaNpIfLAhUG0hoKHR4r
CF8QFggbMAA&url=https%3A%
2F%2Fen.wikipedia.org%2Fwiki%
2FCD59&usg=AFQjCNFZFSEvS
W0KRMdXdyHXqz0qc9Pd1g
(rearding cd59)
UKEwiK0uSYpIfLAhUD1RoKHYo
OAi8QFggrMAM&url=http%3A%2
F%2Fwww.ncbi.nlm.nih.gov%2Fb
ooks%2FNBK2271%2F&usg=AF
QjCNH2GKqPAi3gQ0QE6BP7Eh
9OCbqDJQ (duffy)
ed/7494001 (regarding point on
heparan sulfate)
FA 2016 pg 636
151
Microbiology
N/A
151
Microbiology
Mnemonic only, no references

available
151
Microbiology
http://www.cdc.gov/chikungunya/
151
Microbiology
151
Microbiology
151
Microbiology
151
Microbiology
/clinical-manifestations-anddiagnosis-of-dengue-virusinfection?source=search_result&s
earch=dengue+fever&selectedTitl
e=1%7E56
/clinical-manifestations-anddiagnosis-of-west-nile-virusinfection?source=search_result&s
earch=west+nile+virus&selectedT
itle=1%7E68
/yellowfever?source=machineLearning&
search=yellow+fever&selectedTitl
e=1%7E72&sectionRank=1&anch
or=H5#H5
Uworld Qbank id: 11377 (546041)
151
Microbiology
/clinical-manifestations-anddiagnosis-of-enterovirus-andparechovirusinfections?source=search_result&
search=cocksackie&selectedTitle
=1%7E77
151
Microbiology
152
Microbiology
http://www.merckmanuals.com/pr
ofessional/infectiousdiseases/arboviridae,arenaviridae,-andfiloviridae/overview-of-arbovirus,arenavirus,-and-filovirusinfections
http://www.cdc.gov/vaccines/hcp/
vis/vis-statements/rotavirus.html
152
Microbiology
(Knipe, David M.; Howley, Peter

M. (2007). Fields' Virology (5th
ed.). Lippincott Williams &
Wilkins. pp. 1156, 1199. ISBN
978-0-7817-6060-7.; Buckley, A.;
Gould, E. A. (1988). "Detection of
virus-specific antigen in the nuclei
or nucleoli of cells infected with
Zika or Langat virus" (PDF).
Journal of General Virology 69
(8): 191320. doi:10.1099/00221317-69-8-1913. PMID 2841406.;
Hayes, E. B. (2009). "Zika Virus
Outside Africa".Emerging
will be nice to have all this in the table. Thank you
It's worth mentioning that the "intranuclear inclusions" that may be

seen with HSV-1, HSV-2, and VZV are called Cowdry bodies.
(This does appear on page 636 in the Rapid Review.)
Mnemonic that ties together the existing information in the Delta
virus category: *D*elta virus: H*D*V is a *d*efective virus that
requires the presence of HBV to repro*d*uce.
Please consider this mnemonic, to replace PERCH for PICORNA
VIRUSES :- PEECORnA - Polio, Entrovirus, Echovirus,
COxsakie, Rhinovirus, hepatitis A
Chikungunya recently spread to the Americas and Carribean.
Given it's recent media attention, I believe that there will be
upcoming exam questions on this topic. At a minimum, it should
be listed under togaviruses on page 151.
There are zero details about Dengue fever in this book. Some
high-yield's to add for 2017 include the fact that it also called
"break-bone fever" due to the muscle/ joint pain it causes. It's a
hemorrhagic fever. Thrombocytopenia is almost always present.
Clarification
to current
text
Mnemonic
West Nile virus needs more details, especially with the amount of
press it received. High-yield facts include: it causes encephalitis
and meningitis, leading to come and/or death. It can cause flaccid
paralysis and seizures.
High-yield
addition to
next year
For yellow fever, it is high-yield to know that it causes

hemorrhage, commonly manifesting as hematemesis and bloody
diarrhea.
High-yield
addition to
next year
Chikungunya fever should be included in next years addition to

FirstAid. As it has been a major and growing problem in south
american, carribbean islands, and in the USA. for the last 3years.
The blurb on Coxsackievirus is missing some key facts. First, it
should be separated into Coxsackievirus A and B. A causes
aseptic meningitis, herpangina, hand/foot/mouth disease. B
causes myocarditis and pericarditis. It should be added to your
text that B also causes pleurodynia,an extremely painful
sensation in the lower chest that makes breathing difficult.
Hantavirus is considered a arbovirus. So please just add a "a" at
the end of it.
High-yield
addition to
next year
High-yield
addition to
next year
I suggest adding "increased risk for intussusception" as a serious

side effect of Rotavirus vaccination. In fact the vaccine is also
contraindicated in children with a history of intussusception.
Please see CDC recommendation.
In light of the Zika virus epidemic, I have pooled information about
the virus, with references. The information is as followsZika Virus
Definition Zika virus is enveloped and icosahedral with a nonsegmented, single-stranded, positive-sense RNA genome. Knipe,
David M.; Howley, Peter M. (2007). Fields' Virology (5th ed.).
Lippincott Williams & Wilkins. pp. 1156, 1199. ISBN 978-0-78176060-7. Pathogenesis The pathogenesis of the virus is
hypothesized to start with an infection of dendritic cells near the
site of inoculation, followed by a spread to lymph nodes and the
bloodstream. Knipe, David M.; Howley, Peter M. (2007). Fields'
Virology (5th ed.). Lippincott Williams & Wilkins. pp. 1156, 1199.
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Infectious Diseases 15 (9): 1347

50.doi:10.3201/eid1509.090442.
PMC 2819875.PMID 19788800. ;
Foy, B. D.; Kobylinski, K. C.; Foy,
J. L. C.; Blitvich, B. J.; Travassos
Da Rosa, A.; Haddow, A. D.;
Lanciotti, R. S.; Tesh, R. B.
(2011). "Probable NonVectorborne Transmission of Zika Virus,
Colorado, USA". Emerging
Infectious Diseases 17 (5): 880
2.doi:10.3201/eid1705.101939.
PMC 3321795.PMID 21529401.;
"Caso de aborto confirma que
zika consegue atravessar a
placenta". Bem Estar (in
Portuguese). globo.com. 20
January 2016; Vogel, Gretchen (3
December 2015). "Fast-spreading
virus may cause severe birth
defects".Science News. AAAS.
doi:10.1126/science.aad7527;
Musso, D.; Nilles, E.J.; CaoLormeau, V.-M. "Rapid spread of
emerging Zika virus in the Pacific
area".Clinical Microbiology and
Infection 20 (10): O595
O596.doi:10.1111/14690691.12707.; Beaubien, Jason
(22 January 2016). "The Zika
Virus Takes A Frightening Turn
And Raises Many Questions".
NPR.: Oliveira Melo, A. S.;
Malinger, G.; Ximenes, R.;
Szejnfeld, P. O.; Alves Sampaio,
S.; Bispo de Filippis, A. M. (1
January 2016). "Zika virus
intrauterine infection causes fetal
brain abnormality and
microcephaly: tip of the iceberg?".
Ultrasound in Obstetrics &
Gynecology 47 (1): 6
7.doi:10.1002/uog.15831. ISSN
1469-0705.;
http://portalsaude.saude.gov.br/in
dex.php/cidadao/principal/agenci
a-saude/21014-ministerio-dasaude-confi%20rma-relacaoentre-virus-zika-e-microcefalia,
Wikipedia
153
Microbiology
uptodate.com
153
Microbiology
153
Microbiology
153
Microbiology
/rubella?source=search_result&s
earch=rubella&selectedTitle=1%7
E150
/rubella?source=search_result&s
earch=rubella&selectedTitle=1%7
E150
kaplan
154
Microbiology
http://web.stanford.edu/group/par
asites/ParaSites2001/taeniasis/sa
ginata3.html
154
Microbiology
/clinical-manifestations-anddiagnosis-ofmeasles?source=search_result&s
ISBN 978-0-7817-6060-7. Flaviviruses generally replicate in the

cytoplasm, but Zika virus antigens have been found in infected
cell nuclei. Buckley, A.; Gould, E. A. (1988). "Detection of virusspecific antigen in the nuclei or nucleoli of cells infected with Zika
or Langat virus" (PDF). Journal of General Virology 69 (8): 1913
20. doi:10.1099/0022-1317-69-8-1913. PMID 2841406.
Transmission Zika virus is transmitted by daytime-active
mosquitoes. Hayes, E. B. (2009). "Zika Virus Outside
Africa".Emerging Infectious Diseases 15 (9): 1347
50.doi:10.3201/eid1509.090442. PMC 2819875.PMID 19788800.
Possible sexually transmitted. Foy, B. D.; Kobylinski, K. C.; Foy,
J. L. C.; Blitvich, B. J.; Travassos Da Rosa, A.; Haddow, A. D.;
Lanciotti, R. S.; Tesh, R. B. (2011). "Probable NonVector-borne
Transmission of Zika Virus, Colorado, USA". Emerging Infectious
Diseases 17 (5): 8802.doi:10.3201/eid1705.101939. PMC
3321795.PMID 21529401. "Caso de aborto confirma que zika
consegue atravessar a placenta". Bem Estar (in Portuguese).
globo.com. 20 January 2016. Placental transmission- Zika virus
RNA was detected in the amniotic fluid of two fetuses, indicating
that it had crossed the placenta and could cause fetal infection.
Scientists have detected genetic material of Zika virus in the
placenta of a woman who had undergone an abortion due to the
fetus' microcephaly, which confirmed that the virus is able to pass
the placenta Vogel, Gretchen (3 December 2015). "Fastspreading virus may cause severe birth defects".Science News.
AAAS. doi:10.1126/science.aad7527 Clinical Symptoms The main
clinical symptoms in patients are low-grade fever, conjunctivitis,
transient arthritis/arthalgia (mainly in the smaller joints of the
hands and feet) and maculopapular rash that often starts on the
face and then spreads throughout the body. Musso, D.; Nilles,
E.J.; Cao-Lormeau, V.-M. "Rapid spread of emerging Zika virus in
the Pacific area".Clinical Microbiology and Infection 20 (10):
O595O596.doi:10.1111/1469-0691.12707. Microcephaly Link
(High Yield) Zika virus RNA was detected in the amniotic fluid of
two fetuses, indicating that it had crossed the placenta and could
cause fetal infection. Scientists have detected genetic material of
Zika virus in the placenta of a woman who had undergone an
abortion due to the fetus' microcephaly, which confirmed that the
virus is able to pass the placenta Vogel, Gretchen (3 December
2015). "Fast-spreading virus may cause severe birth
defects".Science News. AAAS. doi:10.1126/science.aad7527
Data suggest that newborns of mothers who had a Zika virus
infection during the first trimester of pregnancy are at an
increased risk for microcephaly. Beaubien, Jason (22 January
2016). "The Zika Virus Takes A Frightening Turn And Raises
Many Questions". NPR. Oliveira Melo, A. S.; Malinger, G.;
Ximenes, R.; Szejnfeld, P. O.; Alves Sampaio, S.; Bispo de
Filippis, A. M. (1 January 2016). "Zika virus intrauterine infection
causes fetal brain abnormality and microcephaly: tip of the
iceberg?". Ultrasound in Obstetrics & Gynecology 47 (1): 6
7.doi:10.1002/uog.15831. ISSN 1469-0705.
http://portalsaude.saude.gov.br/index.php/cidadao/principal/agenc
ia-saude/21014-ministerio-da-saude-confi%20rma-relacao-entrevirus-zika-e-microcefalia
Treatment for Influenza virus: symptomatic, antivirals: oseltamivir,
zanamivir, amantadine, rimantadine. I would suggest to group
them together in the section of influeza viruses so that students
dont have to flip through the pages to look for them.
Text states that rubella causes "pink coalescing lesions" that
begin at head and move down. However, multiple sources say
that the lesions do not coalesce (vs. rubeola)
First Aid states that rubella causes a "confluent" rash when other
sources say that the lesions are discrete and do NOT coalesce
(distinguishing it from rubeola).
i think we can add bile stained knobby eggs to the text which is
depicted in the picture.
The picture for Taenia Solium does not clearly depict hooks. This
is a distinguishing difference between T. solium and T. Sagniata
(hookless)
It is high-yield to know that the measles virus contains
Hemagluttinin (HA) as a virulence factor
High-yield
addition to
next year
Major
erratum
Major
erratum
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
earch=measles+hemagluttinin&se
lectedTitle=1%7E150
/parainfluenza-viruses-inadults?source=search_result&sea
rch=parainfluenza&selectedTitle=
1%7E63
/clinical-manifestations-anddiagnosis-ofrabies?source=search_result&se
arch=rabies+virus&selectedTitle=
1%7E150
N/A
154
Microbiology
154
Microbiology
155
Microbiology
155
Microbiology
155
Microbiology
155
Microbiology
http://reference.medscape.com/ar
ticle/966678-overview#showall
156
Microbiology
156
156
Microbiology
/overview-of-cryoglobulins-andcryoglobulinemia?source=search
_result&search=cryoglobulinemia
n/a
Microbiology
N/A
156
Microbiology
/overview-of-hepatitis-b-virusinfection-in-children-andadolescents?source=search_resu
lt&search=HBV&selectedTitle=3
%7E150
156
Microbiology
157
Microbiology
/overview-of-hepatitis-b-virusinfection-in-children-andadolescents?source=search_resu
lt&search=HBV&selectedTitle=3
%7E150
First Aid USMLE Step 1 2016
Edition
157
Microbiology
n/a
157
Microbiology
/image?imageKey=GAST%2F606
27%7EGAST%2F60827&topicKe
y=PEDS%2F5943&rank=3%7E15
0&source=see_link&search=HBV
&utdPopup=true
157
Microbiology
/diagnosis-of-hepatitis-d-virusinfection?source=search_result&s
earch=HDV&selectedTitle=1%7E
35
158
Microbiology
www.firstaidteam.com
158
Microbiology
http://www.uptodate.com
/contents/screening-anddiagnostic-testing-for-hivinfection?source=search_result&s
earch=hiv+diagnosis&selectedTitl
e=2~150#H3828456
http://stacks.cdc.gov/view/cdc/23
447
/epidemiology-clinicalmanifestations-diagnosis-andmanagement-ofmumps?source=search_result&s
earch=mumps&selectedTitle=1%
7E150
N/A
It is high-yield to know that the parainfluenza virus has

hemagluttinin and neuraminidase as virulence factors, similar to
the influenza virus (orthomyxoviruses).
High-yield
addition to
next year
It is high yield to specify that the specific type of ACh receptor that
the rabies virus binds to is the nicotinic ACh receptor.
Clarification
to current
text
Emphasize that infection more commonly comes from raccoon,

bat, and skunk bites by highlighting *Ra*, *b*, and *s* in RaBieS
and Raccoon, Bat, and Skunk.
It is high-yield to know that the mumps virus has both
hemagluttinin and neuraminidase as virulence factors. Especially
neuraminidase, since this differentiates it from the measles virus.
Mnemonic
To remember many of the unique features of the rabies virus, I

use the word RABIES as a mnemonic: Retrograde transport; ACh
receptors; Bullet shaped/ bats; Immunoglobulin if exposed;
Encephalitis (cause of coma and death); (CN)S inclusions (Negri
bodies)
In addition to orchitis, mumps can also cause oophoritis
Mnemonic
It is high-yield to know that hepatitis C can cause cryglobulinemia.

From uptodate: occurs in "40 to 65 percent in hepatitis C-infected
individuals, and as high as 64 percent in HIV and hepatitis C
confection."
n'A'k'E'd Hep viruses: A and E
For HCV, to emphasize that a carrier state is common, you should
make the C red in "Carrier" and "Common". This goes along with
all the other red C's you have for this virus (Cirrhosis, Carcinoma,
Chronic)
Under HBV, you guys say that most adults have full resolution. It
is high-yield to contrast this with newborns who acquire HBV
during delivery, who almost always progress to chronic HBV.
From UpToDate: "The proportion of patients progressing to
chronic infection is much higher in neonates (up to 90 percent)
compared with 1 to 5 percent in adults and intermediate values in
young children."
For HBV, it is high-yield to remember that HBV can present with 2
specific kinds of kidney involvement. From UpToDate: "HBV
infection can induce both membranous nephropathy and, less
often, membranoproliferative glomerulonephritis."
I found the mnemonic for SS+ RNA virus to be hard to remember.
I think this is a good alternative but for the SS- : BAD PROF;
Bunyaviruses, Arenaviruses, Delta Virus, Paramyxoviruses,
Rhabdoviruses, Orthomyxoviruses, Filoviruses
In Addition to Anti HBs marker indicating Hep B immunity it also
can indicate resolution of prior HepB infection. So just include
prior infection or resolution to the current text.
It would be very helpful if the order of the columns of the HBV
serological markers was changed to reflect the chronological
order the appear. The first column would be HBsAg, then HBeAg,
then Anti-HBc, then Anti-HBe, then Anti-HBs. This would give
visual learners a much more clear timeline to follow.
You mention that HDV needs HBV for infection. You should
elaborate that it is specifically the HBsAg that is necessary. Very
testable. From UpToDate: "Due to the dependence of HDV on
HBV, the presence of HBsAg is necessary for the diagnosis of
HDV infection."
There is a missing parentheses after "(p24 and p17" in the bullet
that talks about gag.
According to the 2015 Updated CDC Testing Recommendations
for Diagnosis of HIV, Western Blot (gold standard since 1989) is
no longer recommended to make a diagnosis of HIV infection.
Instead, HIV-1/2 antigen/antibody combination immunoassays
that detect both HIV-1/2 and p24 antigens should be used and,
when positive, followed by a confirmatory HIV-1/HIV-2 antibody
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Spelling/for
matting
Clarification
to current
text
differentiation immunoassay.
To remember that gp41 is responsible for HIV fusion, I remember
"Forty does Fusion" with both F's in highlighted in red.
The new CDC guidelines actually call for fourth generation
immunoassays to be used as part of the diagnostic algorithm.
This has been shown to be more reliable than the standard
testing process.
Falsely negative ELISA/Western blot for the first 1-2 months after
HIV infection is no longer the case. Currently used 4th generation
antibody tests for HIV can detect HIV before seroconversion and
have a window period of 2-4 weeks; they are very unlikely to be
falsely negative afterwards.
Under route of transmission for CMV, there is a forgotten comma
between congenital and transfusion.
The book states that N. meningitidis is a maltose fermenter. This
is incorrect. Per the CDC website "Neisseria spp. produce acid
from carbohydrates by oxidation, not fermentation. N. meningitidis
oxidizes glucose and maltose, but not lactose or sucrose." Since
N. meningitidis oxidizes but does not ferment maltose, I would
suggest that it be changed to N. meningitidis oxidizes maltose
and glucose while N. gonorrhoeae oxidizes glucose only.
Increased risk of cryptosporidiasis is seen in HIV patients with
CD4+ count below 100 (not below 500 as the book mention),
158
Microbiology
N/A
158
Microbiology
http://www.cdc.gov/hiv/pdf/hivtesti
ngalgorithmrecommendationfinal.pdf
158
Microbiology
www.cdc.gov/hiv/pdf/hivtestingalg
orithmrecommendation-final.pdf
159
Microbiology
Not needed
160
Microbiology
http://www.cdc.gov/meningitis/lab
-manual/chpt07-idcharacterization-nm.html
160
Microbiology
160
Microbiology
http://www.aafp.org/afp/2011/021
5/p395.html
for CD4+ cell count < 200/mm3: HIV: change "Dementia" to

"Dementia, neuropathy, kidney disease"
160
Microbiology
162
Microbiology
UW Question ID:1100;
164
Microbiology
https://en.wikipedia.org/wiki/Nitrite
_test
164
Microbiology
164
Microbiology
/infections-due-to-serratiaspecies?source=search_result&s
earch=serratia+motile&selectedTi
tle=1%7E101
https://en.wikipedia.org/wiki/Urea
se
165
Microbiology
/overview-of-torch-infections
166
Microbiology
USMLE World Question Id 1669

[662429], CDC paper rubella
page 326.
Histopathology of HIV associated dementia shows microglial

nodules (i.e. groups of activated microglial cells formed around
small areas of necrosis). Multinucleated giant cells may be
present as a result of fusion of the activated microglial cells.
In the Microbiology-Systems section, Y. enterocolitica should
either be placed in both the bloody diarrhea (in <10%) and watery
diarrhea (in 78-96%) sections, as it may cause either, or placed
solely in the watery diarrhea section because this is the
predominant symptom
While describing the nitrite test it should clarify that the nitrites are
produce of the conversion of urinary nitrates and usually indicates
gram negative infection. The test use the term "reduction of
nitrates", which is kind of misleading.
Serratia is a motile bacteria. This is high-yield because it
differentiates it from Klebsiella, another cause of nosocomial
UTI's. From UpToDate: "Serratia species are motile, and can
adhere to cells via fimbriae."
On page 164, Staph Saprophyticus should be included along with
Proteus and Klebsiella as urease positive organisms capable of
causing UTIs. This is especially important considering it is the
second most common cause of UTI in sexually-active females.
Regarding TORCH infections (or ToRCHeS) as indicated in the
text, originally O was included as OTHERS to cover some
infections like HIV, Parvovirus, VZV, etc. I have two suggestions
for this part. First please add a note to CMV to indicate it's the
most common congenital viral infection in the US since it would
help students to choose between the choices if the most common
is questioned (see reference). Additionally VZV is an important
TORCH infection (originally classified in O as others, but maybe
you can use H as Herpes Simplex and include both HSV2 and
HSV3/VZV in it). In either was I suggest to add VZV as an
important TORCH infection with classic skin lesions and
symptoms of: Cutaneous scars, which may be depressed and
pigmented in a dermatomal distribution; Cataracts, chorioretinitis,
microphthalmos, nystagmus; Hypoplastic limbs; Cortical atrophy
and seizures. (please be advised that the symptoms are copied
from UpToDate, see reference).
Rubella macules do not coalesce as opposed to measles which
does coalesce.
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Microbiology
171
Microbiology
/clinical-manifestations-anddiagnosis-of-acute-interstitialnephritis?source=search_result&s
earch=penicillin+nephritis&select
edTitle=3%7E150
Penicillin is a common cause of drug-induced interstitial nephritis.
Avibactam is a new beta lactamase inibitor which confers
Mnemonic
Clarification
to current
text
Clarification
to current
text
Spelling/for
matting
Major
erratum
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
High-yield
/extended-spectrum-betalactamases/abstract/66
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na
171
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FA2016
171
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No reference
171
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self mnemonic
172
Microbiology
172
Microbiology
First AId
172
Microbiology
First AId
172
Microbiology
FA2016
172
Microbiology
FA2016
172
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http://www.jstor.org/stable/30136
528?seq=1#page_scan_tab_cont
ents
172
Microbiology
FA2016
172
Microbiology
First Aid 2016, UpToDate

Cephalosporins
172
Microbiology
173
Microbiology
173
Microbiology
Doctors-In-Training Video 12B

Micro 12 (Not authoritative
resource, but definitely something
to explore)
/aztreonam-systemic-druginformation?source=search_result
&search=aztreonam&selectedTitl
e=1%7E59
/vancomycin-druginformation?source=search_result
&search=vancomycin&selectedTit
le=1%7E150
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/vancomycin-druginformation?source=search_result
&search=vancomycin&selectedTit
le=1%7E150
174
Microbiology
/aminoglycosides
175
Microbiology
/methicillin-resistantstaphylococcus-aureus-mrsa-inadults-treatment-of-skin-and-softtissue-
resistance ti KPC, AmpC but not NDM1 beta-lactamases. Please

add Avibactam to the list, the mnemonic can still stay CAST
[Clavulanic acid, Avibactam, Sulbactam, Tazobactam]
Augmentin: Amoxicilin + Clavulanic acid= "Augment the
temperature (AC)" Unasyn: Ampicillin + Tazobactam= "where U
AT?" Timentin: Ticarcillin + Clavulanic acid " Time is TiCking"
The mnemonic for the clinical use of the penicillinase-sensitive
antibiotics is HHELPSS. The E stands for E coli. At the end of
your list is enterococci, which you don't include in the mnemonic.
Why not make the mnemonic HHEELPSS (note the extra E for
enterococci)? It fits quite nicely.
For the mnemonic "ampicillin/amoxicillin HHELPSS kill
enterococci" Enterococci should also be in red
penicillinase resistant penicillins are like "DON" Dicloxacillin,
Oxacillin, Nafcillin
CeftriAXone and cefotAXime are good for meningitis. "Like an
AXe to the head"
3rd Generation Cephalosporins can be remembered as the 3T:
cefTRIAXone, cefoTAXime, cefTAZidime. All of the third
generation feature a strong T sound/word after the prefix cefCeftazidime works against pseudomonas. It can be remembered
as TAZ-MONA-IAN Devil. With MONA being a tie in to
pseudoMONAs
Ceftriaxone can be remembered as a third generation
cephalosporin by bolding the TRI (tri- for three) in its name.
The mnemonic for 2nd generation cephalosporins (Fake Fox Fur)
needs improvement. The "fa" in Fake comes from ceFAclor. The
problem is that cefazolin, a 1st generation cephalosporin, also
has this "fa". I think you should change the mnemonic to be "Fox
Face Fur," with the FACe indicating ceFAClor. This will make it
not able to be confused with cefazolin anymore.
It is extremely high-yield to add that the 3rd generation
cephalosporins can cross the blood-brain barrier. This is the
reason they are first line against many meningitis-causing
organisms.
To remember that ceftazidime is effective against psuedomas,
You can highlight ceftAZidime and psuedomonAZ (replacing s
with z)
Under Mechanism you have written that "Organisms typically not
covered by 1st-4th generation..." and then later mention that there
is an exception "5th generation cephalosporin." There is no need
to say this is an exception because you already mentioned that it
was only 1st-4th generations that do not cover MRSA.
"New data suggests that it is not the case that cephalosporins
increase the nephrotoxicity of aminoglycosides."
addition to
next year
It's important to know that, like 3rd generation cephalosporins,

aztreonam can cross the blood-brain barrier. This makes it useful
in treating meningitis.
High-yield
addition to
next year
It is important to know that vancomycin can cross the blood-brain

barrier, making it useful for some causes of meningitis. From
UpToDate: "Relative diffusion from blood into CSF: Good only
with inflammation." Note that meningitis results in inflammation,
and thus good CNS availability.
Vancomycin can cause DRESS Syndrome (Drug Reaction with
Eosinophilia and Systemic Symptoms), which is important to
recognize since it can be life-threatening. Notably, this presents 28 weeks after discontinuation of the drug, is most common in antiepileptic drugs, and most commonly affects the liver, kidneys, and
lungs. This description of DRESS Syndrome is important and
should be included somewhere in FA2017. The only mention of it
in FA2016 is on page 500, and it doesn't describe the condition at
all.
Highlight that AminoglycoSIDEs are "bacteriSIDEal", which is
atypical for protein synthesis inhibitors (usually bacteriostatic). As
already noted in FA, this is due to the frameshift mechanism that
creates nonfunctional proteins.
Doxycycline and minocycline are effective against MRSA. This
should be added to the clinical use.
High-yield
addition to
next year
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
High-yield
addition to
next year
Mnemonic
Clarification
to current
text
Major
erratum
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
infections?source=search_result&
search=tetracyclines+MRSA&sel
ectedTitle=1%7E150
http://www.accessdata.fda.gov/dr
ugsatfda_docs/label/2008/021356
s026lbl.pdf
175
Microbiology
175
Microbiology
not needed
176
Microbiology
First AId
176
Microbiology
http://reference.medscape.com/re
farticle-srch/297351-overview
177
Microbiology
Formatting
177
Microbiology
/pathophysiology-and-clinicalmanifestations-ofmyelomeningocele-spinabifida?source=search_result&sea
rch=trimethoprim+neural+tube&s
electedTitle=1%7E150
177
Microbiology
http://www.cdc.gov/std/tg2015/chl
amydia.htm
178
Microbiology
na
179
Microbiology
179
Microbiology
/dapsone-systemic-druginformation?source=search_result
&search=dapsone&selectedTitle=
1~148
FA2016
179
Microbiology
ed/16308281
180
Microbiology
ed/10411262
180
Microbiology
180
Microbiology
/isoniazid-inhpoisoning?source=search_result&
search=isoniazid&selectedTitle=6
%7E150
N/A
181
Microbiology
5/p538.html,
http://thelancet.com/journals/lanc
et/article/PIIS01406736%2815%2961465-9/fulltext
183
Microbiology
184
Microbiology
/chloroquine-druginformation?source=search_result
&search=chloroquine&selectedTit
le=1%7E108
185
Microbiology
http://cid.oxfordjournals.org/conte
nt/34/5/695.full
186
Microbiology
http://www.merriamwebster.com/dictionary/preferably
186
Microbiology
Personal mnemonic
Ingesting expired tetracyclines has been associated with

development of Fanconi Syndrome. This is exactly the rare and
random type of association that USMLE loves
Linda stands on the bridge while Metro passes under it
(cLINDAmycin for anaerobes above diaphragm and
METROnidazole for below the diaphragm)
All macrolides have the letters THRO in the middle.
AziTHRomycin, clariTHROmycin, eryTHROmycin. This can be
bolded to make memory easier.
The text refers to "Chlamydia" as an atypical pneumonia, when it
should read "Chlamydophila," the new name for the family of
bacteria causing pneumonia.
Under clinical use it says "Gram-, gram ." Why is that dash
between gram and positive? You guys never use a dash between
gram and the plus or minus. I think this is an error.
All the folate synthesis blockers (sulfonamides, dapsone, and
trimethoprim) increase the risk of neural tube defects if taken
during pregnancy, particularly if the mother is not taking folate
supplements. From UpToDate: " Folic acid deficiency has been
implicated in the development of NTDs (folate sensitive NTDs)
and administration of valproate or folic acid antagonists (including
carbamazepine, phenobarbital, phenytoin, primidone,
sulfasalazine, triamterene, and trimethoprim) increases the risk."
Sulfonamides are not used in the treatment of chlamydia as
stated by the text. Doxycycline is the recommended drug,
alternatively fluoroquinolone or macrolide may be used.
the metro (subway) goes UNDERground ( metronidazole treats
anaerobes BELOW the diaphram)
instead of 'delay resistance' - it would be better to say 'delays
resistance' - make it plural - flows better - link below is just to fill in
that box.
High-yield
addition to
next year
Mnemonic
Where you says that isoniazid is used alone for prophylaxis, you
could say "ISOniazid is used in ISOlation for TB prophylaxis." This
ability to be used alone is important to remember, since rifampin
can't be used alone due to rapid resistance development.
Rifabutin does in fact induce Cytochrome P-450. This is the exact
opposite of what is written in First Aid.
Add that pyrazinamide resistance is due to decreased
pyrazinamidase activity.
Mnemonic
Another side effect of isoniazid that should be included here is

anion gap metabolic acidosis. It is the "I" in the MUD PILES
mnemonic for remembering which drugs cause anion gap
metabolic acidosis. You included it on your list on page 543.
To remember that ethambutol is a cell wall agent, you can think of
the rhyme "ethambutALL works at the wALL" (misspelled on
purpose to fit rhyme).
Penicillins are no longer recommended as prophylaxis for
endocarditis with surgical or dental procedures. This concept is
tested in nbmes. please it should be corrected else students will
have it wrong in the exam. It should be noted that the lancet
recently contradicted this point of no prophylaxis but as it stands,
the usmle says .. NO PROPHYLAXIS. SO students should be
made to know.
It is high-yield to know that chloroquine can exacerbate psoriasis,
so it should be used cautiously or avoided in these patients. From
UpToDate: " Psoriasis: Use with caution in patients with
psoriasis; may exacerbate disease symptoms."
In clinical use I suggest adding "start within 48 hours of
symptoms". It's an important note.
Linezolid causes thrombocytopenia. Mnemonic: Linezolid = Low
Platelets (L = L)
A word is misspelled: "preferrably" should be spelled "preferably"
in the line that reads "2 NRTIs and preferrably an integrase
inhibitor."
A mnemonic to remind of the mechanism of action of Maraviroc
is: (MaraviROC puts a ROCK on CCR-5, blocking its interaction
Mnemonic
Minor
erratum
Spelling/for
matting
High-yield
addition to
next year
Minor
erratum
Mnemonic
Spelling/for
matting
Minor
erratum
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
Mnemonic
Spelling/for
matting
Mnemonic
with gp120).
In the 2015 edition, on 186 it reads "(Dapsone, used to treat
lepromatous leprosy, is a closely related..." However, dapsone is
used to treat tuberculoid, not lepromatous, leprosy, as is
mentioned on 188 and 134 (all pg #s from 2015 edition)
Enfuvirtide inhibits vital entry. it can be rememberd as ENtry
reFUsed ViRus with the EN-FU-VIR forming much of the name of
Enfuviritde
There's mnemonic to help remember the names of the NNRTI's.
Its "NEVER a PINE in DELAWARE but it's still my E-FAVOURITE
state" for Neverapine, Delaviridine and Efavirenz.
Protease inhibitors: "Navir tease a FAT protease" worked better
for me; it helped me remember the lipodystrophy associated with
protease inhibitors.
Sofosbuvir is used with Ledipasvir, NOT Simeprevir
186
Microbiology
No supporting reference
necessary; this errata regards a
contradiction btw different pages
within First Aid 2015.
186
Microbiology
First AId
184
Microbiology
Personal Mnemonic
186
Microbiology
A mneumonic.
187
Microbiology
https://www.ncbi.nlm.nih.gov/pub
med/26704693
187
Microbiology
/treatment-regimens-for-chronichepatitis-c-virus-genotype-1
187
Microbiology
First Aid Page 187
190
Immunology
http://www.chompchomp.com/ter
ms/fragment.htm, and many other
grammar texts
191
Immunology
None, just a mnemonic
191
Immunology
Jesus told me in a dream. Cluster

A schizotypal.
192
Microbiology
https://en.wikipedia.org/wiki/Ribav
irin
Ribavarin is a nucleoside inhibitor
192
Immunology
ed/22706078
192
Immunology
http://www.nature.com/nri/journal/
v9/n7/fig_tab/nri2575_F1.html
193
Immunology
None. Just submitting mnemonics
193
Immunology
n/a
193
Immunology
my own
194
Microbiology
n/a
194
Immunology
UWorld QId 762 [727457]
195
Immunology
/normal-b-and-t-lymphocytedevelopment#H1230945
197
Immunology
Kaplan immunology book- page
Platelets have no nucleus however interestingly they express

MHC I like nucleated cells and research shows that they might be
involved in presenting antigens to T cells. In row of "Expression" I
suggest adding platelets too.
In row for Antigen Loading please add role of "proteasome" in
MHC I because it's a high yield association with MHC I pathway
(Proteasome and TAP).
Heres some additional mnemonics to complement the existing
ones on the HLA table. DR-2 : MAPS - Multiple-sclerosis,
Atopy(hay fever), goodPasture, Sle; DR-3 : 2 HAGS with Diabetes
- Hashimoto, Addison, Graves, Sle, DM-type1; DR4 : (mnemonic
itself is DR-4) - Diabetes mellitus type 1, Rheumatoid arthritis,
4ddison disease (4 looks almost like an A); DR-5 : (5)fi-tamin B12
deficiency (pernicious), hashimoto's (5)phi-roiditis
HLA-DR2 associated diseases: i HAYte 2 MisS GOOD SLEep
(HAY fever, MS, GOODpasture, SLE)
for diseases associated with DR2: say HAY & GOODmorning 2
MS. SLE (highlight capitals and number 2)
My page number is actually from the 2015 edition. My mnemonic
is for protease inhibitors for HIV treatment (-navir suffix): You can
check out any time you like, but you can navir cleave
In addition to IFN-g, Th1 cells (column 2) also secrete IL-2 and
Lymphotoxin beta. Also, Th2 cells (column 3) are involved in
regulating antibody class switching.
The diagram shows that a dendritic cell is presenting antigens to
the naive T cell. Then the T cell goes onto secreting cytokines to
induce switching in B cells. There should be some clarification
that both B cells and Dendritic cells can present antigens to naive
T cells. B cells have the MHC I/II receptors, along with the B7 and
CD40L.
IgG- participates in Antobody-dependent cell mediated
Add "or in combination with Ledipsavir (NS5A inhibitor)." to the

treatment regimen given in the first paragraph in the third column
for the second entry(Sofosbuvir) and replace the first paragraph in
the third column of the third entry(Simeprevir) with "Chronic HCV
in combination with ribavirin +/- peginterferon ailfa" since both are
given with ribavirin and pegineterferon alfa, but only Sofosbuvir is
combined with Ledipasvir (in Harvoni) and not Simeprevir.
Change Chlorhexidine: denature proteins and disrupts cell
membranes. To Denature proteins and disrupt cell membranes.
This change is needed to match the line above pertaining to
alcohols.
In the Follicle row there is a formatting error. The text reads "In
outer cortex. Primary follicles are dense and dormant." There
should not be a period after "In outer cortex." This is a sentence
fragment.
A mnemonic more germane to the topic for encapsulated
organisms that asplenic patients are more susceptible to: "Some
Heavily Encapsulated Bugs Can Kill No-Spleen Patients" -- Strep
pneumo, H. flu, E. coli, group B strep, Cryptococcus (the only
encapsulated fungus), Klebsiella pneumo, N. meningitidis,
Salmonella, Pseudomonas.
Salmonella spp bacteria are all encapsulated for realsies? Naaah.
Major
erratum
Mnemonic
Mnemonic
Mnemonic
Major
erratum
Major
erratum
Spelling/for
matting
Spelling/for
matting
Mnemonic
Major
erratum
Minor
erratum
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
Mnemonic
Mnemonic
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
Clarification
76
197
Immunology
kaplan immunology book- page

71
197
Immunology
kaplan immunology book- page

76
197
Immunology
https://en.wikipedia.org/wiki/B_cel
l
197
Immunology
ed/10352312
199
Immunology
199
Immunology
199
Immunology
/complementpathways?source=search_result&
search=complement&selectedTitl
e=2~150
200
Immunology
N/A
200
Immunology
N/A
200
Immunology
no need
201
Immunology
/chronic-granulomatous-diseasepathogenesis-clinicalmanifestations-anddiagnosis?source=preview&searc
h=%2Fcontents%2Fsearch&anch
or=H39#H16
cytotoxicity. neutralization- involved in IgG, IgM and IgA. IgG, IgA

and IgE are involved in memory B cell antigen receptor (one only)
IgM-has 5x the capacity for binding antigenic epitopes. the
valence of the molecule is 10 meaning 10 identical epitopes can
be stimulateneously bound. Cant mediate ADCC because the Fc
portions are in the center of the pentamer so it cannot to attached
to cause the ADCC. Affinity of IgM is low but the avidity of IgM is
the highest of them all
IgD- better to clarity and say that it is a naive b cell antigen
receptor as well as IgM
2nd sentence reads: Mature, naive b cells prior to activation
express IgM and IgD. I would suggest changing to "IMMATURE
(or MATURING) , naive B....."
The text states that IgE "mediates immunity to worms by
activating eosinophils." This is a common misconception, simply
because eosinophils start with the letter "E." However, eosinophil
expression of FcRI (the Fc receptor for the IgE isotype) is
minimal. Hence IgE does not activate eosinophils. Instead, IgG
and (especially) IgA acitvate eosinophils as evidenced by their
high expression of (FcRII and FcRI).
For DAF deficiency and PNH, I would suggest changing the line
to indicate that all hematopoietic cells (RBC, WBC, and platelets)
are affected since complement-mediated lysis of RBCs implies
that only RBCs are involved. In fact DAF is absent on all these
cells and not only RBC. Please see the following lines from
medscape "Paroxysmal nocturnal hemoglobinuria (PNH) was
previously classified as purely an acquired hemolytic anemia due
to a hematopoietic stem cell mutation defect. This classification
was abandoned because of the observation that surface proteins
were missing not only in the RBC membrane but also in all blood
cells, including the platelet and white cells."
The C3 convertase in the Lectin and Classic Pathway is C4b2a,
not C4b2b
Acquired or Hereditary Angioedema C1 esterase Inhibitor
deficiency is now more commonly referred to as C1INH deficiency
for short in UWORLD. Please add that in brackets to prevent
further misunderstanding when asked in reference to C1INH
specifically. Also, it blocks kallikrein-induced conversion of
kininogen to bradykinin = increased Bradykinin.
The existing mnemonic for IL8 being a chemotactic factor for
neutrophils is the worst mnemonic I've ever come across: "Clean
up on aisle 8." While it's clever that "aisle" and "IL" sound like the
same word, there's nothing to help us remember that we're talking
about 8, and not 9, or 12, or 5, etc. I propose an improved
mnemonic: "IL-*8* goes with n*oo*trophils." Get it? The oo looks
like an 8 on its side? Okay, so it's maybe not the best mnemonic
either, but "Clean up on aisle *can't remember what number*" is
certainly worse.
The existing mnemonic for IL-10 is "TGF- and IL-*10* both
at*ten*uate the immune response." Can this mnemonic be
updated to also emphasize the "" and the "b" in the word "both"
so that it helps the reader remember that TGF- is part of this
mnemonic? "TGF-** and IL-10 *b*oth at*ten*uate the immune
response."
you guys can remember IL8 as chemotactic factor if you have
seen the movie Hateful Eight 2015 ,where 8 people gather
together .
FA2016 says "Phagocytes of patients with CGD can utilize H2O2
generated by invading organisms and convert it to ROS. Patients
are at increased risk for infection by catalase positive species (eg,
S aureus, Aspergillus) capable of neutralizing their own H2O2,
leaving phagocytes without ROS for fighting infections." However,
UpToDate says "It was thought that CGD phagocytes could use
the hydrogen peroxide produced by catalase-negative microbes
to generate reactive oxidants, thereby bypassing the intrinsic
CGD defect. However, the majority of pathogens in general are
catalase positive, and only a few cause infections in CGD,
suggesting that catalase production alone is insufficient for
pathogenicity. Furthermore, targeted deletion of the catalase gene
in Aspergillus nidulans and Staphylococcus aureus did not affect
to current
text
Clarification
to current
text
Clarification
to current
text
Minor
erratum
Minor
erratum
High-yield
addition to
next year
Minor
erratum
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Major
erratum
201
Immunology
Nil. Just formatting/organising

existing content in the sections
described.
201
Immunology
Please see Uworld question 1468

[648952]
202
Immunology
202
Immunology
/clinical-trials-of-hiv-antiretroviraltherapy-agents-in-advancedstages-ofdevelopment?source=machineLe
arning&search=cxcr4&selectedTit
le=1~46&sectionRank=1&anchor
=H13#H9
FA2016
202
Immunology
ed/10579123
202
Immunology
http://www.jimmunol.org/content/1
68/5/2225.full.pdf
202
Immunology

203
Immunology
203
Immunology
https://aidsinfo.nih.gov/contentfile
s/Recommended_Immunizations
_FS_en.pdf
FA2016
204
.00
Immunology
uptodate.com
204
Immunology
(Kumar page 765) Kumar, Vinay,

Abul Abbas, Jon Aster. Robbins &
Cotran Pathologic Basis of
Disease, 9th Edition. Saunders,
2015.
204
Immunology
First Aide Step 1 2016
virulence in animal models of CGD, indicating that microbial

catalase is not a significant virulence factor for CGD infections."
Page 201 has a section on interferon alpha and beta. Page 187
also has a similar section, on interferons. Wht cant we have both
cubbed for better reading?
4th line says that interferons act locally on uninfected cells.
Although interferons work in autocrine/paracrine fashion on
neighboring cells, this also includes infected cells. In fact the
effects of interferons on halting protein synthesis (e.g. activating
RNase L, protein kinase R) is selectively started in the presence
of double-stranded RNA in "infected cells". So maybe it's better to
clarify this part by only mentioning autocrine/paracrine effects or
of both infected and neighboring cells.
FA2016 lists CXCR4 and CCR5 as being cell surface proteins on
cytotoxic T cells (CD8+ T cells). It would be better to list them as
being cell surface proteins on Helper T cells (CD4+ Th cells),
since the major clinical relevance of CXCR4/CCR5 is that they're
the co-receptors used for HIV to enter and infect CD4+ Th cells.
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
I suggest adding a line about antigenic drift to this segment

because an important mechanism for some of the bugs listed is
drift and mutations in protein synthesis (like influenza, or lack of 35 exonuclease activity in HCV). Antigenic shift is mentioned that
only applies to segmented viruses (BOAR) and it also worth
mentioning here again. Also you might want to add Rhinovirus
(common cold) to the viruses with antigenic variations.
I believe it states that Th1 cells are activated by INF-gamma,
when in fact it should be IFN-gamma.
The page confuses students as to which receptors are present
where. It is very important to clarify the presence of CCR5 on
CD4+ helper cells. While the text does state that these receptors
are present on every T-cell, it again lists them in the CD8+ box.
This is confusion and can cause students to misidentify the cell
type infected by HIV using the CCR5 receptor.
It says CD56 is a unique marker of NK cells; however, CD56 is
also found on neurons, glia, and skeletal muscle. It can serve as a
marker of neuroendocrine tumors.
MMR and Varicella are live vaccines that should be given to HIV
patients with a CD4 >200.
Clarification
to current
text
In live attenuated vaccines, please add Rotavirus vaccine (live

attenuated oral vaccine) that is now also included in page 152.
You can also add small-pox although it shouldn't be that highyield since eradicated. Another important point is Adenovirus
vaccine that is unique in being live unattenuated vaccine used
mainly in military. It certainly worth mentioning because it's the
only important vaccine that is unattenuated. Maybe you can add a
line to this segment.
Type 1: in addition to histamine released by the mast cells and
basophils, an enzyme called tryptase is also released and
elevated serum levels of tryptase is often used to support a
clinical diagnosis of anaphylaxis after the patient has been
stabilized. Type III: i would suggest to add rheumatoid arthritis as
well. Type IV: i would like to suggest to add Hashimoto thyroiditis
in that group.
First Aid has pernicious anemia listed as a type II hypersensitivity.
However, according to Pathoma it is a type IV hypersensitivity.
Also, Robbins and Cotran also support the basis of it being a type
IV hypersensitvity: "CD4+ T cells directed against parietal cell
components, including the H+,K+-ATPase, are considered to be
the principal agents of injury in autoimmune gastritis. This is
supported by the observation that transfer of H+,K+-ATPasereactive CD4+ T cells into nave mice results in gastritis and
production of H+,K+-ATPase autoantibodies. Autoantibodies to
parietal cell components, most prominently the H+,K+-ATPase, or
proton pump, and intrinsic factor are present in up to 80% of
patients with autoimmune gastritis. However, these antibodies are
not thought to be pathogenic because neither secreted intrinsic
factor nor the luminally oriented proton pump are accessible to
circulating antibodies, and passive transfer of these antibodies
does not produce gastritis in experimental animals. Nevertheless,
the presence of these autoantibodies is a useful diagnostic tool."
I got a rash (contact dermatitis ) from poison IVy while CaMPinG
High-yield
addition to
next year
Spelling/for
matting
Clarification
to current
text
Clarification
to current
text
Major
erratum
High-yield
addition to
next year
Minor
erratum
Mnemonic
204
Immunology
don't have access to the

suggested online resources - You
can find this info in the Kaplan
Immunology book. Also in this
paper
207
Immunology
UpToDate:
(http://www.uptodate.com/content
s/clinical-features-and-diagnosisof-lambert-eaton-myasthenicsyndrome)
207
Immunology
rticle/204930-workup#c16
207
Immunology
207
Immunology
207
Immunology
207
Immunology
https://labtestsonline.org/understa
nding/analytes/intrinsic-factorantibody/tab/test/
208
Immunology
208
Immunology
208
Immunology
208
Immunology
/agammaglobulinemia?source=se
arch_result&search=x+linked+ag
ammaglobulinemia&selectedTitle
=1%7E35
/agammaglobulinemia?source=se
arch_result&search=x+linked+ag
ammaglobulinemia&selectedTitle
=1%7E35
209
Immunology
N/A
209
Immunology
N/A
210
Immunology
N/A
210
Immunology
N/A
210
Immunology
na
212
Immunology
na
213
Immunology
FA2016
Contact Dermatitis Multiple Sclerosis PPD Graft-vs-host disease.

IVy can be used to remember that these are type IV-4
hypersensitivity reactions.
Guillain-Barre syndrome is wrongly placed under type 2
hypersensitivty (in examples list). It's a common mistake because
of the presence of auto-antibodies. However, it is still considered
to be a type 4 hypersensitivity reaction (Similar to hashimoto's
thyroiditis - it also has autoantibodies but it's still considered a
type 4 HSR).
For consistency, since all other autoantibodies do not state
"antibodies" in their title, "Voltage-gated calcium channel
antibodies" should be changed to simply "Voltage-gated calcium
channel" because the autoantibodies in Lambert Eaton are to the
channel and not to channel antibodies, as the title makes it sound.
Please consider the following changes in this page: For
Pernicious anemia please also add anti-intrinsic factor (Anti-IF)
antibodies (less sensitive, but almost 100% specific) in
comparison with Antiparietal cell antibodies that are more
sensitive but less specific. Also in MPO-ANCA/p-ANCA please
add Ulcerative Colitis to associated disorder. For anti-SSA antiSSB you can add SLE too because it is positive is some cases of
lupus and is associated with neonatal heart block. For LambertEaton please add "presynaptic" voltage gated Ca channels to the
autoantibody.
Ulcerative colitis is associated with the autoantibody p-ANCA
Primary sclerosing cholangitis is associated with the autoantibody
p-ANCA
Anti-intrinsic factor should be included as an autoantibody
associated with pernicious anemia
Major
erratum
Spelling/for
matting
High-yield
addition to
next year
Major
erratum
Major
erratum
Major
erratum
anti-glutamic acid decarboxylase subtypes GAD65 and GAD67

are both associated with type 1 DM
In autosomal dominant hyper IgE syndrome (Job Syndrome).
Normally STAT3 gene is responsible for two functions: 1- Th17
Differentiation. 2- Production of IL-10. So a mutation in STAT3 will
lead to : 1- Deficiency in Th17 (Th17 produce IL-17 which recruit
neutophils). so, there will be impaired recruitment. 2- Decreased
IL-10 production will increase production of other cytokines like IL4,IL-5 (IL-4 will lead to increase IgE production, IL-5 will lead to
eosinophilia) .
It is high yield to know that X-linked agammaglobulinemia also
predisposes you to Giardia infections, according to Pathoma.
Minor
erratum
Clarification
to current
text
Under x-linked agammaglobulinemia, it is important to note that

live vaccines (ex: polio) are absolutely contraindicated. The killed
polio vaccine is still acceptable.
High-yield
addition to
next year
Despite being unable to generate ROS using NADPH Oxidase,

phagocytes of patients with CGD can utilize H2O2 generated
by....
For Wiskott-Aldrich, the given mnemonic is "WATER." I couldn't
help but notice that IgA and IgE are elevated in Wiskott-Aldrich,
so why not include them in the "wAtEr" mnemonic?
In Chronic Granulomatous Disease, increased susceptibility to
catalase + bugs -- "Now Catalase Positive Bugs Seem to Have
An Extra Life": Nocardia, Candida, Pseudomonas cepacia, B.
cepacia, Streptococcus, H. pylori, Aspergillis, E. coli, Listeria
Mnemonic for bacterial infections in patients with decreased
granulocytes: "Granny, Please Start Buying New Socks."
(Pseudomonas aeruginosa, Staphylococcus, Burkholderia
cepacia, Nocardia, Serratia)
The text states that B-cell deficiencies tend to produce recurrent
bacterial infections - Recommend emphasizing the B in B-cell and
bacterial.
to help remember who an allograft is from: "you say "allo!" to
another human being when you see them"
"BACKsiliximbab": kidneys are located near your back, and it
blocks IL-2R ( 2 RENALS)
For remembering Filgrastim and Sargramostim I recommend
highlighting (changing the font to red) as follows: filGRAstim=
GRAnulocyte stimulation= G-CSF, sarGRAMOstim=
Clarification
to current
text
Mnemonic
High-yield
addition to
next year
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
213
Immunology
213
Immunology
213
Immunology
https://en.wikipedia.org/wiki/Eltro
mbopag,
https://en.wikipedia.org/wiki/Romi
plostim
mnemonic
214
Immunology
First aid ... Hematology and

oncology chapter/Pharmacology.
214
Immunology
214
Immunology
http://www.mountsinai.org/patient
-care/health-library/diseases-andconditions/crohns-disease,
http://www.ccfa.org,
http://www.mayoclinic.org/disease
s-conditions/crohnsdisease/basics/definition/con20032061
N/A
214
Immunology
ed/17989688
215
Immunology
USMLE World Qbank
216
Pathology
216
Pathology
/tumor-necrosis-factor-alphainhibitors-an-overview-ofadverseeffects?source=see_link&section
Name=TNFalpha+biology&anchor=H3#H3
ed/11279541;
articles/PMC22270/
217
Pathology
http://radiopaedia.org/articles/acut
e-pancreatitis
217
Pathology
Just google the H/E stain
225
Pathology
Pathoma pg.9. chapter 1: growth

adaptations, cellular injury, and
cell death.
225
Pathology
None needed
228
Pathology
/clinical-features-evaluation-andtreatment-of-retroperitoneal-softtissuesarcoma?source=search_result&
search=liposarcoma&selectedTitl
e=1%7E39
GRAnulocyte-MOnocyte stimulation= GM-CSF. Actually I think it

should be the real basis of the nomenclature of these drugs
stim=stimulation GRA=granulocyte and MO=monocyte. For
platelet drugs it's a bit of stretch but all of them have letters p (and
also l ) in them! so maybe helps for remembering.
IFN-gamma is also used in IL-12 Receptor Deficiency
Romiplostim is a TPO analog, Eltrombopag is a TPO receptor
agonist
IFN-y used in chronic granulomatous disease; mnemonic: Chronic
"GAMMA"lomatous disease
Add "Gastric Cancer" in the clinical use of Trastuzumab, in
addition to Breast Cancer.
Throughout the text 'Crohn Disease' is used instead of the correct
'Crohn's Disease'. I have Crohn's and go to Mt. Sinai where it was
discovered by Dr. Crohn.
The letters VA in the monoclonal antibody (beVAcizumab) can be

highlighted to remind that it's target is VAscular endothelial growth
factor.
Eculizumab is described as a complement protein c5 when it
should be a complement protein c5 INHIBITOR.
partial albinism (oculocutaneous albinism)
Under "Extrinsic (death receptor) pathway, it is stated in the page

quoted that, "TNF-@ binds to TNF". It should be TNF-@ binds to
its receptor.
The statement that Apaf-1 interacts directly with Bcl-2 is not

undoubtedly true. There has been numerous experiments that
demonstrate Apaf-1 failing to have any form of interaction with
Bcl-2. In fact, Bcl-2s wiki page does not formally list Apaf-1 as
one of the molecules it interacts with. Granted, Bcl-2 like
homologs are a vast family, and actually includes the proapoptotic BAK molecule. Wiki lists an entry called Bcl-2 Like 1
Protein has having interaction with Apaf-1. Nevertheless, the
association has been challenged, and it may be prudent to
remove the direct inhibition of Apaf-1 by Bcl-2 as shown in the
image.
Liquefactive necrosis is also seen in pancreatitis. Proteolytic
enzymes from pancreas liquefy parenchyma of pancreas itself.
The text states that there is increased cytoplasmic binding of
acidophilic dyes, and the picture shows pink cells. There is
increased affinity for *acidic* dyes (e.g. eosin) due to denaturing
of the cellular proteins. The *acidophilic* dye in H/E is
hematoxylin, and if the cytosol had increased affinity for that it
would turn blue. When something is acidophilc/eosinophilic, it is
positively charged (basic), which is why it attracts the acidic dye.
under organ-specific,Alzheimer disease due to deposition of bamyloid protein cleaved from amyloid precursor protein. Should
be "Ab-amyloid protein".....cleaved from "b-amyloid precursor
protein"
First sentence says "Abnormal aggregation of proteins(or their
fragments)". There should be a space after the word "proteins".
Nowhere in FA2016 are there any facts about lipomas or
liposarcomas. High-yield for lipoma is that it's the most common
benign soft tissue tumor of adults. High-yield for liposarcoma is
that it's the most common malignant soft tissue tumor in adults.
The characteristic cell is called is a lipoblast. From UpToDate:
"Microscopically, well-differentiated liposarcomas consist of a
background of adipocytes that contain scattered lipoblasts, each
with a single atypical nucleus surrounded by large
intracytoplasmic vacuoles."
High-yield
addition to
next year
Clarification
to current
text
Mnemonic
High-yield
addition to
next year
Spelling/for
matting
Mnemonic
Major
erratum
Clarification
to current
text
Minor
erratum
Minor
erratum
High-yield
addition to
next year
Minor
erratum
Minor
erratum
Spelling/for
matting
High-yield
addition to
next year
229
Pathology
My own
229
Pathology
My own
230
Pathology
N/A
230
Pathology
http://ghr.nlm.nih.gov/gene/PTEN
231
Pathology
http://www.foodsafetywatch.org/fa
ctsheets/aflatoxins/
232
Pathology
232
Pathology
http://www.humanpathol.com/artic
le/0046-8177(95)901949/abstract & FA 2016
Regarding B-hCG. I believe Large cell carcinoma (Non-small cell)

lung cancer should be included due to its ability to secrete B-hCG.
232
Pathology
LDH should be added as a tumor marker for dysgerminoma
233
Pathology
http://www.medsafe.govt.nz/profs/
PUArticles/PglycoproteinSept2011.htm
233
Pathology
N/A
233
Pathology
UW QID 11754
233
Pathology
Mnemonic
233
Pathology
Reference is text itself
237
Pharmacolog
y
/use-of-vasopressors-andinotropes#H11
I think P-Glycoprotein is a high-yield subject and many questions

can be drawn from this. I suggest adding these facts to GGlycoprotein: 1. Normally present at intestine, renal cells, and
blood brain barrier. 2. Some important drugs that are substrate of
P-Grlycoproteins are Loperamide, Digoxin, Colchicine,
Dabigatran. 3. Some important inhibitors of P-Glycoprotein
(means less drug excretion by kidney, increased CNS penetration
of drugs, more toxicity) are Diltiazem, Verapamil, Amiodarone,
Quinidine, and most P450 inhibitors.
"Carcinomas (that) Reach Far Hematogenously" =
Choriocarcinoma, Renal cell carcinoma, Follicular thyroid
carcinoma, Hepatocellular carcinoma. This mnemonic helps me
remember the 4 exceptions, plus the rule (eg, most carcinomas
do not metastasize hematogenously but lymphatically).
Osteolytic blastic and mixed tumors : Osteoblastic (scerotic, ie.
more bone) 1. Prostate 2. Hodgekins 3. Small cell lung cancer My
mnemonic : PHd Schloar! Gets more bone :P Osteolytic 1.
Multiple Myeloma 2. Melanoma 3. Renal cell cancer 4. Non small
cell lung cancer 5. Non hodgekins lymphoma My mnemonic :
MMR = No No! (no bone gained by getting a shot) Mixed 1.
Breast 2. Butt (I mean, GUT-- GIT tumors.
"Hematogenous Spreading Cancers Really Flourish" H is for
Hepatocellular carcinoma, S is for sarcoma, C is for
choriocarcinoma, R is for renal cell carcinoma, F is for Follicular
thyroid carcinoma. A mnemonic to help remember which cancers
spread hematogenously.
Carcinomas that spread hematogenously: Find Hematogenous
Routes Consistently (Follicular thyroid carcinoma, Hepatocellular
carcinoma, Renal cell carcinoma, Choriocarcinoma)
Tachyphylaxis examples: Phenylephrine leading to rebound
rhinorrhea due to extended use also Nitric Oxide
237
Pharmacolog
y
Mnemonic
238
Pharmacolog
y
238
Pharmacolog
y
/tricyclic-antidepressantpoisoning?source=search_result&
search=tca+overdose&selectedTi
tle=1%7E34
238
Pharmacolog
y
/tricyclic-antidepressantpoisoning?source=preview&langu
age=enUS&anchor=H2&selectedTitle=1~
34#H15
increased Erythropoietin: HaHa U R Polycythemic

(Hemangioma, HCC, Utrine Leiomyoma/moyomata, RCC,
Pheochromocytoma)
hypercalcemia due to increased PTHrP: hypercalcemia = Release
Of Bone Substance (Renal cell carcinoma, Ovarian cancer,
Breast cancer, Squamous cell carcinoma)
In order to be consistent with the "Oncogenes" fact, I would
recommend reformatting the "Tumor suppressor genes" fact so
that columns 2 and 3 are switched (eg, "Gene Product" as column
2 and "Associated Condition" as column 3).
PTEN tumor supressor associated with cancers in "Prostate, Tits,
Endometrium and is a "kNockout"
For Aflatoxins please add species "flavus" since Aspergillus flavus
is the most important producer of Aflatoxin and it should not be
confused with Aspergillus fumigatus that cause the disease
aspergillosis, ABPA and aspergilloma.
Should be noted that alkaline phosphatase is elevated in
conditions of cholestasis (e.g, biliary obstruction)
Loading Dose = C x Vd / F ,,,,, Mnemonic: Loading = Video CD /

Failure
States TCA is weak base, treatment is ammonium chloride. The
treatment of TCA overdose is bicarb.
TCAs are acidic and overdose needs to be treated by Sodium
Bicarbonate. In FA 2016 TCAs are listed under weak bases.
While TCAs are correctly listed as a weak base, UpToDate lists
increased excretion via NH4+Cl- as ineffective in managing TCA
overdose. Na+HCO3- is used for TCA overdose to protect against
cardiotoxicity; alkalizing the serum favors the neutral (nonionized) form of TCA, decreasing its affinity for Na+ channels and
increases extracellular Na+, further attenuating the TCA induced
Na+ channel blockade (the main mechanism by which TCA
Mnemonic
Mnemonic
Spelling/for
matting
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Clarification
to current
text
Mnemonic
Minor
erratum
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erratum
Major
erratum
238
Pharmacolog
y
238
Pharmacolog
y
/tricyclic-antidepressantpoisoning?source=search_result&
tle=1~34
rticle/819204-medication
238
Pharmacolog
y
238
Pharmacolog
y
/tricyclic-antidepressant-poisoning
238
Pharmacolog
y
none
240
Pathology
240
Pathology
240
Pharmacolog
y
https://www.mskcc.org/cancercare/types/brain-tumorsmetastatic/about-metastaticbrain-tumors
s-conditions/bonemetastasis/basics/riskfactors/con-20035450
Personal mnemonic
240
Pharmacolog
y
FA2016
240
Pharmacolog
y
Personal Mnemonic
240
Pharmacolog
y
Not applicable.
241
Pharmacolog
y
Ropper, A., & Samuels, M. (n.d.).

Adams and Victor's principles of
neurology (Tenth ed.).
241
Pharmacolog
y
None
241
Pharmacolog
y
http://www.sciencedirect.com/scie
nce/article/pii/S15660702150001
32
242
Pharmacolog
y
http://www.adrenoceptor.com/bet
aintro.htm
242
Pharmacolog
y
https://en.wikipedia.org/wiki/Musc
arinic_acetylcholine_receptor_M3
242
Pharmacolog
y
Basic and clinical Pharmacology,

Katzung, chapter 6. Table 6-2
242
Pharmacolog
FA2016
causes cardiotoxicity).
Under "Urine pH and drug elimination," TCAs are listed as
examples of weak bases, where overdoses can be treated with
ammonium chloride. TCAs are weak acids and overdose is
treated with bicarbonate.
It stated under the section about urine pH and drug elimination,
that you use ammoninum chloride to treat TCA overdose.
However in the Pharm section of the Pysch chapter, it stated that
Sodium bicarbonate is used. I also looked it up on eMedicine to
see which was right (sodium bicarbonate).
It says that TCAs are a weak base next to amphetamines. I
thought that TCAs are weak acid so the treatment for overdose is
bicarbonate. On the first aid 2015 it says that TCAs are weak
acids and even on Uworld I got a question for TCA overdose
being treated with bicarb..
TCAs are weak acids, not bases. It's listed under weak bases.
Their overdose is treated with bicarbonate
For phase II of drug metabolism: 2 CONJUGATED POLAR bears
who are INACTIVE and love KIDNEY beans produce Much GAS.
Tumors metastasizing to brain. "Lots of Pretty Bad Stuff Kill Glia" Lung, Prostate, Breast, Skin, Kidney, GI
Minor
erratum
Minor
erratum
Major
erratum
Minor
erratum
Mnemonic
Mnemonic
Common mets to bone: "BLT with a Kosher Pickle" - Breast,

Lung, Thyroid, Kidney, Prostate
Mnemonic
The drugs with a low therapeutic index (Warfarin, Theophylline,

Digoxin and Lithium), can be remembered by the following
mnemonic: (Watchout These Drugs are Lethal), where each
capital letter stands for one of the drug names.
I think in the figure, between ED50 and TD50, therapeutic "index"
should be changed to therapeutic "window". TI is a fraction
(TD50/LD50) and the distance between log drug concentrations of
ED50 and TD50 should more represent the window that is both
safe and effective to use the drug.
There was another mnemonic earlier, but this one may be better
and incorporates quinine, digoxin, aminoglycosides and
vancomycin as well. For Theophylline, Warfarin, Quinine, Lithium,
Digoxin, Aminoglycosides, and Vancomycin: "The War Queen
Likes to Dig Ameanguy's Van Low."
Low Therapeutic index: THEophylline, DIgoxin, WArfarin, LIthium
@THE DiWaLi
At the adrenal medulla portion of the image, there is a label of
"neurohumoral transmission" near the "blood". Rather than just
the adrenal postsynaptic communication constituting
neurohumoral transmission, all forms of transmission that involve
neurotransmitter release from a presynaptic cell through a
synapse and onto a postsynaptic cell are considered
"neurohumoral".
In the diagram, under the autonomic nervous system,
parasympathetic fibers are said to be innervating "Cardiac
muscle, smooth muscle, gland cells, nerve terminals" and for
sympathetic fibers, norepinephrine activates the same set of
endpoints but is listed differently as "Cardiac and smooth muscle,
gland cells, nerve terminals." For consistency, it should be listed
without the "and."
The figure that shows the autonomics and its innervations to
receptors is missing the parasympathetic origin from the sacral
region. The parasympathetics are known to be derived from
"craniosacral" areas. And only showing that it comes from the
brainstem is misleading.
Remove increased lipolysis from 1 & 2. Rather it is only a
function of 3 receptors. [attached images from Katzung
Pharmacology]
For M3 receptors add " insulin secretion". Question on Uworld
tested this concept (with a supporting chart).
Mnemonic
For Dopamine D1 I suggest also adding brain to be consistent

with other parts of the book. D1 is a major dopaminergic pathway
for example in striatum as discussed in Parkinson disease. In the
current version it seems D1 is only on renal vascular smooth
muscle and D2 is present in brain.
In the diagram below the page, please add an arrow between Ca
Minor
erratum
Mnemonic
Mnemonic
Clarification
to current
text
Spelling/for
matting
Clarification
to current
text
Minor
erratum
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
242
Pharmacolog
y
N/A
243
Pharmacolog
y
N/A
242
Pharmacolog
y
243
Pharmacolog
y
physiology 5e by L. Costanzo.
page 62. "Other muscarinic
receptors (M2) alter physiologic
processes via a direct action of
the G protein. In these cases, no
other second messenger is
involved. For example,
muscarinic receptors in the
cardiac SA node, when activated
by ACh, produce activation of a
Gi protein and release of the i
subunit, which binds directly to K+
channels of the SA node. When
the i subunits bind to K+
channels, the channels open,
slowing the rate of depolarization
of the SA node and decreasing
the heart rate. In this mechanism,
there is no stimulation or
inhibition of either adenylyl
cyclase or phospholipase C and
no involvement of any second
messenger; rather, the Gi protein
acts directly on the ion channel"
First AId
244
Pharmacolog
y
https://en.wikipedia.org/wiki/Pralid
oxime
244
Pharmacolog
y
Mnemonic by myself; facts from

pg 244 of FA 2016, UWorld
question #1564
244
Pharmacolog
y
med/12387297
245
Pharmacolog
y
Mnemonic
245
Pharmacolog
y
N/A
245
Neurology
/trihexyphenidyl-druginformation?source=see_link
247
Pharmacolog
y
see attachment
249
Pharmacolog
y
251
Pharmacolog
y
/antihypertensive-drugs-andlipids?source=machineLearning&
search=carvedilol+alpha&selecte
chor=H2#H2
no source used to create the
mnemonic
251
Pharmacolog
y
https://en.wikipedia.org/wiki/Salic
ylic_acid
251
Pharmacolog
y
251
Pharmacolog
y
First aid page 251
251
Pharmacolog
y
/major-side-effects-of-amiodarone
and
/major-side-effects-of-class-iantiarrhythmic-drugs
and Protein Kinase C since both DAG and Ca work to activate

PK-C. I think the current arrow means "increased Ca".
New mnemonic for V2 (vasopressin) receptors. V two found in
twobules (as in collecting tubules of kidney).
Easy way to remember general functions of Beta-1 and Beta-2
receptors is that Beta-1 acts on your ONE heart, while Beta-2 acts
on your TWO lungs.
Although M2 receptor is coupled to Gi protein, it is unique in its
effect on heart rate in that it acts WITHOUT a 2nd messenger. It
acts directly via the alpha-i subunit on the potassium channel
causing it to open -> decreased heart rate. No 2nd messenger is
involved in this effect on heart.
to current
text
Mnemonic
To remember that Mydriasis means Dilation you can Bold the D in

myDriasis and the D in Dilation. That will prevent confusion
between Mydriasis and Miosis when it comes to defining which
one means pupil dilation
Pralidoxime can put a LID on cholinesterase inhibitor poison if
given early by regenerating AChE
A short, simple mnemonic add-on: in addition to "phyxing"
atropine OD, physostigmine also "phreely" cross the BBB. This
helps us remember that physostigmine can reverse CNS effects
of atropine.
It might be worthwhile to mention sarin gas as another example of
a cholinesterase inhibitor (along with parathion).
Mnemonic
"Bloated as a Toad" A mnemonic for the urinary retention, and

constipation side effects.
I think it's better to bold "Tropi" aTROPIne, TROPIcamide,
homaTROPIne, IpraTROPIum and tioTROPIum to reminds us
that these drugs are somehow related to anti-muscarinic effect of
aTROPine
Please consider adding trihexyphenidyl to the list of Parkinson's
drugs; it has come up quite a few times in practice questions
when studying for pharmacology NBME exams
For the isoproterenol figures, the heart rate graph says that it is
increased due to a reflex tachycardia. But this is incorrect
because the increase is due to direct Beta 1 activation of the
heart.
Carvedilol is listed as a nonselective alpha-beta blocker, but it
should be listed as an alpha1-beta blocker.
For betablocker toxicity reversal: "b-utt blockers are reversed with

GAS!" ( glucagon, atropine, saline)
Currently, there is no (acid) written next to salicylates. (acid)
should be added to be consistent with the form ( basic) written
next to amphetamines.
For copper toxicity treatment, you could highlight "COPPER" in
read and "PENI" of penicillamine in red. So the Mneumonic is
"copper peni" (read "copper penny")
Dopamine: flip p to become b, then notice D > B > A in receptor
binding
The "Drug reactions -- cardiovascular" table lists Class IA and
Class III antiarrythmetics as causing Torsades, but Amiodarone is
an important exception that might be worth noting here since its
far less common (although it is (correctly) not listed in the cardio
pharm section). The reason I think this detail is important is
because it is mentioned in Sketchy Pharm chapter 4.3 and in a U
Mnemonic
Clarification
to current
text
Mnemonic
Mnemonic
High-yield
addition to
next year
Mnemonic
Mnemonic
High-yield
addition to
next year
Minor
erratum
Minor
erratum
Mnemonic
Clarification
to current
text
Mnemonic
Mnemonic
Clarification
to current
text
World question (Q ID 899).

New mnemonic for agents that cause hyperglycemia: "High
Calorie TPN" (HCTZ, Corticossteroids, Tacrolimus, Protease
inhibitors, Niacin
Pill-induced esophagitis mnemonic ("Pills Burning Throat" Potassium chloride, Bisphoshanates, Tetracyclines)
In Japan Tetra (4) is a bad luck number. You get tetradotoxin from
Japanese pufferfish.
252
Pharmacolog
y
None
252
Pharmacolog
y
Mnemonic
252
Pharmacolog
y
252
Pharmacolog
y
/overview-of-shellfish-andpufferfish-poisoning
/ciguatera-fish-poisoning
253
Pharmacolog
y
See age 178 FA2016 for

Daptomycin side effects.
253
Pharmacolog
y
http://medicaldictionary.thefreedictionary.com/c
inchonism
For cinchonism please define it as a note : tinnitus, visual

disturbance, GI symptoms, CNS symptoms
253
Pharmacolog
y
Page 554 FA2016
253
Pharmacolog
y
Mnemonic
253
Pharmacolog
y
NA
253
Pharmacolog
y
Uworld Q ID 10930 [648952]
254
Pharmacolog
y
Personal mnemonic
254
Pharmacolog
y
Nil. Mnemo
254
Pharmacolog
y
Mnemonic
259
Pharmacolog
y
none available
263
Cardiovascul
ar
N/A
263
Cardiovascul
ar
Grammar and punctuation
264
Cardiovascul
ar
FA p. 264
264
Cardiovascul
ar
265
Cardiovascul
ar
https://en.wikipedia.org/wiki/Sinoa
trial_nodal_artery
266
Cardiovascul
ar
Guyana and Hall Textbook of

Medical Physiology (12th edition)
Chapter 15, p. 169.
For interstitial nephritis please add proton pump inhibitors (PPI),

Rifampin, and Sulfonamides to be consistent with drugs
mentioned in the related topic in Renal section of the book
(please see page 554)
Drugs causing myopathy mnemonic ("Good Fish N' CHIPS" Glucocorticoids, Fibrates, Niacin, Colchicine, Hydroxychloroquine,
IFN-, Penicillamine, Statins)
In Myopathy: why not simply move statin to first line to include
statin, fibrates, and niacin (all lipid-lowering drugs) in a continuous
order and make it easier to remember?
For osteoporosis/ drugs increasing the risk of osteoporotic
fractures, Uworld provides an extensive list of drugs that at least
some of them seem to be high-yield and worth mentioning. In
addition to corticosteroids and heparin that are already
mentioned, the list includes: proton-pump inhibitors,
anticonvulsants (phenytoin, phenobarbital, carbamazepine,
aromatase inhibitors, medroxyprogesterone, GnRH agonists,
Thiazolidinediones.
Drugs that cause disulfiram-like reaction, and therefore shouldn't
be taken with alcohol (Sulfonylureas, Procarbazine,
Cephalosporins, Griseofulvin and Metronidazole), can be
remembered by the mnemonic (Sorry Pals, Cant Go Mingle).
Please consider this mnemonic. Shorter than the existing one.
Drugs causing pulmonary fibrosis : BBCC-MAN : Bleomycin,
busulfan, carmustine, cyclophosphamide, mtx, amiodarone,
nitrofurantoin
Drugs with disulfiram-like reaction - "Sucks Guzzling MolsonCoors Products" (Sulfonylureas, Griseofulvin, Metronidazole,
Cephalosporins, Procarbazine)
for the michaelis-menton graph. you put a space in between
inhibitor for competitive inhibitor graph
The diagram portraying heart morphogenesis for the ventricles is
not an easily interpreted image. Id suggest revising the image,
particularly the membranous intraventricular septum. Perhaps
using blue and red arrows to demonstrate blood flow from the
ventricles around the rotating septum.
Under the "Outflow tract formation" section, please remove the
periods after "Transposition of great vessels", "Tetralogy of
Fallot", and "Persistent truncus arteriosus". These are not
sentences and thus should not have periods.
Please bold "ductus arteriosus" under #3. This is to highlight the
third shunt as you have already highlighted the first two (ductus
venosus and foamen ovale). This will be more clear.
In the 3rd shunt, it should say "ductus arteriosus', not patent
ductus arteriosus. Patent is added when the shunt remains open
after birth and is pathological.
AV nodal artery is based on dominance to the heart. It would be
more accurate to state that SA nodes are usually supplied by
RCA and AV nodes are supplied by dominant circulation.
FA 2016: "Increased pulse pressure in ...aortic regurgitation..."
Correction: There is a decreased pulse pressure in aortic
regurgitation. In Guyton and Hall Textbook of Medical Physiology
(12th edition) Chapter 15, p. 169: "In aortic regurgitation, the
aortic valve is absent of will not close completely. Therefore, after
each heartbeat, the blood that has just been pumped int the aorta
flows immediately backward into the left ventricle. As a result, the
Pronounced Cigaratoxin. They cant feel their hot cigar due to

temperature-related diasthesis (main differentiating factor).
Please add Daptomycin to causal agents for Myopathy since it's
high-yield and is also mentioned in microbiology segment.
Mnemonic
Mnemonic
Mnemonic
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
Mnemonic
Mnemonic
Spelling/for
matting
Clarification
to current
text
Spelling/for
matting
Clarification
to current
text
Clarification
to current
text
Clarification
to current
text
Major
erratum
aortic pressure can fall all the way to zero between heartbeats."
On Myocardial oxygen demand the Arrow pointing upward is
repeated two times, 1 before Myocardial and one before by. It
reads: (Upward arrow) Myocardial O2 demand is (Upward
arrow) by: the first one should be erased.
With the inhibition of phospholamban, aside from increased
subsequent contractility of muscles due to increased SERCAmediated sequestration of Ca++, the increased sequestration of
intracellular Ca++ in itself can increase rate of relaxation, and
therefore lead to increased heart rate. So overall, inhibition of
phospholamban -> increased heart rate and contractility Also, its
good to correlate these with downstream effects of beta-agonists.
Increased in beta-agonist -> activation of cAMP >
downstream eventual phosphorylation of phospholamban (leads
to inhibition of phospholamban) -> increased contractility and
heart rate. No doubt its not the only reason for beta agonist
effects, but it helps.
Remove of organ in parallel system of resistance should increase
Total Resistance . Lets, take Ex. this organ in parallel 1/R = 1/2 +
1/2 In this example, R = 1. Now lets remove one organ remove
one of the organs, then it will be 1/R = 1/2, and hence R = 2. 2>1
so there is an increase in Total Resistance not decrease. That is
why capillaries, which have the highest resistance of individual
vessels because of their small diameter
Under subheading contractility. Digitalis reverses Na+/Ca2+
exchanger activity. Remove the downward arrow.
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https://en.wikipedia.org/wiki/Phos
pholamban
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http://www.cvphysiology.com/He
modynamics/H005.htm
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http://reference.medscape.com/dr
ug/lanoxin-digoxin-342432#10
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Costanzo, pg 121
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modynamics/H005.htm
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USMLE Step 1 Kaplan

Physiology 2013,Peripheral
Circulation,Page : 94.
268
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2015 edition says
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http://www.jci.org/articles/view/10
8970/version/1/pdf/render
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First Aid 2015 pg. 274
268
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modynamics/H004.htm
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You can calculate this from the

equation for total resistance of
vessels in parallel in column 1:
1/Rtotal = 1/R1 + 1/R2... You can
also see the Wikipedia page on
series & parallel circuits
(https://en.wikipedia.org/wiki/Seri
es_and_parallel_circuits). I also
attached a page from Kaplan's
book.
http://www.prep4usmle.com/foru
m/thread/37655/
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kaplan, and many other refrences
268
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https://www.karger.com/Article/Pd
f/172842
268
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https://www.karger.com/Article/Pd
f/172842
nephrectomy will increase total peripheral resistance.
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http://circ.ahajournals.org/content/
35/2/272.abstract
In the 2016 edition it states that "Removal of organs in parallel
Removal of organs in parallel arrangement (eg nephrectomy)

should result in an INCREASE in TPR and DECREASE in CO.
The book has it listed the opposite way (decreased TPR and
increased CO).
Removal of organs in parallel arrangement will INCREASES TPR
and DECREASES CO. FA2016 p.268 says DECREASES TPR
AND INCREASES CO.
TPR increases when an organ is removed in a parallel
arrangement and as TPR is inversely proportional to CO it should
decrease.In FA it is given the other way around.
Nephrectomy should increase tpr and decrease co
The section states that removal of organs in parallel arrangement
will decrease TPR and increase CO. These are reversed. The
TPR should decrease because the organs are in parallel, and the
CO should decrease as a result.
Removal of an organ(s) in parallel arrangement (eg.
nephrectomy) results in an increase in TPR and a decrease in CO
as CO is inversely proportional to TPR
My name is Michael Fatuyi, Am bringing to your notice an error
made on page 268 of the first aid 2016 about the removal of an
organ in parallel arrangement is meant to increase TPR and not
Decrease in TPR.. Will be appreciated if you see to the mistake
and let me know if am right about the correction..Thanx for the
Great work..
Removing organs in parallel circuits increases total peripheral
resistance. In the text (p. 268, second section, second column) it
says that removing an organ will decrease total peripheral
resistance. This is true for organs in series, but not in parallel.
It says removal of organs in parallel arrangement (eg

nephrectomy) results in decreased TPR and increased CO. I
thought it would result in the opposite which is increased TPR and
decreased CO as ststaed in FA 2015
removal of organs in parallel arrangment (eg, nephrectomy) >>
decrease TPR and increase CO,, this should the opposite the
TPR increase and the CO decrease
nephrectomy will increase total peripheral resistance.
Spelling/for
matting
High-yield
addition to
next year
Major
erratum
Clarification
to current
text
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erratum
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erratum
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Major
268
Respiratory
USMLE Step 1 Physiology

Kaplan lecture notes
2013,Peripheral Circulation,Page
94.
ed/15600262; UWORLD qx ID:
1625
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/examination-of-the-jugularvenous-pulse#H9
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UpToDate Link: (Article Title:

"Examination of the jugular
venous pulse" under
"Abnormalities of the x descent")
https://www-uptodatecom.libproxy.unm.edu/contents/e
xamination-of-the-jugular-venouspulse?source=search_result&sea
rch=jugular+venous+pulse&select
edTitle=1~30#H9
https://books.google.jo/books?id=
LiVCDt897lUC&pg=PA361&dq=ri
ght+heart+failure+x+descent&hl=
en&sa=X&redir_esc=y#v=onepag
e&q=right%20heart%20failure%2
0x%20descent&f=false
ticle/712256_4
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https://en.wikipedia.org/wiki/jugul
ar_venous_pressure
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ticle/712256_4
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ganong 24th page 544
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https://en.wikipedia.org/wiki/Jugul
ar_venous_pressure
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First Aid 2016
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Heard it years ago
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Mnemonic given to me during a

lecture.
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Page 272 FA2016. Figure
arrangement (eg, nephrectomy)" causes a decrease in TPR and

increase in CO. This is the opposite of true, removal of a resistor
in a parallel system such as in the case of a nephrectomy, will
lead to an INCREASE in TPR and DECREASE in CO. Thank you.
TPR increases in removal of an organ in parallel
arrangement.Here in the book it is given TPR decreases.
erratum
On Cardiac and vascular function curves on TPR graph point 6

where is noted that in a AV shunt there is decreased TPR, the
graph should be corrected for ''acute'' or ''chronic'' AV fistula,
because in Acute AV fistula there's decrease in TPR without
change in mean systemic pressure whereas in Chronic AV shunt
there's increased in mean systemic pressure changing the X
intercept to the right
Under x-descent, its printed as "prominent in tricuspid
insufficiency." Its prominent in cardiac tamponade, and absent in
Tricuspid regurgitationas (As printed in the earlier line in the
book).
Under Jugular venous pulse (JVP), the description of the "x
descent" reads "Absent in tricuspid regurgitation. Prominent in
tricuspid insufficiency..." Tricuspid regurgitation and tricuspid
insufficiency describe the same phenomenon in regards to JVP
abnormalities. The text should remove the phrase "Prominent in
tricuspid insufficiency" to make the passage correct.
Major
erratum
FA says: "x descent: Absent in tricuspid regurgitation. Prominent

in tricuspid insufficiency and right HF". It should be absent in
tricuspid regurgitation/insufficiency and right HF.
Minor
erratum
the v wave is prominent in tricuspid insufficiency and right HF
High-yield
addition to
next year
Minor
erratum
Absent X descent: tricuspid regurgitation. Prominent X descent:

constrictive pericarditis. Slow Y descent: tricuspid stenosis,
cardiac tamponade. Prominent and deep Y descent: constrictive
pericarditis.
"Prominent in tricuspid insufficiency and right HF" This is put
under the x wave when it should be with the v wave, this causes
confusion because under the x wave tricuspid regurgitation
decreases the x wave when the next line that is meant to go with
v wave is contradictory to that statement. Just an organization
issue, the fact its self is mentioned in the errata list.
A helpful mnemonic is Lubs are Lower. This is in reference to the
classic 'Lub Dub' assessment of heart sounds and can be useful
to remember that the AV valve closures are heard first.
the peak of c wave of JVP should be in the period of isovolumetric
contraction instead of rapid ejection
S4 = Pressure Overload that leads to Hypertrophy. The easy way
to remember if Pressure overload is associated with S3 or S4 is
that if you look at 4 and P they are mirror images of each other 4
P.
JVP x decent. This is the atrial relaxation and the tricuspid valve
bulges downward while right ventricle contracts. It is absent in
tricuspid regurg NOT prominent in tricuspid insufficiency which is
the same thing as regurg. It would still be absent
Fixed splitting occurs in ASD - remember using the letters - In
patients with ASD - Pulmonic valve Always Sounds Delayed
(ASD=Always Sounds Delayed)
On the right side of the heart auscultation image, the T in
Tricuspid stenosis is bolded for no apparent reason. It's not part of
a mnemonic or anything.
R(I)ght sided murmurs get louder with (I)nspiration and L(E)ft
sided murmurs get louder with (E)xpiration
Location of the Auscultation points. Aorta - All, Pulmonic Physicians, Tricuspid - Take, Mitral - Money. All Physician's Take
Money to auscultate a patients heart.
Last section in the table, in systolic heart sound, please add
murmur of hypertrophic cardiomyopathy to be consistent with the
figure and the table. Since it's an obstruction type murmur with
unique characteristics it cannot be included in any of the
mentioned entities (A/P stenosis, M/T regurgitation, VSD, MVP).
Minor
erratum
Minor
erratum
Major
erratum
Spelling/for
matting
Mnemonic
Major
erratum
Mnemonic
Minor
erratum
Mnemonic
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matting
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Mnemonic
Clarification
to current
text
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https://en.wikipedia.org/wiki/Mitral
_valve_prolapse
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/clinical-manifestations-anddiagnosis-of-chronic-mitralregurgitation?source=search_res
ult&search=mitral+regurgitation&s
/auscultation-of-cardiac-murmursin-adults?source=see_link
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http://www.medicinenet.com/mitra
l_valve_prolapse/article.htm
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BRS Physiology 6th edition

costanzo
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98/18/1928.long
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dubin rapid ekg p. 265
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So please add it in systolic heart sounds.

MVP: later onset of click/murmur should be later onset click and
shorter murmur
Atrial septal defects are associated with crescendo-decrescendo
systolic ejection murmurs. The 2016 text says they are associated
with a diastolic murmur. The murmur comes from the increased
flow through the pulmonary artery outflow tract (during systolic
ejection), not through the ASD itself.
Another Fun Mnemonic for where to auscultate the heart: All
(Aortic) Physicians (Pulmonary) Take (Tricuspid) Money (Mitral)
It should be added that rapid squatting increase the intensity of
mitral regurgitation murmurs. From UpToDate: "The murmur may
become louder when left ventricular volume increases... or when
arterial pressure increases (squatting or isometric hand grip).
Minor
erratum
Minor
erratum
Mnemonic
High-yield
addition to
next year
aortic regurgitation can be heard over the left sternal border (as
noted in the text) or over the RIGHT SECOND INTERSPACE
(aortic area)
Pulmonic regurgitation is best heard at the left second and third
interspaces NOT the left sternal border
High-yield
addition to
next year
Minor
erratum
VSD "is maximal over the third and fourth interspaces along the
sternal border"
Minor
erratum
"An atrial septal defect with left to right shunting results in an

ejection mid-systolic murmur resulting from increased flow across
the pulmonic valve" NOT increase flow across tricuspid valve
Squatting increases intensity of MR, VSD, and AR. Aortic
Stenosis shows variable changes: increase in systemic vascular
resistance decreased intensity of AS. Increased preload causes
increased intensity of AS.
Minor
erratum
Spelling/for
matting
na
Under Systolic Heart murmur section there is a clarification

needed for descriptive part of Aortic stenosis. This line "LV >>
aortic pressure during systole" should replaced by "LV
pressure>> aortic pressure during systole". Eventhough it is
understood but this should be clarified by putting "Pressure"
following LV.
Under the aortic stenosis section, shouldn't it is a crescendodecresendo murmur with a midsystolic click or even a midsystolic
murmur. Since the valve has to be forced open the abrupt stop of
the valves creates an ejection click. The figure that accompanies
the text shows that the murmur starts immediately after S1.
mitral valve prolapse ( three words), you will hear mid systolic
click ( also three words.) due to chordea tendinae tensing ( three
words)
The myocardial action potential chart and description is missing
the late sodium current proponent in phase 2. This channel phase
is important because ranolazine works on this phase of the
sodium channel to provide its effects.
Phase 4 is caused by inward Na current from If Channels. It is not
due to K inward current.
In the graphics that support each other in a color coordinated,
there seems to be a vector direction that is inconsistent with the T
wave. The graphic of the heart shows the direction of
repolarization traveling endocardium to epicardium. With
repolarization as a negative charge traveling endo to epi direction
on what seems to be a lead II should show a negative inflection in
the adjoining ECG. The graphic could be clarified, or adjusted
showing the direction of the repolarizing arrows to reflect the
appropriate epicardium to endocardium direction. This can help
support the concept that what is 1st to depolarize is last to
repolarize supporting the contraction needs of the ventricle. As
the epicardial action potential is shorter than the endocardial one
(more Ito receptors), repolarization proceeds from epi to endo.
Thank you for your consideration for adjustment, Myles.
T wave inversion may indicate ischemia NOT recent MI. ST
changes indicate MI. Q waves indicate old infarct.
U OK? U wave is present with hypOKalemia
http://www-uptodatecom.proxy.its.virginia.edu/content
s/auscultation-of-heart-
The text uses S1 to illustrate the concept of splitting, including

normal, wide, fixed, and paradoxical. However, the classic
Major
erratum
/auscultation-of-cardiac-murmursin-adults?source=see_link
https://www-uptodatecom.foyer.swmed.edu/contents/p
hysiologic-and-pharmacologicmaneuvers-in-the-differentialdiagnosis-of-heart-murmurs-andsounds?source=machineLearning
&search=rapid+squatting&selecte
chor=H4#H4
https://en.wikipedia.org/wiki/Aortic
_stenosis ;
http://www.cvphysiology.com/Hea
rt%20Disease/HD004.htm
Minor
erratum
Minor
erratum
Mnemonic
Clarification
to current
text
Minor
erratum
Major
erratum
Minor
erratum
Mnemonic
sounds?source=search_result&se
arch=fixed+split+s2&selectedTitle
=1%7E150#H12063836
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I thought of this while studying.
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Thought of it while studying
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none needed
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The only EKG book you'll ever

need, 8th edition by Malcolm s.
Thaler
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http://www.cvphysiology.com/Blo
odPressure/BP017.htm
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/use-of-angiotensin-ii-receptorblocker-and-neprilysin-inhibitor-inheart-failure-with-reducedejection-fraction#H866463489
and
/nesiritide-in-the-treatment-ofacute-decompensated-heartfailure?source=search_result&se
arch=nesiritide&selectedTitle=4%
7E22
BRS physiology 5th edition, page
86
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http://www.medbullets.com/step1cardiovascular/8022/baroreceptor
s-and-chemoreceptors
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articles/PMC3285950/,
http://eurheartj.oxfordjournals.org/
content/35/26/1719
http://eurheartj.oxfordjournals.org/
content/35/26/1719
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/management-of-patent-ductusarteriosus
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https://en.wikipedia.org/wiki/Coar
ctation_of_the_aorta
https://pedclerk.bsd.uchicago.edu
/page/coarctation-aorta
inspiratory splitting described in the text is best heard at S2, which

is the closing of the pulmonic/aortic valves. All of the conditions
described in the text are heard with S2 , and while some (like
electrical conduction block) split S1 as well, not all of them do (like
pulmonic and aortic stenosis, which affect S2 only). Also
UpToDate says S1 is normally slightly split regardless of
inspiration. Wide and fixed splitting is usually described as S2.
This came up in a Step1 practice test I took and it was key to the
right answer!
The normal EKG tracing for WPW syndrome is slightly incorrect
due to the lack of Q wave.
For Congenital long QT syndromes: Romano-Ward (autosomal
dominant: Roman's were dominant). For Jervell and LangeNielsen syndrome, drop the J and flips the letters (LNS-->SNL
[sensorineural loss])
Jervell and Lange-Nielsen Syndrome: Jervell and Lange (The
names) ARen't (Autosomal Recessive) able to hear
(Sensorinerual Deafness) their Hearts (Cardio).
Romano-Ward syndrome is autosomal dominant, no
sensorineural deafness. Romans are dominant and can hear their
attackers coming.
Arrhythmia: sinus origin, ectopic rhythms, reentrant arrhythmia
(supraventricular arrhythmia, ventricular arrhythmia), conduction
blocks (P278 and bundle branch block, hemiblock), preexcitation
syndromes (Wolff-Parkinson-White syndrom etc)
Atrial natriuretic peptide and brain natriuretic peptide can be
summarize by a flow chart attached with the submission
Please add the drug sacubitril (ANGIOTENSIN RECEPTORNEPRILYSIN INHIBITOR) under the description of ANP, its
extensively used now. Also, under the BNP section (below the
quoted section) please include the drug Nesiritide (BNP
anologue) and add descriptions of its use in heart failure.
The aortic arch only responds to increases, not decreases in

arterial pressure. This should be corrected, and the baroreceptor
reflex should also not that it is only the carotid that is involved not
just "increased stretch"
It states that aortic arch receptors responds to decrease and
increase in blood pressure, I taught aortic arch receptors respond
ONLY TO INCREASE BLOOD PRESSURE and not to decrease
BP.
Very high central aortic systolic pressures in a young
hypertensive patient on telmisartan: Is central aortic systolic
pressure associated with white coat hypertension?
(Please disregard my previous submission, it has a wrong
description) The current ventricular and aortic pressures on the
illustration are too high. Given that a BRACHIAL systolic pressure
of 130mmHg is considered as pre-hypertension and a diastolic
pressure of 90mmHg is already Stage 1 Hypertension as per
JNC, and given the physiologic concept that brachial pressures
(or any downstream arterial pressure) are higher than the central
aortic pressures (ventricle and aorta) due to increased resistance,
the 130/90 listed here are too high. A figure in the article Very
high central aortic systolic pressures in a young hypertensive
patient on telmisartan: Is central aortic systolic pressure
associated with white coat hypertension? gives mean central
pressures ranging from 100-120mmHg from ages 20 to 80, while
the Oxford journal already considers 125/90mmHg as a cut-off
value.
FA says a PDA results in progressive RVH and/or LVH and HF.
Actually, the chambers aminly involved are the left atrium and left
ventricle not the right ventricle.
Coarctation of the Aorta is generally subdivided into two types. I
personally believe that instead of grouping them together as
"Juxtaductal," they instead be known as "Pre-Ductal" & "PostDuctal." It would be great if there was a chart comparing the two
variations. For example, Pre-Ductal: Infantile; Lower Extremity
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
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Minor
erratum
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to current
text
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/atrial-septal-abnormalities-pfoasd-and-asa-and-risk-of-cerebralemboli-inadults?source=search_result&sea
rch=arterial+septal+defect&select
edTitle=4%7E150
http://www.embryology.ch/anglais
/pcardio/patholcardio03.html
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/clinical-manifestations-anddiagnosis-of-thoracic-aorticaneurysm?source=search_result
&search=thoracic+aortic+aneurys
m&selectedTitle=2%7E70
/overview-of-abdominal-aorticaneurysm?source=search_result
&search=abdominal+aortic+aneur
ysm&selectedTitle=2%7E132
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my own but the 1,1,1 from

pathoma
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Pathoma
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error in grammar
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N/A
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NA
Cyanosis; Associated with Turner's Syndrome vs. Post-Ductal:

Adult Type; Non-Cyanotic; Notched Ribs. Thanks for the
consideration!
Disorder: transplacental transmission of maternal SS-A/SS-B Ab;
Defect: Congenital heart block
Under Atrial Septal Defect, please add that the patient can
present with paradoxical emboli. You included this when
describing patent foramen ovale on page 262, but it can also
occur in ASD. From UpToDate: "Right-to-left shunting through a
PFO or an ASD can result in a paradoxical embolus"
High-yield
addition to
next year
High-yield
addition to
next year
In the section of "Left to Right shunts" the heading is written

wrong as "Right to Left Shunts" at p. 283 FA 2016. VSD, ASD,
PDA all are Left to Right Shunts.
Just two points to add to the text that I think might be high-yield:
1) Adding a sentence indicating that fatty streaks are very early
changes that are seen in almost all children above age 10 (I had a
test on this fact in UWorld). 2) Adding that oxidized LDL is taken
up by macrophages via scavenger receptors (although SR-B3 or
CD36 is proposed but I think it might not be a well-known area
and it's better not to mention the specific receptor type)
Chlamydia pneumoniae infection has been established as a risk
factor for atherosclerosis. or at least strongly associated with its
development.
It is extremely high-yield to know that thoracic aortic aneurysms
may dilate the aortic valve root, leading to aortic insufficiency.
From UpToDate: "Ascending aneurysms can present with heart
failure due to aortic regurgitation from aortic sinus dilatation"
Major
erratum
It is high-yield to know that abdominal aortic aneurysms have an

increased risk of rupture when their diameter is greater than
5.5cm. This is a potentially lethal complication that affects
management, and the size can be easily mentioned in a question
stem. From UpToDate: "The likelihood that an aneurysm will
rupture is increased for those with aneurysm diameter >5.5 cm"
Under sudden cardiac death it would be better to have ventricular
tachycardia together with ventricular fibrillation since VT is a more
common cause of SCD. (Rapid Review Pathology, Gojan, 4th
edition, page 250). The article on eMedicine does not state
whether VT or VF is more common, but it mentions them both
equally. It would be better to have both of the arrhythmias as
examples.
On Coronary steal syndrome it says: ...dilates normal vessels and
shunts blood toward well- perfused areas-> flow and ischemia in
poststenotic region. It would be better to add to worsen* before
ishcemia saying: flow and worsen ischemia in poststenotic
region ( to clarify that the '''' arrow is only for flow not for
ischemia))
On the text when describing presentation of the disease, it is
written: "can present with tearing chest pain, of sudden onset,
radiating...." , its better to reframe and write: "Sudden onset of
tearing chest pain, radiating....."
Repeated episodes of stable angina cause gradual loss, fibrosis
and vacuolization of damaged myocytes located in the
subendocardial locations.
please see attached simple graphics. upper row = light
microscopy (blue text = complications (eats = ruptures)), bottom
row = gross morphology (red text is white border is red =
granulation tissue, white box = fibrosis), columns = time. Sadly i
don't have access to professional graphics software right now or
i'd have made more visually appealing.
It would be extremely helpful if you added a cross-sectional image
through the ventricles that showed the result of infarction of
various vessels. This is high-yield because of its anatomy tie-in.
Attached is one I sketched into FA2016 from Pathoma.
Add a closing parentheses following the word "aspirin". The text
should read "...antiplatelet therapy (eg, aspirin) + ADP receptor
inhibitors..."
Parenthesis after antiplatelet therapy is not closed
High-yield
addition to
next year
For Acute coronary syndrome management, There is the known

pnemonic MONA BAH which stands for (Morphine, Oxygen,
High-yield
addition to
next year
High-yield
addition to
next year
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addition to
next year
Clarification
to current
text
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
Spelling/for
matting
Spelling/for
matting
Mnemonic
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http://heart.bmj.com/content/83/5/
499.full#T3
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123/9/1044.full,
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/genetics-of-hypertrophiccardiomyopathy?source=search_r
esult&search=hypertrophic+cardi
omyopathy+genetics&selectedTitl
e=1~150#H112767698 "In all
study populations, mutations in
the cardiac myosin binding
protein C gene are most
common, accounting for up to half
of the mutations identified
[6,19,21]. Mutations in the cardiac
beta-myosin heavy chain gene
are second in frequency, being
present in 25 to 40 percent of
patients [6,19,20]."
None
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rticle/155340-overview ,
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/hypertrophic-cardiomyopathyclinical-manifestations-diagnosisand-evaluation
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/definition-classification-etiologyand-pathophysiology-of-shock-inadults?source=search_result&sea
rch=shock&selectedTitle=1~150
N/A
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/acute-traumatic-spinal-cordinjury?source=see_link&sectionN
ame=Cardiovascular+complicatio
ns&anchor=H25317479#H25317
Nitroglycerine, Aspirin, B-Blocker, ACE-inhibitor, Heparin)

There is a missing parenthesis after "(eg, aspirin"
In FA 2016, on the page and subsection I listed above, it states
under Ventricular free wall rupture: "Occurs 5-14 days after
MI.Free Wall rupture --> cardiac tamponade.", I believe this table
is new in the 2016 edition. I have seen the range of 3-7 days
listed in other study materials: notably in UWorld questions #193
and #195 where they specifically associate the ventricular free
wall rupture with this time frame. Further, in Fundamentals of
Pathology by Husain A. Sattar, Rupture of the ventricular free wall
is addressed on p.74 of the 2015 edition. It associates a time
frame of 4-7 days to this complication. Additionally, in primary
literature (notably the article Im attaching under supporting
references), it states 40-50% of L. Ventricular free wall ruptures
occur within 48 hours of the MI, and this proportion is
underrepresented due to the number of people that die from free
wall rupture before reaching the hospital. There is a late
classification (>48 hours) that accounts for the remainder of the
ruptures, but the authors do not assign proportions of wall
ruptures to granges of time. However, given the proportion of the
cases that present in the Early period as defined by the article, I
believe that the proper time frame for this complication should be
significantly shorter. I would suggest, the 3-7 (or 4-7) days that is
established among published USMLE Step 1 study material. I
believe this evidence, taken along with the molecular mechanisms
that are proposed to weaken the ventricular free wall post MI
(notably coagulative necrosis), makes me confident that the time
frame of 5-14 days needs to be modified to a much shorter range,
such as the 3-7 days that I have suggested. Please contact me if
there are any questions surrounding this submission.
FA 2016 States that the posteromedial papillary muscle is at an
increased risk for rupture due to its single blood supply from the
Posterior Descending Artery. While this papillary muscle is at an
increased risk, its blood supply comes from the Right Coronary
Artery, not the PDA.
in Hypertrophic cardiomyopathy: mutations in the "cardiac myosin
binding protein C" gene are most common. beta-myosin heavy
chain gene are SECOND in frequency
Spelling/for
matting
Major
erratum
Major
erratum
Clarification
to current
text
ABCCCDFGH -- Alcohol, Beriberi, Cocaine, Coxsackie, Chagas,

Doxorubicin, Fetus (Peripartum), Genetics (Familial),
Hemochromatosis
The cardiomyopathy section ( restrictive/infiltrative) refers to
Lffler syndrome as endomyocardial fibrosis with a prominent
eosinophilic infiltrate, which is the description of loEffler
endocarditis (extra e, no accent), whereas Lffler (no E after o,
with accent) syndrome refers to a separate syndrome of infection
related pulmonary eosinophilia (e.g. from Ascaris lumbricoides).
See references for the separate conditions.
"Eccentric hypertrophy (sarcomeres added in series)" is included
in the Dilated cardiomyopathy section. To complement this, the
hypertrophic cardiomyopathy section should include "Concentric
hypertrophy (sarcomeres added in parallel)
Tension pneumothorax is the third cause of obstructive shock and
should be included in this table.
Mnemonic
Good (Abs) decrease mortality. This mnemonic can help remind

of the drugs that decrease mortality in heart failure, which are:
ACE inhibitors/ARBs, Beta-Blockers and Spironolactone.
In regards to Distributive shock. From Up to Date: CNSNeurogenic shock refers to hypotension, usually with bradycardia,
attributed to interruption of autonomic pathways in the spinal cord
Mnemonic
Spelling/for
matting
Clarification
to current
text
Clarification
to current
text
Clarification
to current
text
479
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My roommate's friend is an
attending pulmonologist, and
confirmed this correction.
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/antimicrobial-therapy-of-nativevalveendocarditis?source=machineLea
rning&search=hacek&selectedTitl
e=1~51&sectionRank=1&anchor=
H22#H22
N/A
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N/A
293
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myself
294
Biochemistry
mnemonic
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https://en.wikipedia.org/wiki/Rheu
matic_fever &
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/cardiactumors?source=search_result&se
arch=myxoma&selectedTitle=1%
7E46#H14
/cardiactumors?source=search_result&se
arch=myxoma&selectedTitle=1%
7E46#H14
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Mnemonic suggestion
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Goljan RR 4th edition page 233.

and wikipedia
https://en.wikipedia.org/wiki/Polya
rteritis_nodosa
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N/A
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Pathoma
causing decreased vascular resistance and decreased cardiac

output.
Diastolic dysfunction- normal EDV. Diastolic dysfunction has a
reduced EDV. Emedicine states that both systolic dysfunction and
diastolic dysfunction have reduced stroke volume. Ejection
fraction=SV/EDV if SV decreased and EDV stayed the same then
EF would decrease which isn't the case for diastolic dysfunction.
There is impaired filling! so the EDV must be reduced.
Although pulmonary embolism is correctly listed as a potential
cause of obstructive shock, it leads to a preload reduction (unlike
the other causes of obstructive shock).
Haemophilus aphrophilus; the H in HACEK has been changed to
Aggregatibacter aphrophilus
For Acute Bacterial Endocarditis passage, the A in Acute & the A

in Staph aureus could be noted in red to remember that they are
correlated.
You should consider adding photos of Roth spots and Osler
nodes. These are hard to describe in words in a way that makes
them stick, but pretty unique looking (and thus easy to remember)
in photographs.
The O in Osler nodes stands for Ouch to distinguish that these
cause pain while Janeway lesions do not.
ADPKD- mutation on chromosome 16- "AD polysixteen kidney
disease"
Rheumatic Fever memorization can be benefited via the 5 A's: 1.
group A Step. 2. Aschoff Bodies. 3. Anitschkow Cells. 4. Antistreptolysin. 5. Antibodies against M protein. All characteristics
begin with the letter A (Except group A Strep, having 'A' in the
middle).
For myxoma I suggest adding notes about its histologic findings
that are very high yield : gelatinous appearance, abundant ground
substance, lipidic cells embedded in vascular mixed storm,
vascular tumors (increased VEGF), increased cytokines (IL-6).
For Rhabdomyomas maybe add more common in ventricle,
benign hamartoma.
It is high-yield to know that myxomas are mesenchymal tumors,
since this separates them from Rhabdomyomas, which are
tumors of myocardium. Form UpToDate: "The cells originate from
a multipotent mesenchyme"
Knowing which tumors have a propensity to metastasize to the
heart is high-yield. Melanomas are the most common, and you
should include this one at least. Many other solid tumors and
leukemia/lymphoma also like to go to the heart. From UpToDate:
"Malignant melanomas are particularly likely to metastasize to the
heart [118,153,157,158]. Other solid tumors commonly associated
with cardiac involvement include lung cancer, breast cancer, soft
tissue sarcomas, renal carcinoma, esophageal cancer,
hepatocellular carcinoma, and thyroid cancer [159]. There is also
a high prevalence of secondary cardiac involvement with
leukemia and lymphoma."
Please consider this mnemonic along with the "CRASH and burn"
mnemonic. :- K*awasaki K*ills young K*ids K*oronaries :
Aneurysm > Thrombosis/Rupture
In polyarteritis nodosa, only the one associated with Hep B is
immune complex mediated. Others are unknown. It would be
helpful to avoid the confusion that all PN are related to IC.
For Kawasaki Disease please consider adding a note about
Echocardiography as the study of choice for evaluation of
aneurysm that should be done at diagnosis, at 2 weeks, and 6-8
weeks after onset of disease for follow-up. You might also want to
add a note that aneurysm is most common at proximal LAD.
(please see ref)
"Bu(e)rgers? Try smoking without fingers!"--Occurs in heavy
smokers and leads to autoamputation of digits, resolves with
smoking cessation
You can rewrite wegener as weCener (almost phonetically the
same) to remember that it's C-anca and treated with
Cyclophosphamide and Corticosteroids (all the C's should be in
Clarification
to current
text
Major
erratum
Clarification
to current
text
Mnemonic
High-yield
addition to
next year
Mnemonic
Mnemonic
Mnemonic
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addition to
next year
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addition to
next year
High-yield
addition to
next year
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
Mnemonic
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N/A (my own idea)
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/management-of-new-onset-atrialfibrillation?source=machineLearni
ng&search=atrial+fibrillation+treat
ment&selectedTitle=1~150&secti
onRank=2&anchor=H8#H8
N/A
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ticle/727150
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N/A
300
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UWorld Q 11634
300
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ed/11701475
300
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UWorld Question 11844
301
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1.
ug/lanoxin-digoxin-342432#10 2.
/use-of-digoxin-in-heart-failuredue-to-systolic-dysfunction 3.
109/24/2959.full 4. Katzung Basic
and Clinical Pharmacology,
Chapter 13 5. Digoxin drug
information in UpToDate/lexicomp
296
298
/drugs-used-for-the-treatment-ofhypertensiveemergencies?source=see_link
FA 2016
red).
Polyarteritis Nodosa (PAN) = Pulmonary Artery Not included
Mnemonic
Mnemonic to remember Osler nodes are painful and Janeway

lesions are painless. "Osler = Ouch"
Two, four, fix rate; As you can probably tell, this sounds like "2, 4,
6, 8" so it should be really easy to remember in that sense. Betablockers and Calcium channel blockers (classes II and IV,
respectively) are used to control heart rate.
Mnemonic
"Hypertensive Moms Love Nifedipine" = Hydralazine, (a)Methyldopa, Labetalol, Nifedipine

Under "Clinical Use": Change "Clevidipine: hypertensive urgency
or emergency" to "Clevidipine and Nicardipine: hypertensive
urgency or emergency."
Mom's Hypertension Needs Lowering (Methyldopa, Hydralazine,
Nifedipine, Labetalol)
For Nitrates I would suggest adding a note indicating that both
Nitroglycerin and Isosorbide dinitrate (ISDN) have extensive first
pass metabolism (TNG is only prescribed sublingual or IV; ISDN
needs frequent dosing), while isosorbate mononitrate (ISMN) has
almost 100% bioavailability when given orally. I had a test on
UWold on this concept and think it might be high-yield.
HMG CoA Reductase Inhibitor (Statins), drug mnemonic:
Lovastatin, Atorvastatin, Fluvastatin, and Simvastatin can be
remembered as "Lov At First Statin"
Ezetimibe decreases intestinal absorption of cholesterol by
inhibiting the Niemann-Pick C1 like 1 (NPC1LI) transporter
protein, this transports dietary cholesterol from the GI lumen into
the intestinal enterocytes
Fibrates cause gallstones but it is not explained why. It is
important that they inhibit 7a-hydroxylase, decreasing bile acid
production from cholesterol. This increases the cholesterol:bile
acid ratio in the gallbladder, increasing chances of stone
formation. Connects drug mechanism to side effects.
In addition to niacin, fibrates (also) work by reducing hepatic
VLDL synthesis. Please include this in the mechanisms of action
section. There was a UWorld question on this that sort of threw
me off.
I would suggest expanding the list of drugs and conditions
causing Dig toxicity since it's a commonly tested area. It's better
to make subheadings (like medical conditions, electrolytes,
medications, ...). My suggestions are the followings: 1.Medical
conditions: Renal failure, Thyroid disease, Acid/Base
derangements, Myocardial disease (e.g. MI); 2. Electrolytes :
Hypokalemia, Hypomagnesemia, Hypercalcemia; 3. Medications:
Non-dihydropyridine CCB (Verapami/Diltiazeml), Antiarrythmics
(Amiodarone, Quinidine, Propafenone), Antibiotics (Erythromycin,
Clarithromycin, Tetracyclines), Diuretics (loops,
hydrochlorothiazide, amiloride, triamterene), Indomethacin,
Amphotericine B. In case you think the list is too extensive, I
would suggest at least adding Erythro and Clarithro ( used for
pulmonary infections in elderly) and diuretics.
Well I'm sure this one will look very strange (I, myself, am very
confused too!). The mechanism of action of digoxin is mentioned
as direct inhibition of NA/K/ATPase (which is absolutely correct)
and indirect "inhibition" of Na/Ca exchanger (which is what many
board references and even Katzung pharmacology 2015 says,
and is the classic mechanism we learnt in med schools). However
it's very shocking to me to see many valid references (including
medscape and uptodate) are mentioning a total opposite
mechanism regarding the Na/Ca pump and its direction. To be
specific, they indicate that inhibition of Na/K ATPase by digoxin
will cause indirect "ACTIVATION" of the Na/Ca exchanger that
actually increases the calcium "influx" to the cell ( in exchange for
efflux of extra sodium trapped in the cell). Please see the
references (and also a brief google image search will show that
the calcium pumps are drawn working in different directions in
various images). So I hope your experts can come to a conclusion
or simply change the indirect effect to "increased intracellular
calcium" to avoid misinterpretation. Also please keep in mind that
any changes in the text should also be reflected in the image that
shows the direction of the Na/Ca exchanger.
Mnemonic
Mnemonic
Clarification
to current
text
Mnemonic
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Major
erratum
302
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302
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No reference because I created

the mnemonic
http://www.pharmacorama.com/e
n/Sections/Sodium-6.php
302
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ar
http://www.cvpharmacology.com/
antiarrhy/sodium-blockers
302
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ar
http://www.cvpharmacology.com/
antiarrhy/sodium-blockers
303
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ar
Figure is saved from google

image search from the following
website:
https://www.studyblue.com/notes/
note/n/week-22/deck/1892776
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303
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304
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/antihypertensive-drugs-andlipids?source=machineLearning&
search=carvedilol+alpha&selecte
chor=H2#H2
/sotalol-druginformation?source=search_result
&search=sotalol&selectedTitle=1
%7E107#F222456
N/A - heard or saw this mnemonic
a couple years ago
304
Cardiovascul
ar
http://www.drugs.com/cons/diltiaz
em.html
305
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ar
305
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ar
/pindolol-druginformation?source=preview&sea
rch=%2Fcontents%2Fsearch&an
chor=F210121&selectedTitle=1~2
8#F210124
306
Endocrine
https://en.wikipedia.org/wiki/Adre
nal_cortex
306
Endocrine
306
Endocrine
Langman's Embryology pg. 267
307
Endocrine
ed/?term=The+neurophysins+in+
health+and+disease.
307
Endocrine
NA
302
Takayasu has weak upper extremity pulses. "Can't TAKE-A-YU

pulse"
IA Adverse effects
Mnemonic
For Class IA please add a note indicating that in addition to Na

channel blockade they also prolong repolarization by inhibiting K
channels. This is an important fact and the reason that AP
duration and QT interval is increased in class IA (similar to class
III that acts on K channels).
For Class IB I suggest adding Tocainide too (although it's not
currently used in US). Additionally adding Tocainide will help with
the mnemonic too that contains a "T" but currently both T and M
are referred to MexileTine! Tocaidine still appears in the questions
too.
For Class IC, please add Moricizine too. You can include it in the
current mnemonic by adding a "More" (Can I ave More Fries
Please?). However I suggest rephrasing the mnemonic to " I Can
have More Fries, Please" and printing "M, F, P" in red to indicate
the drugs (Moricizine, Flecainide, Propafenone) and also I and C
for class IC to be consistent with the other 2 mnemonics (IA and
IB).
I think there is a potential error in the figure related to class II
drugs (beta blockers). While indicating that class II will cause
prolonged repolarization at AV node (which is true due to
decreased K current), the figure actually depicts a more narrow
curve (blue curve) compared to the gray reference curve. It
should be wider actually to indicate prolonged repolarization. It
should somehow look like the figure for calcium channel blockers
in the next page (304). Please also see the attachment.
Carvedilol is listed as a nonselective alpha-beta blocker, but it
should be listed as an alpha1-beta blocker.
Clarification
to current
text
Sotalol should be listed as both a type II and type III

antiarrhythmic drug
Minor
erratum
A mnemonic to remember what two drugs make up the Class IV

antiarrhythmics is "4 Door Volkswagen," where the IV in the topic
heading would be bolded in red, along with the 4, D, and V in the
mnemonic and the V and D in verapamil and diltiazem when
listed.
For remembering what Diltiazem is and does, the drug itself is the
clue. DIL =DILation thus, Vesodilation (DIL in red for highlighting)
and TIAZ sound similar as the THIAZ in BenzoTHIAZapine
(highlighted the same way). SO one can recall Diltiazem is a
benzothiazipine and vasodilator.
Pindolol and acebutolol are partial B-agonists, contraindicated in
angina. "Pindolol, Acebutolol - Partial Agonists"
Neither pinodol or acebutolol are listed as contraindicated for use
in angina on UpToDate. Acebutol is actually listed as a
medications FOR angina and Pindolol is also listed as a
medication for angina prophylaxis (Canada). Pindolol is listed as
contraindicated in Prinzmetal angina due to lack of 1 blocking
activity but not for stable/unstable angina pectoris
In the mnemonic, you say "GFR corresponds with Salt (Na+),
Sugar (glucocorticoids), and Sex (androgens)". Instead of Na+,
you should have aldosterone in the first parenthesis because the
format is 'mnemonic (secretory product)', not a further description
of the mnemonic.
A new paper was published in 2015 that now shows that the
embryonic origin of parafollicular C cells in the thyroid gland is
from endoderm, NOT neural crest.
The parafollicular cells of the thyroid are embryologically derived
from the 4th branchial pouch, which is endoderm. They are not
derived from neural crest. On page 570 of first aid 2016 this fact is
stated correctly. So the book is contradicting itself with this
statement page 306.
Oxytocin is transported to posterior pituitary via neurophysin type
I. Vasopressin is transported to posterior pituitary via neurophysin
type II.
For the 2 major hormones made in hypothalamus and secreted
Mnemonic
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Minor
erratum
Minor
erratum
Mnemonic
Mnemonic
Minor
erratum
Spelling/for
matting
Major
erratum
Major
erratum
High-yield
addition to
next year
Mnemonic
307
Endocrine
Mnemonic
307
Endocrine
FA 2017 page 456
308
Endocrine
308
Endocrine
http://onlinelibrary.wiley.com/store
/10.1002/iub.315/asset/315_ftp.p
df;jsessionid=B27A66596E3E187
5FF148E3305A8E935.f04t02?v=
1&t=ijac3s0t&s=89dc2c251ada31
af11ec13f53a2dad1ed5dfed4a,
https://en.wikipedia.org/wiki/Gluco
se_transporter, Uworld QID847
NA
308
Endocrine
ed/15561910
308
Endocrine
First aid for the Basic Sciences

Organ System 2nd ed Page 158.
308
Endocrine
https://en.wikipedia.org/wiki/Insuli
n_signal_transduction_pathway
309
Cardiovascul
ar
http://www.educus.com/Journals/
23928650?AspxAutoDetectCooki
eSupport=1
309
Endocrine
N/A
310
Endocrine
https://en.wikipedia.org/wiki/Follicl
estimulating_hormone#Effects_in_f
emales;
https://en.wikipedia.org/wiki/Lutei
nizing_hormone
310
Endocrine
311
Endocrine
https://en.wikipedia.org/wiki/Endo
cannabinoid_system and
ed/12383777
311
Endocrine
Kaplan usmle step 1 physiology

book Section X, Chapter 3, page
269 and 271
311
Endocrine
ed/?term=Ghrelin+receptor+nome
nclature%2C+distribution%2C+an
d+function
from posterior pituitary (ADH and Oxytocin). a mnemonic to

remember them is "SAD PROXY" SAD= Supraoptic nucleus
makes ADh. PROXY= PaRaventricular nucleus makes OXYtocin.
For acidophils, insert "A PiG" in red for acidophils prolactin and
growth hormone
Under Posterior Pituitary, text states "Stores and releases
vasopressin (antidiuretic hormone, or ADH) and oxytocin, both
made in the hypothalamus (supraoptic and paraventricular
nuclei)..." text should say "supraoptic and paraventricular nuclei
respectively"
I think its worth clarifying that the GLUT-1 transporters in the
brain are actually in the blood-brain barrier (not neural tissues
themselves). While that of GLUT-3, instead of brain, neurons (to
reflect all literature talking about glucose transporters.)
About the BRICK L mnemonic I think it's extra and can be omitted
(because except adipose and muscle other tissues are
independent and also use different GLUT transporters). It's best
to remember the GLUT-4 and insulin-dependent tissue (i.e
adipose and striated muscle). You can use a mnemonic like 4A.M. (Four- Adipose. Muscle) to remember those tissues instead.
In insulin regulation a very useful note is added about oral
glucose and incretins. There are two important incretins (GLP-1
and GIP) which work similarly to increase insulin and decrease
glucagon. I would suggest also adding the second one (GIP:
gastric inhibitory peptide aka as " glucose-dependent
insulinotropic polypeptide") which is an important incretin secreted
after oral ingestion of foods. This would help to better recognize
the incretins and the mechanism of oral glucose in increasing
insulin.
Insulin is a receptor that has two alpha subunits that is entirely
extracellular and two transmembrane beta subunits. This
information should be added to the picture of the insulin receptor
on the bottom of the page.
I think the two figures at the bottom of the page should be
switched. FIRST, glucose enters a beta cell via glut-2, the beta
cell releases insulin, the insulin enters circulation, THEN insulin
acts on the skeletal muscle or adipose tissue and causes
expression of GLUT-4
Ivrabradine is a pure heart rate lowering drug with no effect on
cardiac contractility and/or relaxation. Selective inhibition of If
current in the SA node prolongs the slow depolarization phase,
resulting in decreased SA nodal firing rate.
Under glucagon's function, the text lists gluconeogenesis under
"catabolic effects" But, gluconeogenesis is an anabolic, not
catabolic, process. Also, to be consistent with the formatting used
for insulin, I'd suggest using up/down arrows for each effect of
glucagon (e.g. <up arrow> glycogenolysis, etc)
On the diagram: it lists FSH (above) + LH (below) followed by an
arrow > then depicts both leading to ovulation (above) +
spermatogenesis below. Firstly, spermatogenesis should be
above for symmetry as it is due to FSH and ovulation to LH. It
could be replaced with 2 individual arrows "FSH >
Spermatogenesis initiation, follical growth" & "LH: testosterone,
ovulation'
TRH can increase prolactin secretion in primary, NOT secondary
hypothyroidism (because TRH is not elevated in secondary
hypothyroidism).
In Endocannabinoids description part of appetite regulation
clarification to Endocannabinoids action on its receptor to
increase appetite should be more clarified like how the hedonic
system work to increase the appetite.
ADH regulation has its strong influence from plasma osmolarity
(1% change stimulates it) and hypovolemia also stimulates but
10-15% change is required to stimulate ADH release.So #Plasma
osmolarity should be mentioned as major regulator. # And also
please mention ADH release is directly related Plasma osmolarity
and indirectly related to blood volume
(via GH secretagog receptor) --> should be (via GH secretagogue
receptor)
Mnemonic
Clarification
to current
text
Clarification
to current
text
Mnemonic
Clarification
to current
text
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
Spelling/for
matting
312
Endocrine
https://en.wikipedia.org/wiki/Steroi
dogenic_acute_regulatory_protei
n
ed/11181954 Kaplan usmle step
1 book 2013-2014 version,
section,chapter 4, P-280
312
Endocrine
312
Endocrine
N/A - FA2016
312
Endocrine
312
Endocrine
313
Endocrine
/apparent-mineralocorticoidexcess-syndromes-includingchronic-licorice-ingestion
http://press.endocrine.org/doi/full/
10.1210/edrv.21.1.0389
313
Endocrine
313
Endocrine
313
Endocrine
First Aid 2016 page 538 under

Syndrome of Apparent
Mineralocorticoid Excess, first
and second line of the paragraph
314
Endocrine
ed/17634140
314
Endocrine
314
Endocrine
rticle/874690-overview;
https://courses.washington.edu/c
onj/bess/bone/bone2.html;
ed/11423563
314
Endocrine
/calcium-and-vitamin-d-for-bonehealth-beyond-the-basics
315
Endocrine
Reference 1:
https://en.wikipedia.org/wiki/Thyro
id#/media/File:Thyroid_hormone_
synthesis.png reference 2:
Physiology (Linda S. Costanzo,),
5th edition, chapter: Endocrine,
page number 408-409
315
Endocrine
Mnemonic, Ref N/A
steroidogenic acute regulatory protein (StAR) is the rate-limiting

step in the production of steroid hormones which should be added
in the biosynthesis pathway of setoids and it is very high yield as
it translocate cholesterol from cytosol to mitochondria and
Angiotensin II and K+ Act to increase Aldosterone by stimulating
this StAR. And mutation in its gene may lead to lipoid congenital
adrenal hyperplasia.
In 17-alpha hydroxylase defficiency, mineralocorticoids precursors
will be elevated but you should clarify that the aldosterone levels
will be normal or decrased (elevated 11-deoxycorticosterone will
produce hypertension, which inhibit renin and angiotensin, leading
to decreased aldosterone production.
You can remember that 17-alpha hydroxylase deficiency is the
only one that reduces sex hormones by giving it a "NC-17 - No
Sex" - the rating keeps you from seeing sex
Consider making the estradiol--> estrone arrow double-headed to
correspond to how it is shown on pg, 600
"Glycyrrhetic acid inhibits" 11b-hydroxysteroid dehydrogenase,
the spelling is also incorrect and should be "glycyrrhetinic acid"
For first bullet point in Function ( increase in blood pressure), up
regulation of alpha receptors on arterioles and increased
sensitivity to NE and Epi is a classic example of "permissive
action" of cortisol for catecholamines. I would suggest adding
"permissive action" in parentheses after that.
1,25-(OH) 2 D3 instead of 1,25-(OH)2
Cortisone synthesis from Cortisol is NOT converted by
Aldosterone synthase as implied by the chart. Rather it is by
11Beta-hydroxysteroid dehydrogenase.
Under function, there should be a note indicating that vitamin D
can also act synergistically with PTH to resorb bone. This is
demonstrated in the figure on the next page, but not listed as a
function of vitamin D on this page.
The book says RANK-L (receptor activator of NH-B ligand.
RANK-L is known as the Receptor Activator of Nuclear Factor
(NF)-B ligand. Not NH-B ligand.
On the side it states that PTH binds to osteoCLASTS and their
precursors when in fact PTH binds to osteoBLASTS to indirectly
stimulate osteoCLASTS
To whom it may concern. I am a 2nd year medical student who is
currently using your First Aid for USMLE STEP 1 2016 edition.
While I was reviewing your section on the Endocrine system. I
noted there is what may be a mistake on page 314 at the bottom
drawing. There are two columns that show the effects of PTH.
However, the column on the right, states that Calcitriol acts on the
kidney to increase absorption of Ca2+ and (PO4)3-. However, it is
to my understanding that: Calcitriol is secreted by the kidney to
act on the GIT with those same results but it does not act on the
kidney itself to increase those ions. You could probably put the
effects of calcitriol on the kidney separately from those of the GIT
to avoid the confusion by just drawing a separate arrow to the
kidney. Thanks.
In the graph, the vitamin D does not cause bone to release Ca
and phosphate (ie there shouldn't be a line going from Vit D to
bone).
In the steps of Thyroid Hormone synthesis coupling reaction by
the Thyroid peroxidase occur before the step of endocytosis in the
follicular lumen (not within cell as given in the figure). After
endocytosis, next step --> Hydrolysis occur by lysosomal engyme.
Basically after endocytosis Thyroglobulin droplets fuse with
lysosomal membranes. Lysosomal proteases then hydrolyze
peptide bonds to release T4, T3, MIT, and DIT from thyroglobulin.
T4 and T3 are transported across the basal membrane into
nearby capillaries to be delivered to the systemic circulation. MIT
and DIT remain in the follicular cell and are recycled into the
synthesis of new thyroglobulin. So this should be corrected. i have
given few references below. thanks
Regarding the current mnemonic, "T3 functions - 4 B's" ; why not
change that to 5 B's by adding in "BLOOD SUGARS" as the 5th
B? (Increases gluconeogenesis, glycogenolysis and lipolysis)
High-yield
addition to
next year
Clarification
to current
text
Mnemonic
Clarification
to current
text
Major
erratum
Clarification
to current
text
Spelling/for
matting
Major
erratum
High-yield
addition to
next year
Spelling/for
matting
Major
erratum
Minor
erratum
Clarification
to current
text
Minor
erratum
Mnemonic
315
Endocrine
315
Endocrine
https://en.m.wikipedia.org/wiki/Th
yroid_peroxidase
315
Endocrine
https://en.wikipedia.org/wiki/Thyro
id_peroxidase
315
Endocrine
First Aid 2016, Page 315
315
Endocrine
http://pathwaymedicine.org/thyroi
d-hormonesynthesis;https://en.wikipedia.org/
wiki/Thyroid_hormone
316
Endocrine
https://en.wikipedia.org/wiki/Colon
_(punctuation)
318
Endocrine
/pathophysiology-and-clinicalfeatures-of-primary-aldosteronism
318
Endocrine
318
Endocrine
http://www.merckmanuals.com/pr
ofessional/endocrine-andmetabolic-disorders/adrenaldisorders/secondary-adrenalinsufficiency
http://cjasn.asnjournals.org/conte
nt/5/6/1132.full
318
Endocrine
Several books I've read
318
Endocrine
/causes-of-secondary-andtertiary-adrenal-insufficiency-inadults
318
Endocrine
319
Endocrine
/measurement-of-acth-crh-andother-hypothalamic-and-pituitarypeptides?source=machineLearnin
g&search=proopiomelanocortin&s
electedTitle=1~23&sectionRank=
1&anchor=H7#H7
http://www.firstaidteam.com/
319
Endocrine
319
Endocrine
320
Endocrine
http://www.nature.com/bonekeyre
ports/2014/140205/bonekey2013
233/full/bonekey2013233.html
FA 2016 page 306
http://radiopaedia.org/articles/mib
g,
Replace "decrease TBG in hepatic failure, steroids" with steroid

use or increased steroids. The following sentence says pregnancy
or OCP 'use'. Currently its unclear as even hepatic failure that
preceeds it is a decrease in function.
In the overview diagram showing the synthesis of thyroid
hormones, the arrow from I- (in the thyroid follicular epithelial cell)
to I2 (in the follicular lumen) is labeled "oxidation of I2"; however,
I- is the substrate and I2 is the product, so this should say
"Oxidation of I-" or "oxidation to I2". As currently written, the text
implies that I2 is being oxidized. In 2015 FA, the diagram shows I---->oxidation--> I2. The reference is to the Wikipedia page for the
enzyme thyroid peroxidase.
I gets to the follicular lumen through pendrin, after which thyroid
peroxidase oxidizes iodide to atomic iodine (I0) or iodinium (I+),
not I2 form in the figure. And atomic iodine(I0 or I+) is bound to
the thyroid peroxidase in the colloid.
On the first image that describes the regulation of thyroid
hormones; add Thyroid-Stimulating Immunoglobin (TSI). Add an
arrow pointing to Thyroid Follicular Cells. With the (+) sign that
indicates that TSI stimulates the follicles. TSI should have Graves
Disease between brackets and below. (Image attached as an
example)
The coupling reaction is mistakenly placed inside the thyroid
follicular epithelial cell after the endocytosis step. This should be
corrected to take place within the follicular lumen (colloid) after
the organification of I2, and the step should depict a thyroglobulin
molecule with DIT, MIT,T3 and T4 attached to it. This should then
be followed by the endocytosis step. After the endocytosis step
the place where the coupling reaction was originally, should be
replaced by an arrow depicting lysosomal enzymatic digesting of
the thyroglobulin-colloid complex releasing T3 and T4 into the
circulation
in nonreceptor tyrosine kinase for the examples of
Immunomodulators, add a colon after cytokines (ie. cytokines: IL2, IL-6, IFN). Grammatically preferred for enumerating a list.
According to Combank & Pathoma (and uptodate) - Primary
Hyperaldosteronism is most commonly due to "Bilateral Adrenal
Hyperplasia" - the First Aid text should be more clear about this
With secondary adrenal insufficiency, add to the mnemonic
Secondary Spares the Skin/Mucosa AND SALT, meaning that
aldosterone isn't involved
Spelling/for
matting
Aldosterone scape mechanism is only seen in primary

hyperaldosteronism not secondary. The book mention this
mechanism as something shared by all hyperaldosteronism states
and this is false. The aldosterone scape should be in the section
of primary hyperaldosteronism.
No edema should be specified as Primary Aldosteronism only,
because in 2ndary Ald there is edema.
Minor
erratum
Discontinuation of chronic exogenous glucocorticoid therapy is

the main cause of Secondary adrenal insufficiency not
Tertiary(even if it lowers CrH but its main action is on ACTH).
Tertiary is due to decreased CrH due to hypothalamic injury
Proopiomelanocortin is has a hyphen on page 318. It does not
have a hyphen on a previous page (307), and UpToDate and
other encyclopedias spell it without a hyphen.
Minor
erratum
Minor
erratum
Clarification
to current
text
Major
erratum
Spelling/for
matting
Clarification
to current
text
Mnemonic
Clarification
to current
text
Major
erratum
Spelling/for
matting
Here's a cool nmemonic for cortisol's ANTI-Inflammatory effects.

neutroPHILE! It blocks Prostaglandings, Histamine, IL2,
Leukotrienes, and Eosinophilia. Also, Cortisol causes Neutrophilia
to put the acronym in context. This is already in first aid but I
noticed the letter pattern and thought it was cool. I didn't include a
relevant hyperlink because this is already in FA 2015.
Under Vitamin D Function, Vit D increases bone
MINERALIZATION, not resorption. **2015 edition
Mnemonic
In "Secondary adrenal insufficiency", there is no hyperkalemia

(aldosterone synthesis preserved because aldosterone is
regulated by RAA not ACTH).
I suggest adding MIBG scan, a scintigraphic radiolable study, for
investigation of pheochromocytoma and also neuroblastoma,
Clarification
to current
text
High-yield
addition to
Major
erratum
http://radiopaedia.org/articles/org
an-of-zuckerkandl
320
Endocrine
320
Endocrine
/clinical-presentation-anddiagnosis-of-pheochromocytoma
320
Endocrine
med/25385035
321
Endocrine
322
Endocrine
/diagnosis-ofhyperthyroidism?source=machine
Learning&search=HYPERTHYRO
IDISM&selectedTitle=1%7E150&
sectionRank=1&anchor=H259750
24#H25975024,
https://en.wikipedia.org/wiki/Hype
rthyroidism#Signs_and_symptom
s
323
Endocrine
/iodine-induced-thyroiddysfunction?source=search_resul
t&search=jod+basedow&selected
Title=1%7E1 ,
https://en.wikipedia.org/wiki/JodBasedow_phenomenon
323
Endocrine
First Aid 2015 page 329.
323
Endocrine
Fundamentals of PathologyPathoma page 161
324
Endocrine
325
Pharmacolog
y
/thyroidbiopsy?source=search_result&se
arch=thyroid+biopsy&selectedTitl
e=1%7E14
Kaplan 2016 pharm book page
106
325
Endocrine
325
Endocrine
NA
325
Endocrine
325
Endocrine
325
Endocrine
/hypoparathyroidism?source=prev
iew&language=enUS&anchor=H1747052&selected
Title=1~130#H1747052
particularly the extra-adrenal variants. Also in the etiology part I

suggest adding a parentheses after 10% extra-adrenal to include
the most common sites i.e. bladder wall and organ of Zuckerkandl
at the base of inferior mesenteric artery.
In Hashimoto, I suggest adding a line or parentheses to define
Hurthle cells since usually in tests the name of Hurthle is given
away and instead a histologic explanation is given. Hurthle cells
are oncocytic cells with acidophilic (pink) granular cytoplasm and
high number of mitochondria. They may also be seen in other
benign or neoplastic thyroid disease.
I suggest changing the "rules of 10's" to the "rules of 90's." It is
easier to remember what is, as to what is not. The Rule of 90's:
90% Benign, 90% Unilateral, 90% Adrenal Medulla, 90% Do not
Calcify, 90% Adults.
Up to 40% of cases of pheochromocytoma are now associated
with germline mutations.
Hyperthyroidism causes gastric hypermotility, or as per
UpToDate, "hyperdefecation," which is not necessarily diarrhea,
as also emphasized in UpToDate and Wikipedia.
next year
It should also be noted that Hashimoto thyroiditis is also

associated with HLA-DR3
High-yield
addition to
next year
Spelling/for
matting
In Jod-Basedow phenomenon, is written as: Thyrotoxicosis if a

patient with iodine deficiency and partially autonomous thyroid
tissue is made iodine replete. Instead of IF after thyrotoxicosis
should be IN. The thyrotoxicosis is described IN a patient with
an iodine deficient goiter in made iodine replete. (Hyperthyroidism
following administration of iodine or iodide.)
Information regarding the arrows for picture C was left out. It was
displayed correctly in first aid 2015 page 329. "Note follicles of
various sizes distended with colloid (black arrows) and lined by
flattened epithelium with areas of fibrosis and hemorrhage (blue
arrows)" should be added to the text.
On page 323 In the Graves disease section, "GAGs" is not
defined abbreviations and symbols page. GAGs=
glycosaminoglycan.
It is actually high-yield to know that thyroid cancer should be
biopsied using Fine Needle Aspiration. I have gotten several
questions about the method of thyroid biopsy. From UpToDate:
"FNA is the procedure of choice for evaluating thyroid nodules."
class 1A:block activated/open Na channels 1B:inactivated Na
clannels. 1C:all types of Na channels
It would be really helpful to make a table or indicate that
pseudopseyudohypoPTH has normal level of PTH. normal level of
Ca, and normal level of PO4. compared to psudohypoPTH type
1A, that has high level PTH but low level of Ca, and high level of
PO4.
I suggest moving this topic to the next page after
Hyperparathyroidism. The current order causes a bit confusion
because it comes after hypopara and pseudohypopara in the
same page although it is more relevant to hyperpara
(hypercalcemia and normal to increased PTH). So moving it to the
next page makes it easier to remember when it is read in the
context of hyperpara.
The normal area indicated by green color in the diagram, covers
calcium ranges from about 8.2 to nearly 12 mg/dl. However the
normal range of total serum calcium is hardly ever more than 10.5
mg/dl (the reference page in FA book is 8.4 to 10.2 mg/dl). I think
it should be corrected.
Mnemonic: "CHeck CHeek, Tap TRi in low PT" (The capitol letters
are the important ones) Used to remember the neuromuscular
irritation (tetany) caused by low serum Ca2+ CH = Chvostek sign
T = Trousseau sign PT = parathyroid; Parethesia/Tetany
The image "diagnosis of parathyroid disease" has the box
illustrating normal using an upper limit of PTH ~40 pg/ml.
According to eMedicine, the normal range for PTH is 10-65
pcg/ml. Reference ranges do vary, but none that I have found use
Clarification
to current
text
Mnemonic
Minor
erratum
Clarification
to current
text
Clarification
to current
text
Spelling/for
matting
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
Mnemonic
Clarification
to current
text
325
Endocrine
326
Endocrine
http://spectrum.diabetesjournals.o
rg/content/21/1/19/F1.expansion.
html They have a very good
flowchart. Figure 1. It would be
really helpful to add similar flow
chart to the text. It would be really
helpful.
326
Endocrine
326
Endocrine
328
Endocrine
240681-overview#a4 and UW
question 1065 and your website:
http://www.firstaidteam.com/6241/
mnemonic-monday-groans-andmoans-no-its-not-test-week-itshypercalcemia
rticle/127351-overview#showall .
Pathoma by Dr. Sattar 2015,
page 165
First Aide Step 1 for the USMLE
(2015) edition
328
Endocrine
First Aide for the USMLE Step 1

2015
328
Endocrine
n/a
330
Endocrine
330
Endocrine
FA 2015 P334
332
Endocrine
332
Endocrine
/image?imageKey=ENDO%2F56
015&topicKey=ONC%2F2527&ra
nk=1%7E12&source=see_link&se
arch=carcinoid+appendix&utdPop
up=true
332
Endocrine
332
Endocrine
333
Endocrine
/diabetic-ketoacidosis-andhyperosmolar-hyperglycemicstate-in-adultstreatment?source=search_result&
search=hyperosmolar+nonketotic
+hyperglycemia&selectedTitle=1
%7E131
your own text is my authoritative
resource
333
Endocrine
Not a source-able change

suggestion.
334
Endocrine
/metformin-in-the-treatment-of-
an upper limit below 50 pcg/ml. Harrison's, for example, has 8-51

pcg/ml (19th Ed, Laboratory Values of Clinical Importance, table
2). The green box indicating normal values should be moved to
reflect the accurate reference range.
can also manifest with Blueberry muffin baby appearance
Secondary hyperPTH related to Chronic renal disease has two
pathophysio. In FA 2016, it only listed one of them, which is
hypovitD due to the loss of 1a-hydroxylase. However, another
main and major mechanism is the increased amount of PO4 that
cannot be excreted will bind to Ca2+. This leads to decreased
serum ionized Ca2+ which further cause increase in PTH. Check
the link down below: It would be really helpful to add similar flow
chart to the text. It would be really helpful.
The hypercalcemia symptoms listed with mnemonic ''stones,
bones, groans and psychiatric overtones'' should include
''thrones'' due to hypercalcemia induced polyuria (due to inhibition
of aquaporin 2 channels) ; the mnemonic is already on your page,
it was submitted for the 8th edition for Step 2 CK
Primary hyperparathyrodism persons has higher prevalence of
peptic ulcer disease.
This is a good mnemonic to remember the causes of SIADH
using the name. Small cell lung cancer Injury of the lung
(Pulmonary disease) ADH (ectopic secretion) Drugs Head
trauma/CNS disorder
This is a good mnemonic for remembering the treatment of
SIADH using the name: Saline (hypertonic) given IV ADH
blockers (conivaptan, tolvaptan) Demeclocycline Halt (restrict)
fluids
Bellow the table describing the 2 DI. The superscript a before
the text No water intake for 2-3 hrs follows no relationship
with the text above. On the previous edition of First Aid, that
superscript a was after Water Restriction test on the diagnosis
row, on the 2016 this is erased.
4 P's of Papillary carcinoma: "Papillary, Psammoma, Pupil nuclei
(Orphan Annie), Prognosis (good)"
The flowchart starts with insulin deficiency. It should also include
insulin insensitivity or glucagon excess. Just like how FA 2015
does.
Carcinoids in the gut, commonly arise, in places you can pass
AAIR. (Appendix, ascending colon, Ileum, Rectum)
Clarification
to current
text
Major
erratum
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
Mnemonic
Clarification
to current
text
Mnemonic
Clarification
to current
text
Mnemonic
In the entry of somatostatinoma, it mentions inhibition of gastrin.

so it would make sense to add achlorhydria to the presentation.
Also a major mechanism that results in diabetes is from inhibition
of gastric inhibitory peptide. It would be nice to include that in
also.
Right side valve disease caused by carcinoid: TIPS (Tricuspid
Insufficiency, Pulmonary stenosis)
The lab value deals with Hyperosmolar Hyperglycemic Nonketogenic Syndrome stating that there is a high serum osmolarity
(>320 mOsm/kg). According to multiple sources it should be a
high effective serum osmolality! I get these terms confused all the
time so I looked it up and being consistent with kg it should be
osmolality.
Clarification
to current
text
In the visual chart for MEN1, 2A, 2B, You should have less
overlap between red and yellow circles and more between green
and yellow circles to show that MEN2A/B have more in common.
Additionally, just below the figure, You should list MEN1= 3P's in
this order: Pituitary, Pancreas, and Parathyroid instead of
Pituitary, Parathyroid, and Pancreas so it reflects the figure and
helps cement the overlap between MEN1 and MEN2A.
Instead of using the mnemonic "'All MEN are dominant' (or so
they think)", please use some variation of "All MEN syndromes
have autosomal 'doMENant' inheritance" to remove gender
associations. Thanks!
Please include the mechanism of action of metformin under its
pharmacology (this is already in the question banks) Metformin
Spelling/for
matting
Mnemonic
Spelling/for
matting
Mnemonic
High-yield
addition to
adults-with-type-2-diabetesmellitus?source=outline_link&vie
w=text&anchor=H2#H2
334
334
Endocrine
N/A
Endocrine
N/A
334
Endocrine
N/A
334
Endocrine
n/a
335
Endocrine
Mneumonic
335
Endocrine
335
Endocrine
no reference needed
335
Endocrine
See page 315 FA2016 about

oxidation, organification, and
coupling
335
Endocrine
/hyperthyroidism-duringpregnancy-treatment
335
Endocrine
p 335 FA 2016
335
Endocrine
n/a
335
336
Endocrine
mnemonic
Endocrine
A mneumonic.
338
Endocrine
338
Endocrine
First Aid 2015
338
Gastrointesti
nal
FA 2016
338
Gastrointesti
nal
rticle/935858-overview#showall
339
Gastrointesti
nal
UW,Question ID:438. UpToDate

and Medscape disagree here.
Medscape says bilious vomiting is
hallmark
(http://emedicine.medscape.com/
article/930411-clinical) and UTD
says emesis is usually nonbilious
(www.uptodate.com/contents/ann
ular-pancreas). The latter cites a
case series where 15/16 had
nonbilious vomiting. I found
suppresses gluconeogenesis by inhibiting a specific mitochondrial

isoform of glycerophosphate dehydrogenase (mGPD), an enzyme
responsible for converting glycerophosphate to dihydroxyacetone
phosphate, thereby preventing glycerol from contributing to the
gluconeogenic pathway [14,15].
Because gLARGine is LARGe, its a long-acting insulin.
Risks/Concerns for lower half of table (Oral hypoglycemic drugs)
is formatted incorrectly. The lines between rows should extend all
the way to right. "GI upset..." is Biguanides only. "Risk of
hypoglycemia..." is Sulfonylureas only. "Weight gain..." is
Glitazones/thiazolidinediones only. All of the Risks/Concerns do
not apply to all of the oral hypoglycemic drugs listed.
"Insulin preparations" table should not have horizontal lines in the
Action column. Making this change clarifies that all the insulin
preparations share the same mechanism of action.
There is precious little room to annotate and make notes in the
DM drugs section. There also isn't a "Notes" page at the end of
this chapter that would solve that problem. Too many entries
crammed into 3 pages without adequate space for notes.
Pramlintide can be remembered as an amylin analog by using the
mneumonic "prAMyLINtide". DPP-4 Inhibitors all end with -gliptin.
The mechanism for DPP-4 inhibitors is to indirectly activate GLP1. Use mneumonic "-GLiPtINs INdirectly activate GLP-1" so that it
is not confused with GLP-1 analogs.
Suggestion to add the following information to the adverse effects:
agranulocytosis is most commonly treated with G-CSF
(filgrastim).
"Block thyroid peroxidase, inhibiting the oxidation of iodide and
the organication (coupling) of iodine". Organization and coupling
are two different steps. It would be more clear to separate these
two rather than combining them together with a ()
In mechanism it says: ...oxidation of iodide and the organification
(coupling) of iodine. However, organification and coupling are not
the same and are two separate processes that both are driven by
peroxidase and inhibited by Thionamides. It is also in contrast
with FA2016 text in thyroid physiology (page 315) that says:
Thyroid peroxidase is the enzyme responsible for oxidation and
organification of iodide as well as coupling of monoiodotyrosine
(MIT) and di-iodotyrosine (DIT). So I suggest correcting it to avoid
implying that organification and coupling are the same.
The most recent clinical practice guidelines for the management
of hyperthyroidism in pregnancy state that PTU use should be
limited to the first trimester only, after which the risk of
hepatotoxicity outweighs the potential teratogenic effects of
methimazole. Thus, pregnant women with hyperthyroidism should
be treated with PTU in the 1st trimester, then be switched to
methimazole thereafter.
The SGLT-2 inhibitors (canaGLIFLOzin, dapaGLIFLOzing, and
empaGLIFLOzin) cause GLIcemic FLOw in the kidney
The SGLT-2 inhibitors increase glucose FLO out of the kidney
(canagliFLOzin)
Tin of DiPP 4 your Lip. All DPP4 inhibitors end in "Lip-tin".
Cinacalcet: "Cinacalcet Cinses (senses) CALcium"; it is a Cal
cinsor (sensor).
All S's for sulfonylureas. "Sulfonylureas Stimulate Secretion of
Self-insulin"
Glulisine GOOD Lisipro LADS Aspart ALWAYS Regular
REMEMBER NPH NEVER Detemir DUMP Glargine GIRLS (For
remembering the duration of action of insulins)
To remember that Omphalocele goes through the umbilical cord
think of Omphalocele as "om-bilical"
It would be beneficial to add the fact that EA with distal TEF would
present with maternal polyhydramnios. It can be seen in the
pathophysiology section of the supporting reference.
Annular pancreas can lead to bilious vomiting
next year
Mnemonic
Spelling/for
matting
Spelling/for
matting
Spelling/for
matting
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
another source where 13/22 had

nonbilious vomiting
(http://www.ncbi.nlm.nih.gov/pmc/
articles/PMC4261261/). I
recommend rejecting the change
and keeping current text, but
request expert to confirm. -FD
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ticle/556156
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ticle/556156
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/annular-pancreas
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NA
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NA
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no reference needed
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/colonic-ischemia
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http://www.firstaidteam.com/
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FA 2015 image that is over the

text on the same page (i.e., page
348)
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image on 344
345
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Netters Anatomy
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not needed
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https://classconnection.s3.amazo
naws.com/12/flashcards/518012/
png/picture1jpg14179C9580171036EBA.png
ticle/556156
http://peds.stanford.edu/Rotations
/nicu/documents/NICU_Case__Bilious_Emesis.pdf
http://www.med.umich.edu/lrc/cou
rsepages/m1/anatomy2010/html/
gastrointestinal_system/peritoneu
m_lecture.html
The text states "Annular pancreas - ventral pancreatic bud

abnormally encircles 2nd part of a duodenum; forms a ring of
pancreatic tissue that may cause duodenal narrowing (A) and
nonbilious vomiting". However, annular pancreas produces
"bilious vomiting" not "nonbilious vomiting"
When annular pancreas presents with s/s of duodenal obstruction
in an infant, it typically causes *bilious* emesis (FA states
nonbilious). The adult presentation is that of duodenal stenosis
recurrent pancreatitis.
Some structures are secondary retroperitoneal vs primary. I have
added asterisk to these structures and added a note indicating
that they are secondary retroperitoneal (i.e began intraperitoneal
early in life and had a mesentery but lost it and migrated to
retroperitoneal space later). These include : pancreas, Duodenum
(2nd-4th part), Colon (ascending and descending). You can
simply use asterisk for these three structures and add a note
below.
Annuli most commonly affect the descending duodenum and may
be partially or completely circumferential. Complete duodenal
obstruction typically occurs below the level of the ampulla of Vater
and presents as bilious vomiting that worsens with subsequent
feeding
An annular pancreas that encircles the 2nd part of the duodenum
below the Sphincter of Oddi would cause billious vomiting.
"Annular pancreas [...] may cause [...] non bilious vomiting" >
Should be changed to bilious vomiting or excluded. Vomiting may
be bilious or non-bilious, most sources say bilious. See:
doi:10.5152/eajm.2010.33
In Hepatoduodenal ligament, Pringle maneuver, it's better to
change it as "to control hepatic bleeding" instead of just bleeding,
to be more clear. (Also I found it an important fact that if hepatic
bleeding is not stopped after this maneuver the likely sources are
retrohepatic vena cava or hepatic veins).
In the right side figure some branches of vein are colored white.
They should be in blue.
In figure, bifourcation at L4, please change the font of "4" to red
too so it would be consistent with the red four in bifourcation.
Left testicular/ovarian artery drains to left renal artery, please
correct the graph.
Specify that there is a watershed area at the splenic flexure of the
large bowel supplied by both the SMA and IMA that is particularly
prone to ischemia
Gastroduodenal artery gives off PSPDA then divides to become
the ASPDA and right gastroepiploic artery. Therefore, switch the
labels for PSPDA and ASPDA.
In the chart on this page, under the Portal <-> Systemic header,
the items listed have inconsistent use of periods. The first and
third rows have no period at the end, while the second one does.
site 1: Esophagus listen the anastomosis as: Left gastric (Portal)
to esophageal (systemic) . It should said esophageal (portal) to
azygous (systemic). Just for completeness this listed information
is entirely portal (i.e., Left gastric vein > esophageal veins). The
diagram above lists it correctly.
above pec line > venous drainage > IMV > splenic vein (which
joins SMV) > making portal system (inferior mesenteric vein joins
the splenic vein which connects with SMA to make portal vein
[image on page 344 shows it correctly]
The venous drainage pathway listed is missing a step. It should
read "superior rectal vein to inferior mesenteric vein to splenic
vein to portal system.
Addition of some histology images to the empty portion of the
page could benefit us.
Hesselbach triangle is listed with bullets of the 3 bordering
structures. Add the anatomical position for clarity (especially since
the lateral border of rectus abdominis could be mistaken as the
Minor
erratum
Minor
erratum
Clarification
to current
text
Minor
erratum
Major
erratum
Minor
erratum
Clarification
to current
text
Spelling/for
matting
Spelling/for
matting
Clarification
to current
text
Clarification
to current
text
Minor
erratum
Spelling/for
matting
Major
erratum
Minor
erratum
Minor
erratum
High-yield
addition to
next year
High-yield
addition to
next year
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not needed
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First Aid pg. 349
350
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I made it up
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N/A
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FA2016 pg.351
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Ross 6th edition Page 578.
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n/a
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rticle/852373-overview;
/malignant-salivary-gland-tumorstreatment-of-recurrent-andmetastatic-disease
heard it years ago
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n/a
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/metaplastic-chronic-atrophicgastritis?source=search_result&s
earch=autoimmune+gastritis&sel
ectedTitle=1%7E150
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N/A - FA2016
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na
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na
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http://www.webmd.com/digestive-
350
356
UW Question ID:1319
/mallory-weisssyndrome?source=search_result
&search=mallory+weiss&selected
Title=1%7E24
/hiatushernia?source=search_result&se
arch=hiatal+hernia&selectedTitle
=1%7E86
First Aid 2016 p. 130; p. 231
lateral border in an exam [high tension] setting. (i.e., 'lateral,

medial, inferior' or 'superolateral, inferolateral, medial'. See
attached image (only a conceptual demonstration).
should read "Hesselbach". To the left side with image has a type:
says "(Hesse bach)"
INdirect hernias go thru the INternal inguinal ring in INfants.
Emphasize the IN in internal to differentiate from direct hernias.
(Infants is already emphasized)
K cells make GIP: Spell glucose gluKose
Spelling/for
matting
Mnemonic
Mnemonic
In the source section for VIP, pancreas should be include so that

readers are aware that VIP is secreted from pancreas under
normal conditions, as well as in pathological conditions (e.g.,
VIPoma)
It is pretty important to add that the D cells are also located in the
antrum, explaining the paracrine effect of somatostatin
The table is a bit tight on this page. It's difficult to add notes into it.
It would be great if there was an additional space at the bottom of
each row. Moreover, the general spacing on the following pages,
352 & 353, could span out just Physiology, thus moving Pathology
to the next page. The charts on page 352 don't leave enough
space to add in more notes. Or simply moving the beginning of
the Pathology section to it's own page would be super helpful.
The letter B in Bicarbonate can written in bold/different color to
remind that it is secreted by Brunner glands (which also start with
the letter B).
Chief cells are located at the base of the FUNDIC glands of the
stomach. Figure has Chief cells in the body which is incorrect.
"Iron Fist, Bro" is the currently listed mnemonic, but I think "Iron
First, Bro" makes more sense here since iron is absorbed first.
Also the latter is the way the mnemonic is presented in the
USMLE Rx Express video.
2nd bullet point: "Cholesterol excretion (body's ONLY means of
eliminating cholesterol)." Should really be body's MAJOR means
of eliminating cholesterol, as it can also be excreted by
desquamation of skin.
Mucoepidermoid carcinoma is the most common malignant
SALIVARY tumor. Currently, it is stated that it is the most
common malignant tumor.
Clarification
to current
text
(B)oer(H)aave syndrome is someone who has (B)een (H)eaving

[heaving is another word for vomiting]
It is very high yield to mention that Mallory-Weiss syndrome can
progress to Boerhaave syndrome, since this makes it a much
more emergent patient. From UpToDate: "Rarely, perforation can
occur with repeated, protracted vomiting."
Very high-yield to know that Gastroesophageal reflux disease is
highly associated with hiatal hernias. From UpToDate:
"Endoscopic and radiographic studies suggest that 50 to 94
percent of patients with GE reflux disease (GERD) have a type I
hiatus hernia as compared with 13 to 59 percent of normals."
The current text mentions that Boerhaave Syndrome is
"Transmural". I suggest adding "Tear" so that it becomes
"Transmural Tear". This should avoid any misinterpretation, as
transmural alone is not complete and could mean anything else
(e.g. transmural infarction).
"aDOWNocarcinoma" - lower 1/3 of esophagus
Mnemonic
Gastric adenocarcinoma should be included as a risk of H. pylori

chronic gastritis
It is very important to know the usual findings of autoimmune
gastritis: hypochlorhydria with high gastrin and G cell metaplasia.
From UpToDate: "The hypochlorhydria associated with AMAG
induces hyperplasia of the G cells (the cell type responsible for
producing gastrin) and hypergastrinemia. "
The "mentating" disease, stomach is "mentating with gyri"
stomach with hypertrophied rugae "gyri"
Virchow node: CHOW goes in your gut --> metastasis from the
stomach.
Krukenberg tumor: KrukenBIRD: birds lay eggs --> metastases to
the ovaries.
The definition for "Lactose Intolerance", in the right-hand column it
Major
erratum
High-yield
addition to
next year
Minor
erratum
Spelling/for
matting
Mnemonic
Minor
erratum
Mnemonic
Minor
erratum
Minor
erratum
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Major
nal
disorders/tc/lactose-intoleranceexams-and-tests,
s-conditions/lactoseintolerance/basics/testsdiagnosis/con-20027906,
/diagnosis-of-celiac-disease-inadults?source=search_result&sea
rch=celiac+disease&selectedTitle
=1%7E150
should read "..value rises <20.." instead of: ",,,value rises >20".
erratum
Since there is an increased rate of IgA deficiency with Celiac

disease, it should be mentioned that having a negative IgA antitissue transglutaminase test does not indicate absence of
disease. IgG testing should be used in patients with IgA
deficiency. From UpToDate: "In patients in whom low IgA or
selective IgA deficiency is identified, IgG-based testing (preferably
IgG DGP) should be performed."
It is high yield to know that Whipple disease causes fat
malabsorption ( steatorrhea), since the resulting malnutrition is
what causes many of the clinical symptoms you describe.
High-yield
addition to
next year
Tropical Sprue involve the jejunum and ilium more than

duodenum.
Clarification
to current
text
Duplicated text "Malabsorption/malnutrition, colorectal cancer

(increased risk with Pancolitis)"written in both Crohn & U.C., is
too vague and broad. Pancolitis is more commonly associated
with Ulcerative Colitis only. Thus should be removed from the
Crohn's column in order to better differentiate between Crohn and
Ulcerative Colitis. Furthermore, risks of developing colorectal
cancer are far greater and more commonly associated in U.C.
than in Crohn. This can be easily corrected by noting risk of
colorectal cancer is (U.C. > Crohn).
Pnemonic for CROHN disease: CHRONIIIIC: Cobblestone
mucosa, tH1, Rectal sparing, Non caseating granulomas
(histologic hallmark), Involves all Layers, Ileum (most common
site), Intermitent lesions, In all GI tract, Creeping fat
Add in the table that CD is mediated by Th1 and UC is mediated
by Th2. This fact has come up on several QBanks
Clarification
to current
text
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s-conditions/crohnsdisease/basics/definition/con20032061
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http://link.springer.com/chapter/10
.1007%2F978-1-4614-09984_15#page-1
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In the treatment category- specify the progression of treatment

from initial therapy- with Corticosteroids for CD, and 5 ASA for UC
followed by the Immune modulators and finally the biologics
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/overview-of-the-medicalmanagement-of-mild-tomoderate-crohn-disease-inadults?source=machineLearning
&search=crohns&selectedTitle=1
~150&sectionRank=1&anchor=H
11241188#H11241188
rticle/179037-workup#showall
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/acute-appendicitis-in-adultsclinical-manifestations-anddifferential-diagnosis
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None necessary
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I think it's better to explain the three high yield physical exam
signs rather than just naming them since it is very unlikely that in
the exam they provide the name of the exam (e.g Rovsing,
Psoas, Obturator) but they will describe the finding. Also the main
importance of these findings are the relations to anatomic position
of the appendix that should be mentioned too. For example for
Psoas sign, passive right hip extension will cause RLQ pain that
is in favor of a retrocecal appendix. Also for Obturator sign, flexion
of the right knee and hip followed by internal rotation of hip will
cause irritation of obturator internus muscle by a pelvic appendix.
These are very important anatomic relations and essential for
understanding the signs. Also please add a note that in Rovsing
sign, pressure on LLQ will cause pain in RLQ that is in favor of
peritoneal irritation. (Please see the physical examination section
in UpToDate reference for more info).
"Meckel's got Muscle (muscularis externa); Posers got none" -- to
remember that pseudodiverticulae don't involve the muscularis
externa.
Add Mittelschmetz to differentials for appendicitis
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/peutz-jeghers-syndromeepidemiology-clinicalmanifestations-and-diagnosis
AND
/whipplesdisease?source=search_result&s
earch=whipple+disease&selected
Title=1%7E72
Pathoma 2015, Page 108.
rticle/182986-differential
Goljan, Edward F. "Chapter 18:
Gastrointestinal Disorders." Rapid
Review Pathology. 4th ed.
Philadelphia, PA:
Elsevier/Saunders, 2013. 457.
Print.
anti-Saccharomyces cerevisiae antibodies (ASCA) is associated

with cron disease.
I believe changing midgut volvulus to cecal volvulus would be

more accurate or only adding that cecal volvulus is most common
among midgut volvulus in children,
For Turcot please add parentheses after CNS tumors to mention
medulloblastoma and glioma. For Peutz-Jeghers syndrome
please add testicular cancer to GI and breast cancer since about
9% of men with PJS develop testicular cancer.
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
/clinical-manifestations-anddiagnosis-of-familialadenomatous-polyposis
Clinical manifestations and
diagnosis of familial adenomatous
polyposis
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N/A
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None (mnemonic)
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/peutz-jeghers-syndromeepidemiology-clinicalmanifestations-and-diagnosis
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http://www-uptodatecom.proxy.westernu.edu/contents
/gardnersyndrome?source=machineLearni
ng&search=gardner+syndrome&s
electedTitle=1~32&sectionRank=
2&anchor=H3#H3
http://www-uptodatecom.proxy.westernu.edu/contents
/peutz-jeghers-syndromeepidemiology-clinicalmanifestations-anddiagnosis?source=machineLearni
ng&search=peutz+jeghers+syndr
ome&selectedTitle=1~44&section
Rank=1&anchor=H3#H3
/approach-to-the-patient-withcolonicpolyps?source=search_result&se
arch=hamartomatous+polyp&sele
ctedTitle=1~12
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NA
365
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NA
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UW2014 Q id 100
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ed/17696928
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No reference
/clinical-manifestations-diagnosisand-treatment-of-infections-dueto-group-d-streptococcistreptococcus-bovisstreptococcus-equinus-complex
First Aid 2016
I think the part on colonic polyps need a bit of revision. Firstly it's
better to initiate the classification with non-neplastic polyps
(Hamartomatous, mucosal, submucosal [e.g. lipoma],
inflammatory [e.g. IBD pseudopolyps]) and neoplastic (Serrated,
Adenomatous). Also note that in UpToDate now Hyperplastic
polyps is included in both non-neoplastic and neoplastic because
they can progress to serrated polyps although rarely. One
important point is Hyperplastic polyps are categorized as serrated
polyps (and this is in contrast with FA2016 text that includes
different categories for hyperplastic and serrated. Also the "sawtooth" and "serrated" are two terms that are used in histology of
hyperplastic polyps that adds to the confusion if these two are
categorized separately. I think it needs a bit of extra work to
change this part. Please see the reference.
It's not exactly rated PG, but it is a memorable way to remember
all the key aspects of Lynch syndrome: Lynch COMES
Dominantly. C=CRC; O=ovarian cancer; M=microsatellite
instability; E=Endometrial cancer; S=Skin cancer.
Dominantly=Autosomal Dominant
For adenomatous polyps, VILLOUS histology is VILLainOUS
(more malignant than tubular histology).
Peutz-Jehger's=PJ's: For great kinky sex, take off your PJs and
use your lips, mouth, hands, and genitals. Tell her to be dominant
(AD), but no hitting w hammers (GI hamartomas) (PJ=peutzjeghers), hyperpigmented lips/hands/mouth/genitals
Gardner syndrome: Gardener's dig up bones (osseous tumors)
Clarification
to current
text
Peutz-Jeghers syndrome: 'Jegher-Meister' gets you hammered

(hamartoma) and leaves your lips black (hyperpigmentation)
Mnemonic
Although hyperplastic polyps are well known as benign and nonneoplastic lesions, I think It's useful to add this fac that Distal
small hyperplastic polyps rarely, if ever, develop into colorectal
cancers (CRCs), BUT large hyperplastic polyps are thought to be
a precursor to sessile serrated polyps, which can progress to
colorectal cancer.
Clarify that Strep. Bovis Type I (or Strep. Gallolyticus - new name
for S. Bovis Type I) as having high association with colorectal
carcinoma
High-yield
addition to
next year
You have under presentation that "Right side bleeds; left side
obstructs" however the descending/left colon has hematochezia
not the right side according to the text.
Blue arrow (pointing to splenomegaly) is difficult to see against
the black background. Suggest changing color to yellow
Blue arrow (pointing to splenomegaly) is difficult to see against
the black background. Suggest changing color to yellow
palmar erythema is one of the effects of liver failure ( not
mentioned in the figure)
Minor
erratum
The figure in this page is greatly improved. Thanks. You might

want to also add "Renal" and include hepatorenal syndrome
which is an important sequela of cirrhosis complicating the course
of disease in about 40% of cirrhotics.
Metabolic disturbances in cirrhosis include acid-base
abnormalities. Lactic acidosis (liver cannot convert lactic acid to
pyruvate) and also a respiratory alkalosis (toxic products
overstimulating respiratory center) are common
Functional Liver markers: Prothrombin should be Prothrombin
time
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Clarification
to current
text
Spelling/for
matting
Spelling/for
matting
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
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From the information on that page

of First Aid (note page number
may be wrong because I have the
2015 edition)
/clinical-manifestations-anddiagnosis-of-alcoholic-fatty-liverdisease-and-alcoholiccirrhosis?source=preview&search
=alcoholic+aspartate&language=
enUS&anchor=H1681012&selected
Title=1~150#H1681012
fact comes from First Aid,
mnemonic from my brain
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/hemostatic-abnormalities-inpatients-with-liver-disease
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ug/xifaxan-rifaximin-342685#10
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http://www.educus.com/Journals/
20412036?AspxAutoDetectCooki
eSupport=1
https://www.xifaxanhe.com/aboutxifaxan-550
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Page 93 FA2016
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ticle/720248
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articles/PMC352892/
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/hepatic-encephalopathy-inadultstreatment?source=search_result&
search=hepatic+encephalopathy
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http://journals.lww.com/jpgn/fullte
xt/2005/01000/hepatocellular_car
cinoma_in_hereditary_tyrosinemi
a.17.aspx
http://dictionary.reference.com/br
owse/metastasis?s=t
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up to date Overview of the

treatment of primary biliary
cholangitis (primary biliary
cirrhosis)
http://www.medbullets.com/step1gastrointestinal/7071/dubinjohnson-rotors-syndrome;
ed/1592353
124/20/2253.full
Villous adenomatous polyps are more "villainous" (more

malignant potential) than tubular adenomatous polyps.
Mnemonic
Alcohol can make you an ASs-- alcohol elevates aspartate

aminotransferase over ALT
Mnemonic
AST > ALT for Alcoholic liver disease. Shots do more than Lager
does
Under the table, it says 'PROTHROMBIN' is high in advanced
liver disease. This is wrong. Prothrombin Time is increased in
liver disease. Prothrombin factor 2 is a vitamin k dependent
clotting factor. It should be low, but PT should be high. Please
clarify.
I couldn't select for Neomycin, I attached the explanation for the
correction as a word document.
In the treatment of hepatic encephalopathy where it says
"rifaxamin or neomycin (decrease NH4+ producing gut bacteria)"
it should instead say "decrease NH3 producing guy bacteria"
Rifaximin decreases NH3 (ammonia) producing gut bacteria, not
NH4+ (ammonium).
Mnemonic
Rifaximin decreases ammonia (NH3) producing gut bacteria
Major
erratum
Clarification
to current
text
For lactulose it's better to indicate" increased NH4 trapping in gut"

or "increased NH4 production and trapping" to be more clear.
Also it might be a bit confusing that one of the treatments
increase NH4 production and the next one (rifaximin and
neomycin) decrease NH4 as indicated in the text. However I
agree with the comments that others already submitted about
Rifaximin (decreasing NH3 producing bacteria). You might also
want to add Benzoate, phenylbutyrate, and phenylacetate from
page 93 (Fact name: Hyperammonemia)
"...rifaximin or neomycin (decrease NH4+ producing suit bacteria)"
NH4+ should read NH3
Neomycin/rifaximin decrease NH3 producing (urease +) gut
bacteria, not NH4.
It is extremely high-yield to know that hepatic encephalopathy is
reversible, since most causes of mental deterioration are nonreversible. The first line of the relevant UpToDate article even
mentions this fact: "Hepatic encephalopathy or portal-systemic
encephalopathy represents a reversible impairment of
neuropsychiatric function associated with impaired hepatic
function."
Rifaximin is a non-absorbable antibiotic that alters GI flora to
decrease intestinal production of ammonia. The arrow is showing
a decrease in ammonium instead of ammonia is a typo.
For hepatic encephalopathy treatment, it might be nice to clarify
that lactulose does not actually "increase NH4+ generation," but
instead, acidifies the GI tract, which affectively favors the
conversion of the soluble NH3 to the much less soluble NH4+,
effectively trapping ammonia in the gut, subsequently reducing
plasma levels.
Type I tyrosinemia is a high yield risk for hepatocellular carcinoma
(via buildup of fumarylacetoacetate causing oxidative damage to
hepatocytes)
Metastasis is spelled wrong. on the book is spelled as
"Metastases"
Change 1 biliary cirrhosis to 1 biliary cholangitis
The grossly black liver appearance seen in Dubin-Johnson can be

attributed to the accumulation of epinephrine metabolites.
It should be added in this section that hemochromatosis is
associated with HLA-A3
Iron overload cardiomyopathy in hemochromatosis usually leads
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to a restrictive (infiltrative) cardiomyopathy, and sometimes

dilated.
100% of patients with primary sclerosing cholangitis have HLADR52a
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uptodate Clinical manifestations,

diagnosis, and prognosis of
primary biliary cholangitis
(primary biliary cirrhosis) &
Journal of Hepatology Volume 63,
Issue 5, November 2015, Pages
12851287 Cover image Position
Paper Changing nomenclature for
PBC: From cirrhosis to
cholangitis
/wilson-disease-clinicalmanifestations-diagnosis-andnatural-history
up to date Wilson disease:
Epidemiology and pathogenesis
371
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Epidemiology and pathogenesis
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Clinical manifestations, diagnosis,
and natural history
371
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It makes sense because

hemochromotosis is defined by
an iron-overload state.
First Aid p. 371
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articles/PMC4491957/ UW
Question:1867
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UpToDate
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UWorld QID:403;
Primary biliary cirrhosis is destruction of interlobular bile ducts,

not intra-.
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Mnemonic suggestion
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/primary-sclerosing-cholangitisepidemiology-andpathogenesis?source=search_res
ult&search=primary+sclerosing+c
holangitis&selectedTitle=3~99
None
To remember that hemochromatosis is caused by mutations in

the HFE gene, just think of HFE as "High Fe" or "High Iron"
Primary sclerosing Cholangitis is associated with haplotypes HLADR52a, HLA-B8, HLA-DR3
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up to date Acalculous
cholecystitis /
rticle/187645-overview /
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FA QMax
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/acute-cholecystitis-pathogenesis-
Primary biliary cirrhosis is now refered to as Primary biliary

cholangitis and has been accepted by all relevant groups
to current
text
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Text states that Wilson disease is a "Recessive mutation" should

read "Autosomal recessive mutation" because it is not clear
whether it is x-linked or autosomal.
The second lines states inadequate copper excretion into blood,
the copper is not excreted into the blood, the mutation results in
impaired incorporation of copper into apoceruloplasmin, in fact,
increased heaptic content + hepatocyte damage results in the
release of copper into the blood and an elevation of free serum
copper, while the pathophysiologic nuances are probably beyond
the scope of Step 1, I would suggest rephrasing to say
Inadequate copper incorporation into apoceruloplasmin and
excretion into bile.
In the second line, the text as presented suggests that decrease
in ceruloplasmin results in an increase in urinary copper, this is
incorrect, simply by the fact low ceruplasmin levels do not result in
the clinical manifestations of wilsons disease moreover,
increased hepatic copper content + hepatocyte damage results in
the release of copper into the blood and an elevation of free
serum copper which results in an increase in Urinary copper
excretion, in order to clarify this I would add free serum copper
concentration
tremor, dysarthria, dystonia, parkisonism are not neurologic
disease per se they are clinical diagnostic criteria/ of neurological
diseases would add manifestations after disease to correct
Hemochromotosis is caused by a mutation in the HFE gene (the
"H-Fe" gene aka the hemochromotosis iron gene).
Major
erratum
To remember drugs used to chelate Iron (Fe): write out the drug
names highlighting the De and Fe: DeFerasiroc DeFe roxamine,
DeFeriprone
It should be noted that Primary Biliary Cirrhosis is also commonly
associated with Xanthelasma.
Mnemonic
Epidemiology for primary sclerosing cholangitis should be in

"young men with IBD" not "middle aged men with IBD"
First line, autosomal should be added to "recessive mutation"
I think "pneumobilia" and "gallstone ileum" are TERMS that

should be bolded and in blue -- maybe consider reformatting
Acalculous cholecystitis comprises about 10% of Acute
Cholecystitis. I do not agree with the word rarely in the text, while
a multitude of risk factors and or causes result in acalculous
cholecystitis its prevalence is common 10%, I would change
rarely to less commonly or something along those lines
It would be helpful to clarify that choledocholithiasis occurs with
obstruction of the common bile duct vs cholecystitis that occurs in
the cystic duct. Also add that to differentiate between the two,
LFTs would be higher with choledocolithiasis
Question stems for cholecystitis often indicate that the RUQ pain
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search=cholecystitis&selectedTitl
e=1%7E150
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up to date - Etiology and

pathogenesis of chronic
pancreatitis in adults
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up to date - Etiology and

pathogenesis of chronic
pancreatitis in adults
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No reference
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s/NBK22599/
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(Just a typo)
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ticle/429755_6
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&search=biliary+atresia&selected
Title=1~46&sectionRank=1&anch
or=H19842421#H19842428
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up to date Alprostadil: Pediatric

drug information / up to date /
rticle/891096-medication#2 /
ticle/410907_5
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N/A
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and
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ed/10400410
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and
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UW Q ID: 8261
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Hematology
and
/postnatal-diagnosis-and-
382
382
382
radiates to the R shoulder/scapula region, since this should

seriously hone you in on the correct diagnosis. You should add
this fact in. From UpToDate: "The pain may radiate to the right
shoulder or back."
Confusing writing: "CTR.... can cause chronic pancreatic
insufficiency. Can lead to pancreatic insufficiency -->
steatorrhea..." I think instead it should say "Can lead to pancreatic
insufficiency-->steatorrhea..." and at the bottom say that CFTR
can slow pancreatic function thereby causing pancreatitis
there is a subtle but important difference between saying
idiopathic or idiopathic pancreatitis. idiopathic pancreatitis is
essentially a subtype of pancreatitis, I would suggest adding the
word pancreatitis after idiopathic
there is a subtle but important difference between saying
idiopathic or idiopathic pancreatitis. idiopathic pancreatitis is
essentially a subtype of pancreatitis, I would suggest adding the
word pancreatitis after idiopathic
Somatostatin and ProstaglandinsGinot G1
In the graphic, Carbonic Anhydrase catalyzes CO2 + H20 -->
bicarb, not "H2".
In the diagram, somatostatin and prostaglandin are activating
"G1", it should be "Gi".
Misoprostol works to decrease HCL secretion via activation of Gi
receptor. This is incorrectly labelled as G1 receptor in both the
chart p/ 374 & corresponding table p. 375.
Biliary atresia: neonatal biliary obstruction characterized by
extrahepatic biliary tree destruction and fibrosis, thought to be due
to viral or immune-related etiology. Presents with jaundice (< 8
weeks of age), acholic stools, and dark urine (due to increased
urinary excretion of bilirubin). Biopsy reveals bile duct
proliferation, portal tract edema, fibrosis, inflammation, and bile
duct plugs. Increased direct bilirubin and GGT.
I cannot find any relevant journal or source that confirms that
misoprositol is used to maintain a PDA. Alprostadil another PGE1
analog is approved for use in maintenance of a PDA but not
Misoprostol not even in an off label form to the best of my
knowledge moreover to the best of my knowledge misoprositol is
only available in a tablet form unlike alprostadil which can be
given IV there used to maintain a PDA
"Miso SOUP" M - mucosal barrier, S - stimulates labor, O - open
PDA, U - ulcers from NSAIDs, P - PGE1 analog
LOPeramide = Lots Of Poop
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Mnemonic
Mnemonic
side effects of direct thrombin inhibitors is said in FA2016 that

attempted to be reversed by fibrinolytic agents such as
tranexamic acid, but in fact its antifibrinolytic agent
It is now accepted by the scientific community that eosinophils
produce major basic protein, eosinophil peroxidase, eosinophil
cationic protein, and eosinophil-derived neurotoxin. Eosinophil
peroxidase and major basic protein are the only eosinophil
derived proteins uniquely expressed by the eosinophil. MBP and
eosinophil cationic protein are both helminthotoxins. The most
recent information I can find stating that eosinophils produce
histaminase is from papers dating back to 1977.
Clarification
to current
text
Minor
erratum
To keep Tc/Th CD complexes straight: just as 8>4, so "cytotoxic"

is longer word than "helper" (and thus is assigned the
corresponding larger number).
In blood type O plasma Anti-A and Anti-B antibodies are IgG, not
IgM. (this is stated correctly on the same page under ABO
hemolytic disease of the newborn)
Type O mothers have antibodies(anti-A, Anti -B) that are
predominately of IgG type which can cross the placenta.
Mnemonic
Uworld q id #8261
Type O mothers have antibodies(anti-A, Anti -B) that are

predominately of IgG type which can cross the placenta.
Major
erratum
/prevention-of-rh-dalloimmunization
You might want to also add a note about postpartum

administration of anti-D immune globulin (RhoGAM) in addition to
the third trimester dose (28 weeks gestation). It will be consistent
with the table that mentions "during and after" each pregnancy.
Regarding the type of immunoglobulin in O group (IgM vs IgG)
Clarification
to current
text
https://www.merckmanuals.com/p
rofessional/hematology-andoncology/eosinophilicdisorders/eosinophil-productionand-function
N/A
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Oncology
management-of-hemolyticdisease-of-the-fetus-and-newborn
382
Hematology
and
Oncology
Uworld Qbank question Id #:

8261[6846881]
383
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and
Oncology
None. Minor editing/addition in

the same text.
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See the attachment
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there are already two other comments in the errata list (104,323)
however I think it needs more clarification since none seem to
correct the text and explain the reason. I have used multiple
resources (including UpTpDate and Medscape and some articles)
to reach this conclusion: In fact the major type of antibodies in
plasma in O blood group is "IgM" (as indicated in the text similar
to A and B and AB; and in contrast to errata submitted by 104 and
323), however some people also have lower amounts of Anti-A or
Anti-B "IgG" too (that can cross the placenta). That explains why
sometimes hemolytic disease of newborn (HDN) happens from
ABO blood group (and almost universally this happens in mother
with O blood group and very rarely in other groups, because the
IgG type appears in O group). So the major and dominant Anti-A
and Anti-B in O group is still IgM (that does not cross the
placenta), however sometimes IgG appears (that cross the
placenta). This also explains the discrepancy that "although ABO
incompatibility occurs in about 15 percent of all pregnancies, it
results in neonatal hemolytic disease in only 4 percent of such
pregnancies" (see uptodate). So overall I would recommend to
keep the anti-A and anti-B in table as IgM but add "some IgG"
under it to make it clear. Also in the fact "ABO hemolytic disease
of the newborn" make minor changes to reflect this fact that some
antibodies are IgG that cross the placenta (in comparison to
dominant IgM antibodies).
In the ABO classification blood group chart, under "O" column:
The anti-A and anti-B antibodies are classified as "IgM." However,
Type O mothers have antibodies "predominantly IgG type, which
can cross the placenta and cause hemolysis of the fetus."
In the text to the right side of the diagram, "HbA migrates the
farthest, followed by HbS, followed by HbC."; it will be helpful to
add HbF also, after HbA. Also, the "A, F, S, C" in the same text
,can be in red colour, to further complement the current
mnemonic, A big, Fat Santa Claus."
The fact and the digram are very useful additions to the FA2016
text. Great job. I have only minor edits for the diagram. First is
about HbF band that according to the current diagram in only
present in "normal newborn". However it's not the case and
although the percentage is very low but the band is present even
in adult Hb electrophoresis as a tiny band and is more
pronounced in sickle cell disease (recall that hydroxyurea is used
in SCD to increase HbF too) and HbC disease. So I would
recommend to correct this to be more precise. My second
suggestion is adding HbA2 (would be the closest band to
cathode) although it would somehow ruin your mnemonic but
maybe you or one the readers can come up with something else
(in fact I'm using a less interesting mnemonic as 2 CSF
Aspirations : A2 HbC HbS HbF HbA). I also suggest including
beta-thalassemia major and trait in the rows. I have attached a
photo of my old book and the diagram I drew by using several
pics in google.
The diagram shows LMWH having activity against Thrombin,
despite the fact they don't, and HMWH + Heparin
to current
text
First aid 2016
In diagram under "contact activation (intrinsic) pathway," Box has

"VIII with vWF)". Extra parenthesis needs to be removed.
Spelling/for
matting
/overview-ofhemostasis?source=search_resul
t&search=coagulation+cascade&
selectedTitle=1~98#H11
Just a typo, no reference needed.
Coagulation cascade should include that thrombin also positively

feeds back to further activate factor XI. From Uptodate: he small
initial amount of thrombin generated then activates factor XI in a
feedback manner, leading to amplification of thrombin generation.
"thrombomodulin" is missing a "t": Replace "Thrombinhrombomodulin complex" with "Thrombin-thrombomodulin
complex" (Find it in the protein C pathway)
The enzyme responsible for the vitamin k dependent gammacarboxylation of factor II, VII, XI, X, and protein C/S is gammaglutamyl carboxylase, not gamma-glutamyl transferase
Minor
erratum
The letter "T" is missing from "Thrombomodulin" in the

subheading "Thrombin-Thrombomodulin Complex"
Spelling/for
matting
Missing the T in" thrombomodulin" complex in the text describing

Protien C actvation via thrombin-thrombomodulin complex
Spelling/for
matting
/vitamin-k-and-the-synthesis-andfunction-of-gammacarboxyglutamicacid?source=search_result&searc
h=vitamin+k+dependent+gamma
+glutamyl+carboxylase&selected
Title=1~2
N/A
https://en.wikipedia.org/wiki/Thro
mbomodulin
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https://en.wikipedia.org/wiki/Risto
cetininduced_platelet_aggregation
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mboplastin
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Goljan RR- page 35
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Deficiency of Vit. K reduces synthesis of factors II, VII, IX, X and

protein S and C. Mnemonic is diSCo 1972 . diSCo: protein S and
protein C. 1972: factors 10 (X) 9 (IX) 7 (VII) 2 (II)
The enzyme that gamma-carboxylates the inactive precursors of
factors II, VII, IX, X, C, and S is gamma-glutamyl carboxylase not
gamma-glutamyl transferase.
"The effects of vitamin K deficiency were diSCovered in 1972
(decreased synthesis of protein S/C, 10, 7, 9, and 2)" *make the
following text in RED: the capital S & C in diSCovered, 1972,
protein C/S 10, 7, 9, 2 *
In the entry for Ristocetin it say" Ristocetin activates vWF to bind
GpIb. Failure of agglutination with ristocetin assay occurs in von
Willebrand disease and Bernard-Soulier syndrome." it should say
AGGREGATION .. you guys already made the correction on page
398.
The Diagram of Thrombogenesis has a picture of a endothelial
cell with the caption in which thromboplastin is missing T and is
spelled as hromboplastin instead of Thromboplastin.
In the table for blood groups under ABO classification it states
that the anti-A and anti-B antibodies in the plasma of a patient
with Type O blood are IgM when they are in fact mostly IgG. This
distinction is important because the fact that they are IgG means
they can cross the placenta and cause hemolytic disease of the
newborn. If they were IgM they would not be able to do so.
Aspirin should not cause TXA2 sythesis. It inhibits cycloxygenase
thus preventing prostaglandin H2 and further downstream
prevents the formation of TXA2 synthesis.
Rouleaux formation- seen in MGUS, multiple myeloma,
Waldebstrom macroglobiulinemia. anemia promotes rouleaux
formation. Abnormally shaped RBC such as sickle cell do NOT
produce rouleaux
Basophilic stippling is seen in a peripheral blood smear, whereas
ringed sideroblasts are seen in bone marrow biopsy
The capitalization of the notes for the alpha thalassemias is
inconsistent. After the part that says "4 allele deletion: " the next
letter is capitalized. In contrast, there's no capitalization for the 3,
2, or 1 allele deletion descriptions.
Under extrinsic (in the green section of the flowchart), it says
"Microangiopa hic" - it should read "Microangiopathic"
Mnemonic
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Mnemonic
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Myself
In the flowchart caption "han" should read "than"
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matting
Myself
In the flowchart caption "han" should read "than"
Spelling/for
matting
/image?imageKey=HEME/76236
&source=graphics_search&rank=
0&search=iron+deficiency+anemi
a
/partial-gastrectomy-andgastrointestinalreconstruction?source=machineL
earning&search=gastrectomy&sel
ectedTitle=1%7E114&sectionRan
k=1&anchor=H182343258#H182
343258
/pathophysiology-of-alphathalassemia?source=search_resu
lt&search=thalassemia&selectedT
itle=3%7E150
My brain
In the labs for iron deficiency anemia, it is high yield to know that
Free Erythrocyte Protoporphyrin (FEP) increases Since there is a
relative decrease in Fe levels, there is extra protoporphyrin that
leaks into blood.
Gastrectomy should be listed as a high-yield cause of Iron
deficiency anemia.
High-yield
addition to
next year
Thalassemias (both and ) are protective against Plasmodium

falciparum. Please add this high-yield fact.
High-yield
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Bolden the "alpha symbol" in alpha-Thalassemia, the "A" in Asian,

& the "A" in African; "ALPHA-thalassemias are in "A"sians &
"A"fricans
"Esophageal webs appear together with microcytic hypochromic
anemia and atrophic glossitis to complete the triad of major
findings in the rare Plummer-Vinson syndrome."
To remember Plummer Vinson Syndrome: "The Beefy Plumber
trid to unclog the web in the iron pipes" Where beefy = beefy red
tongue (atrophic glossitis), Plumber = Plummer Vinson Syndrome,
Web/Pipes = Esophageal web, Iron = Iron deficiency anemia
The texts in blue for Beta-thalassemi are incorrectly formatted;
weird overlaps/spacing
Mnemonic
https://www.clinicalkey.com/#!/co
ntent/3-s2.0B9781455726134000177?scrollT
o=%23c00017
Pathoma 2015 pg. 42 and FA
2016
Myself
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Mnemonic
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FA 2016 page 389
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/anemia-in-children-due-todecreased-red-blood-cellproduction
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s/NBK7047/
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/anemia-of-chronic-diseaseinflammation?source=machineLe
arning&search=anemia+of+chroni
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Diamond blacken anemia is listed

as a megaloblastic anemia in pg.
388 of FA
None. Created by me.
/overview-of-hemolytic-anemiasinchildren?source=preview&langua
ge=enUS&anchor=H5&selectedTitle=2~
24#H6
http://jama.jamanetwork.com/artic
le.aspx?articleid=200611
/hereditary-spherocytosis-clinicalfeatures-diagnosis-andtreatment?source=search_result&
search=hereditary+spherocytosis
N/A
articles/PMC2721357/ ;
Reversible causes of Sideroblastic anemia: My son dodged 6

bullets while he was tottering from side to side with a cup of
alcohol. Son: Isoniazid, 6: Vitamin B6 deficiency, Bullets: lead,
Side to side: Sideroblastic anemia, Cup: Copper deficiency,
Alcohol: alcohol.
In sideroblastic anemia, the first line says defect in heme
synthesis due to X-linked defect in ALA synthase gene, however
the next line lists the causes and one of them is genetic while
others are acquired so would not be related to X-linked defect. So
it's better to change these lines to indicate most of the time it is
genetic (X-linked ALA synthase gene defect) and might be
acquired (listing other causes). Or simply move the X-linked part
to parentheses after genetic.
Diamond-Blackfan anemia in age 390 is wrongly put under
megaloblastic aneia - It should be under non-megaloblastic
anemia. On page 388 it is correctly placed (diagram) under nonmegaloblastic anemia.
Diamond-Blackfan anemia is listed under megaloblastic anemia
on p. 390; this contradicts the chart on p.388 which lists it under
non-megaloblastic anemia (which is correct)
Page 390 is inconsistent with page 388. In the Anemia chart,
under Macrocytic anemias, Diamond-Blackfan anemia is listed
under non-megaloblastic. However, on page 390, DBA is listed
under megaloblastic.
Diamond-Blackfan anemia should be classified under nonmegaloblastic macrocytic anemia as indicated in the figure on
pg.388
Where it should say "description" in the header, the text
formatting is weird
Mnemonic
Diamond-Blackfan anemia is supposed to be under

nonmegaloblastic anemia and not under megaloblastic anemia
Minor
erratum
Hello! Just a quick mnemonic I came up with for MICROCYTIC

ANEMIAS >> "TAILS". This mnemonic is useful for me when I
practice with questions. As soon as I see "patient has microcytic
anemia", I think TAILS: thalassemia, anemia of chronic disease,
iron deficiency, lead poisoning, sideroblastic. Hope you find it
helpful!
In the "Anemia of chronic disease" treatment section, it says that
EPO is used in chronic kidney disease only. Treatment should
really say "Treat the underlying disease. Use EPO in patients with
chronic kidney disease or in the absence of a successful primary
treatment."
Mnemonic
Although Fanconi anemia is considered a type of aplastic anemia,

it should not be under normocytic anemia. Most sources I've seen
(including UpToDate and even Wikipedia) mention it as mainly a
macrocytic anemia. In fact macrocytic anemia is usually the first
detected abnormality at birth. I suggest either moving fanconi
anemia to the macrocytic anemia section (very similar to
Diamond-Blackfan) or keeping it in the same place and
mentioning that it is not necessarily a normocytic anemia to avoid
confusion.
Spherocytes are seen in certain kinds of extravascular hemolysis
(immune mediated (autoimmune) hemolytic anemia (usually IgG)
and in hereditary spherocytosis), but NOT other kinds of
extravascular hemolysis (e.g. sickle cell disease, thalassemia,
G6PD deficiency)
Clarification
to current
text
There is not urobilinogen in urine in intravascular hemolysis.

Urobilinogen is formed from conjugated bilirrubin in the gut and it
wont be formed in intravascular hemolysis. The correct is
hemosiderin in urine in intravascular hemolysis.
Bilirubin gallstones are a common complication of Hereditary
Spherocytosis. High-yield to know that, I got a QBank question on
it.
Major
erratum
Place the section on HbC disease after the section on Sickle Cell
disease since it is presented as a minor form of HbSS. As of now
it is separated from Sickle cell disease by Paroxysmal nocturnal
Hemoglobinuria, which is not related to HbC disease.
Paroxysmal Nocturnal Hemoglobinura: Dark urine at night and
Urine Hemosiderin are strongly suggestive of PNH (also Labs
Clarification
to current
text
Clarification
to current
text
Major
erratum
Major
erratum
Spelling/for
matting
Minor
erratum
Spelling/for
matting
Major
erratum
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
/pathogenesis-of-paroxysmalnocturnalhemoglobinuria?source=machine
Learning&search=pnh&selectedTi
tle=2~58&sectionRank=1&anchor
=H13962299#H1
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and
Oncology
http://onlinelibrary.wiley.com/doi/1
0.1002/ajh.23218/pdf
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and
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First aid 2016
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and
Oncology
/pathogenesis-clinicalmanifestations-and-diagnosis-ofacute-intermittent-porphyria
395
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and
Oncology
/pathogenesis-clinicalmanifestations-and-diagnosis-ofacute-intermittent-porphyria
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Mneumonic
396
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and
Oncology
See page 543 FA2016

MUDPILES mnemonic Iron
Tablets
396
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and
Oncology
/acquired-inhibitors-ofcoagulation?source=search_resul
t&search=coagulation+factor+inhi
bitor&selectedTitle=1%7E150
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and
Oncology
/immune-thrombocytopenia-itp-inadults-clinical-manifestationsand-
show Elevated LDH, Elevated Indirect Bilirubin (possible mild

jaundice) ; Explanation of why paroxysmal flares of hemolysis
occur at night (due to hypoventilation during sleep, causing
acidification of blood, leading to up-regulation of complement
mediated hemolysis)
The description of the Direct Coombs test currently reads "anti-Ig
antibody (Coombs reagent) added to patient's blood." This is not
entirely correct. The sentence should read as follows: anti-Ig
antibody (Coombs reagent) added to patients RBCs." The Direct
Coombs test is useful for detecting antibodies that are attached to
patients red blood cells, so these cells need to be isolated from
the blood and washed to remove unbound immunoglobulin and
complement (i.e., the patients serum) before adding the Coombs
reagent. From the linked American Journal of Hematology paper
on the Direct Coombs test: The patients RBC are washed with
saline to remove unbound immunoglobulin and complement,
[Coombs reagent] is added, and the RBC suspension is
centrifuged. Using gentle tapping, the RBC pellet is dislodged and
examined for agglutination . . . This change to the current text
would not only be a more accurate description of how the test is
performed, but also would better enable students to compare the
Direct and Indirect tests. Specifically, the Direct test is performed
on RBCs isolated from patient blood, whereas the Indirect test is
performed on serum isolated from patients blood. The description
for the Indirect Coombs test is clear on that point.
By "Lymphopenia", one of the causes, "corticosteroids,a", is
formated with the superscript a after the comma. Should it be
before the comma so as not to confuse the superscript note?
In acute intermittent porphyria I suggest adding the alternative
name of the main enzyme PBG deaminase. It is also referred as
Hydroxymethylbilane synthase (HMBS) as addressed in
UpToDate. (some sources also refer to it as Uroporphyrinogen I
synthase). But it's important to know HMB synthase as alternative
name that may show up in questions.
In acute intermittent porphyria, one of the accumulated
substances named is coporphobilinogen. I think you can omit it
and simply refer to urinary porphyrins (as mentioned in UpToDate
and many other sources). Or maybe it should be changed to
urinary coproporphyrin and uroporphyrin (see reference). Another
thing that is odd with this substance is "COPOR" in its name
(while mostly "copro" is the prefix in porphyrins. However, one
article in medscape mentions it exactly with the same spelling as
in FA2016 (maybe it's your reference), but I didn't find it in any
other good reference (in google it gives about 300 results that
most are student forums). Uptodate does not mention it at all so
overall I think because it's not in the figure and it's not high-yield
you can simply change it to urinary porphyrins (after all other
porphyrins are checked too).
The accumulated substances in acute intermittent porphyria
include porphobilinogen and ALA but NOT Coporphobilinogen
(Coporphobilinogen should be removed). It is a basic biochemical
rule that whenever an enzyme is deficient, there is a buildup of
the substrates upstream of the enzyme. Coproporphyrinogen is
downstream of porphobilinogen deaminase. Consequently, we
should expect to see a decrease of this intermediate, not an
accumulation in the urine.
for description of the urines in AIP vs PCT a way to remember it is
pcT gives Tea colore urine as in PCTea but AIP gives Port
colored urine as in aiP
In signs and symptoms of iron poisoning please add the high yield
metabolic acidosis with increased anion gap ( "I" in MUDPILES
stands for Iron and Isoniazid)
Acquired Coagulation Factor Inhibitors are totally missing as a
pathology of 2 hemostasis. These are acquired antibodies
against coagulation factors (usually factor 8) impaired clotting.
Presents similarly to hemophilia A. You can distinguish the two by
using a mixing study. In hemophilia A, PTT will correct once
mixed with control plasma. If Coagulation Factor Inhibitors are
present, PTT will not correct. That last point is particularly high
yield.
It is high yield to know that Immune thrombocytopenia can be
secondary to lupus (SLE), not just viral illness like you have listed.
next year
Minor
erratum
Spelling/for
matting
Clarification
to current
text
Clarification
to current
text
Major
erratum
Mnemonic
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
diagnosis?source=search_result&
search=immune+thrombocytopen
ic+purpura&selectedTitle=1%7E1
50
/thrombocytopenia-inpregnancy?source=see_link
397
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and
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and
Oncology
UpTodate " congetinal and

acquired disorders of platelets"
398
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and
Oncology
/thrombotic-and-hemorrhagicdisorders-due-to-abnormalfibrinolysis?source=search_result
&search=disorders+of+fibrinolysis
399
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and
Oncology
399
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and
Oncology
/epidemiology-pathologicfeatures-and-diagnosis-ofclassical-hodgkinlymphoma?source=search_result
&search=hodgkin+lymphoma&sel
ectedTitle=2%7E150
/overview-of-hodgkin-lymphomain-children-andadolescents?source=search_resu
lt&search=hodgkin+lymphoma+ty
pes&selectedTitle=1%7E150
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/epidemiology-clinicalmanifestations-pathologicfeatures-and-diagnosis-of-diffuselarge-b-celllymphoma?source=search_result
&search=dlbcl&selectedTitle=1~1
10#H8 ;
/pathobiology-of-diffuse-large-bcell-lymphoma-and-primary-
/clinical-manifestationspathologic-features-anddiagnosis-of-mycosisfungoides?source=search_result
&search=mycosis+fungoides&sel
ectedTitle=1%7E88
/image?imageKey=HEME%2F75
793&topicKey=HEME%2F1674&r
ank=1%7E88&source=see_link&s
earch=mycosis+fungoides&utdPo
pup=true
/clinical-manifestationspathologic-features-anddiagnosis-of-extranodal-malt-andnodal-marginal-zonelymphomas?source=search_resul
t&search=marginal+zone+lympho
ma&selectedTitle=1%7E46
/clinical-manifestationspathologic-features-anddiagnosis-of-mantle-celllymphoma?source=search_result
&search=mantle+cell+lymphoma
+cd5&selectedTitle=1%7E97
FA 2016 Pg 231
It is high yield to know that immune thrombocytopenia in a

pregnant woman may cause temporary thrombocytopenia in her
baby since IgG against the platelets can cross the placenta.
defect in the platelet integrin IIb3 (integrin alphaIIbbeta3;
previously known as GPIIb/IIIa
Disorders of fibrinolysis are completely absent from this book. It is
high-yield to know that these disorders are due plasmin
overactivity, present with bleeding (like DIC), have PT/PTT
(like DIC), have bleeding time (like DIC), have normal platelet
counts (vs DIC), have normal D-dimer levels (vs DIC). Treatment
is blocking activation of plasminogen with aminocaproic acid.
It is high yield to know that eosinophilia is classically associated
with Hodgkin lymphoma.
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
next year
A discussion of the high-yield subtypes of Hodgkin lymphoma is

missing. Nodular sclerosis is the most common subtype.
Lymphocyte-rich has the best prognosis. Lymphocyte-depleted
has the worst prognosis. Mixed cellularly presents with
eosinophilia
You guys left out the pathognomonic high-yield finding of Mycosis
fungoides: aggregates of neoplastic cells in epidermis called
Paltrier microabscesses. From UpToDate: "Pautrier
microabscesses are pathognomonic"
High-yield
addition to
next year
Under Sezary Syndrome, you should include a picture of the

characteristic cerebriform Sezary cells. It's a fairly high-yield and
unique looking image, and that page has plenty of room for
another photo.
High-yield
addition to
next year
A discussion of Marginal Zone Lymphomas is completely missing.

It is important to know that these are a B cell proliferation
associated with certain inflammatory conditions, like Hashimoto
thyroiditis, Sjogren syndrome, and H. pylori gastritis.
High-yield
addition to
next year
For Mantle Cell lymphoma, it is high-yield to know that it is CD5

positive. From UpToDate: "They also express pan-B cell antigens
(eg, CD19, CD20), CD5"
High-yield
addition to
next year
Primary central nervous system lymphoma is associated with

EBV.
High-yield
addition to
next year
Mnemonic
Great way to remember the translocation number for Burkitt

Lymphoma. There are 15 letters in Burkitt Lymphoma so change
the "B" in Burkitt to "8"urkitt Lymphoma. So 8 represents the first
translocation number and the remaining 14 letters will represent
the second translocation number which is 14.
To remember B-cell lymphomas involving translocations with
chromosome 14. "Burkitt went to see Mick (c-myc) at 8 (t(8;14))
under the starry sky (appearance of lymphocytes)." Follicular
lymphoma: "Lauren Bacall (BCL-2) started waxing (and waning
lymphadenopathy) her follicles at age 18 (t(14;18)); it didn't hurt
(painless lymphadenopathy)." Mantle cell lymphoma: "He (males
>females) always cycled (cyclin D) so aggressively (aggressive
and late-stage presentation); he has 11 (t(11;14)) trophies on his
Mantle."
Diffuse large B-cell lymphoma is highly associated with Bcl-6
mutations in most cases
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
401
Hematology
and
Oncology
401
Hematology
and
Oncology
402
Hematology
and
Oncology
402
Hematology
and
Oncology
402
Hematology
and
Oncology
Hematology
and
Oncology
Hematology
and
Oncology
402
402
mediastinal-large-b-celllymphoma?source=see_link&sect
ionName=ABERRANT+BCL6+EXPRESSION&anchor=H3#H3
/clinical-features-laboratorymanifestations-and-diagnosis-ofmultiple-myeloma
/clinical-features-laboratorymanifestations-and-diagnosis-ofmultiple-myeloma
/acute-myeloid-leukemia-amltreatment-in-adults-beyond-thebasics
N/A
Update to existing "CRAB" mnemonic: R can also stand for

Rouleaux formation, since this is a frequent histological finding for
multiple myeloma.
Another update to existing "CRAB" mnemonic: C can also stand
for clock-face chromatin, a common morphologic finding for
multiple myeloma.
Acute myelogenous leukemia is misspelled as "Acute
myelogenous leukemiaa"
Mnemonic
For remembering symptoms and stain of hairy cell leukemia I

recommend one of the following: Hairy LAP is a TRAP, Dry TAP !
or simply: LAP TRAP dry TAP! LAP: is lymphadenopathy (and
also splenomegaly), TRAP is the stain (tatrate-resistant acid
phosphatase), Dry TAP for bone marrow.
Under the "Myeloid neoplasms" heading, "leukemia" is misspelled
in "Acute myelogenous leukemiaa" -- there is an extra "a"
Mnemonic
N/A
It is printed as "Acute myelogenous leukemiaa" and needs to be

printed as "Acute myelogenous leukemia"
Spelling/for
matting
/classification-of-acute-myeloidleukemia?source=search_result&
search=acute+myelogenous+leuk
emia&selectedTitle=1~150
Misspelled - Acute myelogenous leukemiaa. Should be "Acute

myelogenous leukemia."
Spelling/for
matting
This is a very high-yield page however I think it can be a bit more

organized and with a bit more space (it's very crowded with words
now making it hard to follow). For AML please consider
separating at least three important high-yield subtypes ( APL
[M3], acute monocytic leukemia [M5], acute megakaryocytic
leukemia [M7]). APL is already in the text but the other two are
not. My suggestion is two put them each in separate line with
these explanations: APL: M3 AML, in younger patients, Auer rods
(peroxidase+), involving retinoic receptor (RAR) on chromosome
17, responds to all-trans retinoic acid, DIC common (primary
granules activate coagulation) ; Acute Monocytic leukemia (M5
AML): Peroxidase - (usually lacks MPO), nonspecific esterase +,
infiltrates gums, poor prognosis ; Acute Megakaryocytic leukemia
(M7 AML): Lacks MPO, platelet peroxidase +, increased risk in
Down syndrome (usually before age of 5), poor prognosis.
It should be highlighted that a characteristic and high yield finding
in chronic myelogenous leukemia is basophilia. From UpToDate:
"Absolute basophilia is a universal finding in the blood smears
from CML patients, and absolute eosinophilia is seen in about 90
percent of cases."
It is very high yield to add that Acute Lymphoblastic Leukemia
may have the Philadelphia chromosome (t(9;22) BCR/ABL1
translocation). Since t(9;22) is classically associated with CML, its
possible presence on ALL is highly testable.
High-yield
addition to
next year
Under Hairy Cell Leukemia, it is very high-yield to add that the

splenomegaly is due to *red pulp* infiltration in the spleen. Other
leukemias infiltrate white pulp, making this a highly testable fact.
High-yield
addition to
next year
Under Hairy Cell Leukemia, it is very high-yield to add that

lymphadenopathy is usually absent. From UpToDate:
"Hepatomegaly and lymphadenopathy are not major features of
HCL."
High-yield
addition to
next year
Under Hairy cell leukemia, it should be added that this cancer is

CD11c and CD25 positive. Form UpToDate: "The cell also
expresses surface antigens that are not common on B cells, such
as CD11c (monocytes and neutrophils), CD25 (activated T cells)"
High-yield
addition to
next year
It is extremely high-yield to note that Hairy Cell Leukemia

presents with pancytopenia, as this is a unique characteristic
among the leukemias. From UpToDate: "Sixty to 80 percent of
patients with HCL present with pancytopenia"
High-yield
addition to
next year
For Acute Lymphoblastic Leukemia (and other tumors), it is
High-yield
Leukemia
402
Hematology
and
Oncology
402
Hematology
and
Oncology
/clinical-manifestations-anddiagnosis-of-chronic-myeloidleukemia?source=search_result&
search=cml&selectedTitle=1%7E
150
402
Hematology
and
Oncology
402
Hematology
and
Oncology
402
Hematology
and
Oncology
402
Hematology
and
Oncology
402
Hematology
and
Oncology
402
Hematology
and
/overview-of-the-presentationand-diagnosis-of-acutelymphoblastic-leukemia-inchildren-andadolescents?source=search_resu
lt&search=ALL&selectedTitle=1%
7E150
/clinical-features-and-diagnosisof-hairy-cellleukemia?source=search_result&
search=hairy+cell+leukemia&sele
ctedTitle=2%7E48
ctedTitle=2%7E48
search=CD11c&selectedTitle=1%
7E21
ctedTitle=2%7E48
/tumor-lysis-syndrome-definition-
Mnemonic
Spelling/for
matting
Spelling/for
matting
High-yield
addition to
next year
High-yield
addition to
next year
Oncology
pathogenesis-clinicalmanifestations-etiology-and-riskfactors?source=see_link
Hematology
and
Oncology
Hematology
and
Oncology
Hematology
and
Oncology
Hematology
and
Oncology
n/a
Hematology
and
Oncology
Hematology
and
Oncology
Hematology
and
Oncology
Spelling
402
Hematology
and
Oncology
A mneumonic.
402
Hematology
and
Oncology
Dictionary.com; Webster's
Dictionary; Spell Check.
402
Hematology
and
Oncology
Not necessary. I made this

awesome mneumonic up.
403
Hematology
and
Oncology
Hematology
and
Oncology
https://en.wikipedia.org/wiki/S100
_protein
403
Hematology
and
Oncology
Please see page 402 FA2016

t(12,21) in ALL
403
Hematology
and
Oncology
N/A, this is a cosmetic

suggestion, not new info
403
Hematology
and
Oncology
http://reference.medscape.com/fe
atures/slideshow/chronicleukemia
403
Hematology
and
Oncology
404
Hematology
and
Oncology
/post-remission-therapy-forphiladelphia-chromosomepositive-acute-lymphoblasticleukemia-in-adults
Pathoma -Fundamentals of
pathology White Blood Cell
Disorders page 59
404
Hematology
and
Oncology
402
402
402
402
402
402
402
403
important to add that patients can present with hyperuricemia due

to tumor lysis syndrome after treatment with chemo. If this is
suspected, treatment with allopurinol and aggressive IV hydration
is indicated. From UpToDate: "TLS most often occurs after the
initiation of cytotoxic therapy in patients with high-grade
lymphomas (particularly the Burkitt subtype) and acute
lymphoblastic leukemia."
Typo: "leukemia" is misspelled with two a's in "Acute
myelogenous leukemia"
addition to
next year
UpToDate
Acute myelogenous leukemia title is spelled as "leukemiaa"
Spelling/for
matting
/clinical-features-and-diagnosisof-hairy-cell-leukemia
n/a; this is a mnemonic
suggestion for already existing
notes
Mature Males are more Hairy. Hairy cell leukemia is a Mature Bcell tumor with a strong predominance in Males.
Mnemonic
Suggestion to highlight/bold the letter "A" in notes for Acute

myelogenous leukemia. For example: Acute, Adult, Auer rods,
vitamin A, Alkalating
Acute myelogenous leukemiaa
Mnemonic
http://www.dictionary.com/browse
/leukemia?s=t
Acute Myelogenous Leukemia. On page 402 it's has been spelt

as Acute Myelogneous Leukemiaa (minor typo).
Spelling/for
matting
"Hairy TRAPs dry the tap but respond well to Pentostat" (Hairy hairy cell leukemia, TRAP - tartate resistant acid phosphatase,
dry tap - bone marrow fibrosis leads to hypocellular bone marrow
aspiration, Pentostat: treated with adenosine deaminase inhibitors
like Pentostatin)
A break in the (Liberty) bell (BCR-ABL) in Philadelphia
(Philadelphia chromosome); we fight against the TYRant KINg
(BCR-ABL encodes a TYRosine KINase).
Under subheading "Myeloid neoplasms," the topic header, "Acute
myelogenous leukemia" is incorrectly spelled ("leukemiaa" in the
text). Minor, but 1st Aid should be perfect ;).
To remember high yield AML facts: "AML "Auer" old aunt AsTRA
saves the traMPOline." --> All the "A's" help associate them with
AML. Auer Rods; old=median onset in elderly; tx: ATRA; MPO:
myeloperoxidase positive.
"Cells express S-100 (mesodermal origin) and CD1a" S-100 is
neural crest cell origin and not mesodermal origin
Mnemonic
The paragraph for Burkitt Lymphoma's translocation explanation

is below the mnemonic for the Philadelphia gene so it looks like
the t(18:14) explanation goes with the Philadelphia chromosome
gene.
In chromosomal translocations please also add t(12,21) for ALL
that is mentioned in page 402. You can add "good prognosis" for
it in the parentheses. Also you can add parentheses after ALL in
t(9,22) to indicate "poor prognosis" though in a way that it only
refers to ALL and not CML.
It would be extremely helpful if you made a table showing which
surface markers the normal cells and pathological cancerous cells
expressed. For example, CLL is CD5 and CD20 positive, mantle
cell lymphoma is CD5 positive, Reed-Sternberg cells are CD15
and CD30 cells, normal NK cells are CD16 positive, etc. You guys
have (some of) these written with the corresponding diseases, but
seeing all of them in one table would be extremely helpful.
"Philadelphia CreaML cheese. The Ig heavy chain genes on
chromosome 14 are constitutively expressed. When other genes
(eg, c-myc and BCL-2) are translocated next to this heavy chain
gene region, they are overexpressed." THis all runs together and
appears to suggest C. 14 is involved in CML. The CML line
should be moved lower, so FL, BL, and MCL are together with the
mneumonic.
PhilALLdelphia CreaML cheese - Philadelphia chromosome
t(9;22) is seen in CML AND ALL
Major
erratum
Essential thrombocytopenia is the only myeloproliferative disorder

with no increased risk of hyperuricemia or gout. Because platelets
lack nucleus.
In the table, it may be useful to indicate the primary driver of each
polycythemia subtype to help easily distinguish between them (ie.
red arrow or 1* next to O2 sat, EPO, or RBC mass).
High-yield
addition to
next year
High-yield
addition to
next year
N/A
N/A
Spelling/for
matting
Spelling/for
matting
Mnemonic
Spelling/for
matting
Mnemonic
Minor
erratum
Clarification
to current
text
Clarification
to current
text
Mnemonic
Mnemonic
404
Hematology
and
Oncology
/clinical-manifestations-anddiagnosis-of-polycythemiavera?source=search_result&sear
ch=polycythemia+vera&selectedT
itle=1~115
404
Hematology
and
Oncology
404
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and
Oncology
/prognosis-and-treatment-ofpolycythemiavera?source=search_result&sear
ch=polycythemia+vera&selectedT
itle=2~115
/pathogenetic-mechanisms-inprimarymyelofibrosis?source=search_res
ult&search=myelofibrosis+PDGF
&selectedTitle=1~150
404
Hematology
and
Oncology
Up to Date
405
Hematology
and
Oncology
Mnemonic, Ref N/A
405
Hematology
and
Oncology
405
Hematology
and
Oncology
Hematology
and
Oncology
www.medscape.com/viewarticle/5
04601_2
405
Hematology
and
Oncology
405
Hematology
and
Oncology
/tranexamic-acid-druginformation?source=preview&sea
rch=%2Fcontents%2Fsearch&an
chor=F229898&selectedTitle=1~8
2#F229898
/tranexamic-acid-druginformation?source=see_link
405
Hematology
and
Oncology
Hematology
and
Oncology
https://en.wikipedia.org/wiki/Trane
xamic_acid#Mechanism_of_actio
n
http://www.nejm.org/doi/pdf/10.10
56/NEJMra044440
405
Hematology
and
Oncology
Katzung and Trevors

Pharmacology Examination and
Board Review
405
Hematology
and
Oncology
406
Hematology
and
Oncology
406
Hematology
and
/fondaparinux-druginformation?source=search_result
&search=fondaparinux&selectedT
itle=1~63#F173978
/warfarin-druginformation?source=search_result
&search=warfarin&selectedTitle=
1~150
ug/coumadin-jantoven-warfarin-
405
405
http://www.drugs.com/cdi/tranexa
mic-acid.html
For polycythemia vera, it is high-yield to know that it can lead to

Budd-Chiari syndrome due to hepatic vein thrombosis. From
UpToDate: " Major thrombotic events can occur in patients who
otherwise have few clinical and laboratory features of PV.
Examples include the Budd-Chiari syndrome"
For polycythemia, the treatments are high yield. First line is
phlebotomy, which is fairly obvious. The second line treatment is
not as obvious but just as high-yield: hydroxyurea.
High-yield
addition to
next year
For myelofibrosis, it is high-yield to know that you have a

neoplastic proliferation of megakaryocytes, since those cells
secrete TGF-beta and Platelet Derived Growth Factor (PDGF),
which is what leads to the bone marrow fibrosis. From UpToDate:
"The major megakaryocyte-derived cytokine implicated in the
mediation of BMF in PMF is transforming growth factor (TGF)beta... Other growth factors also may contribute to the fibrotic
reaction, including platelet derived growth factor (PDGF)"
In my heme/onc studies I found that I needed clarification
between Primary Myelofibrosis and M7 AML Megakaryocytic
myelofibrosis. Also in reading Pathoma Dr. Sattar says the
megakaryocytic secrete platelet derived growth factor which
stimulates fibroblasts to run wild and produce collagen in the bone
marrow. Here is an excerpt from Up To Date: Acute myelofibrosis
is a syndrome characterized by severe bone marrow fibrosis
associated with fever and pancytopenia, teardrop RBCs, and a
leukoerythroblastic blood picture [91,92]. However, unlike PMF,
the spleen is often not palpable in acute myelofibrosis and in
some instances the bone marrow may show excess
megakaryoblasts, suggesting a diagnosis of acute
megakaryoblastic leukemia (FAB classification M7). This
distinction is critical since the appropriate treatment for acute
myelofibrosis is antileukemic chemotherapy with or without
hematopoietic cell transplantation. (See "Classification of acute
myeloid leukemia".)
Mnemonic to remember that the drugs act to inhibit thrombin
(Factor II) : Lep(I)*rud(I)*n (II); Argatro(two)ban, (Bi)valrudin =2,
Da(bi)gatrin =2
MINOR ERROR IN LISTING Vit K dep. Factors: "Proteins C and
S have shorter half-lives than clotting factors II,***[ VI,]->CORRECT TO VII*** IX, and X..."
Typo of Warfarin clotting factor inhibition
High-yield
addition to
next year
"Can attempt to use activated prothrombin complex concentrates

(PCC) and/or **fibrinolytics** (eg, tranexamic acid)." It should read
ANTI-fibrinolytics
Tranexamic acid is listed as fibrinolytic. It is an antifibrinolytic
agent.
Major
erratum
Under adverse effects, states that for bleeding, "can attempt to

use... fibrinolytics (eg, tranexamic acid)." Should say *anti*fibrinolytics.
Tranexaminic acid is antifibrolytic,not fibrinolytic
Minor
erratum
It seems that FA2016 has dropped two other direct thrombin

inhibitors and only mentions Bivalirudin. I can't find a reason for
that because they are important drugs and in clinical use. So
please add Dabigatran and Argatroban to DTI list.
In adverse effects it is written "fibrinolytics (eg tranexamic acid)"
that should be changed to "antiplasmin agents (eg. tranexamic
acid and aminocaproic acid)"
Clarify that Fondaparinux is selective for Xa. As it's stated, it
sounds like it is active against IIa as well.
High-yield
addition to
next year
Factor VII has the shortest half life of all factors (including Protein
C and S)
Minor
erratum
With regard to the table comparing warfarin to heparin, I have a

mnemonic for the route of administration of warfarin. Warfarin
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
Minor
erratum
Minor
erratum
Minor
erratum
Major
erratum
Major
erratum
Clarification
to current
text
Oncology
342182#0
406
Hematology
and
Oncology
NA
406
Hematology
and
Oncology
https://www.theanswerpage.com/
study.php?specialty_id=4&topic_i
d=42&q=2
406
Hematology
and
Oncology
Hematology
and
Oncology
Hematology
and
Oncology
Hematology
and
Oncology
N/A
407
Hematology
and
Oncology
NA
407
Hematology
and
Oncology
ed/11176530
407
Hematology
and
Oncology
Please see Medscape-->

Pumonary Embolism--> Practice
Essentials--> Essential Update.
Also please see drug information
of Apixaban in Medscape.
407
Hematology
and
Oncology
Sketchymedical.com, Drugs.com
408
Hematology
and
Oncology
<1> http://www.uptodate.com/contents
/bortezomib-druginformation?source=search_result
&search=bortezomib&selectedTitl
e=1%7E94#F142119 <2> http://www.uptodate.com/contents
/carfilzomib-druginformation?source=search_result
&search=carfilzomib&selectedTitl
e=1%7E17#F14641319
408
Hematology
and
Oncology
FA2016 cancer drugs
408
Hematology
and
Oncology
Hematology
and
Oncology
N/A spelling
409
Hematology
and
Oncology
ug/xeloda-capecitabine342211#4,
ug/adrucil-fluorouracil-342092#4
409
Hematology
and
Oncology
N/A
410
Hematology
and
Oncology
N/A
407
407
407
409
administration is oral, and "warfarin" sounds like "wafer." This

could be remembered through, "eating a Communion wafer(in)",
or simply "eating a wafer". Are most people familiar with vanilla
wafers? That could work also. But the wafer-warfarin connection
helps me remember the ROA.
Instead of the current mnemonic "EX-PresidenT went to
WAR(faring)" maybe it's better to use a simpler one like "
WARFARe EXPerT"
in the section of Warfaran the book says that the protein C,S has
the shorter half life then listed ones, but in fact its the factor 7 with
the shortest elimination half life
Phyt War Bleeding (PHYTonadione is an example of a vitamin K
drug used to counteract WARfarin-induced bleeding.
Mnemonic
Clarification
to current
text
Mnemonic
personal mnemonic
Api(xa-ban), Rivaro(xa-ban), Api and Rivaro Ban Xa from

working.
Mnemonic
Mnemonic
GPIIb /IIIa Inhibitors : Abciximab, epti*FIB*atide, tiro*FIB*an

GPIIb/IIa is a receptor for *FIB*rinogen and vWF
Mnemonic
ug/lysteda-tranexamic-acid-oral999903
In adverse effect, treating toxicity you might want to also add

"tranexamic acid" to aminocaproic acid as two anti-fibrinolytics to
also be consistent with page 405 where tranexamic acid is
mentioned (I assume you will correct the error in that page based
on the comments that it is an "anti"fibrinolytic)
In adverse effects, for Neutropenia that is seen with ticlopidine,
you can change the font color to red for "Ne"utropenia and
ticlopidi"Ne" , or just simply the "N"s because it's the only drug
listed that has an N in it.
Dipyridamole is listed as a phosphodiesterase 3 inhibitor, but it's
main mechanism of action is through inhibiting phosphodiesterase
5.
In clinical use, Rivaroxaban is mentioned in the parentheses for
treatment and prophylaxis of DVT and PE, implying that Apixaban
is not used for this purpose. However, new updates indicate that
FDA has extended the use of Apixaban for treatment and
prophylaxis of DVT and PE. So there is no need to mention only
Rivaroxaban in the parentheses. Please see references.
Ticlopidine causes granulocytopenia specifically, which is a high
yield fact for USMLE Step 1. The text only has it listed as
Neutropenia.
Please include proteosome inhibitors(bortezomib, carfilzomib), as
a new column, including its mechanism of action and uses.
"Mechanism : Bortezomib inhibits proteasomes (enzyme
complexes which regulate protein homeostasis within the cell)
leading to activation of signaling cascades, cell-cycle arrest, and
apoptosis."; "Uses :Multiple Myeloma(bortezomib, carfilzomib),
mantle cell lymphoma(bortezomib)"; Adverse effects : "Peripheral
neuropathy, rash, amyloid heart disease, nausea and
hypotension"
For the orange box please consider the following changes: 1)
Instead of cisplatin I think it's better to mention Platinum drugs
(this would be consistent with the cell-cycle independent drugs in
the upper figure in the same page and also includes carboplatin).
2) for TopII inhibitors add Teniposide to Etoposide in the box 3)
For TopI inhibitors add Topotecan to Irinotecan in the box.
In the S phase part of the diagram, "DNA synthesis" is misspelled
as "DNA syn hesis."
Clarification
to current
text
To remember that the antimetabolite Cytarabine is a pyrimidine

analog, you can remember the mnemonic (Arabs have the
Pyramids).
Please consider these two comments: 1) Add Capecitabine to 5FU (similar mechanism, prodrug that converted to 5-FU in
neoplastic cells) 2) Very important and unique side effect of these
two drugs is hand-foot syndrome or palmar-plantar
erythrodysesthia that can present with tingling and numbness
progressing to painful swelling and desquamation.
Mnemonic for the clinical use of 5-FU. 5-FLOORouracil used to
treat things on the FLOOR (bottom) - basal cell carcinoma, colon
cancer.
Most anti-cancer drugs cause bone marrow suppression. The 3
main ones that dont (Vincristin, Cisplatin and Bleomycin) can be
remembered by the mnemonic (don't Vacuum Clean Bone
marrow)
Mnemonic
N/A
Mnemonic
Clarification
to current
text
Minor
erratum
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Spelling/for
matting
High-yield
addition to
next year
Mnemonic
Mnemonic
Hematology
and
Oncology
Hematology
and
Oncology
Hematology
and
Oncology
Hematology
and
Oncology
None
Kids are the WERst when they act out - Actinomycin D for Wilm's,
Ewing's, and Rhabdomyomas.
Mnemonic
NA
Examples listed under Nitrosoureas is missing an open

parenthesis
Spelling/for
matting
n/a
BOLT PLATes- "B"ladder, "O"vary, "L"ung, "T"esticular

carcinomas treat with cisPLATin or CarboPLATins
Mnemonic
lus/druginfo/meds/a607055.html;
lus/druginfo/meds/a699019.html
Mnemonic
413
Hematology
and
Oncology
this is a mneumonic so why do I

need a source?
413
Hematology
and
Oncology
not needed
416
Musculoskele
tal, Skin, and
Connective
Tissue
Please see the text.
417
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Dictionary
This is a mneumonic to remember the mechanism, clinical use,

and adverse effect of trastuzumab (herceptin). Sit on her(1)
lap(2), and trust(3) her(1) to(4) break your heart(5) 1- HER 2
receptor 2- Lapatinib (tyrosine kinase inhibitor HER2) 3Trastuzumab 4- her to ~ HER2 also Trastuzumab 5- break your
heart = cardiotoxicity associated w/ trastuzumab
"HER 2 BOOBs are aTRAShy and her friends don't have the
HEART to tell her." This is a mnemonic to remember that HER2+
breast cancer requires use of Trastuzumab which has
cardiotoxicity.
Cisplatin/carboplatin -> seems like this is repeated twice. Line 1,
and line 6 can be combined onto 1 single line, in line 1.
"Cisplatin/Carboplatin: ototoxic (acoustic nerve damage) and
nephrotoxic"
In the figures for abnormal passive abduction and adduction I
believe that the captions should be changes. Currently it states
external and internal rotation, respectively. However as indicated
in the text the tests are more based on valgus and varus stress
and not on rotation. So for Abnormal passive abduction it should
say "valgus/abduction force" and for Abnormal passive adduction
it should say "varus/adduction force" instead of the rotations.
in teres minor, the "T" should be capitalized.
Clarification
to current
text
418
Musculoskele
tal, Skin, and
Connective
Tissue
419
Musculoskele
tal, Skin, and
Connective
Tissue
47
419
Musculoskele
tal, Skin, and
Connective
Tissue
47
420
Musculoskele
tal, Skin, and
Connective
Tissue
na
420
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
First Aid for the Basic Sciences

General Principles
For scaphoid avascular necrosis please add "proximal part" in

order to clarify the importance of retrograde blood supply. AVN
mostly happens in fractures of proximal of the scaphoid bone
and affects the proximal part because the vascular supply travels
from distal to proximal. It's better to mention the proximal part in
the text.
Replace Scaphoid, Lunate, Triquetrum, Pisiform, Hamate,
Capitate, Trapezoid, Trapezium.(So Long To Pinky, Here Comes
The Thumb) to Scaphoid, Lunate, Triquetrum, Pisiform,
Trapezium, Trapezoid, Capitate, Hamate. (She Looks Too Pretty
Try To Catch Her)
The named structures as left main coronary artery and circumflex
coronary artery on figure of coronary artery anatomy can
confuse the students because in anatomical literature there are
only two coronary arteries, right and left. The circumflex artery is a
branch of the left coronary (circumflex branch of the left coronary
artery).
Isolated lesion of the musculocutaneous nerve will produce weak
flexion and supination of the forearm, but not absent. The biceps
brachialis contribution to flexion and supination is lost but the
supinator muscle (innervated by the radial nerve) preserve the
supination function of the forearm. Also the brachioradialis muscle
is innervated by the radial nerve and flexes the forearm at the
elbow joint. In case of musculocutaneous lesion, the patient is
able to supinate the forearm and weak elbow flexion, and loss of
sensation over the lateral forearm
Suggestions for Klumpke palsy: 1) In the image, 2 is labelled as
Claw hand (Klumpke palsy). In the conditions chart, the condition
is listed as Klumpke palsy. The formatting of diagram key could
be more parallel by having Klumpke palsy before claw hand (sort
of like how 1 is Erb palsy ("waiter's tip") like it appears in the
chart). 2) In the diagram label, include the word total in front of the
phrase claw hand (like how it is referred to in functional deficit)
's? -- on page 27 of First Aid for the Basic Sciences it says Erb's
palsy vs in First Aid for the USMLE Step 1 it says Erb palsy
Mnemonic
Musculoskele
tal, Skin, and
Klumpke palsy, resulting from injury to the lower trunk, classically

presents as total claw hand. Accordingly, this palsy can be
remembered with the deliberate misspelling "Claw-mpke" (or
"Klaw-mpke" if the initial "K" is preferred).
Brachial Plexus collateral branches: Lucy Sings Lullabies Under
410
410
411
413
418
420
420
rticle/328658-followup#e5
Personal mnemonic
Mnemonic
Clarification
to current
text
Minor
erratum
Spelling/for
matting
Mnemonic
Clarification
to current
text
Clarification
to current
text
Spelling/for
matting
Spelling/for
matting
Mnemonic
Connective
Tissue
420
Musculoskele
tal, Skin, and
Connective
Tissue
421
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
https://en.wikipedia.org/wiki/Recu
rrent_branch_of_the_median_ner
ve
423
Musculoskele
tal, Skin, and
Connective
Tissue
423
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
FA page 472: Nerves C1C7 exit

above the corresponding
vertebra. C8 spinal nerve exits
below C7 and above T1. All other
nerves exit below (eg, C3 exits
above the 3rd cervical vertebra;
L2 exits below the 2nd lumbar
vertebra).
http://www.ijssurgery.com/10.101
6/j.ijsp.2012.05.001
422
422
423
na
mnemonic for tibial nerve injury: 1. Baker's dozen is

apPROXimately 12 = baker cyst is a proximal injury. 2. the light at
the end of the tunnel is DISTant = tarsal tunnel syndrome is a
distal lesion.
Herniation of L3-L4 disc affects L3 spinal nerve.
Mnemonic
Herniation of L3-L4 disc affects the L3 spinal nerve. (on FA16

p423.1, it is written that it affects L4 spinal nerve which is
incorrect.)
Signs of lumbosacral radiculopathy can be remembered as the
action of kicking a ball. Intervertebral disc herniation at L2-L3:
weakness of hip flexion. L3-L4: weakness of knee extension. L4L5: weakness of dorsiflexion. L5-S1: weakness of plantar flexion.
Diad is spelled as "dyad" for cardiac muscles, and is a more
commonly used term so as not to be confused with sister
chromatids for cellular replication, which are "dyads."
An Interesting Zoo Must Have Mammals (Actin in I-band attaches
at Z line, Myosin in H-band attaches at M-line
Major
erratum
Regarding the drawing on the top left, I can't think of a good

reason why different colors are used for the same channels. The
DHP and Ryanodine receptors are drawn orange and red on left
and the same channels are drawn green and blue on the right.
Maybe it is implying activation? However I think it's better to use
the same color coding for the same receptors to avoid
misunderstanding.
Copyright (c) UWorld, Please do not save, print, cut, copy or
paste anything while a test is active.
Clarification
to current
text
Anatomy: an essential textbook.

Gilroy. page 5.
Clavicle is formed by membranous ossification.
https://en.wikipedia.org/wiki/Oste
opetrosis
Came up with a pneumonic to remember the enzyme defect in

Osteopetrosis. Pet CAT. Pet signifies pet in osteoPETrosis CAT
refers to Carbonic Anhydrase Two.
6th line in parentheses it says : osteocytes with lacunae in chaotic
juxtapositions. I think it should be "within" and not "with".
Osteocyte with lacunae would not make sense.
You might want add this histologic findings to Paget: increased
number of overly large osteoclasts containing as much as 100
nucleus. Also I think it's better to add another synonym to "mosaic
pattern" as buzzwords : jigsaw puzzle pattern.
Hypophosphatemic rickets is a high yield addition to this section.
X-linked dominant hypophosphatemic rickets is a defect in PHEX,
a FGF-23 inhibitor. High FGF-23 leads to phosphate wasting in
the kidney. Autosomal dominant hypophosphatemic rickets is a
mutation in FGF-23 which renders it resistant to cleavage. Labs
for both show low phosphate with inappropriately normal Vit. D.
Treatment is oral phosphate, calcitriol, osteotomy to correct leg
shape if severe.
I have a couple of suggestions for the lower left figure
Clarification
to current
text
Mnemonic
FA 2016; 423
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue

427
Musculoskele
tal, Skin, and
Connective
Tissue
https://ghr.nlm.nih.gov/condition/h
ereditary-hypophosphatemicrickets
429
Musculoskele
NA
424
425
425
426
427
427
Clarification
to current
text
Spelling/for
matting
In the "Tibial nerve" row, there should be a space in

"plantarflexion" in column 3.
http://medicaldictionary.thefreedictionary.com/d
yad,
https://en.wikipedia.org/wiki/Dyad
Uworld Qbank Q ID:1734
424
Minor
erratum
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
424
Daniel's Lamp (Long thoracic nerve, Suprascapular nerve, Lateral

pectoral nerve, Upper subscapular nerve, Dorsomedial, Lower
subscapular nerve)
Erb palsy causes ADDUCTION of the shoulder because
ABDUCTION is the function of the deltoid and supraspinatus
muscles, which have been compromised by damage to the upper
trunk. Because the fuction of these 2 muscles is to ABD-uct the
shoulder, the patient is no longer able to do so due to paralysis of
the upper trunk. FA 2016 menions that the arm is ABD-ucted due
to the lesion, instead of ADD-ucted.
nerve that supply thenar muscles is "recurrent branch" of median
nerve.
N/A
NA
Minor
erratum
Mnemonic
Spelling/for
matting
Mnemonic
Major
erratum
Spelling/for
matting
Clarification
to current
text
High-yield
addition to
next year
Clarification
tal, Skin, and

Connective
Tissue
429
Musculoskele
tal, Skin, and
Connective
Tissue
Patrick Ewing
429
Musculoskele
tal, Skin, and
Connective
Tissue
/osteosarcoma-epidemiologypathogenesis-clinicalpresentation-diagnosis-andhistology
430
Musculoskele
tal, Skin, and
Connective
Tissue
https://www.uptodate.com/content
s/synovial-pathology-inrheumatoid-arthritis;
430
Musculoskele
tal, Skin, and
Connective
Tissue
FA 2016, Pathoma
430
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
431
Musculoskele
tal, Skin, and
Connective
Tissue
432
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
/1828?search=PSEUDOGOUT+C
RYTALS&source=graphics_searc
h&imageKey=RHEUM/74417#H2
0 and pictures :
/image?imageKey=RHEUM/7441
7&source=graphics_search&rank
=0&search=PSEUDOGOUT+CR
YTALS
Pathoma
430
432
432
433
434
434
http://www.hopkinsarthritis.org/art
hritis-info/rheumatoid-arthritis/rasymptoms/
N/A
/diagnosis-and-classification-ofsjogrenssyndrome?source=see_link#H57
368768
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Myself
Musculoskele
tal, Skin, and
Connective
N/A
summarizing the bone tumors. First, you can add a blue cartilage
to the epiphysis and also a blue cartilage cap on the
osteochondroma. Also the "simple bone cyst" does not look
simple at all; maybe it's better to just include a well demarcated
round mass (similar to the one for fibrous dysplasia). Also maybe
it's better to include osteoid osteoma (and it's counterpart
osteoblastoma) in the text and add a couple of lines to explain
them (their size >2 vs <2 cm, common location: cortex of long
bones vs vertebrae, response to aspirin)
NEXT LEVEL PNEUMONIC for remembering all you need about
Ewing sarcoma: Just picture Patrick Ewing as young, high schoolphenom that works part-time on an onion farm before he's made
his millions in the NBA: "Young Patrick Ewing Dunking a bag of
Blue Onions". Affects Young (<15 yo), Patrick Ewing t(11;22),
Dunking=Diaphysis, Blue cells, Onion-skinning periosteal
reaction. Hope that helps!
Under malignant tumors: Osteosarcoma (osteogenic sarcoma)
the text states that it is the 2nd most common primary malignant
bone tumor. However the literature (cited below from uptodate
and in the attached file) describes it as: **Most common** primary
malignancy of bone in children and adolescents; and then rise in
incidence again within adults over the age of 65 y/o
In the image showing rheumatoid arthritic changes, the arrow for
the "pannus formation" points to the bone itself. Pannus is tissue
that attaches to the articulate cartilage. Either the arrow would
need to be moved or, to stick with the other lines in the image,
just switch the arrow to a dot, and it will be indicating the correct
location!
Santi Karnam and I have come up with a mnemonic for the
clinical features of Rheumatoid Arthritis: Big Lady VANS Bakers
cyst, Lymphadenopathy/Lungs (pulmonary interstitial fibrosis,
pleural effusions, etc..), Vasculitis, Arthritis (symmetrical),
Nodules (rheumatoid nodules), Systemic (fever, malaise, weight
loss, myalgia)
In Rheumatoid factor, it's better to clarify that it's IgM autoantibody
against Fc portion of IgG
Under the RA column, Joint Findings row, you list JOINT SPACE
NARROWING for rheumatoid arthritis, however, on Xray you can
see joint space swelling due to the pannus formation and
infiltration of inflammatory cells into the synovium earlier on in the
disease. I would correct to say JS narrowing as the disease
progresses
The image [B] on gout (Monosodium urate crystals) is wrong. The
crystals shoud look yellow when parallel, to be gout. In the
attached image, it looks blue, which is pseudogout.
To remember that Sjogren syndrome causes dental carries (

saliva) and corneal damage ( tear production): "Can't chew a
cracker, got dust in my eyes."
Consider highlighting the S's in Sjogren Syndrome, and the S's in
anti-SSA and anti-SSB. This will make it easy to remember that
these antibodies go with Sjogren Syndrome.
Under "Findings" it incorrectly states: "Presence of antinuclear
antibodies: SS-A (anti-Ro) and/or SS-B (anti-La). Anti-SSA and
Anti-SSB are present, but they are anti-ribonucleoproteins, which
is not the same thing as antinuclear antibodies (ANA). ANA is
also present in the majority of patients with Sjogrens Syndrome
(and this fact is not stated in the topic).
To differentiate which antibodies for SLE are sensitive, as
opposite do specific: "ANA is seNsitive" -- The N in ANA & N in
sensitive can help you remember this
Please add a note to increased PTT that it is not corrected by 1:1
plasma addition (due to presence of inhibiting antibodies) in
contrast to most other causes of increased PTT (factor
deficiency). It is an important step in confirmatory tests.
To remember the causes of death in SLE: "Survival Isn't Really
Clear." Survival to remember that these things decrease survival.
to current
text
Mnemonic
Major
erratum
Minor
erratum
Mnemonic
Clarification
to current
text
Clarification
to current
text
Major
erratum
Mnemonic
Mnemonic
Major
erratum
Mnemonic
Clarification
to current
text
Mnemonic
Tissue
434
Musculoskele
tal, Skin, and
Connective
Tissue
434
Musculoskele
tal, Skin, and
Connective
Tissue
434
Musculoskele
tal, Skin, and
Connective
Tissue
N/A
435
Musculoskele
tal, Skin, and
Connective
Tissue
http://www.niams.nih.gov/Health_
Info/Polymyalgia/
435
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
NA
436
Musculoskele
tal, Skin, and
Connective
Tissue
Pathoma
437
Musculoskele
tal, Skin, and
Connective
Tissue
437
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
---
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
FA 2016; 437
435
437
437
438
439
439
/isoniazid-druginformation?source=search_result
&search=isoniazid&selectedTitle=
1%7E150
nce/article/pii/0002870385900237
Rx qbank, First Aid 2016 pg. 296
Histology: a Text and Atlas, by

Ross and Pawlina, 6e, pp 489-90.
The 7e is online at
http://meded.lwwhealthlibrary.co
m/content.aspx?sectionid=71069
974&bookid=1316
N/A
Please see page 440, Psoariasis.
http://www.dermnetnz.org/termino
logy.html
http://www.dermnetnz.org/doctors
/lesions/dermal.html
I for Infections, R for Renal disease, C for Cardiovascular

disease.
Isoniazid should be added to the list of drugs that can cause druginduced lupus.
High-yield
addition to
next year
For Libman-Sacks Endocarditis, it is very high-yield to know that

the sterile vegetations occur on both the atrial and ventricular
surfaces of the valves, as this is unique to this disease. From the
paper describing it (asterisks added for emphasis): "The verrucae may appear as pea-sized, flat or slightly raised, granular,
gray or pinkish projections, densely adher- ent to the
endocardium, occurring most frequently at the valve rings and
commissures, **spreading over both valve surfaces**, the valve
pockets, and even onto the atrial and ventricular mural
endocardium, chor- dae tendineae, and papillary muscles."
The text states that "anticardiolipid antibodies and lupus
anticoagulant can cause false-positive VDRL/RPR and prolonged
PTT," giving the false impression that both results apply to both
causes. I believe the current text should be followed by the word
"respectively."
A clarification about treatment: while low-dose corticosteroids
would be effective in a patient who only has polymyalgia
rheumatica, high-dose corticosteroids would be prescribed for a
patient who has giant cell arteritis-associated polymyalgia
rheumatica. Currently the text only lists low-dose corticosteroids
as the treatment.
Sarcoidosis symptoms mnemonic - see upload
High-yield
addition to
next year
Since polymyalgia rheumatica is associated with giant cell arteritis

(especially in question stems) it might be good to add that in a
patient with Giant cell arteritis and polymyalgia rheumatica, the
correct treatment would be HIGH dose corticosteroids.
To remember that polymyositis has endomysial inflammation (but
no skin symptoms) and dermatomyositis has perimysial
inflammation (with skin symptoms), you can say "the
PERIMYSIUM is more superficial, just like the symptoms of
DERMATOMYOSITIS," with the capitalized words in red.
There is almost no information regarding apocrine glands and
eccrine sweat glands in the whole book. Although they usually
show up in questions and both the physiology and their
innervation seems to be high yield. Maybe page 437 or
somewhere in Skin anatomy would be a good place to insert it. I
have added these lines to my book: 1.Apocrine glands:
axilla,areola, genitals, anus; active after puberty. oily and viscid
secretions. stimulated by circulating cathecolamines. 2. Eccrine
sweat glands: throughout the skin, thermoregulatory, most
numerous on palms and soles. watery secretion. Direct
sympathetic autonomic innervation via cholinergic receptors.
Bad Skin Grows Large Calluses (Basale, Spinosum, Granulosum,
Lucidum, Corneum)
Clarification
to current
text
Histology image (A) is mislabeled; what is labeled as stratum

lucidum (L) is actually the stratum granulosum. What is labeled as
the stratum granulosum (G) is actually the stratum spinosum.
What is labeled as stratum spinosum (S) is not clearly stratum
spinosum or stratum basale. The stratum lucidum is a subdivision
of the stratum corneum and is only present in thick skin. As the
histology image is of thin skin there is no stratum lucidum layer.
Come, Let's Get Sun Burned (corneum, lucidum, granulosum,
spinosum, basale)
Major
erratum
A useful mnemonic to remember the types of junctions from

apical to basolateral: Travel Agents Don't Go Home (Tight;
Adherens/Actin; Desmosome; Gap; Hemidesmosome)
For acanthosis please also add psoriasis to be consistent with the
next page explanation of psoriasis.
Mnemonic
Currently, you have Plaque characterized as a Papule > 1cm. It

would be better to clarify that a Plaque is a flat (but can be
thickened) palpable lesion of > 1 cm. A Papule is usually elevated
Clarification
to current
text
Clarification
to current
text
Mnemonic
Mnemonic
High-yield
addition to
next year
Mnemonic
Mnemonic
Clarification
to current
text
Minor
erratum
441
Musculoskele
tal, Skin, and
Connective
Tissue
443
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
443
Mnemonic in reference to The

Beatles hit song "Stawberry
Fields Forever"
https://en.wikipedia.org/wiki/Straw
berry_Fields_Forever
/pathogenesis-clinicalmanifestations-and-diagnosis-ofpemphigus?source=search_result
&search=Pemphigus+vulgaris&se
lectedTitle=1%7E33
444
Musculoskele
tal, Skin, and
Connective
Tissue
/pathogenesis-clinicalmanifestations-and-diagnosis-ofpemphigus?source=search_result
&search=Pemphigus+vulgaris&se
lectedTitle=1%7E33
444
Musculoskele
tal, Skin, and
Connective
Tissue
444
Musculoskele
tal, Skin, and
Connective
Tissue
444
Musculoskele
tal, Skin, and
Connective
Tissue
445
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
http://www.emedicinehealth.com/
burn_percentage_in_adults_rule_
of_nines/article_em.htm
Pathoma by Dr. Sattar 2015,
page 207,208.
http://www.nejm.org/doi/full/10.10
56/NEJMoa1103782
445
445
Musculoskele
tal, Skin, and
Connective
Tissue
446
Musculoskele
tal, Skin, and
Connective
Tissue
447
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Musculoskele
tal, Skin, and
Connective
Tissue
Neurology
447
447
450
http://www.uptodate.com.scihub.io/contents/pathologiccharacteristics-ofmelanoma?source=machineLear
ning&search=melanoma&selecte
dTitle=3%7E150&sectionRank=1
&anchor=H7
Pathoma by Dr. Sattar.

ed/15265936
https://www.jci.org/articles/view/1
1830
n/a
ug/forteo-teriparatide-342831#5
ed/10193998
Please see Langman's Medical

Embryology, 12th edition,
Chapter 6, pages 63-70
and palpable, and a Papule > 1cm would be classified as a

Nodule. Examples of nodules you could use are Neurofibromas,
Merkel cell carcinoma.
Stawberry hemangioma - grows rapidly and regresses
spontaneuosly by 5-8 years old. Strawberry Fields NOT forever
Mnemonic
to remember that it is hemidesmosomes for bullous pemphighoid,

think of a bullae, its looks like a hemisphere on skin, so bullae=
hemisphere= hemiidesmososmes
A very classic and important histopathologic finding in Pemphigus
valgaris is "tombstone view" or "rows of tombstone" that refers to
the basal keratinocytes that remain attached to the basement
membrane via unaffected hemidesmosomes. Please add
"tombstone" pathologic finding to this entity.
Erythema nodosum: A high-yield terminology in the definition of
erythema nodosum is "panniculitis" . In fact the provided
explanation as inflammation of the subcutaneous fat is the
definition of panniculitis and it worth mentioning the pathologic
term too.
For Lichen planus please add "hypergranulosis" or increased
thickness of stratum granulosum. This term is added in FA2016 in
page 439 referring to lichen planus so it's best to include it here in
the main topic.
Thermal burn classification and Rule of Nines would be a very
high yield addition as both have repeatedly been tested.
Mnemonic
Since UVB and UVA are mentioned in Sunburn section, it'd be

suffice to clarify that UVB exposure has greater role for skin
cancer development.
Clarification
to current
text
Vemurafenib gets its name from what it inhibits. (V)600(E)

(MU)tated b(RAF) +enib
Mnemonic
Regarding melanoma, I think that just naming the subtypes would

not help. Maybe it's better to add at least a brief note to each one.
My suggestions are : 1)superficial spreading (most common, early
radial growth leads to good prognosis) 2) nodular (early vertical
growth, poor prognosis, regression uncommon) 3) lentigo maligna
(early radial growth, slow progression, regression common) 4)
acral lentiginous (palmar, plantar, subungual or mucosal, not
associated with sun exposure)
Xeroderma pigmentosum is a risk factor for basal cell carcinoma,
squamous cell carcinoma and melanoma. An additional risk factor
for melanoma is dysplastic nevus syndrome, also known familial
atypical mole and melanoma (FAMM).
NF-B is clearly one of the most important regulators of
proinflammatory gene expression. Synthesis of cytokines, such as
TNF-, IL-1, IL-6, and IL-8, is mediated by NF-B, + expression
of cyclooxygenase 2 (Cox-2). So steroids activate IKB which then
inhibit NF-B. If NF-B is being inhabited it can't activate COX2.
That sign should be changed to negative not positive
*Cele*coxib is a "cele-ctive" COX-2 inhibitor - it "celects" COX-2
for inhibition.
Clarification
to current
text
In my opinion, Osteosarcoma should be written along with the

adverse effects, because Teriparatide increases the risk of
osteosarcoma.
Celecoxib is a CELECtive inhibitor for COX 2 only
High-yield
addition to
next year
Mnemonic
This erratum refers to the embryology section (there is no

embryology in the drop list though). At the top the page (in Neural
Development) it is correctly mentioned that notochord induces the
overlying ectoderm to differentiate into "neuroectoderm" and for
neural plate. Neural plate then gives rise to neural tube and
neural crest cells. Having this in mind, in the CNS/PNS origins,
some cells are stated to arise from "neuroectoderm" and some
from "neural crest" (and also the Microglia from Mesoderm that
itself is a bit controversial). To be more precise you should
Minor
erratum
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Major
erratum
Mnemonic
450
Neurology
Please see Langman's Medical

Embryology, 12th edition,
Chapter 6, pages 69 (Table 6-1)
450
Neurology
n/a
451
Neurology
N/A
451
Neurology
/prenatal-screening-anddiagnosis-of-neural-tube-defects
451
Neurology
None needed
451
Neurology
n/a
452
Neurology
http://www.ninds.nih.gov/disorder
s/chiari/detail_chiari.htm
453
Neurology
na
454
Neurology
454
455
Neurology
N/A
Neurology
455
Neurology
http://ac.elscdn.com/S0166432814004860/1s2.0-S0166432814004860main.pdf?_tid=1f53439e-ae5c11e5-bdf700000aacb361&acdnat=1451414
819_aabaad63b1be311c384a13a
c6d69789f
First Aid 2014 errata correction
455
Neurology
455
455
Neurology
Neurology
/etiology-and-pathogenesis-ofparkinson-disease
455
Neurology
N/A
456
Neurology
First Aid 2016
ed/19412960,
ed/3130723, 2014 First Aid erratic
for page 503
NA
replace "neuroectoderm" with "neural tube" and then contrast the

origin of cells from neural "tube" vs "crest". Both neural tube and
crest are in fact derivates of neuroectoderm and the important
thing is neural tube gives rise to CNS while neural crest gives rise
to many PNS neural tissues. Although some references use
neural tube and neuroectoderm interchangeably they are not the
same and for this part it's very important to differentiate between
them. This will also make more sense when considering PNETs
(primary neuroectodemal tumors) that arise from neuroectoderm
but for example medulloblastoma is a central one (from neural
tube) and neuroblastoma in adrenal is peripheral (from neural
crest cells). So overall the text should say neural tube instead of
neuroectoderm.
Many must-know cells are derived from neural crest that worth
mentioning here and it's the best place to summarize them. I
would suggest adding these: Melanocytes, Meninges (pia and
arachnoid), Adrenal medulla, C cells of thyroid, Odontoblasts,
connective tissue and bones of face and neck.
TeDi said Miss Meet My Spine = Telencephalon, Diencephalon,
Mesencephalon, etc
Chiari I: tonsil herniation (1 structure); Chiari II: tonsil + vermis
herniation (2 structures)
For AchE please add a note that it is elevated in "open" neural
tube defects (e.g. myeloschisis, anencephaly). When both AFP
and AChE are elevated it suggests an open NTD with 96%
accuracy (please see the reference in uptodate). Also you might
add "increased AChE" to the Anencephaly fact in the same page
(after increased AFP).
Under the image for spina bifida occulta it says "+/- Tuft of Hair",
but "/" was forgotten for the "+- Skin dimple". "/" should be added
for consistency.
TUBE= 4 letters (occur at 4th week.. when) PORE= 4 letters ( 4th
week, neuroPOREs fail to fuse)
For Chiari malformation I, the text states "congenital". Although
correct and most Chiari malformations are indeed congenital, type
I is the only type that can also be acquired (see ref). So I think
there is no need to mention it or you should also add a note to
indicate it is the only one that can be acquired. Also you might
want to move the Chiari I to the previous page before the Chiari II
and you can mention there that it is mostly associated with
syringomyelia instead of including it in the syringomyelia topic.
SchwONE cells: each schwann cell myelinates only ONE PNS
axon
My Receptors Feel My Pressure (Merkel discs, Ruffini
corpuscules, Free nerve endings, Meissner corpuscles, Pacinian
corpuscles)
MeiSSner Corpusle in hairleSS skin
Serotonin is decreased, not increased in Parkinson disease
Serotonin levles are DECREASED in parkinson diseas

Serotonin levels are DECREASED in Parkinson disease.
DoPamine is low in (Depression and Parkinson disease)

In the Neurotransmitters chart, Dopamine's location of synthesis,
substantia nigra pars compacta, is abbreviated as "SNpc". In the
abbreviations list in the back of the book, however, it is listed as
"SNc". It may add some clarity if either page 455 was changed to
"SNc" or if the abbreviations list was changed to "SNpc".
Raffi (children's music artist) (Raphe nucleus) makes you happy
(Raphe nucleus makes serotonin, decreased in anxiety and
depression)
Better way to remember the hunger satiety areas by describing
normal function You are hungry when you are away (LATERAL)
from home You are satisfied when you are at home
(venteroMEDIAL) Leptin likes to stay Lite (less hungry and more
High-yield
addition to
next year
Mnemonic
Mnemonic
Clarification
to current
text
Spelling/for
matting
Mnemonic
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Major
erratum
Major
erratum
Major
erratum
Mnemonic
Spelling/for
matting
Mnemonic
Mnemonic
456
Neurology
NA
457
Neurology
N/A
458
Neurology
N/A - Blue arrows shown are

difficult to see on image
458
Neurology
N/A
458
Neurology
no authoritative source for this
458
Neurology
Mnemonic
458
Neurology
Mnemonic
458
Neurology
NA
458
Neurology
NA
458
Neurology
http://radiopaedia.org/articles/pap
ez-circuit-1
458
Neurology
Inspired by other mnemonics

submitted to First Aid
458
Neurology
N/A
458
459
Neurology
my own
Neurology
Physiology. 5e Costanzo page
460
Neurology
460
Neurology
http://what-whenhow.com/neuroscience/overviewof-the-central-nervous-systemgross-anatomy-of-the-brain-part3/
First Aid
460
Neurology
s/NBK10847/
461
Neurology
462
Neurology
/etiology-and-pathogenesis-ofparkinsondisease?source=search_result&s
earch=MPTP&selectedTitle=1%7
E4
N/A
462
Neurology
Page 471 First Aid 2016 Hydrocephalus ex vacuo was
satisfied)
hypothalamic Supraoptic nuclues makes ADH and paraventricular
nuclues makes Oxytocin. a mnemonic to remember them is "SAD
PROXY" SAD= Supraoptic nucleus makes ADh. PROXY=
PaRaventricular nucleus makes OXYtocin.
Move the mnemonic stating "At night, BATS Drink Blood" next to
the title "EEG Waveform"
Change blue arrows to yellow (or another bright color) in image
that points to region of amygdala, fornix, mammillary bodies, and
cingulate gyrus.
Include abbreviation of nuclei in parentheses (e.g. Ventral
posterolateral nucleus [VPL])
I think I have a better mnemonic for how to memorize one of the
thalamic nuclei: Lateral Geniculate Nucleus for vision, "Look Good
Naked" That's just something I came up with and wanted to share
it with you. Hope you like it.
Mnemonic for VPL: "Very Painful Leg" Can help you remember
that VPL is the thalamic nucleus for the spinothalamic and dorsal
column tracts.
Better mnemonic for VPM should be "Very Painful Mouth" gives
you a better association that VPM is the thalamic nucleus for the
trigeminal and gustatory pathways.
For VPL change the font color of the L (in Lateral) to red and add
a note that L stands for Limbs (spinothalamic and dorsal column
are afferents mostly from upper and lower limbs)
Well this one is a bit funny ! But the mnemonic says the famous 5
F's but there are 4 F's and one S (Sex)! Ok I understand the
limitations about printing the F-word ! :)) But maybe it's cooler to
change Sex with F*** !! (seriously ! F and three asterisks ! that
would be fun too!) ! Best of luck !
I think it' better to add a diagram/figure from the limbic system to
make it easier to understand anatomically. Also please add
anterior thalamic nucleus as a part of Papez circuit to the text for
limbic system. I have attached a good photo from google image
as a guide.
Hearing is throughg the Medial Geniculate Nucleus = Make Good
Noise
For the limbic system, It would be appropriate for the 5Fs to be:
Feeding, Fleeing, Feeling, Fighting, Fornicating
negative symptoms = Miserable Cortex (MesoCortical)
Another major input is from the inferior olivary nucleus of the
medulla via the climbing fibers (only source is inferior olive) and
they are unique in that they're the only input fibers that directly
influence the Purkinje cells. Involved in error detection. Also, it's
important to note that the only output via the Purkinje cells is
always inhibitory.
I think including an image, like the one I have attached would be
very helpful. I have already seen multiple questions on UWORLD
that have asked very simply to indicate a labelled structure.
Mnemonic
Spelling/for
matting
Spelling/for
matting
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
Mnemonic
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
In the diagram, the substantia nigra pars compacta is called the

SNc, but elsewhere in the chapter (page 455) it is the SNpc. Also,
SNpc is not listed in the back of the book with the explanation of
what it stands for.
The text is correct in its explanation but the picture on this page is
incorrect in regard to the indirect pathway. It shows a red
(inhibitory) arrow from the SNc to the putamen (striatum) in the
indirect pathway. SNc stimulates the striatum in both the direct
and indirect pathways.
It is high-yield to know that MPTP (a contaminant in illegal drugs)
can cause Parkinson Disease.
Clarification
to current
text
A good mmnemonic for remebering the chromosome number,

neurotransmiters affected, and basic symptoms is "HUNTING 4 a
CAG because of ADD" Hunting = huntingtons, 4 = chromosome 4,
CAG for the CAG trinucleotide repeat and the A for decreased
ach and G for decreased GABA, and ADD for aggression,
depression, and dementia.
Hydrocephalus ex vacuo was changed to be named Ex Vacuo
Mnemonic
Major
erratum
High-yield
addition to
next year
Minor
changed to Ex Vacuo
Ventriculomegaly
First Aid 2016 page 461
462
Neurology
463
Neurology
http://www.mnsu.edu/comdis/isad
6/papers/cross6.html
463
Neurology
463
Neurology
/approach-to-the-patient-withaphasia?source=preview&search
=aphasia&language=enUS&anchor=H23&selectedTitle=1
~150#H23
text
464
Neurology
/overview-of-cerebellar-ataxia-inadults#H3280870
464
Neurology
N/a
464
Neurology
464
Neurology
465
Neurology
ed/7248056
s/NBK10804/ or any
neurology/neuroanatomy text
own
467
Neurology
N/A
467
Neurology
https://en.wikipedia.org/wiki/Webe
r%27s_syndrome
467
Neurology
High Yield Neuro Anatomy Ed 4.

Pg 110
467
Neurology
http://stroke.ahajournals.org/cont
ent/33/12/2807.full.pdf
467
Neurology
High Yield Neuroanatomy 4th Ed.

page 110
467
Neurology
n/a
467
Neurology
https://en.wikipedia.org/wiki/Anteri
or_spinal_artery_syndrome
467
Neurology
included pdf
467
Neurology
A mnemonic.
Ventriculomegaly
erratum
Huntington disease get Athetosis as well as chorea. This is

mentoed on page 461, but not in the huntington section on page
462 whereas chorea is mentioned. This is a very testable
concept.
the heading in the second row should say FLUENCY and not
fluidity
Under "transcortical, mixed", the comments section should say
"Broca and Wernicke areas are affected, arcuate fasciculus
remains intact"
High-yield
addition to
next year
Conduction aphasia: Conductors listen to an orchestra and talk to

them, but cannot play back the music
The statement in the book says "alcohol causes degeneration of
the cerebellar hemisphere." Please re check with this reference. It
more commonly is assocated with anterior vermis lesions, and
gait ataxia, and that cerebellar signs are not as prominent. Quote
from reference : "Excessive consumption of alcohol is a common
cause of cerebellar degeneration. Ataxia is usually truncal,
reflecting degeneration of the cerebellar vermis, but scanning
speech and prominent nystagmus can occur uncommonly."
The mnemonic for Wernicke-Korsakoff syndrome is CAN of beer
(Confusion, Ataxia, Nystagmus), but this leaves out
Ophthalmoplegia. How about CAN O' beer for Confusion, Ataxia,
Nystagmus, and Ophthalmoplegia?
Diffuse axonal injury is one of the most common outcomes of
severe head trauma and has the poorest prognosis. Affects white
mater (axons) and Corpus callosum is most commonly affected.
Produces immediate unconsciousness and permanent vegetative
state. MRI for diagnosis. CT fails to demonstrate specific
abnormalities.
add horizontal gaze palsy; ipsilateral for PPRF and contralateral
for FEF.
Mnemonic
Tom Brokaw was a news anchor. Anchors talk at the front, bottom
part of the TV screen: "talking," "Inferior, frontal" gyrus
Include artery abbreviations in parentheses (e.g. Middle cerebral
artery [MCA])
Mnemonic
For Posterior circulation, add following entry. Artery: Paramedian

branches of PCA. Area of lesion: Anterior midbrain: Cerebral
peduncle, affecting (1) corticobulbar tract, (2) corticospinal tract;
and (3) CN VII. Symptoms: (1) dysphagia, dysphonia, dysarthria;
(2) contralateral spastic hemiparesis; (3) ipsilateral ptosis,
pupillary dilation, and lateral stabismus (eye down and out).
Notes: Weber syndrome.
Anterior Inferior Cerebellar artery stroke does not typically involve
the corticospinal tract. Corticospinal tracts are affected in medial
pontine lesions (occlusion of the paramedic branches of basilar
artery) as is seen with associated contralateral hemiparesis. This
is not usually seen in an AICA occlusion or lateral pontine
syndrome
AICA strokes are also associated with Horner's Syndrome
AICA lesion causes decreased lacrimation, decreased salivation
and decreased taste from ant. 2/3 of tongue. As it stands, it reads
that a lesion causes salivation, in addition to a decrease in the
other two. Putting a down arrow in front of salivation (similar to
how it is in front of lacrimation and taste) would make it clearer.
" ANTS are LOW down on the ground" to help remember Anteror
Cerebral artery affects Lower limbs
For Anterior Spinal Artery Stroke, if lateral corticospinal tract is
lesioned, that would lead to ipsilateral (not contralateral) paralysis
because it is after the pyramidal decussation? Or should it just be
motor paralysis (both sides) below the level of lesion since there's
only one spinal artery and it supplies both sides of the cord?
I suggest implementing this excellent technique in the a form of a
schematic diagram. I will work on my own and send it to you when
it's done.
Basilar artery/Locked in syndrome: I remember the symptoms as
Spelling/for
matting
Major
erratum
Major
erratum
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Major
erratum
Minor
erratum
Minor
erratum
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
being able to just "think and blink".

Associations for Berry Anuerysm: SHAAME Smoking,
Hypetension Adult Polycystic Kidney Disease, African American,
(increase risk), Marfan Syndrome Ehlers-Danlos Syndrome
Figure F is formatted into the wrong sentence. It should be next to
the following purposed addition: intraventricular blood layering in
posterior horn of lateral ventricles.
Nimodipine (a Calcium Channel Blocker) is used to treat cerebral
vasospasm which is one of the complications of subarachnoid
hemorrhage.
In subdural hemorrhage: arrows for "acute on chronic"
hemorrhage are a bit confusing in figure D. The text refers to blue
arrow as acute on chronic but it is mostly the area of hypodense
chronic hemorrhage (although a rim of hyperdense hemorrhage is
also present). The red arrow in the right side better shows an
acute site of hemorrhage on chronic hypodense area (in FA2015
it is better phrased as red arrow shows acute on blue arrow that
shows chronic). Also the right-hand red arrow in D does not show
crossing the sutures as indicated in text for red arrows in C and D.
3 B's for subdural hematoma: SuBdural Hematoma is rupture of
Bridging veins. Banana shape
3 B's of subdural hematoma: (suBdural, Banana-shape on MRI,
due to Bridging veins)
Pterion (sphenoparietal suture) is the weakest region of the skull
and overlies the parietal branch of MMA. It is commonly affected
in skull fractures that -> epidural hematoma. And because bleeds
in this region are confined by sutures they commonly ->
transtentorial herniation
Although subdural hematomas do cross suture lines they do not
cross the midline and they do not cross the tentorium ( while
epidural hematomas can cross the tentorium)
The picture of the sinuses does not include arrows for drainage
direction. The picture makes it appear like the cavernous sinus
drains through the sphenoparietal sinus to the transverse sinus. In
reality, the sphenoparietal sinus drains to the cavernous sinus
which drains to the petrosal sinuses which drain to the transverse
sinus
The chart depicting histology changes in ischemic stroke : the first
column (12-48hr) should be changed to 12-24hours. This change
would make it more accurate and would prevent confusion
"optic nerve fenestration surgery" should read "optic nerve sheath
fenestration" as it is not the nerve that is fenestrated, but rather
the overlying meninges. It is also never called optic nerve
fenestration surgery in the literature or by reputable sources.
468
Neurology
469
Neurology
Cross checked with First Aid

2015 on p. 466 having the same
image.
469
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/treatment-of-aneurysmalsubarachnoid-hemorrhage
469
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NA
469
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mnemonic
469
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nmemonic
469
Neurology

Gilroy. page 381
469
Neurology
Learning radiology: Recognizing

the Basics 2e page 281-282
470
Neurology
https://en.wikipedia.org/wiki/Dural
_venous_sinuses
470
Neurology
ed/19690757, Uworld Qbank
ID:19
471
Neurology
471
Neurology
471
Neurology
/idiopathic-intracranialhypertension-pseudotumorcerebri-prognosis-and-treatment,
rticle/1891241-overview,
ed/3273487
/idiopathic-intracranialhypertension-pseudotumorcerebri-clinical-features-anddiagnosis?source=search_result&
search=pseudotumor+cerebri&sel
ectedTitle=1~71
FA 2016 Pg 462
471
Neurology
N/A
In the section for noncommunicating hydrocephalus, Highlight S

in in "Stenosis of aqueduct of Sylvius"
472
Neurology
First aid pg 473
472
Neurology
www.paradoxicalembolisticlife.tu
mblr.com
472
Neurology
473
Neurology
http://www.uptodate.com.proxy.m
mc.edu:2048/contents/lumbarpuncture-technique-indicationscontraindications-andcomplications-inadults?source=search_result&sea
rch=lumbar+puncture&selectedTit
le=1%7E150
http://neuroscience.uth.tmc.edu/s
Under the ascending dorsal column "touch" is listed as being

involved with this tract. Although this is true it should be changed
to "fine touch" to be more precise. On the other hand, ascending
anterior spinothalamic tracts are involved with "Crude touch".
gracilis has a "L" for LOWER LIMB and Cuneatus has a "U" for
UPPER LIMB. A good mneumonic to remember
The structures that the needle passes through when doing a
lumbar puncture. skin, superficial fascia, deep fascia,
supraspinous ligament, interspinous ligament, flavum ligamentum,
epidural space, dura, arachnoid, subarachnoid space
Mnemonic
Clarification
to current
text
Clarification
to current
text
Clarification
to current
text
Mnemonic
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
Minor
erratum
Minor
erratum
Pseudotumor cerebri is most common specifically in "obese"

women of childbearing age. Not "all" women of childbearing age.
Clarification
to current
text
Huntington disease should be added to the list of examples for

"Ex Vacuo ventriculomegaly"
Clarification
to current
text
Clarification
to current
text
Clarification
to current
text
For upper motor neuron the preciser term would be spastic
Mnemonic
High-yield
addition to
next year
Clarification
3/chapter06.html
474
Neurology
https://books.google.com/books?i
d=n02hsdxKXT0C&lpg=PA507&o
ts=uIW2kKNdC6&dq=mnemonic
%20dorsalis&pg=PA507#v=onep
age&q=mnemonic%20dorsalis&f=
false
Please see FA2016 page 474
poliomyelitis.
474
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474
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474
475
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mnemonic
Neurology
475
475
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N/A
Neurology
475
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/polio-and-infectious-diseases-ofthe-anteriorhorn?source=search_result&sear
ch=poliomyelitis&selectedTitle=1
%7E112
/friedreichataxia?source=search_result&sea
rch=fredriech+ataxia&selectedTitl
e=1%7E150
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N/A
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Please see the attachment from

Anatomy Gray's for Students
"paresis" vs flaccid "paralysis" of lower motor neuron. That's

because in UMN defects the muscle can still contract (for
example via reflex pathway) and it's in fact a kind of weakness
(paresis) compared to complete loss of contraction that happens
with paralysis. That's why for UMT the term is more commonly
"spastic paresis" and for LMN it is "flaccid paralysis". So it's better
to change the 7th row in signs to paresis.
DORSALIS: Dorsal Column Degeneration || Orthopedic Pain
(Charcot's joints) || Reflexes; Deep Tendon (Decreased) ||
Shooting Pain || Argyll-Robertson Pupil || Locomotor Ataxia ||
Impaired Proprioception || Syphilis
to current
text
You might want to add "asymmetric" to weakness or flaccid

paralysis to be consistent with page 474.
Clarification
to current
text
High-yield
addition to
next year
Cauda equina syndrome is clinically important and it might be of a

value in the exam i suggest adding it to the list or somewhere else
in the chapter. important points include presentation (saddleshaped sensory loss, radicular pain, LMN symptoms (vs mixed
with conus medullaris syndrome), genitourinary symptoms, back
pain), etiology( tumors arising within vertebral canal or mets),
roots affected ( L3 to Co).
poliomyelitis = poliLOWmyelitis (LMN lesion only)
In the 2016 edition, one finding of Brown-Sequard syndrome is
contralateral pain and temperature loss below level of lesion (due
to spinothalamic tract damage). Although this is correct, the loss
should actually start two to three spinal segments below the level
of the lesion on the contralateral sign. The picture of the person is
misleading because the contralateral loss of pain and temperature
begins AT the level of the lesion, when it should begin 2 to 3
spinal segments below the lesion. This is explained by the fact
that it takes about 2 to 3 spinal segments for the decussating
fibers to reach the opposite side. Please refer to the emedicine
hyperlink. This information is also listed in the textbook
"Neuroanatomy through Clinical Cases" 2nd edition by Dr. Hal
Blumenfeld in Chapter 7 page 280. I also attached an image that
shows the correction. This picture is from my class notes. We use
this textbook: Basic Clinical Neuroscience, 2nd Ed. by Dr. Young
Frederick (9 letters) = Chromosome 9
Respiratory failure needs to be added under poliomyelitis. This is
very high-yield, as it is a common cause of death. It is also the
reason for the use of the iconic "iron lungs" that we have all seen.
It is high-yield to know that Friedreich ataxia is associated with an
increased risk for hypertrophic cardiomyopathy. From UpToDate:
" Electrocardiographic and echocardiographic abnormalities are
characteristic of the usually hypertrophic cardiomyopathy of
Friedreich ataxia"
Friedreich is your favorite frat brother, he's always dressed to the
nines (chromosome 9)
Regarding the dermatome L4 although it includes the medial
kneecap, but the clinically relevant and autonomous site for L4 is
usually lateral side of the great toe or the medial malleolus. In fact
L3 is commonly referred as the dermatome for knee or medial
side of thigh (see reference from medscape and also the attached
photo from my anatomy book, Gray's for students).
Now that FA2016 includes C6 for thumb, it's better to add C7 for
index and C8 for little finger too since they come in order and are
autonomous areas clinically checked. Also in the figure it's better
to move C8 arrow to the little finger since it's more autonomous
than the later distal forearm that is now marked for C8.
I suggest changing the figure to a full-body drawing so you can
complete and include the dermatomes for L5 (that should be
moved to second toe) and S1 (lateral aspect of little toe).
Although the drawing and the mnemonics are more precise by
indicating two myotomes for each reflex, the middle column is
indicating only one (I assume the major one) for this purpose.
However for biceps reflex the major one should be C6 (and not
C5) and for knee jerk it should be L3 (and not L4). So I think it's
better to either correct it this way or simply include both
myotomes for each. (please see the attachment text on the right
hand column for reflexes)
Mnemonic
Mnemonic
Major
erratum
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
Minor
erratum
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
477
Neurology
first aid 2016
477
Psychiatry
478
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478
Neurology
http://www.uptodate.com.huaryu.
kl.oakland.edu/contents/thirdcranial-nerve-oculomotor-nervepalsy-inadults?source=search_result&sea
rch=superior+orbital+fissure&sele
ctedTitle=1~150
Netters 6th edition plate 13
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Any anatomy atlas
479
Neurology

Gilroy. page 433. BRS physiology
page 46
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none
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1/p997.html
480
480
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Mnemonic
Neurology
Jaw Joins the lesion.
480
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Personal Mnemonic
480
Neurology
Dictionary
480
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http://www.merriamwebster.com/dictionary/lesion
480
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http://www.merriamwebster.com/dictionary/lesion
480
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481
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http://www.gpnotebook.co.uk/sim
plepage.cfm?ID=-905576435
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Personal Mnemonic
481
Neurology
http://neurobiologyhearing.uchc.e
du/Course_Content_Library/Audit
ory_Periphery/Duncan%20Salam
anca-1and2-Handouts.pdf
483
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Not applicable
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https://en.wikipedia.org/wiki/Agoni
st
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Neurology
NA
first line beneath diagram should read "4 CN are above pons" or
"4 CN are above the pons". Currently says "4 CN are in above
pons".
Motor cranial nerves (3,4,6,12) exit medially, mixed (sensory &
motor) exit laterally.
Picture for CN V1 (Ophthalmic) has an arrow entering Foramen
Rotundum. When V1 should be through the superior orbital
fissure.
Spelling/for
matting
The foramen spinosum is not in the correct place (it should be

posterolateral to the foramen ovale). Also, the foramen lacerum
should be included in this diagram
The foramen labeled as the foramen spinosum is in the location
where the foramen lacerum should be. The foramen spinosum is
in the temporal bone, lateral to the foramen ovale.
CN V also carries sensations from the nasal mucosa via V2 and
V3 and this is important because in the case when there's a CN I
palsy some irritative substances may still be sensed by the nose
via CN V ( BRS physiology gives ammonia as an example)
The lower motor neuron lesion title says "Lower motor neuron
lesiona". Please remove the a.
The figure does not accurately depict why a stroke would affect
the lower face but not the upper face. The facial motor nucleus
receives motor fibers for the lower face from the contralateral
motor cortex. In the figure, the blue lines for motor fibers of lower
face should have 1 line that crosses to the opposite side of the
face. The facial motor nucleus receives motor fibers for the upper
face from both sides of the motor cortex. The red lines depicting
motor neurons of upper face should branch and have 1 line going
to each side of the face.
For CN V motor lesion: "Bite your wounds"
For jaw deviation toward the lesion I use this mnemonic : Jaw
Joins the lesion. (it is similar to tongue licks the lesion or tongue
tickles the lesion and helps to remember it.)
aLex graHam bell's STD (for Lyme disease, Herpes, Sarcoidosis,
Tumors, Diabetes Mellitus
There is an extra "a" on "lower motor neuron lesiona"
Minor
erratum
Under "Facial nerve lesions" the text reads lower motor neuron
"lesiona" instead of "lesions"
The text says "lesiona" and the correct spelling should be "lesion"
for "Lower motor neuron lesion"
The upper half has the upper hand -- the upper half of the face
has bilateral UMN innervation.
You should mention that a positive Rinne test is actually Normal
(Air > Bone), and a Negative Rinne test is Abnormal (Bone > Air).
"bass not at the base" for low frequency sounds heard at apex
and NOT at the base
Under "Auditory Physiology", the text states that the cochlea is
wide and flexible at the apex and thin and rigid at the base. It
should read "thin and flexible at the apex and thick and rigid at the
base".
In the picture labeling for the anterior and posterior chamber can
be easily misunderstood. Posterior chamber is between the
pupil/iris and the lens. In the picture, it looks as if the posterior
chamber is labeled as space behind the lens. It would be better if
there was a clarification (such as an arrow pointing to the correct
location) as it may lead to confusion. Text by eMedicine (link also
provided): The posterior chamber is bounded anteriorly by the iris,
posteriorly by the lens and zonule fibers, and peripherally by the
ciliary processes.
Trabecular outflow (90%) ... "with M3 agonis" - spelling /
formatting error - missing "t" for agonist
In the diagram under the "Trabecular outflow (90%), the last
statement has a spelling error in the word agonist. It reads
"increased with M3 agonis".
You might want to change the order of some facts in this
segment. For example maybe it's better to mention retinal vein
and central retinal artery occlusion after each other, and mention
Mnemonic
Minor
erratum
Major
erratum
High-yield
addition to
next year
Spelling/for
matting
Minor
erratum
Mnemonic
Mnemonic
Mnemonic
Spelling/for
matting
Minor
erratum
Spelling/for
matting
Mnemonic
Clarification
to current
text
Mnemonic
Minor
erratum
Clarification
to current
text
Minor
erratum
Spelling/for
matting
Clarification
to current
text
the other retinal disorders in order. So I would suggest at least

move "CRAO" after "retinal vein occlusion". It's more organized
this way.
In this figure the the temporal portions of each retina are show
projecting to the lateral geniculate nucleus but not to the pretectal
nuclei. The temporal portions of each retina should also directly
project to the pretectal nuclei to participate in the pupillary reflex.
Text says Horner syndrome is "Associated with lesions of spinal
cord above T1 (e.g. Pancoast tymor, Brows-Sequard, late stage
syringomyelia)". However pancoast tumors are not lesions of
"spinal cord" and most does not affect the spinal cord (spinal cord
is inside the bony column so pancoast tumors normally do not
invade or put pressure on spinal cord itself). The presence of
Horner syndrome in Pancoast tumors however is mostly due to
pressure on stellate or inferior cervical sympathetic ganglion
outside the spinal cord and in the base of the neck. It is mostly the
second order neurons that are involved in pancoast (vs first order
neurons in above T1 lesions in the spinal cord). So I would
suggest differentiating between the spinal cord lesions and
Pancoast tumors (like apical lung tumors). Please see the
reference from medscape indicating that pancoast tumors affect
second order neurons.
Miosis - 2nd neuron: short ciliary nerves to pupillary sphincter
(should be constrictor) muscles
Text at bottom says "To test each muscle, ask patient to move
his/her eye int he path diagrammed below" The diagram is to the
right of the text
I really think the mnemonic for cranial nerves 3-6 is too much !
LR6SO4R3 does not mean anything and it's not even easy to
remember ! I think you can simply remove it since it's easier to
remember the nerves as they are ! or maybe someone comes up
with a better mnemonic !
Text says "path diagrammed below" but diagram is to the right
487
Neurology
487
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487
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First image on same page
488
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None
488
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NA
488
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Me, myself, and I
488
Neurology
Suggestion based on listed errata

suggestion
489
Neurology
N/A
489
Neurology
Add high yield causes for each visual field defect. See attached
below.
489
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489
Neurology
NA
489
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NA
489
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NA
489
Neurology
https://en.wikipedia.org/wiki/Quad
rantanopia
I believe the current text for CN IV damage is very confusing.

Specifically regarding head tilt it mentions both head tilt toward
the lesion and compensatory head tilt in the opposite direction
which makes it confusing (although partly true). The classic head
tilt in CN IV palsy (especially in congenital forms) is a head tilt to
the opposite direction (right CN IV damage head is tilted to left for
compensation). However some patient develop a tilt toward the
lesion to actually ignore one image (paradoxic tilt). So it need a bit
of clarification and it is also in contrast with what the text says as
"head tilt toward the lesion and may present with compensatory
head tilt in the opposite direction"
Please consider these changes to text and the figure: add
temporal lobe and lingual gyrus to text of Myer loop, add parietal
lobe and cuneus gyrus to the text of dorsal optic radiation. In the
figure the arrow for calcarine fissure is vague. Maybe it's better to
somehow show that calcarine fissure is between lingual (inferior)
and cuneus (superior) gyri.
In the figure, the lines are showing site of lesions, however in the
left-lower side "calcarine fissure" has a line with no number. It's
not obvious if it's showing the approximate anatomic site of the
fissure or a site of damage (if latter which number should it be?)
For meyer loop please consider highlighting "L"s in red as follows:
meyer Loop : Lower retina, Lateral, Loops (around the inf horn of
Lateral ventricle), Lingual gyrus
Meyer Loop superior retina, Optic Radiation inferior retina. The
book states vice versa. Meyer's Loop dives down into the occipital
An errata suggestion is to remove the LR6SO4R3 mnemonic.

Instead, it could be changed to the "chemical formula" LR6Sulfate
(SO4). This leaves out R3. The chemical formula can be used to
remember the 2 exceptions where CN III does NOT innervate
ocular muscles (since CN III is an easily remembered function
given its name is oculomotor!)
In the "CN III damage" section, "Motor output to ocular muscles"
should say "Motor output to EXTRAocular muscles".
Clarification
to current
text
Clarification
to current
text
Minor
erratum
Spelling/for
matting
Mnemonic
Spelling/for
matting
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
Clarification
to current
text
Clarification
to current
text
Mnemonic
Major
erratum
489
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rticle/1198462-treatment#showall
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N/A
490
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N/A
491
491
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mnemonic only
Neurology
491
Neurology
https://www.alzheimers.org.uk/sit
e/scripts/documents_info.php?do
cumentID=937
491
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/creutzfeldt-jakobdisease?source=search_result&s
earch=creutzfeldt&selectedTitle=
1%7E68
492
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http://radiopaedia.org/articles/mult
iple-sclerosis
492
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rticle/1146199-treatment#d15
492
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493
Neurology
493
Neurology
494
Neurology
http://www.quickanddirtytips.com/
education/grammar/furtherversus-farther
Pathoma,
http://www.ninds.nih.gov/disorder
s/metachromatic_leukodystrophy/
metachromatic_leukodystrophy.ht
m,
https://en.wikipedia.org/wiki/Acute
_disseminated_encephalomyelitis
,
/acute-disseminatedencephalomyelitis-inadults?source=search_result&sea
rch=Acute+disseminated+enceph
alomyelitis&selectedTitle=1~50
ticle/1183858-overview#a8
494
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/pathophysiology-clinicalmanifestations-and-diagnosis-ofmigraine-inadults?source=search_result&sea
rch=calcitonin+generelated+peptide&selectedTitle=1~
lobe, helps to see things above the imaginary horizontal plane.

Whereas the optic radiation allows for the vision of below the
imaginary horizontal plane.
The image labeled A next to CN III damage is incorrectly placed
in the text. The image shows diminished pupillary light reflex in
the right eye and no signs of ptosis which would be characteristic
of compression to the parasympathetic output of the oculomotor
nerve. This is further supported by the fact that damage to the
motor output does not typically have pupillary involvement. The
key finding in these patients is relative sparing of the pupillary
sphincter with complete or near-complete palsy of the extraocular
muscles innervated by the third cranial nerve, including levator
palpebrae
CN III: Motor output in the Middle (M's), Parasympathetic output
on the Periphery (P's)
Current text states, "contralateral CN III nucleus does not
stimulate medial rectus to fire." "Fire" could be replaced with
"contract" as the former is typically associated with neurons/action
potentials and the latter more specific to the action of muscles.
ApoE4 makes you 4get
Please consider all capital P's part of the mnemonic. I would also
like to ask for separate consideration for the mnemonic for the
First Adie Step 2CS, 2CK and other first aid books where
mnemonics are accepted.Phrontotemporal Dementia/Picks
disease Problems with Public behavior (behavioral variant) and
Personality changes and Primary Progressive aPhasia
Parkinsonism Phrontotemporal degeneration Pick bodies or
ubiquinated TDP-43 not part of mneumoniac but information not
listed in first aid Step 1: Often a Presenile patient (younger than
65) with Prolonged (slow) Progression of symptoms.
This explains why those with trisomy 21 are more likely to get
Alzheimers. The APP gene is on CH21. 3 copies of CH21 = more
AB=more plaques. DYRKA1 gene is also on CH21 DYRKA1 is
more active when there is high AB. It phosphorylates Tau and this
results in more neurofibrillary tangles
For Creutzfeldt-Jakob disease, it is high-yield to know that
periodic sharp waves appear periodically on EEG. From
UpToDate: "A characteristic EEG pattern of periodic synchronous
bi- or triphasic sharp wave complexes (PSWC) is observed in 67
to 95 percent of patients with sCJD at some time during the
course of the illness."
Multiple white matter lesions *disseminated* in space and time ..
rather than "separated"
Last point in treatment, for pain text mentions opioids. However
Tricyclic antidepressants (TCAs) are the first-line treatment of
pain in MS and anticonvulsants can be added as second line
(please see medscape reference section on pain). Medscape also
states : The use of narcotics is seldom indicated.
"more common in whites living further from equator" should be
fArther (distance)
Major
erratum
Mnemonic
Clarification
to current
text
Mnemonic
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
Spelling/for
matting
According to Pathoma, emedicine, and NIh.gov, Metachromatic

leukodystrophy is impaired production and MAINTENANCE of
myelin, with IMPAIRED DESTRUCTION/DEGREDATION of
sulfatides --> buildup of sulfatides.
Major
erratum
subcortical and central white matter and cortical gray-white

junction leision. Periventricular lesions are less common in ADEM
than MS
Clarification
to current
text
In generalized seizures -> Absence (petit mal): the text simply

says 3 Hz. Please clarify it as "3 Hz spike-and-wave complexes
(in EEG)"
The text says "calcitonin generelated peptide," which uses an en
dash but should use a hyphen (i.e., calcitonin gene-related
peptide).
Clarification
to current
text
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http://tools.aan.com/professionals
/practice/guidelines/Status_Epilep
ticus_patient.pdf
494
Neurology
498
Neurology
495
Neurology
rticle/1206956-medication#2,
http://www.webmd.com/eyehealth/adrenergic-agonists-forglaucoma, was also fou
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495
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First Aid 2016
496
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NA
497
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498
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/brimonidine-ophthalmic-druginformation?source=search_result
&search=brimonidine&selectedTit
le=1%7E18#F21733474
Katzung & Trevor's
Pharmacology
498
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rticle/1206147-medication#7
498
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ug/demerol-meperidine-343315#6
498
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499
Neurology
rticle/1206956-medication#2,
http://www.webmd.com/eyehealth/adrenergic-agonists-forglaucoma, was also fou
Katzung 12th Ed pg 572
499
Neurology
http://www-uptodatecom.libproxy.uams.edu/contents/
pentazocine-druginformation?source=search_result
&search=pentazocine&selectedTi
tle=1%7E78
499
Neurology
http://www.drugs.com/ppa/pentaz
ocine.html
499
Neurology
/naltrexone-druginformation?source=search_result
&search=naltrexone&selectedTitl
e=1~53
As per the American Academy of Neurology status epilepticus is

defined as " a seizure, or series of seizures, that lasts more than
30 minutes" however the text defines it as >5 minutes.
Current text repeats "decreases aqueous humor synthesis" twice.
Replace one with "increases outflow of aqueous humor"
Major
erratum
"Grumpy Caf Patrons Never Leave Satisfied" (Glioma, Caf-aulait, Pheochromocytoma, Neurofibromas, Lisch nodules, Skeletal
abnormalities)
VHL: "v"-ochromocytoma, Hemangioma/Hemangioblastoma, and
renaL ceLL carcinoma
Fact refers to "bitemporal hemianopia," should read "bitemporal
hemianopsia"
PhenoBABYtal - to remind you that phenobarbital is 1st line for
seizures in neonates
Since imaging shows cystic lesion, mnemonic is "PiloCYSTIC
Astrocytoma"
Medulloblastoma = Medullo-'BLUE'-s-D'OH-ma. blue for small
"blue" cells. D'oh for "homer" wright rosettes
It would be awesome if you added in a table showing the cellular
origins of each adult vs childhood brain tumor. I have attached a
word document of one that I made as an example.
Under the "a-agonist" section of Glaucoma drugs, the phrase
"[down arrow] aqueous humor synthesis" has been repeated
twice in column 2
Brimonidine Mechanism of Action: In addition to reducing the
production of aqueous humor, it also increases the outflow of
aqueous humor with regular use.
Mnemonic
Epinephrine can also work by increasing outflow of aqueous

humor via uveoscleral veins
Clarification
to current
text
Clarification
to current
text
For Prostaglandins (Bimatoprost, Latanoprost, Unoprostone)

please add increased outflow via "uveoscleral pathway". This is
an important fact (in contrast with trabecular meshwork in
cholinomimetics) and also makes the text consistent with the
figure in page 483 FA2016.
I suggest adding a new fact in opioid analgesics for Meperidine. It
has some unique and high-yield characteristics and also it is
widely used in pregnancy. Due to it's antimuscarinic effects it
usually does not cause miosis ( which is normally a classic sign
for opioid toxicity and is very important to know). For the same
reason in can cause tachycardia. It is safe in pregnancy and is
metabolized by P450 to normeperidine which is a serotonin
uptake inhibitor and may cause serotonin syndrome and seizures
in toxicities.
Current text repeats "decreases aqueous humor synthesis" twice.
Replace one with "increases outflow of aqueous humor
Adverse effects should say "can cause opioid withdrawal
symptoms if patient is also taking full opioid agonist," not
antagonist.
Currently states: "Can cause opioid withdrawal symptoms if
patient is also taking full opioid antagonist (competition for opioid
receptors)." It should read: "Can cause opioid withdrawal
symptoms if patient is also taking full opioid AGONIST." This is
because pentazocine is a mu receptor antagonist so it will block
other opioids that are mu receptor agonists (like morphine).
Pentazocine can cause opioid withdrawal symptoms if patient is
also taking a full opioid AGNOST as this will cause competitive
inhibition for opioid receptors. This should be the same
mechanism as Butorphanol. The text states it may cause
withdrawal symptoms with an opioid antagonist but that does not
seem correct.
Under the listed adverse effects of the opioid analgesics, the text
states that toxicity is treated with "naloxone or naltrexone". Opioid
toxicity, an emergency situation, can be treated by a naloxone
antidote only. Naltrexone, on the other hand, is used as a
maintenance drug (i.e. not in a situation of opioid toxicity).
According to UpToDate, patients should not be started on
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NA
500
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500
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http://www.uptodate.com.proxy.lib
rary.stonybrook.edu/contents/phe
nytoin-druginformation?source=search_result
&search=phenytoin&selectedTitle
=1~150#F209550
formatting
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First Aid
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Stuff already in FA.
500
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/overview-of-the-management-ofepilepsy-inadults?source=machineLearning
&search=generalized+tonic+cloni
c+seizures&selectedTitle=2~83&s
ectionRank=3&anchor=H3#H3
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500
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ug/lamictal-lamotrigine343012#10
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ug/sabril-vigabatrin-343008#5
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ug/sabril-vigabatrin-343008#10
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N/A
502
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502
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502
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/induction-of-generalanesthesia?source=machineLear
ning&search=volatile+anesthetics
+side+effect&selectedTitle=4%7E
150&sectionRank=5&anchor=H2
54392640#H295889239
NA
502
Neurology
FA page 502
503
Neurology
503
Neurology
503
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n/a
503
Neurology
Basic and clinical Pharmacology,

Katzung, chapter 27, Skeletal
Muscle Relaxants (See the
summary table)
Naltrexone until they are proven to be at least 7-10 days opioidfree.

Opioids inhibit release of substance P, Acetylcholine, Norepinephrine, Glutamate, Serotonin. Opioids decrease PANGS.
I spell Phenytoin as "Phen-Na+-toin" in order to remember that
the medication inactivates sodium (Na+) channels.
Mnemonic
Mnemonic
The side effects for ethosuximide are listed twice. Once as a list
and right below it as a mnemonic. It may be best to just list the
mnemonic and put "urticaria" in parentheses after "Itching"
Four rules to easily know the uses of epilepsy drugs: - Always
consider ethosuximide and benzos separately. Ethosuximide for
absence, benzos for acute status epilepticus (and phenytoin for
status epilepticus prophylaxis). - All drugs (with the exception of
ethosuximide and benzos) work for partial simple and partial
complex seizures. Just know that carbamazepine is first-line for
those two. - Ethosuximide (1st line), valproate and lamotrigine are
the only three that work for absence. - Drugs with "gaba"
(gabapentin, tiagabine and vigabatrin) in the name are the only
ones that don't work for tonic-clonic seizures.
Phenytoin has the potential to cause DRESS Syndrome, Anemia
(Megaloblastic), Neuro Sx, Gingival Hyperplasia, Osteopenia,
SLE-Like Syndrome, Teratogenesis, SJS, Hirsuitism, Inducer of
P450. (DAMNed GHOST SHIP).}}
Carbamazepine is a first line for generalized tonic clonic seizures
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matting
There are currently separate columns for simple vs complex

partial seizures, but each has the same check marks and
asterisks for being first-line. If there's no difference in the drugs for
each, then there's no need to have that unnecessary clutter in the
diagram.
For Lamotrigine mechanism please also add inhibition of
glutamate.
Clarification
to current
text
For Vigabatrin, in the side effects please add the back box
warning that is "vision loss" and actually needs baseline and
follow-up vision testing. (you might want to change the font color
of V in Vigabatrin and Vision loss to highlight it).
Vigabatrin is an inhibitor of GABA transaminase. This can be
remembered by the last 8 letters of the drug. vi-GABA-TR-IN =
(GABA) (TR)ansaminase (IN)hibitor.
PhenoBARBitol is first line in neonates - "Give the baby a BARBie
doll"
Propofol is an antiemetic. It can be Said that it PROP-of-FOL,
Props you up when you are Full, so that you don't Vomit.
"Nausea/emesis" should be listed in the "adverse effects" section
rather than the "effects" section
In the mnemonic "Mi" is in red in Mighty but in Midazolam only M

is in red.
INHaled MEDS (Isoflurane, Nitrous Oxide, Halotane,
Methoxyflurane, Enflurane, Desflurane, Sevoflurane)
Baclofen is used for Back Spasm. Way to remember BAC-LOFEN
= "BAC SOFTEN". It relieves muscles spams of lower back.
Baclofen is used for Back Spasm. One way to remember BACLOFEN = "BAC SOFTEN". It relieves muscles spams of lower
back.
Mnemonic for local anesthetic side effects - MATCH
M=methhemoglobin A-arrthymia T=tension changes
(hypo/hypertension) C=cardiovasicular toxicity h
The text says "selective for motor (vs autonomic) nicotinic
receptor". The term "motor nicotinic receptor" would be vague.
Maybe it's better to say they are more selective for muscle-type
(Nm) nicotinic receptors at neuromuscular junction (NMJ). In the
Mnemonic
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to current
text
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to current
text
504
Neurology
FA2015 pg 501, Katzung's Basic

and Clinical pharmacology (13E)
pg 477
504
Neurology
First AId
504
Neurology
None
504
Neurology
N/A
504
Neurology
n/a
508
Psychiatry
N/a
summary table of Katzung pharmacology it says: "nicotinic Ach

receptor, especially at neuromuscular junction".
(centrally) Tolcapone blocks conversion of dopamine to 3-MT (3Methoxytyramine), not 3-OMD. Peripheral COMT converts LDOPA to 3-OMD, Central COMT converts Dopamine to 3-MT.
The diagram in FA2015 illustrated this correctly
Entacapone can be distinguished from Tolcapone by highlighting
the ENTA in ENTAcapone. That allows us to rememeber that
ENTAcapone works in the periphery and allows more dopamine
to ENTA the CNS
Instead of "Park your Mercedes-Benz" for remembering that
Benztropine is used to treat Parkinson Disease, change the
Mnemonic to "Park A Mercedes-Benz" to also remember that the
drug is an Anti-muscarinic
This section uses the mnemonic BALSA, marking the
corresponding letters in the subsequent subsections with bold
rent font: Bromocriptine, Amantadine, Levodopa, and
Antimuscarinic, but someone forgot to make the S in Selegiline
red and bold in the subsection that says "Prevent dopamine
breakdown."
The mnemonic is currently "BALSA" for Parkinson's drugswhy
not do "BASAL" instead to draw a connection to the basal
ganglia?
Add to denial (immature defense): "reality never comes in"
508
Psychiatry
N/a
add to displacement: Redirection of Emotions
508
Psychiatry
http://www.theesa.com/aboutesa/industry-facts/
509
Psychiatry
n/a
The example for Fixation you provide is "Adults fixating on video

games". This is not an example of fixation as the average video
gamer is 35 years old. Your example is based on the stereotype
that video games are for children. This stems from the fact that
video games were made for kids 10-15 years ago, but now those
kids grew up and continue to play video games. Most of the video
games made today are for an adult demographic. An accurate
example of fixation could be oral fixation, such as sucking on a
pen.
Add to Isolation of Affect: Reality is accepted but without emotions
509
Psychiatry
N/a
in Repression: bold the word "Involuntary"
509
Psychiatry
N/a
in Projection: bold "unacceptable internal impulse"
509
Psychiatry
n/a
Add to rationalization: "Justification"
509
Psychiatry
na
in splitting: Bold text = "all good or all bad"
509
Psychiatry
n/a
in Suppression: Bold Text = "Intentionally"
509
Psychiatry
n/a
add to passive aggression: Project hostile feelings in a nonconfrontational manner
511
Psychiatry
http://www.dsm5.org/Documents/
Disruptive%20Mood%20Dysregul
ation%20Disorder%20Fact%20S
heet.pdf . Also, Uworld QID
11605 [713355]
513
Psychiatry
/clinical-manifestationsdifferential-diagnosis-and-initialmanagement-of-psychosis-inadults?source=search_result&sea
rch=Delusion&selectedTitle=1~15
0
514
Psychiatry
http://www.dsm5.org/Documents/
Schizophrenia%20fact%20Sheet.
pdf
514
Psychiatry
DSMV
DSM V has named a new disorder: disruptive mood

dysregulation. Pt shows persistent irritability, inappropriate temper
outbursts. Dx requires 3 or more outbursts per week for at least 1
year in greater than 2 settings where the symptoms are severe in
1 setting. Pt can't go 3 or more months without symptoms. Dx can
only be made at ages 6-18.
The definition of delusion in the book needs to add the fact that
delusions are only called delusions if they are not typical in the
pateients culture of relegion. a beleif might be found false in
certain communities, while it is not in others. here is a qoute from
uptodate "Delusions are defined as strongly held false beliefs that
are not typical of the patients cultural or religious background."
DSM5 raised the threshold to require atleast 2 of the specified
symptoms. Text should read "at least 2 of these should include 13"
Schizoaffective disorder clarification of definition. > 2 weeks or
more of delusions or hallucinations in the absence of a major
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to current
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to current
515
Psychiatry
/unipolar-depression-in-adultsassessment-anddiagnosis?source=machineLearni
ng&search=major+depressive+di
sorder&selectedTitle=1%7E150&
sectionRank=1&anchor=H105621
652#H26342747,
http://onlinelibrary.wiley.com/doi/1
0.1002/da.22217/epdf
515
Psychiatry
none
515
Psychiatry
NA
517
Psychiatry
UW,Question ID:11603
517
Psychiatry
NA
517
Psychiatry
/agoraphobia-in-adultsepidemiology-pathogenesisclinical-manifestations-courseanddiagnosis?source=search_result&
search=agoraphobia&selectedTitl
e=1~37
518
Psychiatry
UWorld Qbank;
http://www.r2library.com/Search?
q=factitious#within=1585624705&
include=1
521
Psychiatry
521
522
Psychiatry
http://web.b.ebscohost.com.proxy
gw.wrlc.org/dynamed/detail?vid=2
&sid=224cfc18-9fca-4948-bca7db20250a999c%40sessionmgr12
0&hid=125&bdata=JnNpdGU9ZHl
uYW1lZC1saXZlJnNjb3BlPXNpd
GU%3d#anchor=anc1406429781&AN=116132&db=d
me
My brain
Psychiatry
mood episode (depression or mania) during the lifetime duration

of the illness. The current definition in 2016 is wordy and unclear.
As per DSM-5, the 6-12 month rule for diagnosing Major
Depressive Disorder has been replaced by exhibiting Five or
more out of nine symptoms (including at least one of depressed
mood and loss of interest or pleasure) in the same 2-week
period. UWorld has already reflected this by having questions
that did not specifically indicate symptoms lasting months but only
a few weeks, nevertheless pointing to major depressive disorder.
This is also reflected in UptoDate
Under "Patients with depression typicall have the following
changes in their sleep stages:" "early-morning wakening) should
be "awakening"
In different facts you have used bold letters to indicate the
timeline needed for diagnosis of mood disorders. For major
depressive disorder "symptoms for 2 or more weeks" should be
bolded instead of "usually lasting 6-12 months". The first one is
diagnostic criteria and the time needed for making the diagnosis.
Treatment for Agoraphobia:1.CBT 2.benzodiazepine(therapitst
unvailable, limited time)
A better and more precise way to describe Agoraphobia is ( fear
of being in a situation that you can't escape from, wither it is an
open, closed place, public transportation or others.) A qoute from
uptodate " Agoraphobia is defined in DSM-5 as fear or anxiety
about and/or avoidance of situations where help may not be
available or where it may be difficult to leave the situation in the
event of developing panic-like symptoms or other incapacitating
or embarrassing symptoms "
* I forgot to add the supporting refference* this was my comment
"A better and more precise way to describe Agoraphobia is ( fear
of being in a situation that you can't escape from, wither it is an
open, closed place, public transportation or others.) A qoute from
uptodate " Agoraphobia is defined in DSM-5 as fear or anxiety
about and/or avoidance of situations where help may not be
available or where it may be difficult to leave the situation in the
event of developing panic-like symptoms or other incapacitating
or embarrassing symptoms ""
m writing to point an issue I noticed many of my classmates
havingduring the psychiatry domain this yearwhen using First
Aid compared to other sources on the topic of Factitious
Disorders. On page 518 in FA, factitious disorders are described:
Patient consciously creates physical and/or psychological signs
and symptoms in order to assume sick role and to get medical
attention. Black and Andreasen, in the 6th edition of Introductory
Textbook of Psychiatry (the required text for the domain), write:
Patients with factitious disorder have no obvious external
incentive for the behavior, such as economic gain. Instead, these
individuals are thought to be motivated by an unconscious desire
to occupy the sick role. UWorld Qbank has a question about
factitious disorder and it provides the following explanation: In
factitious disorder, patients deceptively produce signs and
symptoms of a medical or psychiatric illnesspatients are aware
of their symptoms and conceal their attempts to simulate or cause
them, but they lack conscious awareness of why they do it. The
psychiatry domain content had practice questions that kept
hammering the point that an individual with factitious disorder is
drive by unconscious motivation, and this question even appeared
on the domain examstill tripping up a number of students. I
know many of my classmates struggled with this concept, so
perhaps the First Aid Team might consider this in future versions.
I know the issue Im addressing is a deeper, perhaps more
theory-based or philosophical discussion of this disorder, but I
figured Id pass it along anyway :)
Should say (awaken feeling UNrested)
Hypnopompic - Po(m)p out of bed

Under the "opioids" section, the text states that intoxication of
text
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Clarification
/naltrexone-druginformation?source=search_result
&search=naltrexone&selectedTitl
e=1~53
opioids is treated with "naloxone, naltrexone". Opioid toxicity is

treated by naloxone only. Naltrexone is a maintenance drug to be
used after a patient's body is clear of any opioids for at least 7-10
days. It is not used to treat toxicity.
opIOids causes mIOsis ( to help differentiate which drug
intoxication causes miosis or mydriasis)
under MDMA ecstasy intoxication: hallucination symptoms include
changed perception of sound and colors .
522
Psychiatry
NA
523
Psychiatry
ed/15228154
523
Psychiatry
ed/15056109
MDMA ecstasy intoxication symptoms should include bruxism
524
Psychiatry
ug/strattera-atomoxetine342994#0
525
Psychiatry
A mnemonic.
526
Psychiatry
527
Psychiatry
/lithium-druginformation?source=search_result
&search=lithium&selectedTitle=1
%7E150#F189306
UWorld QID [8327]
For ADHD, please add Atomoxetine as a Nonstimulant drug. It will

complete the list (including both stimulants and non-stimulants)
and also will be consistent with page 511 FA2016 on treatment of
ADHD. Atomoxetine is a newer non-stimulant that is second-line
and sometimes first-line in treatment of children with ADHD.
Antipsychotics: I remember the agents in this drug family by: "If
you commit a sin (-azine), you might go to hell (haloperidol)."
Lithium Side Effects: Lithium leaves you HOSED IN
HypOthyroidism Seizures Ebstein Anomaly Diabetes Insipidus
(Nephrogenic)
527
Psychiatry
527
Psychiatry
It's just a mnemonic I'm not sure

there is a relevant article for this
type thing
na
528
Psychiatry
First AId
528
Psychiatry
/sexual-dysfunction-caused-byselective-serotonin-reuptakeinhibitors-ssrismanagement?source=search_res
ult&search=bupropion&selectedTi
tle=8%7E111#H14004389,
https://en.wikipedia.org/wiki/Bupr
opion#cite_note-pmid1536191934, Uworld QID704
528
Psychiatry
Mnemonic
528
Psychiatry
ug/chantix-varenicline-343212#5
528
Psychiatry
N/A
529
Renal
https://en.wikipedia.org/wiki/Bartt
er_syndrome
531
Renal
/overview-of-congenitalanomalies-of-the-kidney-andurinary-tractcakut?source=search_result&sea
to current
text
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It would be helpful if there was a more extensive list of drugs that

are implicated in Serotonin Syndrome. Per UWorld, Drugs
Implicated in Serotonin Syndrome Include: Antidepressants
(SSRIs, SNRIs, MAOIs, TCAs), Analgesics (Tramadol),
Antiemetics (eg, 5-HT3 Receptor antagonist Odansentron, aka
Zofran), Antibiotics (Linezolid, which has weak MAOI activity), and
Neuropsychiatrics (Triptans).
DAD loves sugar CAIN (the capital letters are for each drug in the
Tricyclics category)
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To help remember that duloxetine is an SNRI, when usually all

the "etines" are SSRIs- "DUOxetine- inhibits reupatke or the duo (
serotonin AND norepi) whereas the other "etines" are just
serotonin
A better mnemonic for the MAOI is the : MAOri TRibe IS
PHENomenally SEcretive. = MAO, TRanycypromine,
ISocarboxazid, PHENelzine, and SElegiline.It includes multiple
letters of each drug inside each word and is less likely to cause
confusion for recall.
Bupropion, while not just having no sexual side effects, is actually
effective in treating sexual dysfunction caused by SSRI and
hypoactive sexual disorders in women, as per Uworld. As for
UpToDate: "In addition, observational studies suggest that
switching from an SSRI to bupropion can be beneficial. One
prospective study (n = 31 patients with fluoxetine-induced sexual
dysfunction) found that after switching from fluoxetine to
bupropion, sexual functioning was much or very much improved
in 81 percent [17]"
Atypical antidepressants "Bad Mood Treatment Varies"
(Bupropion, Mirtazapine, Trazodone, Varenicline)
For Varenicline, a very important side effect ( black box warning)
is serious neuropsychiatric events and increased risk of suicide.
Please add this to the text.
For Bupropion. Recently I have been seeing more information
about its use in ADHD. I forget where I had read the question but I
have also been hearing it from various doctors as well. It can
have a use in patients who are also under depression and are
diagnosed with ADHD. Bupropion is also going to have a far
greater decrease in the potential for abuse vs. the abuse potential
you would possibly see in Methylphenidate or Amphetamines. So
maybe you would be able to re-phase that section with Also used
for smoking cessation and ADHD
concerning features of renal disorders, serum levels of Mg2+ is
low in the Bartter syndrome rather then Gitelman as shown in the
table, since its the Bartter that posesses similar effects as Loop
diuretics known as hypocalcemia and hypomagnesemia.
In unilateral renal agenesis, it is important to realize that the
normal kidney will be hypertrophied, as question stems can give
this as an imaging finding. From UpToDate: "The contralateral
normal kidney is expected to undergo compensatory hypertrophy
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rch=unilateral+renal+agenesis&s
/renal-cystic-diseases-inchildren?source=see_link&sectio
nName=Multicystic+dysplastic+ki
dney&anchor=H3#H3
531
Renal
532
Renal
532
Renal
https://upload.wikimedia.org/wikip
edia/commons/f/f0/Gray1123.png
532
Renal
532
Renal
532
Renal
Clinical Anatomy By Regions, 9th

Edition, Snell pg. 208
533
Renal
Something I learned a long time

ago.
533
Renal
articles/PMC2895306/ UW QID:
383
534
Renal
535
Renal
https://en.wikipedia.org/wiki/Fracti
onal_sodium_excretion
535
Renal
Mathematics order of operations;

/fractional-excretion-of-sodiumurea-and-other-molecules-inacute-kidney-injury-acute-renalfailure
537
Renal
N/A - FA2016
in patients with unilateral RA."

It is very important to know that multi cystic dysplastic kidney is
NOT hereditary. Since it can present similarly to polycystic kidney
disease, especially in rare bilateral cases, question stems will try
to confuse you between the two then ask what the risk of the next
child is for developing dysplastic kidney. It would be the same as
everyone else, since it's not hereditary (vs PKD, which would
have risk since it is hereditary).
In the image "Cross-section of kidney," it shows the renal vein
behind the renal artery. According to my anatomy atlas, the renal
vein passes in front of the renal artery. I would recommend
clarifying this image/fact.
The order goes vein, artery, ureter from anterior to posterior view.
V-A-U mnemonic from front to back.
To be consistent with the reproductive section and also to
complete the the high yield subject of ureteral injury, I suggest
adding a note about the course of ureter when passing under the
ovarian vessels (in suspensory ligament of ovary/
infundibulupelvic ligament) and indicate that the ureter may be
damaged during surgeries ligating this ligament (like surgeries on
ovaries).
The anatomic constriction sites of ureter are important for stone
obstruction. You might want to add these three constriction sites:
1) at ureteropelvic junction 2) at entering the pelvic rim (crossing
over common iliac artery bifurcation) 3. at ureterovesical junction
Renal Blood Flow: renal artery-->segmental artery-->LOBAR
ARTERY-->interlobar artery-->arcuate artery...
Mnemonic: PumpKin= Pump K+ in to the cell leading to HIKIN:
HIgh K+ INtracellularly.
The Endothelium works as a charge selective barrier, according
to the PubMed Article attached. Moreover, coming across one
particular UWorld question, the roles of the Endothelium &
Epithelium seem to be reversed in the book. The Basement
Membrane as well as the Epithelium (Slit Diaphragm) serve as
Size Barriers. The Endothelium & Basement Membrane serve as
charge barriers. If, however, I am not properly understanding the
book and it is written correct with a different meaning to the
layers, I suggest clarifying the reason for the characteristic of
each barrier.
In the text it says normal GFR~100 ml/min. Although it is correct
but most references either mention the value of 120 or a range of
90-120 mL/min/1.73 m2. (Also please note that the unit contains
"per 1.73 m2 body surface" which is missed in the text). Please
see the reference.
For the FE ( Na +) formula, there is * 100 missing. The formula is
used as a percent in azotemia for consistency. 100% is not
included in the FF FORMULA even though it is commonly given
as a percent (eg FF= 20%) but that is because fraction is in the
name hence it is not multiplied by 100. Also for the same formula
on page 535; FE ( Na+) there is an incorrect usage of parenthesis
( GFR=Ucr/V/Pcr). Parenthesis indicate multiplication in
mathematics hence its use is a grammatical error and should be
replaced with an asterisk*.
The provided equation for calculating fractional excretion of Na
(FENa) is problematic for two reasons. A parenthetical comment
on GFR is provided within the FENa calculation, which is visually
confusing since parentheses also denote multiplication in an
equaiton. The second concern is that order of operations is
incorrect throughout the equation. For example, "V x UNa / GFR x
PNa" should actually be written "(V x UNa) / (GFR x PNa)".
Similarly, "PCr x UNa / UCr x PNa" should be written "(PCr x
UNa) / (UCr x PNa)". An alternate solution to preserve the correct
mathematical order of operations would be to display these two
expressions using a vinculum (display the expressions as
fractions). As currently written FENa calculation would produce an
incorrect value.
The nephron chart with various transporters would be made more
clear if 1. the lumen and interstitium were colored differently for
ease of reading (e.g. light yellow and light red) and 2. the # of
molecules is specified (e.g. for the Na/K ATPase). Could also use
color coding of the circles for the transporters for passive,
secondary active and active transport to make them easily
High-yield
addition to
next year
Clarification
to current
text
Major
erratum
High-yield
addition to
next year
High-yield
addition to
next year
Major
erratum
Mnemonic
Major
erratum
Clarification
to current
text
Major
erratum
Clarification
to current
text
Spelling/for
matting
538
Renal
NA
538
Renal
538
Renal
538
538
Renal
https://www-uptodatecom.go.libproxy.wakehealth.edu/c
ontents/bartter-and-gitelmansyndromes?source=machineLear
ning&search=bartter+syndrome&
selectedTitle=1~35&sectionRank
=1&anchor=H3869718#H386971
8
my own
Renal
Medmastery-Acid base essentials

video (Metabolic acidosis caused
by loss of bicarbonate)
538
Renal
Self
539
Renal
any physiology textbook.
540
Renal
https://en.wikipedia.org/wiki/Renin
%E2%80%93angiotensin_system
540
Renal
/mechanical-complications-ofacute-myocardialinfarction?source=machineLearni
ng&search=ventricular+free+wall
+rupture&selectedTitle=1~15&sec
tionRank=1&anchor=H2#H2 & U
World Q.Id: 19517171051
541
Renal
NA
541
Renal
http://www.webmd.com/drugs/2/d
rug-9049/calciferol-oral/details
541
Renal
Page 530 first aid 2015 for step1
541
Renal
NA
541
Renal
541
Renal
/vitamin-d-deficiency-in-adultsdefinition-clinical-manifestationsand-treatment
Spelling
541
Renal
541
Renal
/vitamin-d-deficiency-in-adultsdefinition-clinical-manifestationsand-treatment
dictionary.com
541
Renal
http://www.firstaidteam.com
541
Renal
/overview-of-vitamin-d
541
Renal
N/A
541
Renal
542
Renal
/overview-of-vitamind?source=search_result&search=
calciferol&selectedTitle=2~26
distinguishable.
"Although no rise in pressure in Bartter and Gitel, for all of them, K
is Liddle" (helps distinguish which one will cause hypertension)
Missing Gordon Syndrome
For Bartter Syndrome and Gitelman syndrome it would be nice to
be consistent with the hypo/hypercalcemia. No where in this
section do you put hypo/hypercalciURIA. Although correct, people
focus on the hypo/hyper portion and may be confusing when you
refer to the urine concentration vs the concentration in the cell.
only a LIDDLE amount of Na+ is lost in urine
There is a mnemonic "When Food goes up, pH goes up; When
Food goes down, pH goes down" This will help to remember the
GIT causes of metabolic acidosis and alkalosis.
We can use mnemonic "PLUMSIDE" for causes of anion gap
metabolic acidosis instead of "MUDPILES". Here P -Propylene
glycol, L-Lactic acidosis, U- Uremia, M-Methanol (formic acid), SSalicylates (late), I-Iron tablets or Isoniazid, D-Diabetic
ketoacidosis, E-Ethylene glycol (oxalic acid).
The concentration of Inulin/creatinine should approach 3 times
osmolarity, rather than 1.90 as reflected on the X axis
One of the facts on this page states Na+/K+ pump is inserted.
That should be replaced by Na+ since Na+/K+ pump is not
inserted, only Na+ is due to aldosterone. Also, on the same page
if you could add Sildenafil for mechanism of action similar to
ANP/BNP ( HY correlation and UW question) . Lastly, it should
state macula densa acts on JG then increase renin, the way it
was worded makes it look like a direct effect.
Ventricular free wall rupture on p.290 in FA states 5-14 days after
MI. However, UpToDate and U-World both state that ventricular
free wall rupture can occur within the first 5 days. Specifically,
UpToDate states that 50% of free wall ruptures occur within the
first 5 days and 90% within 14 days. U World states that ruptured
free wall generally occurs within 3-7 days. Both sources are in
agreement, but do not match FA 2016.
Difficult to distinguish the colors used for Angiotensin II and
Aldosterone in the diagram. Suggest changing one of the colors
to red
Calciferol is misspelled as "caciferol".
The arrows for efferent and afferent arteriole are pointing towards
the glomerulus. The efferent arrow should point away
Difficult to distinguish the colors used for Angiotensin II and
Aldosterone in the diagram. Suggest changing one of the colors
to red
Calciferol*
Mnemonic
Clarification
to current
text
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Major
erratum
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to current
text
Minor
erratum
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matting
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"Caciferol" should have a second "L" added so that it is spelt

"calciferol".
Misspelling of "Calciferol" as "Caciferol"
Spelling/for
matting
Minor
erratum
Under Angiotensin II, the second sentence has spelled arteriole

wrong as "ateriole"
alDosterone & aDh have their effects on the Dct & the collecting
Ducts.
"Caciferol" should be "calciferol"
Spelling/for
matting
Mnemonic
In the "Hormones acting on kidney" graphic, there is a box near

the top of the collecting duct that contains K+ and H+ - the arrow
for that box is going into the green section of the DCT, implying
that is caused by ANP. Instead, it would be more clear to put the
arrowhead in the purple part which indicates the effect of
aldosterone in the distal tubule/collecting duct
"Caciferol" should read "Calciferol".. minor spelling error
In the features of renal disorders, primary hyperaldosteronism, the
Spelling/for
matting
Clarification
to current
text
Spelling/for
matting
Clarification
542
Renal
Personal Mnemonic
542
Renal
Mneumonic, based on already

published material
542
542
Renal
na
Renal
p 542 of FA2016
542
Renal
Uworld
543
Renal
N/A
543
Renal
544
Renal
/apparent-mineralocorticoidexcess-syndromes-includingchronic-licoriceingestion?source=machineLearni
ng&search=cushings+metabolic+
alkalosis&selectedTitle=1~150&s
ectionRank=1&anchor=H9#H9
n/a
546
Renal
/clinical-spectrum-ofantineutrophil-cytoplasmicantibodies?source=machineLearn
ing&search=panca&selectedTitle=1~46&sectio
nRank=1&anchor=H7#H7
547
Renal
547
Renal
http://0www.uptodate.com.library.acawe
b.org/contents/clinicalpresentation-classification-andcauses-of-membranoproliferativeglomerulonephritis?source=machi
neLearning&search=membranopr
oliferative+glomerulonephritis&sel
ectedTitle=1~74&sectionRank=1
&anchor=H981933439#H981933
439
n/a
547
Renal
N/a
547
Renal
N/a
547
Renal
548
Renal
/genetics-pathogenesis-andpathology-of-hereditary-nephritisalport-syndrome
548
Renal
Uworld
548
Renal
n/a
548
Renal
/the-nephrotic-syndrome-beyond-
primary disturbance (red arrow) should be put at the increased

aldosterone. Rather in FA 2016, it was put in decreased renin.
Decreased renin should be the result of primary increase of
aldosterone and H2O retention.
K-RSP: potassium is reabsorbed by -intercalated cells and
secreted by principal cells of the collecting tubule
LA DOGS get Weak when they HIKE a Tall Peak... The added
"G" stands for Glucose (same as the S for sugar). HIKE = HIgh
K+ Extracellularly (hyperkalemia), Weak = main symptom for
hyperkalemia, Tall Peak = T-peaks (for peaked T-waves, on ECG)
"alkaLOWsis causes LOW potassium ( hypOkalemia)"
If you have a high serum Na+, you're irritable. In other words,
you're salty!
Under the chart "Features of renal disorders", it says that SIADH
will cause increased blood pressure. This is false as SIADH
results in euvolemic hyponatremia. Hypertension is not a feature
of SIADH as with any transiet increase in blood pressure caused
by ADH driven fluid rebsorption, there is a compensatory
decrease in Aldosterone. This leads to sodium wasting but does
not cause hypertension.
In the right side of diagram Alkalemia is written as "A kalemia".
Ectopic ACTH, Cushing's Syndrome and Licorice should be
added to the list of conditions causing Metabolic Alkalosis
to current
text
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Major
erratum
Spelling/for
matting
High-yield
addition to
next year
Distal RTA is type 1, and is caused by a defect in secretion of H+

(*1* proton). Proximal RTA is type 2, and is caused by a defect in
secretion of *bi*carbonate. And (already in FA2016),
hyperkalemic RTA is type 4, and results in poor excretion of
NH*4*+.
Under rapidly progressive (crescentic) glomerulonephritis, the
association of c-ANCA and p-ANCA with granulomatosis with
polyangiitis and microscopic polyangiitis, respectively, is
obscured. Although granulomatosis with polyangiitis is
horizontally aligned with PR3-ANCA/c-ANCA, microscopic
polyangiitis is not aligned with MPO-ANCA/p-ANCA. This
creates the illusion that both c-ANCA and p-ANCA are associated
with both diseases.
You should add "intramembranous deposit" and/or "characteristic
"sausage-shaped" deposits along the GBM" to the entry on
Membranoproliferative glomerulonephritis type II. This distinction
helps differentiate between Membranous Glomerulonephritis
(subepithelial deposits), MPGN type I (subendothelial), and
MPGN type II (intramembranous/ basement membrane). An
additional factor to be added would be the presence of drusen on
fundoscopic exam, which is exclusive to MPGN type II.
Mnemonic
The description of membranoproliferative glomerulonephritis

(MPGN) switches between using arabic ("1") and roman ("I")
numerals in reference to the two types of MPGN. E.g.: "Type 1
may be 2 to..." followed by "Type II is associated with...".
In membrano-proliferative glomerulonephritis (MPGN): the second
time Type 1 is tipped, is with Arabic # 1 instead of roman
number I. Should me Type I to maintain consistency.
In Membrano-Proliferative Glomerulonephritis (MPGN): the
second time Type 1 appears, is written with arabic number 1
instead of roman number I as previously stated on Type I or
Type II. Should be Type I to maintain consistency.
Alport syndrome is X-linked recessive, not dominant. Goljian,
others state this. It has multiple inheritance patterns, mainly XLR.
Spelling/for
matting
In the FSGS entry, there is an extra period after "C1" in column 2,

middle sentence beginning with "IF--granular..."
Gold,malaria, syphillis, diabetes mellitus should be added to
membranous GN
Spelling/for
matting
High-yield
addition to
next year
Spelling/for
matting
Mnemonic
Focal segmental glomerulosclerosis box 3rd line "deposits of IgM,

C3, C1.." should only have one . not two
NeFROTHic Syndrome has frothy urine
Clarification
to current
text
High-yield
addition to
next year
Spelling/for
matting
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matting
Major
erratum
the-basics
https://en.wikipedia.org/wiki/Glyco
sylation
548
Renal
549
Renal
549
Renal
549
Renal
549
Renal
549
Renal
http://pubs.rsna.org/doi/full/10.11
48/rg.303095146 ,
550
Renal
http://radiopaedia.org/articles/ren
al-oncocytoma
550
Renal
Pathoma and First Aid 2016
550
Renal
/epidemiology-pathology-andpathogenesis-of-renal-cellcarcinoma?source=search_result
&search=renal+cell+carcinoma&s
551
Renal
/non-urothelial-bladdercancer?source=search_result&se
arch=bladder+adenocarcinoma&s
electedTitle=1%7E4
551
Renal
https://ghr.nlm.nih.gov/condition/b
eckwith-wiedemann-syndrome
551
Renal
/beckwith-wiedemannsyndrome?source=search_result
&search=hemihypertrophy&select
edTitle=1~17#H1887423
553
Renal
Pathoma 2015: pg 126
559
Renal
First Aid 559
561
Reproductive
http://eps.harvard.edu/people/and
rew-h-knoll
562
Reproductive
http://www.med.umich.edu/lrc/cou
rsepages/m1/embryology/embryo
/02prefertilization.htm
562
Reproductive
N/A
562
Reproductive
562
Reproductive
http://faculty.southwest.tn.edu/rbu
rkett/A&P2_reproductive_system
_lab.htm
na
/cystinestones?source=machineLearning
&search=cystine+stone&selected
Title=1%7E25&sectionRank=2&a
nchor=H10#H10
N/A
in diabetic glumerulonephropathy nonenzymatic glucose addition

is considered as glycosylation, but its rather glycation.
Cystine stones are radiopaque (less so than calcium stones).
Minor
erratum
Minor
erratum
It's pretty important to remember that cystine stones are more

common in kids. You should bold the 'c' in Cystine and in
Childhood.
Cystine Stones appear RadioPAQUE not Radiolucent on X-ray
findings. Nonetheless, they are less dense than Calcium Stones.
Uric acid stones, like stones of other composition, are usually
visible on NCCT. Helical CT is very good at detecting most kidney
stones, including those that don't show up on KUB.
cystine stones are radioopaque NOT radiolucent.
Mnemonic
The origin of renal oncocytoma is from collecting tubule cells (in

contrast with RCC that is from PCT). I would recommend adding
this fact.
Mnemonic to remember high yield features of sporadic RCC
(think of the S's - Sporadic, Single lesion, arise in upper pole of
kidney (Superior), average age 60 (Sixty), main risk factor
Smoking (Sporadic tumors arise as Single lesions in Superior
kidney in Seniors (Sixty year olds) who Smoke. )
It is very high-yield to know that dialysis is a risk factor for Renal
Cell Carcinoma. Dialysis patients are at risk for an acquired
polycystic kidney disease, which in turn predisposes them to
RCC. From UpToDate: "The risk of developing RCC has been
estimated to be 30 times greater in dialysis patients with acquired
polycystic disease of the kidney than in the general population"
Page 567 mentions in passing that urachal cysts can develop into
adenocarcinoma, but a more detailed discussion of this cancer is
warranted. High-yield facts include: its location in the dome of
the bladder is unique (that's where the embryonic urachus
connects); It arises from the urachal remnant, which is highyield due to the embryology tie in It's lower-yield, but there are
non-urachal causes as well (these have a very poor prognosis)
Beckwith-Wiedemann constellation can be remembered with
"Becky is a WOOMaN". Wilms tumor/WT2, Omphacele,
Organomegaly (tongue is included in this), Muscular
hemihypertrophy, Neonatal hypoglycemia
"Hemihyperplasia," rather than "Hemihypertrophy," should be
used under the section for Beckwith-Wiedemann Syndrome (first
section on the page). According to Uptodate, "Hemihypertrophy"
is a misnomer that is no longer commonly used in medical
literature.
In the comparison chart displaying the 3 forms of AKI, FENa of
postrenal azotemia shows ">1% (mild)". This should be "<1%
(mild)", similar to the FENa in prerenal azotemia.
The side effects of ACEi are A C E i: Angioedema, Cough,
Electrolyte disturbance (K up), impared renal (SCr up)!
The fourth quotation on 561 is accredited to "Andrew H. Knloo."
The name should be spelt "Andrew H. Knoll".
Dear First Aid team. I would like to take an opportunity to thank
you for making my USMLE step1 exam preparation very efficient
with FA 2016 edition. I would highly appreciate, if you consider to
make a correction on the fact that secondary oocyte (N, 2C)
exposes to fertilization at the ovulation. On the given attachment
below secondary oocyte's kariotype is shown as 2N4C.
This is NOT First Aid related but more of a suggestion to the
Errata Submission form. The drop down menu under "Section"
does not have a field for "Embryology." The closest name i found
is "Development" but it doesn't match with the Section name in
First Aid. It would be helpful to add the field "Embryology" to the
drop-down menu of "Section" so that submissions can be done
more accurately matching the correct Section name in First Aid.
The secondary oocyte meets egg when it's arrested in metaphase
2,so it should be 1n2c not 1n1n
Within week 1 line after Blastocyst "sticks" at day 6 there should
Minor
erratum
Minor
erratum
Major
erratum
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
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addition to
next year
Mnemonic
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erratum
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erratum
Mnemonic
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erratum
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erratum
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563
Reproductive
none
563
Reproductive
First Aid 2016
563
Reproductive
FA 2016
563
Reproductive
563
Reproductive
563
Reproductive
n/a
563
Reproductive
563
Reproductive
http://www.parents.com/pregnanc
y/week-by-week/babydevelopment/#page=10
p563 FA 166
563
Reproductive
Nil Mnemo
563
Reproductive
ed/18228258
564
Reproductive
N/A
565
Reproductive
N/A
568
Reproductive
568
Reproductive
N/A
569
Reproductive
https://web.duke.edu/anatomy/em
bryology/craniofacial/craniofacial.
html
569
Reproductive
First Aid page 452
569
Reproductive
N/A
569
Reproductive
be a . (period)
missing comma after retina under the subheading
"neuroectoderm"
Under "Embryologic Derivatives" --> "Ectoderm" -->
"Neuroectoderm" There should be a comma after "retina" right
before "spinal cord".
Redundancy: In the "Surface Ectoderm" section under
"Embryologic derivatives", epidermis is listed twice.
In the list of structures derived form neuroectoderm, there should
be a comma placed between retina and spinal cord to read
"retina, spinal cord"
In the list of surface ectoderm derivatives, epidermis is listed
twice; one entry should be removed
In Neuroectoderm: last line, theres no comma after retina. (retina,
spinal cord). In FA 2014 was retina and optic nerve, spinal cord.
Dont now if its change on the FA 2015 ,but optic nerve is missing
on FA 2016. At the end, in the FA 2016 the spelling is wrong is
missing the comma after retina.
"Men at 10"- at 10 weeks, gender can be identified as male or
female
Repetition of EPIDERMIS in surface ectoderm derivatives-lines 1
and 4, middle column
Neural Crest derived structures : MOTEEL PPAASSS Melanocytes, odontoblasts, tracheal cartilage, ECL like cells,
Larynegal cartilage; Peripheral nerves, Parafollicular C cells, Adr
medulla, aorticopulmonary septum, schwann cells, skull bones,
spinal membranes (arachanoid, pia)
Dura mater should be added as an embryologic derivative of
mesoderm. It is especially important to contrast this to the
previously mentioned pia and arachnoid maters, which are
derived from neural crest.
Instead of "A mean guy hit the baby in the ear," use "A mean guy
hit the baby in the side" so that it slant rhymes, "in the side" refers
to the ear, and the mnemonic more closely resembles the word
AMINoGLYcoSIDE.
Embryology of twinning: missing letter in description of formation
of monochorionic monoamniotic conjoined twins after 13 days of
development. Text reads "Cleavage or axis duplica ion"; should
be "duplication".
It should be clarified that not all of the structures derived from the
Branchial (Pharyngeal) Pouch are of Endodermal Origin. The
Parafollicular "C" Cells of the Thyroid are considered to be Neural
Crest Derivatives. The link attached explains the given
mechanism. The Ultimobranchial body (UB), known to be
pharyngeal endoderm, is invaded/infiltrated by migratory Neural
Crest Cells. This leads to the formation of Parafollicular "C" Cells.
It would be helpful to add this exception as a side
note/mechanism in parentheses following the sentence, i.e.
"Branchial Pouches - derived from Endoderm (except
Parafollicular "C" Cells, which are derived from Neural Crest)."
Would be great to simplify the color scheme in the diagram.
Emphasize the derivatives of the 3rd, 4th, and 6th arches by
eliminating unnecessary colors (eg, orange, brown, dark blue,
pale pink). Make these a uniform color so that the light blue (3rd),
purple (4th), and darker pink (6th) stand out.
anterior 2/3 of tongue should be added to the 1st branchial arch
since in First aid it states where the posterior 1/3 of tongue comes
from.
Add anterior 2/3 of tongue is from 1st brachial arch
For 1st arch-- could possibly highlight "T"s in addition to "M"s:
Temporalis, pTerygoids, Tensor Tympani, Tensor veli palatini,
anterior 2/3 of Tongue (muscles); Trigeminal nerve; Treacher
Collins. For 2nd arch, can highlight additional "S"s: leSSer horn of
hyoid; CN Seven.
Under the 4th arch section, the text should include "CN X
(pharyngeal branches)", which innervate the pharyngeal
constrictors and the levator veli palatini. Currently, only the
"superior laryngeal branch" is listed for arch 4, but that only
innervates the cricothyroid muscle and mucosa (for sensation)--it
does NOT do the pharyngeal constrictors or the levator.
matting
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matting
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Clarification
to current
text
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matting
Mnemonic
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matting
Mnemonic
High-yield
addition to
next year
Mnemonic
Spelling/for
matting
Clarification
to current
text
High-yield
addition to
next year
Major
erratum
Major
erratum
Mnemonic
Clarification
to current
text
570
Reproductive
/surgical-anatomy-of-the-thyroidgland?source=machineLearning&
search=ultimobranchial+bodies&s
electedTitle=1~2&sectionRank=1
&anchor=H9#H9
https://en.wikipedia.org/wiki/Ultim
opharyngeal_body
571
Reproductive
571
Reproductive
FA step 1 (2016), p. 530, Kidney

embryology: Mesonephros
functions as interim kidney for 1st
trimester; later contributes to
male genital system. Metanephric
mesenchyme (ie, metanephric
blastema)ureteric bud interacts
with this tissue
N/A
571
Reproductive
not needed
571
Reproductive
First Aid USMLE Step1
572
Reproductive
http://radiopaedia.org/articles/uter
us-didelphys
572
Reproductive
https://bedahunmuh.files.wordpre
ss.com/2010/05/homologues-ofexternal-genitalia.jpg
573
Reproductive
https://en.wikipedia.org/wiki/Gran
ulosa_cell
573
Reproductive
n/a
573
Reproductive
N/a
573
Reproductive
n/a
574
Reproductive
576
Reproductive
pg. 574 first aid 2016 already

says there are no structures in
the ovarian ligament.
NA
577
Reproductive
577
Reproductive
577
Reproductive
BRS Physiology by Costanzo

sixth edition, page 262.
https://en.wikipedia.org/wiki/Prola
ctin
578
Reproductive
First aid 2016
Williams Gynecology, 2nd ed.,

Chapter 15
http://accessmedicine.mhmedical.
com/content.aspx?sectionid=417
22304&bookid=399&jumpsectionI
D=41726035&Resultclick=2
Mneumonic
Under the 4th pouch derivatives it is given that "Ventral Wings

give rise to Ultimobranchial body and Parafollicular (C) cells
of thyroid." This gives a false perception that Ultimobranchial
Bodies and Parafollicular (C) Cells are two separate derivatives of
Ventral wings of the 4th Branchial Pouch. In reality
Ultimobranchial body is the one which gives rise to Parafollicular
(C) Cells of the Thyroid. So i would suggest this to be reformatted
to "Ventral Wings Ultimobranchial Bodies (in turn gives rise to
Parafollicular Cells of thyroid)."
In the figure below, "Mesonephric kidney" is not correct. It should
be "Metanephric kidney/mesenchyme"
Clarification
to current
text
Please include "Gartner duct" found on page 571 in the Index.
Spelling/for
matting
Clarification
to current
text
In "Paramesonephric (Mullerian) Duct" you write "Male remnant is

appendix testes." But in "Mesonephric (Wolffian) Duct" you write
"In females, remnant of mesonephric duct --> Gartner duct." I
think you can write these both consistently so there is either an
arrow in both or the word "is" in both. For example, change to
"Female remnant is Gartner duct." This would be much more
consistent and highlight the parallel of the Mullein and Wolffian
ducts.
Please add additional strong info into the table.
In Uterine (Mullerian duct) anomalies, for Uterus didelphys, I think

it's better to change the order as : double uterus, cervix, and
vagina (instead of putting vagina after uterus). It's both more
anatomically relevant and also the underlying pathology is mostly
about uterus and cervix (that are somehow duplicated) but the
vagina may have a septum that might not be complete (a proximal
septum and a common introitus).
In undifferentiated picture, genital tubercle points to "glans". The
genital tubercle should refer to a larger portion of the
undifferentiated genitalia.
an easy way to remember the association of Estrogen being
made in the granulosa cell under FSH stimulation: EFG
(alphabetical order): "E"strogen is made when "F"SH stimulates
"G"ranulosa cells
Hypospadias: Highlight/Underline/Bold/Change Color the O in
hypospadias and the O in fold. hypOspadias: . failure of
urethral fOlds ..
Epispadias: Highlight/Underline/Bold/Change Color the E in
epispadias and last E on tubercle. Epispadias: . faulty
positioning of genital tuberclE ..
Discrepancy in information, not very clear: Body of uterus drains
to external iliac lymph nodes, but on page 190 it states that uterus
drains to para-aortic.
The 0varian ligament has 0 structures. Change the O in ovarian to
0 (zero) and highlight both zeros in the sentence.
In spermatogonia, I think it should be : maintain "germ cell" pool.
Germ pool would not mean the intended concept.
The estrogen receptor is different from most steroid receptors in
that it is mostly located in the nucleus, not the cytoplasm.
LT sweet girl. Leydig + Theca cells (Think of male androgens for

lieutenants) and Sertoli + granulosa (Think of female estrogens
for sweet girls).
Written in the right column that fall in progesterone after delivery
disinhibit prolactin and lactation. Progesterone disinhibits lactation
after delivery but prolactin is not, in fact it's written in BRS
Physiology "prolactin levels increase steadily during pregnancy"
so it can't be disinhibited because it wasn't inhibited in the first
place.
So on the "Early fetal development - Early embryonic
development" figure, the secondary oocyte is labeled (1N1C)
Minor
erratum
High-yield
addition to
next year
Clarification
to current
text
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Clarification
to current
text
Mnemonic
Clarification
to current
text
Major
erratum
Mnemonic
Major
erratum
Minor
erratum
whereas on pg 578 under oogenesis, the secondary oocyte is

(1N2C). Would love some clarification to which is right.
On the figure, the corpus luteum has arrows showing what it
produces, progesterone and a little estrogen. The two arrows, to
me, make it a bit difficult to read. For next year, can it have a big
arrow to the progestereone peak and a small arrow pointing to the
second estrogen peak?
Concerning Hormone secretion chart. In several former FA
editions, there was a second peak for hCG secretion around week
30 that is not present for the chart this year.
Hyperventilation does occur during pregnancy, but this can easily
be misinterpreted as increased RR. In reality, minute ventilation
increases because of increased tidal volume. RR remains
essentially unchanged.
Add the fact that APGAR >= 7 is good, 4-6 = assist and stimulate,
<4 needs resuscitation. If apgar < 4 there is increased risk for
neuro problems
579
Reproductive
Clarrification of the figure
580
Reproductive
FA Step 1 2013 & 2015 editions
580
Reproductive
/dyspnea-during-pregnancy
581
Reproductive
44
Behavioral
Science
http://www.ohsu.edu/xd/health/ser
vices/doernbecher/researcheducation/education/residency/up
load/res_lounge_apgar-scoresnejm-2001.pdf, First aid 2015
Goljan Rapid Review Pathology
4th Ed. Chapter 22. Section V
582
Reproductive
N/A
582
Reproductive
585
Reproductive
https://en.wikipedia.org/wiki/Webb
ed_neck;
http://www.hindawi.com/journals/c
rim/2014/682806/
586
Reproductive
587
Reproductive
/pathogenesis-and-clinicalmanifestations-of-disorders-ofandrogen-action and
/diagnosis-and-treatment-ofdisorders-of-the-androgenreceptor
Robbins Pathology Eighth edition
p.1049
587
Reproductive
587
Reproductive
587
Reproductive
No new information, just

mnemonic
587
Reproductive
Gestational Trophoblastic
Disorders: An Update in 2015,
Uworld Qbank Id: 6737
589
Reproductive
/ectopic-tubal-pregnancy-beyondthe-basics
589
Reproductive
Kartagener syndrome should also be included in the list of risk

factors of ectopic pregnancy
591
Reproductive
PATHOMA by Husain A. Sattar &

Uworld
I believe the Female Reproduction section in FA 2016 is missing

a 'VULVA' section. Various diseases are missing; including
Bartholin Cyst, Lichen Sclerosis, Lichen Simplex Chronicus,
Vulvar Intraepithelial Neoplasia (VIN), and Extra-mammary Paget
Disease. All these conditions are fair game on USMLE Step 1,
and hence, are High Yield additions to be considered for FA 2017.
/gestational-trophoblasticdiseasepathology?source=machineLearni
ng&search=hydatidiform+mole&s
electedTitle=3%7E39&sectionRa
nk=1&anchor=H13#H13
UW 1830
Clarification
to current
text
Major
erratum
Clarification
to current
text
High-yield
addition to
next year
Even though Libido decreases in women with the onset of

menopause also due to the fact that estradiol decreases in
menopause, a decrease in SHBG synthesis leads to higher free
testosterone levels and increased libido in some other women
"In the male, androgens are converted to estrogen by cytochrome
P-450 aromatase (primarily in adipose tissue and testis)." is
immediately followed by "Aromatase is the key enzyme in
conversion of androgens to estrogen." Redundance should be
removed.
Mnemonic for contributions of Testosterone: Leydig cells secrete
Testosterone, and LEyDIG for Testosterone functions is Libido,
Epiphyseal growth plate closure, Deepening of voice, Internal
structure development (except prostate), and Growth spurt
Webbed neck,a common finding in Turner Syndrome, is not a
lymphatic defect ,but rather is a congenital skin defect result in
extra skin fold. Putting it in parenthesis after lymphatic defect
implies that is a kind of lymphatic defect but actually It's an
ectopic fibrotic facial band superficial to the trapezius muscle.
Testosterone, and LH is normal in CAIS. FSH is elevated, and so
is estrogen. The cryptorchid testis keeps making testo under the
influence of LH, since LH receptor is alright. Relatively, LH can be
normal, or the upper limit of normal (still normal!)
Clarification
to current
text
Ovarian choriocarcinomas are highly malignant, metastasize

widely, and are much more resistant to chemotherapy than their
placental counterparts. Placental choriocarcinoma is
chemosensitive however ovarian choriocarcinoma is not.
For the components of the sex chromosomes in complete mole,
while the 46XX is the more common one and results from the
duplication of a single sperm, it has to be mentioned that the rare
46XY complete mole is the result of two different sperms (one
containing an X and the other a Y) fertilize the empty ovum.
Major
erratum
Complete moles almost alway have a 46XX karyotype,as

fertilization by Y bearing perm would result in nonviable tissue
due to lack of an X chromosome
Granulosa cells make estrogen/progesterone and has Call-Exner
Bodies, you CALL your EX when you're hormonal.
The chart comparing complete mole versus partial mole should
include p57 protein staining. It is used to distinguish partial from
complete moles. It is a maternal expressed protein that is positive
in partial mole and negative in complete moles.
IUD use - Increased risk of ectopic if pregnancy occurs.
Minor
erratum
Spelling/for
matting
Mnemonic
Minor
erratum
Major
erratum
Clarification
to current
text
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
591
Reproductive
http://www.cancer.gov/aboutcancer/causesprevention/risk/infectiousagents/hpv-fact-sheet
Robbins Basic Pathology, 9th
edition, chapter 18: "Female
Genital System and Breast";
"Fundamentals of Pathology" by
Dr. Husain Sattar
592
Reproductive
592
Reproductive
592
Reproductive
593
Reproductive
593
Reproductive
http://www.pathologyoutlines.com
/topic/ovarytumorgctadult.html
593
Reproductive
Robbins pathology pg. 700
593
Reproductive
NA
594
Reproductive
ed/11557783 &
https://en.wikipedia.org/wiki/Endo
metritis
594
Reproductive
NA
594
Reproductive
Please see Robbins Basic

Pathology, Chapter 18, Pages
692-693
594
Reproductive
http://www.acog.org/ResourcesAnd-Publications/CommitteeOpinions/Committee-on-
/diagnosis-and-management-ofovarianendometriomas?source=search_r
esult&search=endometrioma&sel
ectedTitle=1~32 & FA 2016 p.
594 - "Endometriosis"
emedicine.medspace.com/article/
281850-overview#a6, in
epidemiology 2nd paragraph
Under "Risk Factors," I believe that persistent infection with HPV

16 & 18 should be included
o For completeness' sake, Sertoli-Leydig cell tumors should be
added to the "Benign ovarian neoplasms" section, or at least
mentioned as occurring in the ovary in the Testicular germ cell
tumors section. Sertoli-Leydig cell tumors are sex cord-stromal
tumors that resemble testis tissue, with formation of tubules
composed of Sertoli cells, and Leydig cells between tubules.
Grossly, tumors are small, gray to yellow brown, and solid;
histologically, cells contain characteristic Reinke crystals.
Endometrioma is listed under the heading of "Benign ovarian
neoplasms". Endometrioma is not a neoplasm, but rather a
manifestation of endometriosis (ectopic endometrial tissue) in the
ovary. This could be clarified by re-wording the heading or moving
endometrioma to a different location.
under benign ovarian neoplasms, Mature cystic teratoma, the
entry should read most common germ cell tumour in females but
the text says " germ cell tumour , most common ovarian tumour in
females" as dysgerminoma is the most common malignant germ
cell tumour.
Granulosa cell tumor: Does not produce progesterone (checked
multiple sources including Robbins, and its isn't mentioned nor is
it relavent to the various presentations). Replace with "Often
produces estrogen which presents with age-related estrogenic
effects. Postmenopausal: endometrial hyperplasia > uterine
bleeding, breast tenderness. Prepubertal: sexual precocity." This
would really ease the memory of possible outcomes as it all roots
from estrogenic effects based on age. Aside from the fact I do not
see progesterone listed in literature, I feel removing it is beneficial
reguardless for 2 reasons: it blurrs the rather clear progression
from hormone excess leading to presentation & 2. 10-15% lead to
endometrial cancer which can lead to androgens >
masculinization (testable) [more relavent addition than
progesterone]. Hope this helps, thank you for your time and effort
FirstAidTeam.
Granulosa cell tumor: its is not eosinophilic fluid, rather it is
acidophilic fluid. Eosin stain is an acidophilic stain that coined the
name eosinophil, due to its make up and uptake. The material in
these tumors is not eosinophillic [as per Robbins, and various
other sources]. I noted that Call-Exnar bodies were listed as
eosinophillic on wikipedia but that is incorrect.
Under Immature Teratoma the average age of diagnosis is 18
years old, not after menopause, as it says in First Aid.
Low magnification of Figure E for Dysgerminoma makes it too
vague to look for "fried egg" appearance of oocyte-like tumor
cells. I would suggest changing it to a better figure with higher
magnification if possible. Thanks
Regarding Endometritis. I believe the inclusion of "Plasma cells"
should be incorporated into the definition. Not only is this an
important association with the condition, but emphasizing plasma
cells can aid in a students ability to identify the histological
representation.
I think the Endometrial Conditions fact is a bit wordy and
confusing in its current format. Maybe it's better to split it to 2
facts: benign and malignant conditions. Then you can also include
Leiomyosarcoma (that is not included in the current text and is
distinct from leiomyoma with its characterisitics ) and also better
explain Endometrial carcinoma (which I think currently is very
short and I will post a separate comment to expand that). So
overall I suggest giving a bit more space to these topics.
Endometrial carcinoma is an important topic and needs a bit more
explanation. Most importantly there are two distinct kinds of
endometrial cancer : 1) Endometrioid 2) Seorus carcinoma. Each
of these needs adding the high-yield facts. My suggestions are:
For Endometrioid: 80% of cases, histology similar to normal
endometrium, include the currently mentioned risk factors, PTEN
mutation common. For serous carcinoma: less common (15% of
cases), papillary structure, may have psammoma bodies, P53
mutations, more aggressive and more atypia
A useful mnemonic for abnormal uterine bleeding is PALM COEIN
(pronounced as palm coin) where PALM are the structural causes
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
Clarification
to current
text
Clarification
to current
text
Major
erratum
High-yield
addition to
next year
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
GynecologicPractice/Management-of-AcuteAbnormal-Uterine-Bleeding-inNonpregnant-Reproductive-AgedWomen#figure1
56/NEJM199407073310103
http://www.cancer.org/healthy/find
cancerearly/womenshealth/noncancerousbreastconditions/noncancerous-breast-conditionsfibroadenomas
704-714
595
Reproductive
595
Reproductive
595
Reproductive

704-707
596
Reproductive
http://www.nativechild.com/article.
html
598
Reproductive
ed/20466616
598
Reproductive
5/p1165.html
602
Endocrine
mnemonic GLU-FLOW-zins
increase flow of glucose into
urine.
602
Reproductive
ug/danazol-342756#4
603
Reproductive
ug/nizoral-ketoconazole342592#10,
https://en.wikipedia.org/wiki/Chole
sterol_sidechain_cleavage_enzyme#Nomen
clature,
https://books.google.com.ph/book
s?id=az8uSDkB0mgC&pg=PA50
3&lpg=PA503&dq=cholesterol+si
de+chain+cleavage+enzyme+ket
oconazole&source=bl&ots=ffH7e
Kht7_&sig=K32K5Sp9S9BxUfyR
XXdv33ZRSOE&hl=en&sa=X&re
(Polyp, Adenomyosis, Leiomyoma, Malignancy and hyperplasia)

and COEIN are the non-structural causes (Coagulopathy,
Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified)
fibroadenoma IS a long-term risk factor for breast cancer -> 1.5-2
times higher among patients with fibroadenoma.
Major
erratum
This part is one of the most confusing parts of the book. Both due
to the complexity of the breast diseases and also the type of
classification provided. I have a suggestion for a major change to
classification of this part and it is based on the Robbins pathology
text book. I think it would be very helpful in making it easier to
remember and understand. Instead of the fact "benign breast
tumors" I think it's better to divide this to 4 major facts as follows:
1) Fibrocystic changes (I will provide another comment to clarify
this topic since there are major problems in the way the subtypes
of fibrocystic changes are included in the text). 2) Inflammatory
processes: includes acute mastitis, mammary ductal ectasia, fat
necrosis 3) Benign Tumors : includes Fibroadenoma, phyllodes
tumor, intraductal papilloma 4) Carcinoma. You might also want to
add the Gynecomastia as a separate fact anywhere in between.
I have previously suggested a formatting change to this segment.
However, the most important issue with this segment is that the
fibrocystic changes topic is mentioned separately from its
subtypes. I suggest its best to expand the fibrocystic changes to
include its subtypes (non-proliferative and proliferative, each
including their subtypes). For example currently sclerosing
adenitis and epithelial hyperplasia are mentioned as separate
entities in text (while they are both subtypes of fibrocystic
changes). Please see the attached word file for my suggestions
based of Robbins Basic Pathology and Pathoma book.
For Invasive lobular carcinoma - the mnemonic "Indian file"
sounds pretty racist. I'm surprised that in 2016, we are still using
terms like this. I would suggest for the Star Wars fans out there, it
would be better that "Sandpeople ride in single-file to hide their
numbers." If that's too exclusive of a mnemonic, the current term
should definitely be removed from the book. It's offensive.
While it is possible for there to be testicular involvement of a
systemic lymphoma, there exists a specific subtype of lymphoma
called primary testicular lymphoma (most often a DLBCL) that
accounts for 1-2% of NHLs affecting elderly men. It is itself a
significant cause of malignant testicular cancer (9%). It arises in
the teste, and it is not associated with systemic lymphoma or
systemic leukemia. This is in direct opposition to what First Aid
states. Denoting the lymphoma as primary or secondary has
important significances for its management.
Spermatocele does not transilluminate, as mentioned above as
"benign scrotal lesions transillminate"
For SGLT-2 inhibitors which are newer drugs and work on kidney,
I use the "FLOW" part to identify them. e.g. canagliFLOWzin,
dapagliFLOWzin. I would recommend highlighting this part. Also
the GLIFLOW part helps me to remember that they cause
GLUcose to FLOW in the urine as their mechanism of action. The
prototype "ca-NA-GLU-FLOW-zin" clearly indicates that it works
on "NA-GLU" channel to increase the FLOW !
Please add Pseudotumor cerebri and thromboembolism to
adverse effects of Danazol as a high-yield information. In page
471 Danazol is correctly mentioned as a cause of Pseudotumor
cerebri. It's better to add this to page 602 to be consistent in the
book.
For both ketoconazole and spironolactone, its worth clarifying
that 17,20-desmolase and 17a-hydroxylase are one and the
same. It has yet another name: 17-20 lyase. Furthermore,
ketoconazole can also inhibit cholesterol desmolase, also known
as cholesterol side-chain cleavage enzyme, a different enzyme.
Clarification
to current
text
Clarification
to current
text
Major
erratum
Minor
erratum
Minor
erratum
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
dir_esc=y#v=onepage&q=cholest
erol%20side%20chain%20cleava
ge%20enzyme%20ketoconazole
&f=false
ed/14996087
603
Reproductive
603
Reproductive
ticle/811518_4
606
Respiratory
N/A
606
Respiratory
N/A
606
Respiratory
606
Respiratory
d=NelULlxsFwC&pg=PA386&lpg=PA386&dq=
%22most+common%22+left+pul
monary+hypoplasia&source=bl&o
ts=OVz24frCeL&sig=09CWNvqZy
SiERId-kSEeJuQGwM&hl=en&sa=X&ved=0a
hUKEwiDwbrSj9_KAhVG1x4KHX
mAAuQQ6AEIRDAG#v=onepage
&q=%22most%20common%22%
20left%20pulmonary%20hypopla
sia&f=false;
/radiographic-appearance-ofdevelopmental-anomalies-of-thelung?source=see_link
606
Respiratory
/congenital-anomalies-of-theintrathoracic-airways-andtracheoesophagealfistula?source=see_link&sectionN
ame=Bronchogenic+cyst&anchor
=H29#H29
607
Respiratory
607
Respiratory
/pathophysiology-and-clinicalmanifestations-of-respiratorydistress-syndrome-in-thenewborn
http://link.springer.com/article/10.
1007%2Fs00441-015-2354-x
607
Respiratory
/assessment-of-fetal-lungmaturity#H93483124
607
Respiratory
/assessment-of-fetal-lungmaturity
608
Index
See page 743 and page 408
609
Respiratory
Just thought Id share something quick- fun- and easy. This drug
is found on exams all the time and it has a normal everyday tie in.
Lets see if you can guess it What does MINK mnemonic
represent? Min(K)oxidil (Rogaine) Which opens K+ channels in to
cause vasodilation Causes hypertrychosis (inreased hair like a
MINK coat) Best guys, Michael Diamond
Under adverse effects, "cyanopia" could be reworded to
"cyanopsia" as this latter is the more commonly used word in
medical literature.
The text and the figure below don't go well with each other. In the
text it reads "Saccular (weeks 26 - birth)" but the Figure below
shows it from weeks 24 - birth ; like wise the text reads " Alveolar
(weeks 32 - 8 years) but the Figure below shows it from week 36 40 only. The alveolar arrow should be extended till 8 years
instead of ending at 40 weeks.
Every Premature Child Sucks (resp. distress) Air - for the stages
of lung development (Embryonic, Pseudoglandular, Canalicular,
Saccular, Alveolar)
Pulmonary hypoplasia due to congenital diaphragmatic hernia is
more common in left lung rather than right lung (85%). Bilateral
renal agenesis is associated with bilateral pulmonary hypoplasia.
Therefore, it is incorrect to state that pulmonary hypoplasia
"usually involves the right lung."
Mnemonic
Bronchogenic cysts: FA says that they are "air-filled densities on

CXR". However, they're attenuation is like water/soft tissue
UNLESS there is an INFECTION (air-filled density indicates
previous/current infection according to uptodate).
According to First Aid: Bronchogenic cysts are airl filled, however
they are mostly fluid filled,since they are lined by secretory
respiratory epithelium (cuboid or columnar ciliated epithelium).
They can get air filled either by infection or instrumentation. In
addition, according to uptodate they areGross pathologic
examination demonstrates unilocular cysts that are filled with
thick, clear fluid and do not communicate with the
tracheobronchial tree. Furthermore uptodate states that:
Bronchogenic cysts appear on chest radiograph as round waterdensity masses that may have air-fluid levels associated with
previous or current infection.
Metabolic acidosis is listed as the main complication of neonatal
respiratory distress syndrome, but respiratory acidosis is the
primary mechanism of acidosis, though there is sometimes also
metabolic as well.
There is no mention that Club cells were formally known as Clara
cells. This is vital since many texts and study aids (USMLE-Rx
and DIT) still use Clara cell without mention of Club cells. Also the
2016 index states Clara cells is located on page 607 but when
you read through the page, there is no mention of clara cells.
Lamellar body count is the most commonly used test for fetal lung
maturity in the US. It should be added to the list of tests.
Minor
erratum
Screening tests for fetal lung maturity listed in FA includes

surfactant-albumin ratio. However, according to UpToDate,
"Currently, there are no commercially available tests for
measuring the surfactant/albumin ratio." and "The manufacturer
retired the analytical systems for the TDx-FLM ll test and ended
production of the reagent required to perform it."
On page 743 of the Index, 6-thioguanine is listed as appearing on
page 408 (pharmacology section of Hematology/Oncology
chapter). However, 6-thioguanine does not appear on page 408
nor anywhere else.
In the figure displaying the lobes and fissures of the lungs, the
location where the oblique and horizontal fissures intersect on the
right lung is not present. Nor is there mention of the intersection in
Spelling/for
matting
Clarification
to current
text
Mnemonic
Major
erratum
Minor
erratum
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
Minor
erratum
Minor
erratum
Clarification
to current
text
609
Respiratory
rticle/296198-overview#a12 "The
right upper lobe may be involved
particularly in alcoholics who
aspirate while in the prone
position."
/aspiration-pneumonia-inadults?source=machineLearning
&search=aspiration&selectedTitle
=1~150&sectionRank=1&anchor=
H21#H21
609
Respiratory
611
Respiratory
none (myself?)
612
612
Respiratory
FA 2016
Respiratory
Rearrangement of already
published material
613
Respiratory
/diffusing-capacity-for-carbonmonoxide
613
Respiratory
613
Respiratory
https://en.m.wikipedia.org/wiki/Blo
od_gas_tension
614
Respiratory
firstaid book
614
Respiratory
615
Respiratory
Costanzo, L. S. (2014). BRS

Physiology (p.130): Lippincott
Williams & Wilkins.
https://en.wikipedia.org/wiki/Chlori
de_shift
616
Respiratory
Robbins basic 9e, page 554
618
Respiratory
N/A
618
Respiratory
618
Respiratory
https://en.wikipedia.org/wiki/Obstr
uctive_lung_disease
/aspirin-exacerbated-respiratorydisease?source=search_result&s
earch=aspirin-
the text. First Aid 2016 then gives the impression that they do not
intersect. Since this intersection is an important marker of the
middle lobe of the right lung, it should be included in First Aid. I
have included a page from the 6th edition of Netter's Atlas of
Human Anatomy that illustrates this intersection from the posterior
aspect, as well as a hyperlink to MedScape which displays the
intersection from the lateral aspect of the lung.
The right UPPER lobe is involved if the patient aspirated in the
PRONE position. Seen in alcoholics.
Theres inconsistency in both the wording and information

provided on page 609 and page 624 regarding where aspiration
goes in the lung. Page 609 states, While upright enters inferior
segment of right inferior lobe. While supine enters superior
segment of right inferior lobe. Page 624 states, Upright basal
segments of right lower lobe. Supine posterior segments of
right upper lobe or superior segment of right lower lobe. These
two information uses different words for the same location (basal
vs. inferior vs. lower), and the location for while supine is
inconsistent. Its unclear whether there should be a difference
between aspirating a peanut vs. aspiration in case of lung
abscess. These two pages should display the same information
using the same wording, or use information from UpToDate:
location involved is the lower lobes when aspiration occurs in the
upright position; or the superior segments of the lower lobes or
posterior segment of the upper lobes when aspiration occurs in
the recumbent position.
Suggestion: add a comma and the phrase "Tosses O2 out" with
red "T" after "Taut in Tissues" to remember this form has low O2
affinity. Add a comma and "Rounds up O2" with red "R" after
"Relaxed in Respiratory area" to remember the R form has high
O2 affinity
See attached picture
Right Temp for the BEACH (things that cause a Right shift: Temp,
2,3-BPG, Exercise, Altitude, CO2, H+)
A new and useful sentence is added to this segment indicating
that "DLCO is the extent to which oxygen passes from air sacs of
lungs into blood". Although it is true that DLCO can serve as a
"surrogate" for this purpose, but as its name indicates it measures
the extent that CO (carbon monoxide), and not oxygen, passes
through the diffusion barrier. So I would suggest correcting it to be
clear.
"Dlco is the extent to which oxygen passes from air sacs of lungs
into blood." DLCO is actually the lung diffusing capacity for carbon
monoxide
Pao2= partial pressure of O2 in artrial blood
in the last paragraph change "(physiologic dead space)" to
"(pathologic dead space)" as what is described here is a
pathology (bloodflow obstruction and pulmonary embolus)
A-a gradient shall be 0-10, more than 10 is regarded as
"increased"
High-yield
addition to
next year
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Minor
erratum
Major
erratum
Minor
erratum
Minor
erratum
Minor
erratum
The image makes it look like 90% of CO2 is carried as HCO3inside the RBC, when really it is converted in the RBC and then
exchanged for chloride (via chloride shift) and 90% is carried in
the plasma (as the text says). This also has implications for
chloride/bicarb concentrations in systemic vs. venous blood.
I suggest adding this at the end of the sentence that explains field
cancerization: -> mutiple tumors. "That develop independently
after years of exposure."
The ABCs of Obstructive Lung Disease A Asthma, Aging B
Bronchiectasis C Cystic Fibrosis D Darn Chronic
Bronchitis that does not go away E Emphysema F Foreign
Body Obstruction *everything else is restrictive (or mixed) lung
disease; good general rule of thumb to follow when interpreting
PFTs.
"A big RV obstructs traffic." Obstructive disease=increased RV
Clarification
to current
text
There absolutely needs to be a line about aspirin-intolerant

asthma, as this is a very high yield disease since it's seen in
~10% of adults with asthma. Its classic triad is asthma, aspirin-
High-yield
addition to
next year
Clarification
to current
text
Mnemonic
Mnemonic
618
Respiratory
618
Respiratory
intolerant+asthma&selectedTitle=
1%7E92
/pneumonia-in-childrenepidemiology-pathogenesis-andetiology?source=search_result&s
earch=pneumonia&selectedTitle=
9%7E150 and
/diagnostic-approach-tocommunity-acquired-pneumoniainadults?source=search_result&sea
rch=pneumonia&selectedTitle=3
%7E150 and
/pneumonia-in-children-inpatienttreatment?source=search_result&
search=pneumonia&selectedTitle
=4%7E150 and
/treatment-of-hospital-acquiredventilator-associated-andhealthcare-associatedpneumonia-inadults?source=search_result&sea
rch=pneumonia&selectedTitle=7
%7E150
Pathoma
618
Respiratory
N/A
618
Respiratory
625
Respiratory
/renalamyloidosis?source=search_resul
t&search=bronchiectasis+amyloid
osis&selectedTitle=1%7E150
460865-overview#a7
618
Respiratory
618
Respiratory
/diffusing-capacity-for-carbonmonoxide
619
Respiratory
619
Respiratory
619
Respiratory
620
Respiratory
/imaging-of-occupational-lungdiseases?source=machineLearni
ng&search=pneumoconiosis&sele
ctedTitle=1~105&sectionRank=1
&anchor=H365264528#H365264
528
s/dextromethorphan-druginformation?source=see_link#F15
8827) AND
(http://emedicine.medscape.com/
article/1010513-
induced bronchospasm, and nasal polyps.

You should add a table showing the most common type of
pneumonia in various populations. This would be extremely highyield, since the type of patient given in a question stem can often
times clue you into the answer. Examples include: Elderly
community-aquired = Strep pneumoniae. Pt w/ recent history of
viral URI = Strep pneumoniae or staph aureus. Malnourished,
alcoholics, or nursing home patients = Klebsiella. Cystic Fibrosis
pt = Pseudomonas. Young adults (college students or military
recruits) = mycoplasma pneumoniae. Young sexually active adult
= chlamydia pneumonia. Post-transplant immunocompromised pt
= CMV. Farmers and veterinarians = coxiella burnetii.
High-yield
addition to
next year
To remember that Emphysema is associated with smoking and

commonly affects the supper lobes, you can say "smoke goes up"
with 'smoke' and 'up' in red. This differentiates it from 1antitrypsin deficiency, which is not associated wit smoking and
affects the lower lobes.
You should add a photo of Charcot-Leyden crystals on page 618.
They're very high-yield , and the picture is unique-looking enough
to make it stick in our memories better than a verbal description.
Bronchiectasis can lead to secondary (AA) amyloidosis. This is
high-yield.
Mnemonic
Currently, pancoast tumor is listed as an example of malignancy

causing SVC Syndrome. Instead of pancoast tumor, a mediastinal
mass should be used as an example of the cause of this
syndrome because it is more common. UWorld QID 565[731977],
Chronic bronchitis is hypertrophy of mucus-secreting glands in
bronchi not "hyperplasia",
It is stated that there is a decrease in the diffusing capacity for
carbon MONOXIDE resulting from destruction of alveolar walls. I
believe this is supposed to actually be referencing carbon
DIOXIDE. A subcript 2 is missing after CO. Otherwise if you are
referring to the DLCO test in which CO is measured, this should
also be stated (as not to confuse a build up of carbon monoxide in
patients with emphysema).
The examples of interstitial lung disease are provided in the list
and in line 6 it indicates decreased pulmonary diffusing capacity
for this category. Although true in most cases, this is not the case
in Goodpasture Syndrome. Actually in Goodpasture the diffusing
capacity is INCREASED and DLCO is higher than normal
(increased by 30 percent) because CO is bound to hemoglobin
tapped in alveoli. It's a high-yield and distinguishing characteristic
in Goodpasture and also has diagnostic value. Please see
Medscape topic for Goodpasture Syndrome --> work-up -->
pulmonary function testing.
In the list of examples of restrictive lung diseases, one of the
bullet points is "Pneumoconioses". In parentheses next to the
examples of pneumoconioses, one of the examples is
anthracosis. This is incorrect, because anthracosis is an
asymptomatic deposition of carbon without any cellular reaction,
and therefore would not cause restrictive lung disease.
According to the examples given for pneumoconioses
(Anthracosis, silicosis and asbestosis), I think that (berylliosis)
should be added since its a pneumoconioses and is mentioned in
page 620 of FA in the list of pneumoconioses.
Clarification
to current
text
The antitussives effects of dextromethorphan are not due to the

antagonism of NMDA glutamate receptors. The mechanism of
action for dextromethorphan is due to the decreased sensitivity of
cough receptors and interruption of the cough impulse
transmission via sigma opioid receptor stimulation and depression
Major
erratum
High-yield
addition to
next year
High-yield
addition to
next year
Major
erratum
Minor
erratum
Minor
erratum
Minor
erratum
Clarification
to current
text
overview#showall)
620
Respiratory
Just some thoughts
620
Respiratory
n/a
620
Respiratory
NA
620
Respiratory
n/a
620
Respiratory
N/A
620
Respiratory
N/A
621
Respiratory

621
Respiratory
/central-sleep-apneapathogenesis
621
Respiratory
/central-sleep-apneapathogenesis
621
Respiratory
621
Respiratory
622
Respiratory
623
Respiratory
/pathogenesis-of-obesityhypoventilation-syndrome
"Obesity hypoventilation
syndrome (OHS) is defined as
obesity (body mass index [BMI]
30 kg/m2) and chronic alveolar
{{ hypoventilation (arterial carbon
dioxide tension [PaCO2] >45
mmHg) during wakefulness }}
occurring in the absence of other
conditions that would better
explain hypoventilation"
/acute-respiratory-distresssyndrome-clinical-features-anddiagnosis-inadults?source=search_result&sea
rch=acute+respiratory+distress+s
yndrome&selectedTitle=1%7E150
/overview-of-pulmonaryhypertension-inadults?source=search_result&sea
rch=pulmonary+hypertension&sel
ectedTitle=1%7E150
NA
623
Respiratory
/mechanisms-of-pleural-liquidaccumulation-in-
of the medullary cough center. Only at high doses does

dextromethorphan antagonizes NMDA receptors which can cause
dissociative hallucinations. Edited paragraph: Antitussive (sigma
opioid receptor stimulation). Synthetic codeine analog. Has mild
opioid effect when used in excess. Naloxone can be given for
overdose. Mild abuse potential. At high doses (antagonizes
NMDA glutamate receptors) can cause dissociative
hallucinations. May cause serotonin syndrome if combined with
other serotonergic agents. I hope that helps to clarify. Thank you.
Respectfully, M. Ben Larkin PharmD
The respiratory section is missing a lot of important graphs such
as the Pulmonary Events during breathing, the Pulmonary
Function Test FEV/FVC graphs, to name a few. The CO2
transport picture on page 615 is humongous. You could save
some space and use it for the FEV/FVC graphs
The red bolded text in the silicosis subheading is double printed
and overlapping, giving it yellow blurry shadow. Please correct
this to make the bolded text more clear and readable.
I think you can move the lines and mnemonics about involvement
of base and roof of lung from silicosis explanation to the main
topic explanation above the page (pneumoconioses). It is
comparing asbestosis, silicosis and coal worker's pneumoconiosis
so it's better not to include it under just silicosis.
For the main types of pneumoconiosis on the top of the page, you
should include "berylliosis".
Because asbestos bodies are heavy dumbbells, they fall down to,
and affect the lower lobes of the lungs. (This helps remind of two
facts about asbestosis: the fact that asbestos bodies resemble
dumbbells and that asbestosis affects lower lobes of the lung
while most other pneumoconioses affect upper lobes.)
Modify the current mnemonic "Silica and coal are from the
base/earth and affect the roof" to "Silica, coal, and berries are
from the base/earth and affect the roof" as a simple way to
include beryllosis.
Obesity hypoventilation syndrome: the hypoventilation is not only
due to slow respiratory rate, but also restrictive lung disease (tight
chest wall causes lower tidal volume)
HYPER-ventilation is the most common underlying mechanism for
CENTRAL sleep apnea. Hypoxia -> hyperventlation ->
hypocapnia (CO2 is the major drive during sleep) -> depression of
CNS centers -> apnea. (more like CheyneStokes respiration)
HYPER-ventilation is the most common underlying mechanism for
CENTRAL sleep apnea. Hypoxia -> hyperventlation ->
hypocapnia (CO2 is the major drive during sleep) -> depression of
CNS centers -> apnea. (more like CheyneStokes respiration)
Obesity hypoventlation syndrome: the text implies that the
hypoventlation occurs ONLY during sleep. It happens during
wakefulness as well.
High-yield
addition to
next year
Spelling/for
matting
Clarification
to current
text
Clarification
to current
text
Mnemonic
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Importantly, if the type II pneumocytes (which act as stem cells)

are damaged, pulmonary fibrosis will occur in place of normal
healing.
High-yield
addition to
next year
It should be added that plexiform lesions are seen on biopsy,

particularly in chronic or severe disease. From UpToDate: " It is
characterized pathologically by medial hypertrophy, intimal
hyperplasia as well as by plexiform lesions."
High-yield
addition to
next year
"Unilateral chest pain and dyspnea, unilateral chest expansion,

tactile fremitus, hyperresonance, diminished breath sounds, all on
the affected side." unilateral chest expansion will be on the
UNaffected side. How can the dyspnea be unilateral
Transudate: Due to increase hydrostatic preasure (eg. CHF) {in
the book is HF, should be CHF}
Clarification
to current
text
Clarification
to current
disease?source=search_result&s
earch=transudate+pleural+effusio
n&selectedTitle=3%7E150
Dictionary
623
Respiratory
624
Respiratory
624
Respiratory
625
Respiratory
/superior-pulmonary-sulcuspancoast-tumors
625
Respiratory
/superior-pulmonary-sulcuspancoast-tumors
626
Respiratory
/role-of-surgery-in-multimodalitytherapy-for-small-cell-lungcancer?source=see_link
626
Respiratory
n/a
626
Respiratory
/diagnostic-evaluation-andmanagement-of-the-solitarypulmonarynodule?source=search_result&se
arch=bronchial+hamartoma&sele
ctedTitle=1%7E150
626
Respiratory
N/A
626
Respiratory
N/A
627
Respiratory
627
Respiratory
627
Respiratory
/acetylcysteine-druginformation?source=see_link&utd
Popup=true
/prevention-of-contrast-inducednephropathy?source=search_res
ult&search=n+acetylcysteine&sel
ectedTitle=8~116
N/a
627
Respiratory
627
Respiratory
ticle/484014
627
Index
articles/PMC1857854/ &
https://en.wikipedia.org/wiki/Endot
helin
/pneumonia-caused-bychlamydia-pneumoniae-inadults?source=preview&language
=enUS&anchor=H1&selectedTitle=1~
68#H1 and
http://www.cdc.gov/pneumonia/at
ypical/chlamydophila.html
http://reference.medscape.com/re
farticle-srch/297351-overview
text
Caption for image A should read "Pretreatment". Currently
missing "eat" in "Pretr___ment". Also it would be more visible if
the text font colour was not white.
Under atypical pneumonia, it is chlamydophila pneumoniae, and
psittaci, not "chlamydia" per se, which is the second most
common cause of atypical "walking" pneumonia.
Spelling/for
matting
The text refers to "Chlamydia" as an atypical pneumonia, when it

should read "Chlamydophila," the new name for the family of
bacteria causing pneumonia.
The text incorrectly mentions "superior cervical ganglion"
compression as the cause of pancoast syndrome however this
ganglion is located too high in neck to be affected by tumors of
lung apex. In fact the "inferior cervical ganglion" or the "stellate
ganglion" is the most commonly affected sympathetic nerves in
pancoast tumors (2nd order nerves). Please see both the
references from UpToDate and Medscape clearly indicating this.
For locoregional compression symptoms the first three bullets
indicate : the site of lesion--->sign/symptom. However the last
bullet just mentions the sign (sensorimotor deficit). It should be
something like : brachial plexus (mostly C8-T1 nerve roots)--->
sensorimotor deficits
Add to Small Cell Carcinoma: surgery alone has not shown no
improvement on treatment. Multiple observational series support
the conclusion that surgery alone cannot be considered adequate
as the primary treatment for LS-SCLC.
Suggest to underline the first S of squamous and small cell
carcinoma and the C of central under the location column. [
Squamous Cell Carcinoma - Central ] - [ Small Cell (oat cell)
Carcinoma - Central ]. For a visual connection between these two
cancers and its location. They are the only two that are Central
and start with the letter S
You should mention a quick line about ruling out bronchial
hamartomas, since those also present with a coin lesion on X-ray.
Importantly, they're composed of lung parenchyma and
connective tissue. From UpToDate: "Common causes of a benign
SPN include infectious granulomas and benign tumors such as a
hamartoma."
To remember that small cell carcinoma is not surgically
resectable, I remember "the CELLS are too SMALL for the
SURGEON to see." The capitalized words would be in red.
Sometime we do BAL to get a sample for lung cancer. Lung
cancer metastize to BBAL (brain,bone,adrenal,liver)
N-acetylcystein is stated to be a mucolytic in COPD patients. It is
more commonly used for this purpose in CF patients.
Clarification
to current
text
Clariication
N-acetylcysteine used for contrast nephropathy prevention.
Suggest to underline the first S of squamous and small cell

carcinoma and the C of central under the location column. [
Squamous Cell Carcinoma - Central ] - [ Small Cell (oat cell)
Carcinoma - Central ]. For a visual connection between these two
cancers and its location. They are the only two that are Central
and start with the letter S
For N-acetylcysteine you might also want to add "prevention of
hemorrhagic cystitis in Cyclophosphamide chemotherapy" to be
consistent with page 410 FA2016.
I think it worth mentioning the adverse effect "rhinitis
medicamentosa" or "rebound rhinitis" that is an important and
clinically relevant side effect of nasal decongestants if used more
than 4-6 days.
Regarding Endothelin. I believe a simple definition/function of
endothelin is warranted (eg. potent vasoconstrictor produced in
lung vasculature). In addition, Endothelin is not found in the
index.Lack of definition and index inclusion reduces student
Clarification
to current
text
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
Spelling/for
matting
http://www.uptodate.com.echo.lou
isville.edu/contents/major-sideeffects-of-inhaledglucocorticoids?source=search_r
esult&search=inhaled+corticoster
oids&selectedTitle=2%7E150#H4
n/a
understanding of its vital role.

Adding side effect of Oral Candidiasis for inhaled corticosteroid
use in the respiratory pharmacology section as per UWorld
question.
628
Respiratory
628
Respiratory
628
Respiratory
es-and-corrections
628
Respiratory
NA
631
Rapid
Review
632
Rapid
Review
634
Rapid
Review
636
Rapid
Review
/prenatal-screening-anddiagnosis-of-neural-tubedefects?source=search_result&se
arch=prenatal+screening&selecte
dTitle=5~150#H14
http://www.pathologyoutlines.com
/topic/ovarytumorgctadult.html
636
Rapid
Review
636
Rapid
Review
https://en.wikipedia.org/wiki/Trous
seau_sign_of_malignancy
638
Rapid
Review
First Aid 2016
642
Rapid
Review
First Aid 2016 Microbiology

Systems
642
Rapid
Review
http://library.med.utah.edu/WebP
ath/CVHTML/CV146.html
Cardiac myxoma acts like a ball valve, not "ball AND valve"
642
Rapid
Review
646
Rapid
Review
N/A
662
Abbreviations
and Symbols
https://en.wikipedia.org/wiki/In_vit
ro_fertilisation
689
Index
Page 77 of FA about alpha-1 anti

trypsin , comparing to the index
691
Index
FA 2016 page 691, and page 627
695
Index
Page 378 correctly has it as glucuronidase
Cerebellar tonisllar herniation occurs in Chiari Type I

malformation, not Type II.
Missing letter: In the Rapid Review section on Equations, the
Loading Dose is abbreviated LD but the Maintenance Dose is
abbreviated D. It should instead be abbreviated MD, for
consistency. Interestingly, on the Kindle version, if you highlight
the equation, it shows that the "M" in MD is actually there - It's just
not visible without highlighting, and not visible in the print version.
The abbreviation 'IVF' was used on page 585 when describing
pregnancy treatments for Turner Syndrome (XO). The term IVF
(In Vitro Fertilization) is not found in the Abbreviations and
Symbols section.
Please add addressing to the page 77 where there have been
mentioned to alpha-1antitrypsin and its deficiency
In the FA 2016 index, for Antihistamines, it only has "for
scombroid poisoning, 250". However, antihistamines are
discussed in respiratory pharmacology on page 627 and should
be included since this is the area where the 1st and 2nd
generation options are discussed.
-glucoronidase should be -glucuronidase
698
Index
First Aid 2016, page 564
High-yield
addition to
next year
In the asthma drug diagram: AC and PDE enzymes, along with all
the circles are superimposed, resulting in blurring of the text.
In the diagram regarding effects of cAMP on bronchodilation,
"AC" is not defined in the medical abbreviations on page 659.
"AC" = Adenyl cyclase.
For Omalizumab I think it's better to change the name of receptor
to FcR1 instead of FcRI since the roman numeral might be
mistaken for the letter I, but it's actually the number 1.
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results
treatment for syphilis in endotoxin release). It should be
ENDOTOXIN-like. NOT ENDOTOXIN!
On page 437, the Raynaud phenomenon's disease progression is
from white to blue to red. On page 632 in the rapid review, the
disease progression is listed as "blue to white to red". The correct
disease progression is on page 437, with white to blue to red.
It says that an increased AFP in amniotic fluid/maternal serum is
indicative of spina bifida, but it is not associated with a closed
spina bifida (only open). This also contradicts what is written on
FA 2016 pg. 451 (which is correct)
Spelling/for
matting
Spelling/for
matting
Replace eosinophilic with acidophilic. Granulosa cell tumor: its is

not eosinophilic fluid, rather it is acidophilic fluid. Eosin stain is an
acidophilic stain that coined the name eosinophil, due to its make
up and uptake. The material in these tumors is not eosinophillic
[as per Robbins, and various other sources]. I noted that CallExnar bodies were listed as eosinophillic on wikipedia but that is
incorrect.
For Ferruginous bodies: replace "increase chance of
mesothelioma" with "increase chance of lung cancer". The risk for
bronchogenic carcinoma is greater than mesothelioma as listed
on page 620. The top of the page also makes a point say cancer
and then specifies the greater risk of bronchogenic carcinoma
with the asbestosis sub-section.
For Hypercoagulability (leading to migrating DVTs and vasculitis):
replace "leading to migrating DVTs and vasculitis" with "leading to
migrating superficial venous thrombophlebitis and vasculitis".
the text corresponding to Yellowish CSF: replace "(eg, due to
subarachnoid hemorrhage)s" with "(eg, due to subarachnoid
hemorrhages)" --latter parenthesis is misplaced.
for newborn meningitis add Listeria monocytogenes
Minor
erratum
"Caudal regression system" should read, "Caudal regression

syndrome"
Spelling/for
matting
Major
erratum
Minor
erratum
Major
erratum
Clarification
to current
text
Major
erratum
Spelling/for
matting
High-yield
addition to
next year
Minor
erratum
Major
erratum
Spelling/for
matting
Clarification
to current
text
Minor
erratum
Spelling/for
matting
Spelling/for
matting
Spelling/for
matting
700
Index
N/A
700
Index
First Aid 2015: 135, 698
720
Index
722
Index
N/A
733
Index
https://en.wikipedia.org/wiki/Pariet
al_cell
737
Index
https://en.wikipedia.org/wiki/Propr
anolol
744
Index
Just a minor erratum
747
Index
N/A
752
Index
n/a
172
,18
1.0
0
Microbiology
238
,25
1.0
0
411
940
1
Pharmacolog
y
https://vpn.tufts.edu/+CSCO+1h7
56767633A2F2F6A6A6A2E6863
6762716E67722E70627A++/cont
ents/ceftriaxone-druginformation?source=search_result
&search=ceftriaxone&selectedTitl
e=1%7E150
/tricyclic-antidepressantpoisoning#H15
Renal
/bartter-and-gitelman-syndromes
132
Microbiology
no need
162
(20
15
edit
ion)
175
(in
201
5
edit
ionpag
e
with
To
RC
He
S
infe
ctio
ns
cha
rt)
201
4
edit
ion:
Microbiology
(from the book)
Microbiology
Immunology
The Index lists an item called "CKK hormone" as being on page

319. There's no mention of CKK hormone on that page. I'm also
pretty sure CKK hormone is supposed to be CCK hormone
(cholecystokinin), but CCK isn't mentioned on page 319 either.
TOC states that Citrobacter spp is mentioned on page 126 in the
"Lactose-fermenting enteric bacteria section." It is not mentioned
in that section. It was mentioned in that section in FA15 but is no
longer there in FA16.
Index lists Propanolol (incorrect spelling) reference to 323. Should
be Propranolol.
Kernicterus, mentioned in the Index, is found on pages 177 &
187. However, it is also found on pages 369 & 370.
page 733 in the index says parietal cells on page 207. However
there is no mention of parietal cells on page 207
On p. 737 in the index, there is a spelling error that says
"Propanolol, 323". The correct spelling is Propranolol, and the
incorrect "Propanolol, 323" should be merged with the correct
spelling & index "Propranolol, 249, 303..." to avoid confusion.
The index mentions "somatic hypermutation" on Page 193, but
"somatic hypermutation" is also mentioned on Page 196!
Index entry for "Thymic shadow" only lists page 209. "Thymic
shadow" is also mentioned on page 208 in the "DiGeorge
Syndrome" description!
The index leaves out Page 398 under the Von Willebrand disease
entry, and page 398 by far contains the most information about
Von Willebrand Disease (the other two listed pages barely
mention it)
TRIed sex and got gonorrhea = CefTRIaxone. Literally everyone I
told that to at school uses my mnemonic.
Spelling/for
matting
Example: amphetamines, TCAs. Trapped in acidic environments.

Treat overdose with ammonium chloride. while on page 251,
treating TCA is mentioned to be with NaHCO3. The coorect
answer is NaHCO3 according to uptodate
concerning features of renal disorders, serum levels of Mg2+ is
low in the Bartter syndrome as well as in Gitelman as shown in
the table, since its the Bartter that posesses similar effects as
Loop diuretics known as hypocalcemia and hypomagnesemia.
rickettsia( prowazekii ) sound like Japanese name ,so i would say
the epic prowazekii warrior ,where epic refer to
epidemic.transmission is human to human contact(louse) as in
fighting of the warriors ,to differentiate it from other rickettsia
types.
Are O-Reo segments in a Bun? (Are: Arena, O: Orthomyxo, Reo:
Reoviridae)
Minor
erratum
Neonatal Manifestations for Syphilis should also include: rhinitis &

rash on palms and soles
Minor
erratum
2014 edition states that pro-B cells are low. In your videos on
USMLE-Rx, you state they should be normal. My understanding
and from what I have read about the pathogenesis, the defect is
pro-B to pre-B, therefore it should either be that pro-B cells exist
Major
erratum
Spelling/for
matting
Spelling/for
matting
Spelling/for
matting
Minor
erratum
Spelling/for
matting
Minor
erratum
Minor
erratum
Major
erratum
Mnemonic
High-yield
addition to
next year
Mnemonic
Mnemonic
212
in normal or high levels. Please make this note in your errata

sheet.
DRESS Syndrome - drug reaction with long latency often after
introduction of anticonvulsants, allopurinol, sulfonamides, and
antibiotics. Mnemonic: Diffuse Rash, Eosinophilia, Swelling of
face, Systemic lymphadenopathy. Also multi-organ dysfunction
(liver/kidney/lung)
255
(I
onl
y
hav
e
201
4,
sorr
y)
84
and
89
Pharmacolog
y
www.uptodate.com/contents/drug
-reaction-with-eosinophilia-andsystemic-symptoms-dress
Biochemistry
First Aid 2016
All
Index
http://www.firstaidteam.com/prop
osed-step-1-errata
eg,
435
Musculoskele
tal, Skin, and
Connective
Tissue
Hematology
and
Oncology
http://mpkb.org/home/symptoms/
neurological/cognitive
when mentioned cognitive disturbances ("fibro fog") should be

cognitive disturbances ("Brain Fog")
/hematologic-manifestations-ofsystemic-lupus-erythematosus-inadults?source=see_link
Minor
erratum
Pag
e#
340
in
FA
201
5,
Pag
e#
336
in
FA
201
6.
pag
e
411
FA
201
5,
sorr
y
don
t
hav
e
201
6
xxi
Endocrine
FA 2015, page 332.
SLE having microangiopathic hemolytic anemia is slightly

misleading and I propose that SLE be removed. RBCs undergo
hemolysis by splenic macrophages in the spleen in this disease,
and therefore do not typically show characteristic schistocytes on
peripheral blood smear.
Clinical Use: primary and secondary hyperparathyroidism, Should
it not be tertiary hyperparathyroidism? In primary and tertiary
hyperparathyroidism b/c of hypercalcemia.
Hematology
and
Oncology
None needed for my much better

mnemonic than "it's taxing to stay
polymerized"
"Taxels keep microtubules Together"
Mnemonic
Section I
http://www.usmle.org/pdfs/step1/2015content_step1.pdf
High-yield
addition to
next year
541
Renal
546
Renal
/search?search=caciferol&sp=0&
searchType=PLAIN_TEXT&sourc
e=USER_INPUT&searchControl=
TOP_PULLDOWN&searchOffset
=
/pathogenesis-and-diagnosis-ofanti-gbm-antibody-goodpasturesdisease?source=search_result&s
earch=goodpasture&selectedTitle
I couldn't find how to address the initial pages xx-xxi on "Selected

USMLE Laboratory Values". In cerebrospinal fluid values there is
only Glucose (no protein and opening pressure, two very
important values to remember). I don't know if in the actual exam
these values are provided or not, but in the official handout from
USMLE website at least 6 values are included in CSF. I would
recommend at least adding protein, cell count, and opening
pressure.
Caciferol should be spelt calciferol
Goodpasture syndrome is a Type I (linear IF) , not Type II

(granular IF) rapidly progressive glomerulonephritis.
Minor
erratum
p.
393
Page 84 of this section lists AMP and fructose-2,6bisphosphatase as inhibitors of Fructose-1,6-bisphosphatase but
on Page 89 citrate is listed as an activator, fructose-2,6bisphosphate is an inhibitor and AMP is not listed all.
All of the errata have been deleted. May I have the most recent
copy of the file as it existed a few days ago? Thanks!
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Spelling/for
matting
Clarification
to current
text
Spelling/for
matting
=1~71
First Aid 2016, Mnemonic
456
Neurology
479
Neurology
480
Neurology
/neuronal-control-of-theairways?source=see_link&section
Name=Reflex+regulation&anchor
=H13#H8
Mnemonic
501
Neurology
Mnemonic
72
Biochemistry
ed/16086599
216
Pathology
199
Immunology
/autoimmune-lymphoproliferativesyndrome-alps-clinical-featuresand-diagnosis
N/A
268
Cardiovascul
ar
http://www.electronicstutorials.ws/resistor/res_4.html
124
Microbiology
http://www.resmedjournal.com/art
icle/S0954-6111(06)00179X/abstract
312
Endocrine
Helpful hint that I heard in a DIT

video
595
Reproductive
uptodate
519
Psychiatry
NA
312
Endocrine
Not available
519
Psychiatry
NA
389
none needed
497
Hematology
and
Oncology
Neurology
478
Neurology
FA 2016 p. 478
565
Reproductive
n/a
323
Gastrointesti
nal
314
Endocrine
http://www.jimmunol.org/content/e
497
The easiest way to remember the lateral area of the

hypothalamus is responsible for hunger is "Lat makes you Fat"
Add cough reflex. Afferent: Internal branch of the superior
laryngeal nerve (CNX)
Mnemonic
CN XI lesion: To remember that the SCM contracts to turn head

to the contralateral side, think about bringing your ear (mastoid)
toward your sternum.
To remember that barbiturates increase the duration of Clchannel opening and benzodiazepines increase the frequency of
Cl- opening, think: Barb likes it to last longer, Ben likes it more
frequently
Azithromicyn used as an anti-inflammatory agent,igh-dose
ibuprofen has been shown to slow progression of CF lung
disease, but its use has not been widely adopted despite a
favorable risk-benefit profile
Autoimmune lymphoproliferative syndrome (ALPS) is associated
with defects in the FAS-FASL apoptotic pathway. You can
remember this by remember that you go FAS in the ALPS
C3b = o"b"sonization (in addition to the C3b binds bacteria
mneumonic)
Removal of organs in parallel arrangement will INCREASE TPR.
Adding resistance in parallel decreases total resistance, so
removing a parallel resistance INCREASES TPR.
Langhans is the correct name designated for the giant cells found
in TB. "Langerhans" as it is listed on p 124 is the term for the
dendritic cells found in the skin and mucosa.
For the Congenital Adrenal Hyperplasias: If there is a 1 in the first
number space the patient will have hypertension. If there is a 1 in
the second number space the patient will have excess androgens.
Ex: A patient with 21 hydroxyls deficiency has symptoms of
excess androgens only. While a patient with 11 beta hydroxylase
deficiency (number 1 in both number spaces) will have
hypertension and symptoms of androgen excess!
Missing two important benign breast diseases 1. Periductal
mastitis- aka recurrent subareolar abscess or squamous
metaplasia of lactiferous ducts -painful, erythematous subareolar
mass, 90% ARE SMOKERS, associated with inverted nipple,
HISTO= keratinizing squamous metaplasia of ipple ducts-- keratin
shed plugs up ductal system, cuasing dilation and rupture of duct
which results in chronic and granulomatous inflammation and
possible secondary acute bacterial infection/abcess 2. Mammary
duct ectasia- NOT associated with smoking; poorly defined
periareolar mass associated with thick, white nipple secretions,
usually no pain or erythema, HISTO= dilation of ducts,
insipassated secretions, marked periductal interstitial chronic
granulomatous inflammatory reaction.
In cluster A personality disorder, "paranoid" has no mnemonic
and I suggest this: ParanNOid= NO trust
It is worth adding that since all congenital adrenal enzyme
deficiencies are characterized by increased ACTH clinical
presentation can also involve skin hyperpigmentation (like in
primary adrenal insufficiency).
OCPD= Obsessive Compulsive Personality Disorder = Order
Cyntonic Perfectionism Domination
-thalassemia major: Chipmunk facies . Greek letter on its
side looks like chipmunk cheeks.
Mnemonic
Craniopharyngioma: Childhood, Calcified Cysts Containing

Cholesterol Crystals
The tables on either side of the skull correctly list the point of exit
for CN V1 as the superior orbital fissure; however, the illustration
incorrectly shows CN V1 exiting the foramen rotundum.
Purple heading in the chart says "dizgotic." It should be spelled
"dizygotic."
Risk factors for pancreatic adenocarcinoma: Steve Jobs Died of
Pancreatic Adenocarcinoma. = Smoking, Jewish, Diabetes,
Pancreatitis (chronic), Age. ---------- He always wore a Black
turtleneck and Jeans. = Black heritage (african american), Genes
(genetics)
increase RANK-L (receptor activator of NH-kB ligand) is wrong, it
Mnemonic
High-yield
addition to
next year
Mnemonic
Major
erratum
Mnemonic
Mnemonic
Major
erratum
Spelling/for
matting
Mnemonic
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
Mnemonic
Mnemonic
Clarification
to current
text
Spelling/for
matting
Mnemonic
Minor
arly/2011/07/06/jimmunol.100262
8.full.pdf
should read: (receptor activator of NF-kB ligand), It is an F not an

H.
up to date describes the secondary closed angle glaucoma as
"Secondary angle-closure glaucoma results when the anterior
chamber angle becomes occluded as the result of conditions that
push the iris or ciliary body forward ("pushing" conditions) or
deform the iris so that it is retracted into the angle ("pulling"
conditions)." Nothing was mentioned about vasoproliferation like
what is written on pg484
Syringomyelia is associated with both Chiari I and II
malformations. Chiari II malformations yield more severe
symptoms. (Chiari II is not listed as an association).
erratum
According to the references mentioned below and UWORLD

Qbank, Squamous cell carcinoma is most commonly located in
the upper third of the poSterior vaginal wall, in comparison to
clear cell Adenocarcinoma which is most commonly located in the
upper third of Anterior vaginal wall. Please highlight and place the
capitalized letters in bold as a mnemonic.
Mantle cell lymphoma: "11" looks like candles on a mantle.
Mnemonic
With increased contractility the left ventricular pressure should

also increase so the orange curve should be higher than the
normal black loop.
The cocaine/hydroxyamphetamine localization test seems to be
important for the exam. Step 1- Cocaine drops ( (-) NE reuptake).
No dilation? -> Horner (= no NE). Step 2- Hydroxyamphetamine
drops((+) NE release). Dilation? -> PREganglionic. No dilation? ->
POSTganglionic
when remembering the lateral area and ventromedial area, my
mnemonic of "lateral lesion makes you lanky" (ie a lesion to the
lateral area causes anorexia). Similarly, a "Medial messup makes
you Massive" (ie. a lesion to the ventroMedial area causes
hyperphagia. These were more intuitive to me than the current
memory hooks when I thought them up, I hope they'd be useful to
others!
The named structures as left main coronary artery and circumflex
coronary artery on figure of coronary artery anatomy can
confuse the students because in anatomical literature there are
only two coronary arteries, right and left. The circumflex artery is a
branch of the left coronary (circumflex branch of the left coronary
artery).
For the mnemonic "zoon is zooming" to egg, you can make the
ZOO red for both instead of just making the Z red for both. This
makes it a much better mnemonic!
It should say hyperglycemiC instead of hyperglycemiA in the title.
Major
erratum
484
Neurology
/angle-closure-glaucoma
p.
474
p.
452
591
Neurology
56/NEJMoa1014379#article
Reproductive
www.pathologyoutlines.com/topic/
vaginaclearcelladeno.html,
Blaustein's Pathology of the
Female Genital Tract, fourth
edition, page 160
400
Hematology
and
Oncology
Cardiovascul
ar
n/a
487
Neurology
http://ophthalmology.stanford.edu
/blog/archives/2012/01/pharmacol
ogical.html
456
Neurology
No change in information
265
Cardiovascul
ar
Any atlas of anatomy or Anatomy

book
583
Reproductive
n/a
332
Endocrine
75
Biochemistry
N/A
245
Pharmacolog
y
N/A
p65
.
FA
15
430
Biochemistry
FA
http://www.houstonmethodist.org/
orthopedics/where-does-ithurt/hand/arthritis-of-the-thumb/
CMC is not defined as carpometacarpal under abbreviations
Spelling/for
matting
550
Musculoskele
tal, Skin, and
Connective
Tissue
Renal
Robbins and Cotran Pathologic

Basis of Disease 9e - Kumar,
Abbas, Aster (Elsevier
2015),p.955
Major
erratum
187
Microbiology
/articles/PMC3745404/;
med/11907645;
https://en.wikipedia.org/wiki/Ribav
irin#Mechanisms_of_action
567
Reproductive
http://www.pediatricurologybook.c
om/austinurachal/Figure%202.JP
The picture A of renal cell carcinoma is incorrect. This is papillary

type, not as common as clear cell type. The cell filled with lipids in
the picture is not cancer cell but interstitial foam cells of papillary
crcinoma.
Mechanism of action of Ribavirin on HCV is as a guanosine
nucleoside analog (which thus requires intracellular
phosphorylation). The current mechanism in FA refers to how
Ribavirin works on DNA viruses, and is thus not relevant to this
section.
For "Vitelline duct", the image contains a "normal image" as well
as the various abnormalities. Please include a "normal image" for
270
BRS physiology 5th edition pg 78
W= well developed verbal skills I= increased calcium L= "eLfin

facies" I= eLastin gene micro deletion I= increased sensitivity to
vitamin D A= aortic stenosis (supravalvular) M= mental
retardation S= stranger friendliness
"Protect your eyes with a HAT" (Atropine, Homatropine,
Tropicamide are muscarinic antagonists that affect the EYE)
Mnemonic for direction of DNA/RNA-Synthesis: 5'-3'
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
Mnemonic
Clarification
to current
text
Mnemonic
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Major
erratum
High-yield
addition to
571
Reproductive
https://en.wikipedia.org/wiki/Para
mesonephric_duct
56
Biochemistry
N/A
56
Biochemistry
N/A
59
Biochemistry
N/A
48
Biochemistry
N/A
388
Hematology
and
Oncology
N/A
392
Hematology
and
Oncology
Neurology
N/A
Microbiology
76
Biochemistry
First Aid
326
Endocrine
266
Cardiovascul
ar
http://www-uptodatecom.libproxy2.usc.edu/contents/o
verview-of-chronic-kidneydisease-mineral-bone-diseaseckdmbd?source=see_link&sectionNa
me=Overview&anchor=H4#H4
Physiology by Costanzo page
142
314
Endocrine
ed/18992710
166
Microbiology
http://www.cdc.gov/vaccines/pubs
/pinkbook/downloads/rubella.pdf /
249
Pharmacolog
y
571
Reproductive
/major-side-effects-of-betablockers/abstract/40?utdPopup=tr
ue
s/NBK9967/
499
Neurology
http://jpet.aspetjournals.org.libux.
utmb.edu/content/267/2/624.abstr
act
359
Gastrointesti
nal
UWorld question ID 410
535
Renal
/nsaids-acute-kidney-injury-acuterenalfailure?source=see_link#H64824
59
http://www.medscape.org/viewarti
cle/422939_3
491
124
N/A
the urachus.
Under Paramesonephric (Mullerian) duct, appendix testis is a
male remnant. An additional male remnant is prostatic utricle.
Please add "prostatic utricle"
The "T"-arm of the tRNA is required for "Tethering" of the tRNA
molecule to the ribosome. The "D"-arm is required for "Detection"
of the correct tRNA by the enzyme aminoacyl-tRNA synthase.
"T" RNA is the only RNA that can have the base "Thymidine"
(remember, the general rule is that thymidine is only found in
DNA).
Proteins tagged with ubiquitin are destined for degradation. (U-biquit-in) mnemonic: (U Better Quit!)
Histones are rich in "LA" (with "LA" referring to the amino acids
Lysine and Arginine which are plentiful in histones).
Because the alpha globin is relatively more important than the
beta globin, alpha has 4 genes coding for it, while beta has 2
genes coding for it.
HbC has LyCine (i.e. HbC in HbC defect has the amino acid
Lysine replacing Glutamate).
next year
Clarification
to current
text
Mnemonic
Pick's disease "Picks" the frontal and temporal lobes.

Caseating granulomas A with central necrosis (upper left) and
Langhan not "Langerhans giant cells which is a dendritic cell in
the skin (arrow) are characteristic of 2 tuberculosis
To remember the numbers, the first 6 are in groups of 3's. 1-2-3,
5-6-7, (followed by 9 and 12). Then to remember the vitamins
names in order use the statement: "These Real Nutrients Provide
People Beneficial Factors Continuously"
"renal disease (causes hypovitaminosis D > decreased Ca2+
absorption)" is false, less vit D causes less excretion of PO4
which binds to Ca2+> hypocalcemia (USMLE RX 4745 also
states this)
Mnemonic
Minor
erratum
In the part where it explains the effect of increasing HR on

diastole and the subsequent effect on CO. It is better to replace
CO with SV because that is where the direct effect is and then it
may or may not actually cause a decrease in CO. Increasing HR
will also increase contractility (Bowditch effect) so that will
compensate for the decrease in SV to a certain limit. I suggest
that you either change CO to SV or state clearly that extremes of
HR will severely decrease SV -> decreased CO.
RANK-L is a receptor activator of NF-KB not NH-KB
Clarification
to current
text
Rubella's rash does NOT coalesce like is seen with rubeola.

(Under system section, no option in drop down)
Erectile Dysfunction is not an adverse effect of Beta Blockers. At
best it is simply a placebo affect.
Female is not default development. There is WNT4 signaling that
is present.
First Aid says that pentazocine is a -opioid receptor agonist and
-opioid receptor antagonist, but also that it can cause opioid
withdrawal symptoms if taken with a full opioid antagonist.
However, it is often formulated with naloxone to prevent patients
from using it to get high. Can you clarify this apparent
contradiction? I believe the text should say "if patient is taking a
full opioid agonist."
Toxic megacolon is a life-threatening complication of IBD and is
commonly associated with ulcerative colitis, as well as Clostridium
difficile. It presents with abdominal pain/distension, bloody
diarrhea, fever, and signs of shock. Transmural inflammation
contributes to colonic smooth muscle paralysis. Rapid colonic
distension ensues, thinning the intestinal wall and making it prone
to perforation. Plain abdominal X-ray is the preferred diagnostic
imaging study due to the risk of perforation.
Prostaglandins preferentially dilate the afferent arteriole.
According to UpToDate, "Renal PGs are primarily vasodilators in
the kidneys. Under basal conditions, PGs have no significant role
in the regulation of renal perfusion. However, in the setting of
hypotension and reduced renal perfusion from vasoconstriction
stimulated by angiotensin II, norepinephrine, vasopressin, or
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Major
erratum
Minor
erratum
Major
erratum
Minor
erratum
Clarification
to current
text
Minor
erratum
High-yield
addition to
next year
Major
erratum
513
Psychiatry
212
Immunology
N/a
270
Cardiovascul
ar
/examination-of-the-jugularvenous-pulse
580
Reproductive
442
Musculoskele
tal, Skin, and
Connective
Tissue
Cardiovascul
ar
ed/?term=A+Recommendation+fo
r+the+Definition+of+%E2%80%9
CLate+Preterm%E2%80%9D+(N
earTerm)+and+the+Birth+Weight%E
2%80%93Gestational+Age+Class
ification+System
n/a
270
http://cursoenarm.net/UPTODAT
E/contents/mobipreview.htm?29/1
0/29871?source=see_link#H4
Musculoskele
tal, Skin, and
Connective
Tissue
Pharmacolog
y
Myself
597
Reproductive
499
Neurology
https://uptodate.bidmc.org/conten
ts/pentazocine-patient-druginformation
423
Musculoskele
tal, Skin, and
Connective
Tissue
Atlas of anatomy 2E, Gilroy page

15
184
Microbiology
articles/PMC2745993/figure/F4/
187
Microbiology
Same information as First Aid

2016, just reorganized to fit the
mneumonic
533
Renal
N/A
443
238
endothelin, PG synthesis is increased to maintain renal perfusion

and minimize ischemia." NSAIDs oppose this action and thus
results in the constriction of the afferent arteriole, reducing GFR
and RPF. FirstAid 2016 incorrectly states that the RPF and GFR
are increased. It correctly states that FF is unchanged.
add to the types of delusions: "nihilistic" (i.e., conviction that a
major catastrophe will occur)
For Tacrolimus: The fact "No gingival hyperplasia or hirsutism" is
separated on three lines so that "no" is separate from "gingival
hyperplasia" and "or hirsutism". At quick glance, it seems like
gingival hyperplasia and hirsutism are adverse effects. If you can
get the "no" to be on the same line as at least Gingival
hyperplasia, it would make it easier to read.
The text in FA 2016 explains that tricuspid regurgitation results in
an absent x descent in the jugular venous waveform. It then
comments that tricuspid insufficiency makes the x wave more
prominent. UpToDate clarifies abnormalities in x descents as
follows: "A prominent x descent occurs when there is vigorous
right ventricular contraction that occurs in some patients with atrial
septal defect and in early stage cardiac tamponade. In severe
cardiac tamponade, the x descent is attenuated. The x descent is
also attenuated in patients with severe tricuspid regurgitation."
Definition of embryonic age should be "gestational age PLUS 2
weeks", not "gestational age minus 2 weeks." Ovulation (and
fertilization) does not occur until two weeks after the last
menstrual period. In the supporting reference, please look at
Table 4's definition of conceptional age (also known as embryonic
age).
High-yield
addition to
next year
Spelling/for
matting
Clarification
to current
text
Major
erratum
Erysipelas presents with well-defined demarcation between

infected and normal skin. Erysipelas has Edges.
Mnemonic
Under x descent, it says that it is absent in tricuspid regurgitation

and prominent in tricuspid insufficiency and HF. Insufficiency =
regurgitation. It should read that x descent is prominent in
tricuspid stenosis, not insufficiency.
Here's a somewhat less cumbersome mnemonic to remember
drugs that cause SJS: "SLAP" (sulfa drugs, lamotrigine,
allopurinol, penicillin)
Tricyclic antidepressant overdose should be treated with
bicarbonate. This fact is correct on page 251 but not on page 238
Testicular Torsion: Due to twisting of testis around spermatic
cord. Most commonly presents at birth or during puberty. Leads to
ischemia of gonadal artery which branches directly from
abdominal aorta. Characterized by acute and severe pain, high
riding testis, and absent cremasteric reflex
Adverse effects for Pentazocine state that it can cause opioid
withdrawal if administered with an opioid antagonist. This doesn't
make sense, especially in light of the fact that a) it's commonly
administered orally with naltrexone, and b) the following drug
(butorphanol) with nearly identical pharmacology precipitates
withdrawal if given with an *antagonist*, and c) why would
competing with an antagonist promote withdrawal anyway? The
same thing is stated in the First Aid Express video. Additionally,
UpToDate states that this drug should not be combined with
strong painkillers, but fails to mention opioid antagonists.
I think it would be quite helpful to explain why in the lumbar region
the affected spinal nerve will be at the level inferior to the IV disc
that has herniated. It is because roots at the level of the IV disc
exit ABOVE the IV disc and the root that will be passing next to IV
disc hernia is the root that is exists below. e.g. L4 exists ABOVE
the L4-L5 IV disc and the root passing directly next to it ( its PL
hernia that is) is L5. Maybe add an image similar to the one
attached ( from Thieme's Atals of anatomy, 2e). This also applies
to to the spinal nerves fact page on 472.
Reverse Transcriptase Inhibitors: NRTIs and NNRTIs - the line
drawn in the figure should inhibit the reverse transcription arrow
not the yellow lines representing the uncoated virus
INF-alpha treats MuCH BRiCK (Melanoma, Condyloma
acuminatum, Hairy cell leukemia, hepatitis B, Renal cell
carcinoma, hepatitis C, Kaposi sarcoma)
Aa "salty banana" - a better way to remember that the ICF is high
Major
erratum
Mnemonic
Major
erratum
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Minor
erratum
Mnemonic
Mnemonic
420
Musculoskele
tal, Skin, and
Connective
Tissue
n/a- just a mneumonic
511
Psychiatry
ed/25086269
300
Cardiovascul
ar
56/NEJMp1508120
407
Hematology
and
Oncology
Hematology
and
Oncology
n/a
406
half life of protein C:

ug/ceprotin-protein-c-concentratehuman-342869#10 Factor VII half
life:
Protein S half life:
/clinical-features-diagnosis-andtreatment-of-methemoglobinemia
612
Respiratory
270
Cardiovascul
ar
"Lilly: Pathophysiology of Heart

Disease" pg 30
214
Immunology
n/a
517
Psychiatry
DSM V, UPtodate
523
Psychiatry
UpToDate, Wikipedia
251
Pharmacolog
y
n/a
402
Hematology
and
Oncology
Gastrointesti
nal
n/a
161
Microbiology
/creutzfeldt-jakob-disease#H24
429
Musculoskele
tal, Skin, and
Connective
Tissue
d=5NbsAwAAQBAJ&pg=PA1203
&lpg=PA1203&dq=The+neoplasti
c+cells+express+high+levels+of+
RANKL,+which+promotes+the+pr
oliferation+of+osteoclast+precurs
ors+and+their+differentiation+into
+mature+osteoclasts+via+RANK+
expressed+by+these+cells.&sour
ce=bl&ots=A4cBoXo5Bb&sig=A1r
RB2hKrnqB4b5IsnaBffkYHc4&hl=
en&sa=X&ved=0ahUKEwiO8p-FYrMAhUFyGMKHdSjB14Q6AEIQj
AF#v=onepage&q=The%20neopl
astic%20cells%20express%20hig
h%20levels%20of%20RANKL%2
C%20which%20promotes%20the
363
First Aid 2016
in K+ and the ECF is high in Na+ and Cl- (bananas are high in
potassium and if you put table salt on the banana it would have
sodium and chloride on the outside)
1) Thoracic outlet syndrome: compression of LOWER trunk and
SUBclavian vessels. menmonic= outlet malls have LOWER prices
but usually SUBpar quality 2) Winged Scapula: lesion of LONG
thoracic nerve. mnemonic= fly (with wings) LONG distances. 3)
Klumpke palsy: LOWER trunk. mnemonic= klump! things fall
DOWN/ LOWER.. and it results in clumsy hands ( difficulty with
fine motor movements)
Update neurostransmitter table to reflect 2016 erratum change
regarding lower levels of serotonin in parkinson disease.
PCSK9 Inhibitors have shown up in a few uworld questions
recently, might want to consider adding it to the table of other
lipid-lowering agents. They are "fully humanized monoclonal
antibodies that inactivate proprotein convertase subtilisinkexin
type 9 (PCSK9). That inactivation results in decreased LDLreceptor degradation, increased recirculation of the receptor to
the surface of hepatocytes, and consequent lowering of LDL
cholesterol levels in the bloodstream".
drugs that inhibit Gpiib/IIIa have two is followed by a b, eg epti-f-i-b-atide
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
Mnemonic
From the text, "Proteins C and S have shorter half-lives than

clotting factors II, VII, IX, and X" - this is not true. Factor VII has
the shortest half-life (3-6 hours), Protein C has the second
shortest half life (9.8 hours). Protein S has a half-life of 42 hours!
Major
erratum
With methemoglobin, the oxygen affinity of any remaining ferrous

hemes in the hemoglobin tetramer is increased. This leads to a
left-shift in the oxygen dissociation curve.
Under "X descent", it says "Absent in triscuspid regurgitation.
Prominent in triscuspid insufficiency." that statement is
contradictory.
E-CU-LI-zumab = E is the 5th letter in the alphabet +
CUmplemment + LI (antibody lingo for immune system)
According to the DSM criteria, adjustment disorder is acute when
less than 6 months and chronic when > 6 months. This is not
clear in the current FA text.
It should be included in parantheses like you have for other
hallucingens listed that Phencyclidine is also known as PCP/angel
dust.
For mercury toxicity: "Merc" is in red text in the words "mercury"
and "dimercaprol." If you chose to make "mer" red instead, it
would be highlighted in both "dimercaprol" and "succimer."
Acute myelogenous leukemia is spelled wrong in text as
"leukemiaa"
High-yield
addition to
next year
Minor
erratum
CEO of Merrill Lynch: Colon cancer, Endometrial cancer, Ovarian

cancer, Mismatch repair (caused by Microsatellite instability),
Lynch syndrome
In prion disease it is very high yield to known that protein 14-3-3 is
elevated in the CSF. It is also high yield that EEC may
demonstrated periodic sharp wave complexes. You may also
want to add another variant of prion disease: Familial Fatal
Insomnia- inherited prion disease that presents with exaggerated
startle response and insomnia.
multinucleated giant cells & spindle-shaped mononuclear cells
[that express RANKL]
Mnemonic
Mnemonic
Minor
erratum
High-yield
addition to
next year
Clarification
to current
text
Spelling/for
matting
High-yield
addition to
next year
Clarification
to current
text
%20proliferation%20of%20osteoc
last%20precursors%20and%20th
eir%20differentiation%20into%20
mature%20osteoclasts%20via%2
0RANK%20expressed%20by%20
these%20cells.&f=false
440
Musculoskele
tal, Skin, and
Connective
Tissue
366
Gastrointesti
nal
/tests-of-the-livers-biosyntheticcapacity-eg-albumin-coagulationfactors-prothrombin-time
567
Reproductive
N/A
356
Gastrointesti
nal
/mastocytosis-cutaneous-andsystemic-epidemiologypathogenesis-and-clinicalmanifestations
364
Gastrointesti
nal
/molecular-genetics-of-colorectalcancer
85
Biochemistry
https://ghr.nlm.nih.gov/gene/ALD
OB
388
Hematology
and
Oncology
http://www.bloodjournal.org/conte
nt/116/19/3715?ssochecked=true
193
612
Immunology
N/A
Respiratory
N/A
466
Neurology
na
111
Microbiology
N/A
110
Microbiology
N/A
112
Microbiology
N/A
112
Microbiology
N/A
112
Microbiology
N/A
113
Microbiology
N/A
202
Immunology
/immunology-of-hiv-1infection?source=see_link#H3
92
Biochemistry
n/a
Was tested on nbme 16: Pseudofolliculitis barbae (a.k.a) razor

bumps; painful and itchy hyperpigmented papules on the cheeks,
jawline and neck; due to a persistent irritation caused by shaving;
common in African american males.
"Prothrombin" would actually be decreased in advanced liver
disease due to decreased production of factor II. Conversely
"Prothrombin Time (PT)" would be increased in advanced liver
disease due to the decreased production of various clotting
factors.
Comma splice -- In "Urachal cyst," there should be no comma
between "fluid-filled cavity lined with uroepithelium between
umbilicus and bladder"
Mastocytosis is a high-yield disorder that has shown up several
times on UWorld questions, but is not mentioned in First Aid at all.
It is a systemic disease characterized by abnormal proliferation of
mast cells and excessive release of histamine. It manifests as
flushing, pruritus, hypotension (as well as other histaminergic
effects) in addition to gastric acid hypersecretion (via
overstimulation of H2 receptors).
Over-expression of COX-2 has been linked to the development of
colon adenocarcinoma. This should be added to the flowchart of
the molecular pathogenesis.
In the "Fructose metabolism" box, the enzyme aldolase B is listed
as converting Fructose-1-phosphate to DHAP; however, no
enzyme is listed for the conversion of fructose-1-phosphate to
glyceraldehyde. Page 91 ("Fructose intolerance") states that
aldolase B also converts fructose-1-phosphate to glyceraldehyde,
so it may be helpful to add aldolase B's fructose-1-phosphate ->
glyceraldehyde function to the "Fructose metabolism" box on
page 85.
on page 388 Diamond blackfan is characterized and
nonmegaloblastic and then page 390 it's under megaloblastic
anemia. The classic presentation of DBA includes a usually
macrocytic, or occasionally normocytic, anemia with
reticulocytopenia, essentially normal neutrophil and platelet
counts, and a normocellular bone marrow with a paucity of
erythroid precursors, in a child younger than 1 year
HLA-DR2 mnemonic: DRive 2 MS. SLE's GOOD HAYven
Mnemonic = RUN (Right Unloads); Also "running" will result in all
of the changes that cause a Right Shift. (Acidosis, Decreased
Carbon Dioxide, Increased Temperature, etc.)
ECA from oblique-lateral view should be defined as external
carotid
LOW in the BAC (LOWenstein-Jensen agar for mycoBACterium
tuberculosis)
Add BAE to "These Microbes May Lack Real Color"' for
Bartonella, Ehrlichia, and Anaplasma. "These Microbes May Lack
Real Color BAE"
Change obligate Intracellular bugs to "Chlamydia IN Rick's Cock"
for INtracellular bugs Chlamydia, Rickettsia and Coxiella. If Cock
is not PC then go with Cot.
Change to "SHIN SPiKES" that way SHIN can be together and
highlight that these 3 secrete IgA protease and they have
vaccines available. instead of having shine in one section, nothing
in the vaccine section, and the SHiN in the IgA section
Change "Pee Chunks" to "UR PROTEin CHUNKSS" for Ureasepositive Proteus, Cryptococcus, H. Pylori, Ureaplasma, Nocardia,
Klebsiella, S. epidermidis
Add "INJECT Toxins in 3 SHeEPS " = INJECTisome for Toxin
delivery in Type 3 Secretion by SHigella, E. coli, Pseudomonas,
and Salmonella
It says that CXCR4/CCR5 is receptor on cytotoxic T-cells, while
this is true they are also on macrophages & dendritic cells. It may
confuse some some, mixing it up for GP-120 on CD-4 etc especially since CTL are not the only cells they are on.
Essential amino acids: Pvt Tim Hall read as "private time hall"
High-yield
addition to
next year
Major
erratum
Spelling/for
matting
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Clarification
to current
text
Mnemonic
Mnemonic
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Clarification
to current
text
Mnemonic
38
Behavioral
Science
N/A
(Phe, val, thr, trp, ile, met, his, sometimes arg, lys, leu)
Consider use of a similar figure to the one attached here for better
clarification?
48
Biochemistry
N/A
Bold: lysine and arginine?
55
Biochemistry
Kaplan Biochemistry Lecture

Notes 2016
Alternative splicing is used for: Secretory vs mucous IgA,

Troponins, Dopamine-receptors in the brain
69
Biochemistry
For all examination purposes use p^2=1?
122
Microbiology
https://en.wikipedia.org/wiki/Fidax
omicin
Mechanism of fidaxomicin most likely tested on the boards? have

seen this question in some qbanks recently
262
Cardiovascul
ar

Notes 2016: see picture
It would be better to have this picture so that the text details are
more clear
469
Neurology
Class notes
Subarachnoid hemorrhage vs meningitis: SAH has NO fever but

meningitis has fever. Both will have nuchal rigidity.
531
Renal
Bailey and Love's textbook of

surgery 26th edition
Horseshoe kidney is at level of L4 vertebra
372
Gastrointesti
nal
568
Reproductive
No references
91
Biochemistry
lus/ency/article/000366.htm,
UWorld QID: 1067
92
Biochemistry
s/NBK22453/
270
Cardiovascul
ar
56/NEJMicm1413235
266
Cardiovascul
ar
Ohm's Law Q = deltaP/R.

Physiology by Costanzo page
118.
88
Biochemistry
Mnemonic
394
Hematology
and
Oncology
http://www.ebmconsult.com/articl
es/steroids-glucocorticoids-wbcneutrophiles-increase
19
Section I
ents/default.aspx
50
Biochemistry
Pharmacology LWW, HPIM 18e
While it is mentioned that acalculous cholecystitis is due to

ischemia and stasis, it fails to mention the high-yield fact that it
occurs in the ABSENCE of gallstones. The wording of this section
on cholecystitis can lead one to incorrectly think that gallstones
are present in acalculous cholecystitis. Please add this to the new
addition.
In the graphic for aortic arch derivatives, there is the text box
stating "Right recurrent laryngeal nerve loops around right
subclavian artery". However, the arrow then points to what
appears to be the right brachiocephalic artery, or at best the
branch point. Consider pointing the arrow to the true subclavian
artery
Under Fructose Interolance it explains that a reducing sugar can
be detected in the urine- but this test would be positive in the
other disorders of carbohydrate metabolism (inc. galactose), not
just fructose intolerance.
Mnemonic to remember which amino acids are glucogenic and
ketogenic. For the Glucogenic essential amino acids, remember
"Have you Met Val? He is Sweet." Have= histidine,
met=methionine, val=valine, he is sweet= glucogenic. For the
ketogenic Amino acids, remember "lysine and leucine are lousy",
lousy referring to the side effects of ketone bodies (ketoacidosis).
Cannon A waves are produced when the atrium contracts against
a closed AV valve with a simultaneous ventricular contraction.
Commonly seen in complete heart block, ventricular tachycardia
and reentrant tachycardia.
If the right atrial pressure is non-zero then is must be added to the
MAP= CO X TPR equation to become ( MAP - RAP) = CO X
TPR. It can be tricky specially in questions involving diseased
states where RAP is increased.
Lysine and Leucine are the only purely ketogenic amino acids:
Linus (lycine) has the key (ketogenic) to Lucy's (leucine) heart
It says "Corticosteroids decrease activation of neutrophil adhesion
molecules, impairing migration out of the vasculature." It doesn't
impair migration. It's the opposite. The neutrophils are no longer
"stuck" to the vasculature. This sentence is very confusing.
Number of question under pacing: 280, block contains no more
than 40 questions, time 90 seconds per question
See attached pic
172
Microbiology
As listed in FA 2016
241
Pharmacolog
y
Pharmacolog
y
Gastrointesti
nal
FA 2016
5th generation does not cover: ALE: Atypicals, Listeria,

Enterococci
see attached picture: mnemonic for ACh receptors
FA 2016
possible mnemonic in picture
Mnemonic
FA2016, Kaplan Notes, Nelson

textbook of paediatrics
Kernicterus is mainly due to bilirubin deposits in basal ganglia.

Would be a more specific answer
High-yield
addition to
246
370
Clarification
to current
text
Spelling/for
matting
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
Clarification
to current
text
Mnemonic
High-yield
addition to
next year
Clarification
to current
text
Mnemonic
Minor
erratum
Minor
erratum
High-yield
addition to
next year
Mnemonic
Mnemonic
483
Neurology
FA2016
Size of labels small for reading.
588
Reproductive
N/A
Label myometrium in placenta accrete syndrome
334
Endocrine
http://www.nature.com/nrendo/jou
rnal/v10/n3/full/nrendo.2013.256.
html
99
Biochemistry
n/a
562
Reproductive
FA2016 Page 450 accepted

erratum of changing
neuroectoderm to neural tube in
the Neural Development section.
456
Neurology
none
298
Cardiovascul
ar
480
Neurology
Raymon, L., Davis, C., & Harris,

S. (2015). USMLE step 1
pharmacology lecture notes.
[New York, N.Y.]: Kaplan Medical.
spelling
There was already a submission about needing to add

metformin's MOA. While it was greatly appreciated, a better
explanation would be that meformin inhibits hepatic
gluconeogenesis and opposing the action of glucagon. The
inhibition of mitochondrial complex I results in defective cAMP
and protein kinase A signalling in response to glucagon.
Stimulation of 5-AMP-activated protein kinase, although
dispensable for the glucose-lowering effect of metformin, confers
insulin sensitivity, mainly by modulating lipid metabolism. It also
glycerophosphate dehydrogenase.
The "Findings" for Pompe disease (type II) include "systemic finds
leading to early death." I believe this should state "systemic
[findings] leading to an early death."
I believe Neuroectoderm should be changed to Neural Tube. Both
Neural Tube and Neural Crest are derived from Neuroectoderm,
so it doesn't make sense to compare Neuroectoderm to Neural
Crest. You've accepted a similar change in page 450 from
another submitter.
"You get hungry as you're far away from home" --> Lateral
thalamus = hunger
Thiazide diuretics should be avoided in patients with diabetes
mellitus.
500
Neurology
First Aid 2016, DIT 2016
612
Respiratory
Clarification - none required
270
Cardiovascul
ar
Physiology 5e by Costanzo pages

122 and 148
322
Endocrine
pathoma 2011,P163
610
Respiratory
not applicable
124
Microbiology
382
Hematology
and
Oncology
Hematology
and
Oncology
186
Microbiology
FA 2016, page 187, Hep C

therapy, Simeprevir
598
Reproductive
First Aid p. 598
269
Cardiovascul
ar

175-176
394
Robbins Pathology textbook
Text currently says "Bell palsy". It should read as "Bell's palsy".

Pheny (phenytoin) and Val (Valproic Acid) like to Top
(Topiramate) their Carbs (Carbamazepine) with Lemon
(lamotrigine) and Salt (blocks Na channels)
What is meant by "Nitrites (eg, from dietary intake or polluted/high
altitude H2O"? What is "high altitude H2O"? Is this implying that
water at high altitudes contains more nitrites? It doesn't make any
sense.
The loop that represents an increase in contractiliy is not accurate
as it doesn't show an increase in pressure during phase 2. The
increase in pressure can be explained by the concept of
compliance: Compliance = Volume / Pressure. the compliance is
constant so increasing the volume ( stroke volume) should be
accompanied by an increase in pressure.
Subacute granulomatous thyroiditis does not progress to
hypothyroidism
This is a very minor discrepancy. The lung volumes that cannot
be measured directly using spirometry are acknowledged
accordingly and accurately. However, there is inconsistency in the
wording of how this acknowledgement. RV and FRC say "cannot
be measured on spirometry" while TLC says "cannot be
measured by spirometry"
Langhan's Giant cells and Langerhan's Cells are different.
Langhan's cells are the giant cells seen in granulomas made of
macrophages. Langerhans cells are cutaneous dendritic cells.
"Usually occurs in a type O mother with a type A, B, or AB fetus."
Type O mothers could not have a fetus with AB blood type.
It says "Corticosteroids decrease activation of neutrophil adhesion
molecules, impairing migration out of the vasculature." It doesn't
impair migration. It's the opposite. The neutrophils are no longer
"stuck" to the vasculature. This sentence is very confusing.
Under Protease inhibitors it is stated that "all protease inhibitors
end in -navir." However this is incorrect. The text should say "all
protease inhibitors end in -navir with the exception of Simeprevir."
Simeprevir is a protease inhibitor mentioned on the next page of
the text and is high yield.
Some of the findings of choriocarcinoma can be remembered by
"hCG:" hyperthyroidism, choriocarcinoma, gynecomastia, and
hCG as the marker.
Text states that Point 6 represent exercise but that is inaccurate.
Exercise changes are achieved by the effect of local metabolites
in SM and activation of sympathetic. Sympathetic activation ->
next year
Spelling/for
matting
Clarification
to current
text
High-yield
addition to
next year
Clarification
to current
text
Minor
erratum
Mnemonic
Major
erratum
Spelling/for
matting
Mnemonic
Clarification
to current
text
Minor
erratum
Minor
erratum
Clarification
to current
text
Minor
erratum
Minor
erratum
Major
erratum
Minor
erratum
Mnemonic
Major
erratum
603
Reproductive
http://www.astellas.us/docs/floma
x.pdf
269
Cardiovascul
ar
n/a
420
Musculoskele
tal, Skin, and
Connective
Tissue
Microbiology
First Aid
343
Gastrointesti
nal
ticle/734138_1,
https://en.wikipedia.org/wiki/Barto
nella
http://radiopaedia.org/articles/gast
roduodenal-artery
345
Gastrointesti
nal
https://en.wikipedia.org/wiki/Pecti
nate_line
511
Psychiatry
325
Endocrine
https://en.wikipedia.org/wiki/Rett_
syndrome
https://en.wikipedia.org/wiki/Calci
um-sensing_receptor
325
Endocrine
325
Endocrine
303
Cardiovascul
ar
http://www.modernmedicine.com/
modernmedicine/content/torsades-depointes
338
Gastrointesti
nal
s-conditions/umbilicalhernia/basics/definition/con20025630
493
Neurology
/hereditary-primary-motorsensory-neuropathies-includingcharcot-marie-toothdisease?source=see_link
391
Hematology
and
Oncology
/anemias-due-to-decreased-redcellproduction?source=see_link#H4
413
Hematology
and
Oncology
p 411 First Aid under

Hydroxyurea
557
Renal
NON
358
Gastrointesti
nal
N/A
167
Microbiology
312
Endocrine
https://uptodate.bidmc.org/conten
ts/evaluation-of-scrotal-pain-orswelling-in-children-andadolescents#H9
UpToDate:
112
ed/22142470
https://en.wikipedia.org/wiki/Parat
hyroid_disease
VENOCONSTRICTION -> decreased venous compliance ->

increased stressed volume -> increased mean systemic pressure
Tamsulosin is specific for alpha-1A, as alpha-1B and alpha-1D
are for vascular smooth muscle. It says alpha 1A+B, but it should
just be alpha-1A.
I think this whole page needs to be reviewed or even rewritten
from scratch. Add more COMPLETE scenarios (e.g. excercise,
hemorrhage, compensated/uncompensated HF etc) in addition to
showing the effects in isolation. Also, isolate the curves, only one
curve per graph for the isolated effect e.g. vascular curve for
changes in TPR. Complete examples with curves and minimal
text that explains the sequence of events will be very helpful in
applying the curves to new scenarios. FA is not meant to be a
detailed textbook but this page is high-yield and in its current state
is very confusing.
Change the mnemonic for the brachial plexus to a more culturally
sensitive one. Remember To Drink Cold Beer
Minor
erratum
High-yield
addition to
next year
Mnemonic
As stated on p. 110, Bartonella is an intracellular bacteria. It

should be included in the list of "Facultative Intracellular" bacteria
listed on p. 112.
The gastroduodenal artery descend firstly posterior to the first part
of the duodenum then giving branches , right gastroepiploic and
superior pancreaticoduodenal artery
the drawn of the pectinate line on this page must be on the end of
morgagni columns as wavy line
" a girl cant wake , cant take , cant even hold a fork "
Clarification
to current
text
Major
erratum
mention that the ca-sensing receptor working on G-coupled

receptor
High-yield
addition to
next year
Mnemonic
adding to (cinacalcet )
adding to the chart with example of . 1) primary
hypoparathyrodism ( familial hypocalciuric hypercalcemia) ..2)
secondary hyperparathyrodism adding (
pseudohypoparathyrodism )...3)PTH independent hypercalcemia
adding hydrochlorothiazide
mention that the amiodarone least drug of antiarrhythmic causes
tocsade de point " Although amiodarone lengthens the QT
interval, it rarely triggers TdP, implying that the drug affects the
QT interval in a unique way. Moreover, there's anecdotal
evidence showing amiodarone's success in terminating druginduced TdP"
i think it will be benefit to add topic about umbilical hernia as
embryological error of closure of the umbilical ring , producing
lump during infant crying or straining which can be reducible and
covered by skin .
Under Charcot-Marie-Tooth disease, it would be helpful to add the
buzz words, "hammer toe" under foot deformities, and "foot drop"
in addition to lower extremity weakness, as this is an early
presentation of the disease, and how the disease has been tested
in UWorld and NBME 16
I noticed that in this section, there is mention of increased
reticulocytes on a blood smear for intravascular hemolysis.
Despite this, there is no mention in the 2016 edition about
corrected reticulocyte count. Just to be sure, I looked in the index
to find all the entries related to reticulocytes and none of them
referenced corrected reticulocyte count or how to calculate it. I
feel as though this is high yield because corrected reticulocyte
count can be used to determine if a normocytic/normochromic
anemia is due to insufficient hematopoiesis or RBC destruction.
On chemo-tox man, place a little cross bar across the femur
bones (to look like an H on each leg) which will represent
Hydroxyure, also causing myelosuppression.
DCT: Distal Convoluted Tubule = Decreases Calcium in
Tubule/Thiazides. Therefore increases reabsorption of Calcium.
"PASs the Foamy Whipped cream in a CAN" to remember it
stains positive for PAS
'It takes a real Prehn (friend) to lift you sack'... Prehn's sign
distinguishes epididymitis from other painful testicular problems
(torsion).
In the 2016 edition, the diagram notes that Aldosterone synthase
Minor
erratum
Mnemonic
Mnemonic
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Minor
/adrenal-steroidbiosynthesis?source=machineLea
rning&search=adrenal+cortex&sel
ectedTitle=1~58&sectionRank=2
&anchor=H239059600#H239059
600
na
37
Behavioral
Science
480
Neurology
Not applicable
62
Biochemistry
UW Question 669730
113
511
Microbiology
First Aid
Psychiatry
315
Endocrine
/thyroid-hormone-synthesis-andphysiology
238
Pharmacolog
y
/tricyclic-antidepressantpoisoning#subscribeMessage
337
Endocrine
n/a
32
Behavioral
Science
N/a
585
Reproductive
First AId
402
Hematology
and
Oncology
43
Behavioral
Science
Behavioral
Science
First Aid 2016
456
Neurology
I don't have a reference. My

professor tested us on these two
nuclei and you had to know that
one was stimulated, while the
other was destroyed.
511
Psychiatry
/rett-syndrome
97
Biochemistry
http://themedicalbiochemistrypag
e.org/glycogen.php
307
Cardiovascul
ar
First Aid
89
Biochemistry
http://www.ncbi.nlm.nih.gov/gene
?Db=gene&Cmd=ShowDetailVie
w&TermToSearch=54205
43
First Aid 2016
is also present in Zona Fasciculata, yet it should only be present

in Zona Glomerulosa. (pg. 312)
erratum
For SEM decrease as n increase -- this would be better stated the

other way around as it is the sample size increasing that leads to
the standard error of the mean decreasing. The SEM comes from
n. n comes from the experiment not from SEM, which is why the
statement would be better the other way around.
Lower motor neuron lesion is misspelled as "lower motor neuron
LESIONA"
Ehlers-Danlos can be caused by deficiency in procollagen
peptidase, which cleaves terminal regions of procollagen (Step 5).
It's currently listed under Step 6.
Serratia sounds like Sriracha (which is red)
about rett syndrome " a girl cant talk , cant walk , cant even hold a
fork "
On the diagram of thyroid hormones synthesis, I think it would be
helpful to show which steps the anti-thyroid meds (PTU,
methimazole) work at. Additionally, the mechanism of perchlorate
/ pertechnetate should be added either here or to the pharm
section. I've seen several practice questions about the
mechanism, which is decreasing iodine uptake into follicular cells
due competitive inhibition.
TCAs are listed as a weak base. The text also says the antidotes
is ammonium chloride. Later the antidote is correctly listed as
bicarb on page 251.
I actually like the rhombus, square and triangle depiction of MEN
in FA2015. It was more memorable than three circles.
Phases of Clinical trials: Does the Drug SWIM?: Phase 1 = Safe.
Phase 2 = Work. Phase 3 = Improvement. Phase 4 = postMarketing surveillance. (---> bold and highlight S W I M for each
phase)
the features Turner Syndrome can be remembered by using the
mneumonic Turner and Hootch after the old tom Hanks movie. H=
Horseshoe Kidney O= aOrtic valve is bicuspid O= ovarian fibrosis
T= Thick Neck C= Coarctation of Aorta H= High Arched Palate
Auer Rods indicative of AML "A-ROD plays in the American
League (AML)" This is a nice an easy way to remember some
oncology facts by using baseball
Easier way to remember developmental milestones.
Clarification
to current
text
Please add to the developmental milestones that I just submitted

that at 4 months, baby loses root reflex (nipple suckling reflex). T4
= dermatomal level of nipples to remember this occurs at Month
4.
For the distinction between the dorsomedial nucleus and
ventromedial nucleus of the hypothalamus...you can remember
that you need to "Stimulate the D, and destroy the V" meaning
when the dorsomedial nucleus is stimulated, it causes obesity and
hypothalamic rage...if you destroy the ventromedial nucleus it
causes the same symptoms. So to remember that dorsomedial is
stimulated and ventromedial is destroyed...remember that you
should "Stimulate the D, and destroy the V"
I feel like Rett Syndrome does not belong in the Psychiatry
section because it is more of a neurodevelopmental disorder. I
feel that it fits better on Pg. 73 with Fragile X and other X-linked
dominant disorders. It would be more consistent given the
etiology and clinical features of Rett Syndrome
In the figure, it shows epinephrine acting on an alpha receptor to
increase intracellular calcium. In parentheses, after "Epinephrine",
it is written "(liver)". I believe it should say "(liver and skeletal
muscle)" as there is also an arrow pointing from the calcium to the
calcium calmodulin in muscle.
Easy way to remember which congenital cardiac defects are
associated with 22q11 syndrome (diGeorge): "George Falls off
the tree Trunk" = DiGeorge is associated with Truncus (trunk)
arteriosus and Tetralogy of Fallot (falls)
Cytochrome C is a highly hydrophilic protein that likes to reside on
the intracellular surface of the inner mitochondrial membrane. In
the current diagram, the cytochrome C protein is situated within
Mnemonic
Spelling/for
matting
Minor
erratum
Mnemonic
Mnemonic
High-yield
addition to
next year
Major
erratum
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Clarification
to current
text
Clarification
to current
text
Mnemonic
Clarification
to current
text
397
?
Hematology
and
Oncology
Hematology
and
Oncology
First Aid 2016 Step 1, page 397
black box warning available on

Lexicomp: https://www-uptodatecom.p.atsu.edu/contents/irinoteca
n-conventional-druginformation?source=search_result
&search=irinotecan&selectedTitle
=1%7E130 and drug insert from
FDA:
http://www.accessdata.fda.gov/dr
ugsatfda_docs/label/2002/20571s
16lbl.pdf
/congenital-diaphragmatic-herniain-theneonate?source=search_result&s
earch=pulmonary+hypoplasia&sel
ectedTitle=1%7E126
606
Respiratory
Microbiology
First Aid 2015
430
Musculoskele
tal, Skin, and
Connective
Tissue
Pathology
http://www.webmd.com/arthritis/h
eberdens-and-bouchards-nodes
237
Pharmacolog
y
Uworld
74
Biochemistry
N/A
Musculoskele
tal, Skin, and
Connective
Tissue
http://www.uptodate.com.huaryu.
kl.oakland.edu/contents/congenit
al-cytogeneticabnormalities?source=machineLe
arning&search=patau+syndrome
&selectedTitle=1~61&sectionRan
k=2&anchor=H71#H14
Scattered throughout FA...
462
Neurology
d=P73zAgAAQBAJ&pg=RA2PR14&dq=central+sulcus+atlas&
hl=en&sa=X&ved=0ahUKEwiay8
X41JvMAhVIVT4KHR19Bc4Q6A
EIPjAF#v=onepage&q=central%2
0sulcus%20atlas&f=false
301
Cardiovascul
ar
563
Reproductive
/inotropic-agents-in-heart-failuredue-to-systolicdysfunction?source=machineLear
ning&search=inamrinone&selecte
dTitle=1%7E15&sectionRank=1&
anchor=H3#H24038082
FA2016
397
Hematology
and
Oncology
none needed - formatting
372
Gastrointesti
nal
UW
357
Gastrointesti
nal
230
Pathology
http://jpma.org.pk/full_article_text.
php?article_id=5488 ;
http://www.surgwiki.com/wiki/Pept
ic_ulcer_disease
https://ghr.nlm.nih.gov/gene/BCR
#synonyms
227
n/a
the membrane, which is incorrect given the hydrophilic nature of

the protein.
"There is 1b in Bernard", this is an easy way to remember the
affected receptor in this disease.
Mnemonic
Irinotecan: remember Black Box Warning for severe diarrhea

adverse effect (both early and late onset) with: "Irantothecan" or "I
ran to the can"
Mnemonic
Lung hypoplasia typically occurs on the LEFT lung, as opposed to

the right lung, as mentioned in the book. It occurs in the left lung
because that is where congenital diaphragmatic herniations
occur. The intestines are blocked from going through the
diaphragm by the liver on the right. From UptoDate: In most cases
of CDH, herniation occurs on the left. Right-sided diaphragmatic
hernias occur in 11 percent of cases and bilateral herniation in 2
percent [2]. Disease severity appears to be similar in patients with
left and right-sided lesions.
Remember adverse effects of fluroquinolones with: "QTC: Q:
Quninolones and Qt interval prolongation. T: Tendon rupture. C:
Contraindicated in pregnant women secondary to Cartilage
damage"
HD BP - "High Definition / H.D." for Heberden nodes at DIP.
"Blood Pressure / B.P." for Bouchard nodes at PIP.
Major
erratum
in the first animation depicting Normal cells the basal cell layer is
not labeled and the basement cell layer is labeled as "Base t
layer"
Volume of distribution compartment for low should more
accurately be plasma, not blood. As these drugs are hydrophilic
or protein bound.
Patau is a messed up palindrome (PataP) because of midline
defect (microPhthalmia, cleft lip/Palate, holoProsencephaly,
omPhalocele)
Clarification
to current
text
Minor
erratum
There are a lot of things associated with Marfan Syndrome, but I

don't think I"ve come across one of the handy First Aid tables that
there are for so many other diseases! Perhaps for next year if you
could include a table with the pathophys + clinical manifestations
of Marfan's, that would be super helpful. Thanks!
There are multiple problems with the labels of different functional
areas in this figure. In particular, the central sulcus is incorrectly
labelled. It appears that other structures are consequently labelled
incorrectly due to their positions in relation to this landmark. For
example, the area labelled "primary motor" (precentral gyrus) is
actually the "primary somatosensory" area (postcentral gyrus).
Phosphodiesterase-3 inhibitors: Milrinone and inamrinone
Positive inotropic agents that can be used in refractory heart
failure with severe hemodynamic compromise and low cardiac
output that is not managed with other medication
High-yield
addition to
next year
missing comma: see circled area
Spelling/for
matting
Spelling/for
matting
I think it would be wise to place HUS and TTP directly adjacent to

each other since they share the common pentad of symptoms...
just with neuro syx occurring more in TTP and renal in HUS as
well as sharing similar treatment. You could simply switch places
of ITP and HUS to make this work.
TPN induce biliary stasisgallstone.Thus,TPN should not in
the subtitle of pigment stone
I've encountered several resources that say that anterior
duodenal ulcer rupture is more common than posterior.
The function of the normal BCR is not clear. The protein has
serine/threonine kinase activity and is a GTPase-activating
protein for p21rac.
Mnemonic
Mnemonic
Mnemonic
Major
erratum
High-yield
addition to
next year
Minor
erratum
Minor
erratum
Clarification
to current
text
164
Microbiology
N/A
163
Microbiology
N/A
492
Neurology
N/A
130
476
Microbiology
FA 2016 pg.110
Neurology
N/A
133
Microbiology
FA 2016 pg.296
149
Microbiology
N/A
565
Reproductive
N/A
279
Cardiovascul
ar
www.none.com
72
Biochemistry
Uworld Question ID 1790
241
Pharmacolog
y
none needed.
173
Microbiology
165
Microbiology
Mnemonic based off fact in

section
ticle/553327_3
446
322
Musculoskele
tal, Skin, and
Connective
Tissue
Endocrine
598
Reproductive
614
Respiratory
Costanzo, Linda. Physiology (5th

Edition). Philadelphia, PA:
Saunders.
402
Hematology
and
Oncology
Biochemistry
Spelling error
262
Cardiovascul
ar
I dont have a link its just a clearer

representation of the info given
184
Microbiology
http://www.nature.com/nrmicro/jo
urnal/v11/n12/full/nrmicro3132.ht
ml
85
Submitted by faculty (Finkel) for

QID 1922 Step 1 Qmax
http://www.uptodate.com.arktos.n
yit.edu/contents/subacutethyroiditis?source=search_result&
search=subacute+granulomatous
+thyroiditis&selectedTitle=1~17
https://www.inkling.com/read/robb
ins-cotran-pathologic-basisdisease-kumar-9/chapter24/thyroid-gland or
Robbin's PBD 9e pg 975, UTD:
/epidemiology-of-and-risk-factorsfor-testicular-germ-cell-tumors
ticle/944548-overview#a5 and FA
2015
Spell "Serratia" as "Se-red-ia" to remind it produces a red

pigment.
Mnemonic to remind of causes of meningitis in newborns --> SLE
(Streptococci group B, Listeria, E.coli)
I like to remember more of the symptoms from MS as "SAINT" =
Scannin speech, ANS (bladder/bowel dysfunction), INO
(internuclear opthalmoplegia), Nystagmus, and Tremor (intention
tremor)
Add "Treponema is Tiny" to "Borrelia is Big".
I find it easier to remember the GALANT reflex by thinking of a
GALLANT superman... who flies in a ventral suspension, and
when he notices trouble to one side of him, he turns (lateral
flexion) towards that side
To make the following mnemonic more complete "you drive CARS
using your palms and soles", add "and Kawasaki Motorcycles" to
remind that Kawasaki disease also has palms and soles
involvment.
Highlight the middle letters of the following two viruses to remind
of the cells they are involved with: eBv (infects B cells) & cMv (is
latent in Mononuclear cells)
Minor typo: In the table under Twinning, the header in purple
shade reads "dizgotic (fraternal)" instead of "dizYgotic (fraternal"
"aortic arch...(RESPONDS TO /\ and \/ in BP)"
It should be added that men with cystic fibrosis are not sterile,
even though they often cannot produce kids through sexual
intercouse (vas deferns become pluged up.) However, It should
be added that most men with CF can still have children with
assisted reproductive technology. Asking if a man is sterile can be
a trick question.
Sympathetic; long poStganglionic fibers. paRasympathetic; long
pReganglionic fibers.
AzTHREEonam binds PBP3
163 says HSV-2 is meningitis, HSV-1 encephalitis; 165 says
HSV-2 is encephalitis
In First Aid Facts: Consider placing aspirin in with the other
NSAIDS to make the point that aspirin IS an NSAID, with the
same warnings and uses.
In the book it states that subacute granulomatous thyroiditis
progresses to hypothyroidism but according to various sources
including Robbins, UpToDate, Medscape this is rare. It actually
doesn't even mention it in Robbin's Pathologic Basis of Review
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Spelling/for
matting
Minor
erratum
Clarification
to current
text
Mnemonic
Mnemonic
Clarification
to current
text
High-yield
addition to
next year
s
Klinefelter syndrome is not associated with increased risk of

testicular GCTs. It is, however, associated with a 50x increased
risk of *extragonadal* GCTs (usually mediastinal), but not
testicular.
[PA > or = Pa > Pv] In zone 1, under physiologic conditions,
arterial pressure is just high enough to prevent collapse of
capillaries. The vessels close only when arterial pressure is
lowered (hemorrhage) or alveolar pressure is increased (positive
pressure ventilation).
Acute myelogenous leukemiaa is misspelled. Only need one "a"
for leukemia
Major
erratum
The number 10 indicating Aldose B activity should be put between

Fructose-1-phosphate and glyceraldehyde as well. This is drawn
correctly on pg. 91. Is a relevant fix since fructose intolerance
leads to a build up of fructose-1-phosphate as a result of both
pathways being unavailable
Helpful diagram I made that has been very useful
Clarification
to current
text
Their is an error in this figure with regard to the action of protease

in the HIV life cycle. Protease is thought to proteolytically mature
virions after release from the infected cell. Thus, this figure's
illustration of proteolytic processing prior to packaging and
assembly is inaccurate. The label of the location of protease
inhibitor activity should correspondingly be denoted
Clarification
to current
text
Spelling/for
matting
Clarification
to current
text
Major
erratum
242
Pharmacolog
y
no
608
Respiratory
n/a
543
Renal
UW qid 1980
190
Immunology
270
Cardiovascul
ar
2015 FA is correct. refer to link :

http://www.dartmouth.edu/~nlevy/
pln3.html
http://www.ivline.org/2010/05/quic
k-guide-to-ecg.html
270
Cardiovascul
ar
/auscultation-of-heartsounds?source=machineLearning
&search=S4+heart+sound&select
edTitle=1%7E150&sectionRank=
1&anchor=H24#H24
402
TYPO
100
Hematology
and
Oncology
Biochemistry
626
Respiratory
none needed
302
Cardiovascul
ar
http://howmed.net/pharmacology/
sodium-channel-blockers/
492
Neurology
278
Cardiovascul
ar
According to Robbins and Cotran

Pathologic Basis of Disease
(page 1285), UWorld Question
Bank, and UpToDate
s/pathogenesis-andepidemiology-of-multiplesclerosis?source=machineLearni
ng&search=preservation+of+axon
s+multiple+sclerosis&selectedTitl
e=1~150&sectionRank=1&anchor
=H721369662#H721369662)
Just a Mnemonic for future first
aid
372
Gastrointesti
nal
http://www.emconsulte.com/en/article/287439
549
Renal
N/A
617
Respiratory
298
Cardiovascul
ar
611
Respiratory
I think this is just an minor error

that it's not only pertaining to fat
emboli
/management-of-hypertension-inpregnant-and-postpartum-women
196, 202
First aid 2016
extracellularly.
It should be KINKY, not QINKY in the mnemonic explanation.
WTF MATES?! QINKY? PS SQS is like CQC from Metal Gear
Snake Eater, but with sex.
Description of epithelium in Conducting zone (Pseudostratified
columnar -> Cuboidal) does not match the depiction in the image
(Pseudostratified columnar -> Simple Columnar)
the table says that a bicarbonate less than 20 is acidosis. now uw
qid 1980 says that less than 22 meq/L is metabolic acidosis.
"Medullary sinus" points wrong place.
Clarification
to current
text
Clarification
to current
text
Minor
erratum
Major
erratum
T wave should be longer, similar to the duration of reduced

ejection+isovolumetric relaxation period.
Under the "Heart Sounds" subheading, FA states that the S4
heart sound is considered abnormal regardless of patient age.
However, UpToDate says that S4 sound may be heard in many
healthy older adults without any other cardiac abnormality due to
decreased ventricular compliance with age. S4 may become
audible in otherwise healthy subjects with a prolonged PR interval
due to the separation of S4 from S1. In patients with complete AV
block, S4 is heard at a faster rate than S1 and S2 and may not
indicate any hemodynamic abnormality. To be accurate, an
audible S4 is abnormal in younger adults and children, and it is
always abnormal when it is palpable, regardless of patient age.
Acute myelogenous leukemia is misspelled (leukemiaa instead of
leukemia)
Major
erratum
Major
erratum
GAUCHER = Glucocerebroside/Glucocerebrosidase, Aseptic

Necrosis of the Femur, "Unsupported" due to Osteoporosis,
Crumpled tissue paper macrophages, Hepatosplenomegaly,
"Empty cell lines" (pancytopenia), Recessive (Autosomal)
Under Small Cell Carcinoma where you have all the A's in red, I
would suggest you also highlight the "A" of Chromagranin A+ to
drive home the A theme
Same drugs as listed for Class IA, B and C Antiarrhythmics. To
keep on the same topic for the mnemonic already used for Class
IC (Can I have Fries, Please), I propose changing the Class IA to
Double Quarter Pounder for Disopyramide, Quinidine and
Procainamide. In addition, changing Class IB drugs to Lettuce
and Pickles for Lidocaine and Mexiletine. *Credit given to
Dr.Trzeciakowski*
Periventricular plaques have relative PRESERVATION of axons,
not destruction of axons
Mnemonic
For 2nd Degree Mobitz type I (Wenckebach) AV block which

consists of progressive lengthening of PR intervals and a drop in
QRS (beat) the Mnemonic can be used as MOre MOney MOre
PRoblems (where the first MO is for MObitz and the capital PR is
for Lengthening PR intervals) and DJ Wenckeback drop the Beat
as in QRS is dropped eventually.
Crohn's Disease leads to *Pigment* gallstones through ileal
disease-induced enterohepatic cycling of bilirubin.
To help remeber that a Staghorn calculi in KIDS is usually from a
cystine stone (vs ammonium magneisum phosphate in an adult)
Think CCC "Cids (kids) get Cystine Calculi"
classic triad of hypoxemia, neurologic abnormalities, petechial
rash
Mnemonic
Hypertensive Moms Love Nifedipine to represent hydralazine,

labetalol, methyldopa, and nifedipine
Mnemonic
Text states that a negative intrapleural pressure prevents

pnemothorax. I can't see how a negative pressure prevents air
entry from an area of higher pressure (atmosphere, lung Bullae ).
It actually promotes the development of pneumothorax if there's a
connection with an area of higher pressure. The negative
intrapleural pressure prevents the collapse of the alveoli at FRC
Minor
erratum
Minor
erratum
Clarification
to current
text
Mnemonic
Major
erratum
Major
erratum
Mnemonic
Spelling/for
matting
359
Gastrointesti
nal
n/a
613
Respiratory
83
175
Biochemistry

206. "The diffusion coefficient of
the gas has enormous
implications for its diffusion rate,
as illustrated by differences in the
diffusion rates of CO2 and O2.
The diffusion coefficient for CO2
is approximately 20 times higher
than the diffusion coefficient for
O2; as a result, for a given partial
pressure difference, CO2 diffuses
approximately 20 times faster
than O2."
N/A
Microbiology
articles/PMC352780/
592
Reproductive
Robbins p. 1029, UWorld Q ID

11652, Pathoma p. 146
564
Reproductive
270
Cardiovascul
ar
http://www.cvphysiology.com/Hea
rt%20Disease/HD005.htm
315
Endocrine
FA 2016 p. 315
316
Endocrine
mnemonic clarification
32
mnemonic
59
Behavioral
Science
Biochemistry
60
Biochemistry
mnemonic
69
Biochemistry
mnemonic
73
Biochemistry
mnemonic
73
Biochemistry
mnemonic
454
Neurology
314
Endocrine
478
Neurology
/normal-skeletal-developmentand-regulation-of-bone-formationandresorption?source=preview&sear
ch=rankl&language=enUS&anchor=H1206113&selected
Title=1~64#H3804366
Netter's Atlas of Human Anatomy,
4th Edition, Bones and
Ligaments, Plate 11
mnemonic
as the transmural pressure will be positive.

Way to remember association of granulomas with Crohn's
disease: GRAN(ulo)MA is an old CROHN
the "Dk(P1-P2) difference in partial pressure" statement is
misleading. Dk is important in gases because it takes into account
the solubility of the gas. It is impossible to compare the diffusion
of two gases ( e.g. CO2 and O2 in the lung ) without it.
Mnemonic
Clarification
to current
text
F-O-M-E-pizole is "For Overdoses of Methanol & Ethylene glycol"

Chloramphenicol has both bacteriotatic and bactericidal activities.
It is specifically bactericidal against the organisms that cause
meningitis (Haemophilus influenzae, Streptococcus pneumoniae,
and Neisseria meningitidis). Chloramphenicol does not provide
such activity in meningitis caused by enteric gram-negative bacilli.
It is bacteriostatic against everything else.
FA describes mature cystic teratoma as a cystic mass composed
of all 3 germ layers. Pathoma and UWorld say 2 or 3 germ layers.
It's probably worth it to include hypoglycemia as an effect on the
fetus in maternal diabetes since as soon as the baby is separated
from the mother, the baby will quickly become hypoglycemic.
"x descent... Absent in tricuspid regurgitation. Prominent in
tricuspid insufficiency and right HF." Regurgitation and
insufficiency are the same thing. I have attached a link to a
reputable website as well as a random emedcine article using
both terms interchangeably.
Under T3/T4 function, make "CNS maturation" the first line in the
left column with "bone growth" in the second line so it
corresponds to the order of the 4 B's in the right column. You
could also swap the order of the 4 B's but it makes more sense to
have them both in the same order.
Instead of the current mnemonic for cGMP (BAD GraMPa for
BNP, ANP, and EDRF), it would be much easier to change it to
BAN GraMPa instead, for BNP, ANP, and NO. The best
characterized EDRF is NO, and this is the only EDRF we should
have to know for step 1, as many sources even equate EDRF
with NO.
Phase I = Safety FIRST
Mnemonic
Minor
erratum
COP I - Think: first generation of COPs were RETRO =

RETROgrade
Honestly, the fact that there are Ms in desMin, viMentin, Muscle,
and Mesenchyme makes the provided mnemonic fairly unhelpful.
I suggest keeping the Ms in desMin and Muscle highlighted but
additionally highlight the ME and TI that are common to viMEnTIn
and MEsenchymal TIssue
For Prader-Wili and Angelman syndromes, I suggest the following
to add to the already provided mnemonic: Prader-Willi is a
Paternal Problem and angelMan is a Maternal Messup. I found
myself getting confused about whether the "paternal" in PraderWilli was referring to the imprinting or the mutation/deletion.
Fragile X: CGG from top to bottom = Chin Giant Gonads;
Friedrich Ataxia: GAA = GAit Ataxia; Huntington: CAGs increase
= Caudate, Ach, GABA decrease; Myotonic Dystrophy: CTG top
to bottom = Cataracts, Toupee, Gonadal atrophy
Duchenne = 8 letters, not divisible by 3 = frameshift; Becker = 6
letters, divisible by 3 = non-frameshift
Sensory Fiber type: "C-low" unmyelinated ; "fA t" myelinated
Mnemonic
In the text it says that "RANK-L (receptor activator of NH-kB

ligand)" Should read "RANK- L (receptor activator of NF-kB
ligand). I could find no source that ever mentions NH-kB and it's
association with RANK-L, however NF-kB is highly associated
with RANK-L.
Clarification
to current
text
The foramen spinosum is drawn in the wrong location. The arrow

pointing to the foramen spinosum in the image is actually pointing
to the carotid canal. The foramen spinosum should be located in
the sphenoid bone, posterolateral to the foramen ovale. Where it's
Minor
erratum
Minor
erratum
High-yield
addition to
next year
Clarification
to current
text
Clarification
to current
text
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Mnemonic
479
Neurology
s/NBK385/
270
Cardiovascul
ar
http://www.uptodate.com.lanepro
xy.stanford.edu/contents/examina
tion-of-the-jugular-venouspulse?source=search_result&sea
rch=jvp+curve&selectedTitle=1~1
50#H9
479
Neurology
Dr Ryan Grant, neurosurgeon
469
Neurology
http://www.svuhradiology.ie/casestudy/acute-subarachnoidhaemorrhage-2/
480
Neurology
Dictionary.com
597
Reproductive
ed/2897287
500
Neurology
UpToDate
303
Cardiovascul
ar
No refers
149
Microbiology
366
Gastrointesti
nal
No Reference
62
Biochemistry
U-world
621
Respiratory
/amniotic-fluid-embolismsyndrome
270
Cardiovascul
ar
https://depts.washington.edu/phy
sdx/neck/diffdx.html
419
Musculoskele
tal, Skin, and
Connective
Tissue
/carpal-tunnel-syndrome-clinicalmanifestations-and-diagnosis
currently drawn, it's in the wrong bone (temporal bone), and it's in
the wrong location (it's currently drawn postero-medial to the
foramen ovale).
Under "Facial Nerve Function" column you describe lacrimation
and salivation. I would consider adding "Lacrimal gland" to the
parenthetic inclusion of submandibular and sublingual gland to
make certain students are aware CNVII induces lacrimation
In the explanation of the JVP wave form, it says the x descent is
"absent in tricuspid regurgitation" and "prominent in tricuspid
insufficiency". These are both the same words and directly conflict
with each other. Since this is a descent, words like prominent and
absent may also be a little confusing. UpToDate uses
"attenuated" and says the descent is attenuated in severe
regurgitation
From our professor/neurosurgeon (Dr Ryan Grant) "Lat makes
you Fat" for the lateral area of the hypothalamus
SAH imaging is notable for "5-point star" pattern - bleeding into
ventriclular system (corresponds nicely with image E already on
that page)
Facial nerve lesions --> 1st column "Lower motor neuron Lesiona"
believe it is supposed to be "lower motor lesion" suggest deleting
a
BOTH Leydig cells are Sertoli cells are affected by increased
temperature [in cryptorchidism]; in unilateral cases of
cryptorchidism, the other testis is just able to compensate so
testosterone levels are not affected (as opposed to Sertoli cells
and inhibin B/FSH levels))
The chart on p496 FA 2015 shows gabapentin as a treatment for
simple/complex partial seizures. Per uptodate, uses are:
"seizures, partial onset (excluding Gralise): As adjunctive therapy
in the treatment of partial seizures with and without secondary
generalization in adults and pediatric patients 3 years and older
with epilepsy." Suggest changing explanation to partial seizures
or updating the FA table to match the question explanation.
Faculty comments: Change "impotence" to erectile dysfunction
under adverse effects (Richard Finkel)
At age 21 (CD21) you and your 19 (CD 19 B cell marker) buddies
go to the Barr (EBV) and order Burkitts (buckets) of beer. You
hope to C(see) MYC-elle (Michelle).
The text reads "aspirin metabolites decrease B-oxidation by
reversible inhibition of mitochondrial enzymes. Avoid aspirin in
children, except in those with Kawasaki disease." I would clarify
the text and include that while aspirin's action in this particular
instance is reversible, its main function of inhibition of COX-1 and
COX-2 is irreversible. This can help to limit confusion.
Ehlers Danlos syndrome caused due to deficiency of procollagen
peptidase which results in impaired cleavage of pro-collagen. So
EHS is caused due to defective cleavage of pro-collagen rather
than problems with cross linking.
First Aid 2016 states that Amniotic fluid embolism causes ARDS.
This is directly contradictory to a uWorld question and answer
explanation, as well as the current information on UpToDate.
"While the noncardiogenic edema that occurs in AFES appears to
result from widespread damage to the alveolar-capillary
membrane, it usually does not produce a clinical pattern typical of
acute respiratory distress syndrome (ARDS). Patients who
survive the first hours of AFES generally recover rapidly, whereas
the course of ARDS tends to be protracted." (see supporting
reference for link to UptoDate article)
It states that the x wave of the Jugular venous pulse is absent in
tricuspid regurgitation, but prominent in tricuspid insufficiency.
How are the two causing different effects if they are the same
disease? Or is it TI/TR concomitant with HF that causes a
prominent x wave and TI/TR alone causes its absence?
Under median (C5-T1), Tinel sign is positive for carpal tunnel
syndrome (CTS). The other very important test/physical exam
maneuver is that of a positive Phalen sign for CTS. This test has
comparable sensitivity, specificity, and LR+ for carpal tunnel
syndrome to Tinel sign. This is a high-yield clinical anatomybased concept; as it is a physical exam maneuver which elicits
pain/paresthesia in the cutaneous distribution of the median
Clarification
to current
text
Major
erratum
Mnemonic
Clarification
to current
text
Spelling/for
matting
Major
erratum
Clarification
to current
text
Clarification
to current
text
Mnemonic
Clarification
to current
text
Major
erratum
Major
erratum
Clarification
to current
text
High-yield
addition to
next year
279
Cardiovascul
ar
mnemonic
61
Biochemistry
pg. 63 of 2016 FA
287
Cardiovascul
ar
mnemonc
563
Reproductive
mnemonic
430
Musculoskele
tal, Skin, and
Connective
Tissue
/pathogenesis-of-osteoarthritis
(see first two sentences)for more
information from Nature Reviews
Rheumatology:
335
254
Endocrine
mnemonic
Pharmacolog
y
Personal mnemonic
457
Neurology
ticle/723907_2
455
Neurology
FA 2016 -Pg. 455
176
Microbiology
480
Neurology
/pharmacology-of-antimicrobialagents-for-treatment-ofmethicillin-resistantstaphylococcus-aureus-andvancomycin-resistantenterococcus?source=preview&s
earch=linezolid&language=enUS&anchor=H3&selectedTitle=7~
150#H3 as well as
/azithromycin-clarithromycin-andtelithromycin?source=machineLe
arning&search=macrolides&selec
tedTitle=1%7E150&sectionRank=
4&anchor=H2#H2
na
531
Renal
Pathoma.com
294
Cardiovascul
ar
N/A
582
Renal
334
Endocrine
http://www.ccjm.org/index.php?id
=107937&tx_ttnews[tt_news]=365
001&cHash=d05d6c78948bb0c83
08a32d54371f871
UWorld ID 599 758017
562
Reproductive
N/A
480
Neurology
452
Neurology
N/A
nerve, sparing the palmar branch (which does not travel through
the carpal tunnel).
To remember which receptors respond to PO2 changes directly:
POripheral
Type V Similar locations to Type I Type V: mutated in the
common, classical type of Ehlers-Danlos syndrome (FiveE D)
Stanford A: A = Ascending, Aperate. Stanford B: B = Back, Beta
Block.
neural Crest Cs: Cranial nerves, Color cells (melanocytes),
Chromaffin cells, Catecholamine-producing cells of adrenal
medulla, C cells of thyroid, Close Coverings (pia and arachnoid),
Cranium (bones of skull), Chewers (odontoblasts), and Cardiac
Cushions/AP septum
Formerly, osteoarthritis (OA) was considered a degenerative
wear and tear process as stated in the text. However, with
recent advances in the understanding of the pathogenesis of OA,
its classification as a degenerative joint disease makes many
rheumatologic experts bristle. OA experts and critics of the term
emphasize the importance of the inflammatory process in its
pathogenesis, highlighted by the -itis" in its name. They assert
that the process is more complex than wear and tear, as stated
in the text, and consider the term to be a misnomer.
prAMLINtide is an AMyLIN analog
Mnemonic for CYP 450 Inhibitors to consider in place of existing
one: "QRACK & Alcohol Sure Make Great INHibitors" Q =
Quinidine, R = Ritonavir, A = Amiodarone, C =
Cimetidine/Ciprofloxacin, K = Ketoconazole, Alcohol = Acute
alcohol abuse, S (Sure) = Sulfonamides, M (Make) = Macrolides
except Azithromycin, G (Great) = Grapefruit juice, INH (INHibitors)
= Isoniazid (INH)
Please note that Benzos (as well as opiates, tramodol, etc)
reduce N3 as well as REM (stage 4) sleep - which is WHY they
are useful in treating night terros/sleepwalking
1. ACE PARKs High, HUNTs ALL low 2. DOPey
SCHIZOPHRENIcs HUNT more at DEeP low PARKs 3. GrAB-A
cUCUMBEr for low ANXIETY HUNTING 4. Dont LOCk CEReal
DEeP low NOR high Above 5. SiR RAPHE PARKs DEeP low
ANXIously Mnemonic, See attachment
In the Oxazolidinones section it does not mention that Linezolid
binds to the 23S subunit, which according to UpToDate it does.
However, the Macrolides section is listed as binding to the 23S
subunit which as far as UpToDate is concerned it does not. I think
it is prudent to add the 23S rRNA binding to the mechanism of
action of Linezolid while also removing it from the Macrolide
section.
Lower motor neuron lesion. term lesion is misspelled lesiona

Under POTTER sequence mnemonic, it should say "Renal
agenesis" instead of "renal failure", since in Potter sequence
kidneys have not formed.
I'd like to suggest clarifying which arrows signify the inflammation
in the pericardium (i.e. changing [A. arrows] to [A. red arrows].
Angioedema is a side effect
Hepatotoxicity is not a side effect of the newer Thiazolidinediones

(Pioglitazone and Rosiglitazone). It was a side effect of
Troglitazone which is no longer used.
To rember that you cant SEE the heart until week 6 "Can't SEE a
SICK heart until week SIX" This is a good mnemoic to keep the
4th week and 6th week sperate (4th week it starts to beat, 6 you
can see it on transvaginal ultrasound)
"Lower motor neuron lesiona" section heading should be "Lower
motor neuron lesion"
To maintain consistency on the figure labels with "Sensation" first
and "Taste" second: "Taste and sensation via X" should be
consistent with the other labels and be "Sensation and taste via
Mnemonic
Mnemonic
Mnemonic
Mnemonic
Minor
erratum
Mnemonic
Mnemonic
Clarification
to current
text
Mnemonic
Minor
erratum
Spelling/for
matting
Minor
erratum
Spelling/for
matting
Clarification
to current
text
Minor
erratum
Mnemonic
Spelling/for
matting
Spelling/for
matting
204
Immunology
318
Endocrine
204
Immunology
132
Microbiology
406
Hematology
and
Oncology
kaplan 2016 pharm book page

261
274
Cardiovascul
ar
N/A
281
Cardiovascul
ar
/pathophysiology-and-etiology-ofedema-in-adults
478
124
Neurology
firstaidteam.com
Microbiology
ed/12904545,
ed/6363290
542
Renal
NA
350
Gastrointesti
nal
Renal
I made it up
238
Pharmacolog
y
180
Microbiology
http://www.uptodate.com.auamed
.idm.oclc.org/contents/tricyclicantidepressantpoisoning?source=search_result&
tle=1~53
ed/21835980
399
Hematology
and
Oncology
546
Rapid Review Pathology,4th

Edition Edward F. Goljan MD
page 62 , also first aid 2016
textbook page142
"The increased pigmentation
characteristic of Addisons
disease is related to increased
ACTH binding to the
melanocortin-1 receptor in the
skin, rather than the result of
increased -MSH secretion". The
textbook is: Cushing's Syndrome:
Pathophysiology, Diagnosis and
Treatment; author Bronstein. The
book is on Google Books. "This is
because ACTH is equipotent with
melanocyte-stimulating hormone
(MSH) at the G-protein linked
melanocortin-1 receptor. Thus,
ACTH stimulates melanin
production." The textbook is:
Endocrinology: An Integrated
Approach.
Rapid Review Pathology,4th
Edition Edward F. Goljan page 62
, also first aid 2016 textbook
page142
n/a
/clinical-use-of-plasmacomponents?source=machineLea
X"
type II, also IgE can participate in this type (in case of helminths)
by activation of eosinophils which release major basic protein
First Aid says on page 318 that in Addison's Disease,
"hyperpigmentation is due to increased MSH, a byproduct of
ACTH production from POMC". However, the hyperpigmentation
is directly due to ACTH (and not MSH) binding to the MC1R
receptor on melanocytes.
type II, also IgE can participate in this type (in case of helminths)
by activation of eosinophils which release major basic protein
To associate Rickettsia prowazekii with Epidemic Typhus (rather
than endemic typhus), highlight the "P" in prowazekii and
epidemic (ie. Rickettsia "P"rowazekii: E"P"idemic Typhus
skin necrosis is due to the low protein C. Because protein c has a
shot half life, there's transient hyper coagulability with warfarin
use.
The phase 0 uptick in the diagram should be in red like the other
phases. Because it's currently in black, it looks like an axis.
Sigma represents the reflection coefficient which is actually the
inverse of permeability (or rather, a measure of impermeability). 1
denotes completely permeable while 0 denotes completely
impermeable. The current text in First Aid implies that the
coefficient should be larger with permeability. Changing
"Permeability of capillary to protein" to "Impermeability of capillary
to protein" would be the easiest fix. Also - generally the reflection
coefficient in the Starling forces equation uses the sigma of the
lowercase form: rather than the sigma of the final form: .
jugular foramen = a jug of whisky IX X XI
Under the heading for mycobacteria, it is written that cord factor
"inhibits macrophage maturation and induces release of TNF-."
While cord factor does stimulate release of inflammatory
cytokines such as TNF-alpha, it activates the macrophages (not
inhibit as was written). This is done to promote the formation of
granulomas.
Move Low serum concentration to right column, and High serum
concentration to left column so that it matches the section on
Potassium shifts above it. (or vice-versa for the Potassium shift
section) As it stands, the K+ low serum concentration effects
match up with the hyperkalemia section above it.
GHI: Gastrin [H+] increases. Bold the G, the H, and the I
High-yield
addition to
next year
Major
erratum
High-yield
addition to
next year
Mnemonic
Clarification
to current
text
Clarification
to current
text
Minor
erratum
Mnemonic
Major
erratum
Spelling/for
matting
Mnemonic
Addition of the types of Rapidly Progressive Glomerulonephritis

would help to differentiate the various presentations that RPGN
has, especially in terms of IF. For example, Goodpasture
syndrome (a type III Hypersensitivity reaction) can result in Type
1 RPGN due to linear IF; Type 2 RPGN (due to Type III
hypersensitivity) results in Granular IF. Type 3 RPGN (due to
vasculitis) results in absent IF. Type 4 is a combination of Type 1
and 3. And Type 5 is ANCA-negative Pauci-immune (no IF stain)
renal vasculitis
TCAs are listed as weak bases that are trapped in acidic
environments. Where as in fact there are weak acids and are
trapped in basic environments. It is listed correctly on pg 251,
where it lists NaHCO3 as the treatment for TCAs.
High-yield
addition to
next year
mechanism of action of pyrazinamide: it inhibits trans-translation
High-yield
addition to
next year
Mnemonic
To remember what is in cryoprecipitate remember the roman

numeral V: Cryoprecipitate contains factor V III, V III + V (13), Von
Major
erratum
rning&search=Cryoprecipitate&se
lectedTitle=1~94&sectionRank=1
&anchor=H14#H14
ticle/506997_2
458
Neurology
458
Neurology
https://en.wikipedia.org/wiki/Dejeri
ne%E2%80%93Roussy_syndrom
e
461
Neurology
https://en.wikipedia.org/wiki/Asteri
xis
479
Neurology
https://en.wikipedia.org/wiki/Paras
ympathetic_nervous_system
752
Index
FA 2016
153
Microbiology
246
Pharmacolog
y
/rubella?source=machineLearning
&search=rash+rubella+viruss&sel
ectedTitle=1%7E150&sectionRan
k=1&anchor=H7#H7
N/A
63
Biochemistry
first-aid
376
Gastrointesti
nal
UW 1290
"V"V"illibran factor, and "V"ibronectin

other important pathway for dopamine is the chemoreceptor
trigger zone ( CTZ) , which stimulated by increase dopamine , and
that we can have nausea and vomiting following give high dose of
dopaminargic drugs
DejerineRoussy syndrome or thalamic pain syndrome is a
condition developed after a thalamic stroke, a stroke causing
damage to the VPL and VPM of the thalamus. Ischemic strokes
and hemorrhagic strokes can cause lesioning in the thalamus.
The lesions, usually present in one hemisphere of the brain, most
often cause an initial lack of sensation and tingling in the opposite
side of the body.
flapping tremor (Asterixis)
cranial nerves that have a parasympathatic ganglia is 10 ,9 ,7 ,3

(1973)
Werdnig-Hoffmann disease is missing from the index. Page 474
explains the spinal cord lesion area, genetic inheritance, and
symptoms of the disease.
Minor correction or Clarification: "confluent rash that starts on face
and spreads centrifugally" should be changed to "spreads
caudally" or "centripetally"
Isoproterenol stimulates both Beta 1 & Beta 2 receptors the same.
This can be remembered by highlighting the "iso" in isoproterenol
which means "same/similar".
Osteogenesis imperfecta mnemonic: Blue-eyed Baby with Broken
(or Brittle) Bones at Birth
Diphenoxylate should be added here with loperamide. It's
mentioned in the neuro pharm section, but it's primary use is for
diarrhea. Could also mention that it's combined with atropine to
discourage abuse (unpleasant anti-muscarinic side effects).
High-yield
addition to
next year
High-yield
addition to
next year
High-yield
addition to
next year
Mnemonic
High-yield
addition to
next year
Minor
erratum
Mnemonic
Mnemonic
Clarification
to current
text

2016 FA Step 1 Proposed Errata

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2016 FA Step 1 Proposed Errata & Suggestions

IMED has been replaced by the World Directory of Medical

1 question per 78 seconds should be 82 seconds

one question per 90 seconds

First Aid for Step 1, page 33

"Crush Step 1: The Ultimate

First Aid book for Step 1, page 37

Raising the cut-off point makes it close to Positive (increased

First Aid for the USMLE Step 1,

May 2016 Changes: 280 Questions. Blocks of 40 questionss. 90

Current sentence structure is unreadable... Perhaps shift

First Aid 2016, p. 49

previous page (53) states mRNA

See any recent authorative text

UWorld question ID 2025

First Aid 2016

I=Indications, N=Nature of procedure. WIPE mnemonic for

In latent error section under type of medical errors there is need

"Two steps forward one step

fadem biostats book

Rubin, Emanuel. Essentials of

The cilia structure is positively updated in 2016 version. However

Ouabin, a plant toxin inhibiting NA-K-ATPase, is derived from a

in Menkes Disease and Wilson's Disease (ATP7A and ATP7B,

I think it's easier to remember NF-1 as chromosome 17 because if

mnemonic : GF BOLD SHOW for

Its a mnemonic of own creation.

for #1 big Robbins 8e page1268.

This is just a minor errata.

abnormal elastin. 15 for chromosome 15.

Current text states that trisomy 21 due to mosaicism have no

maternal association. However, mosaic trisomy 21 is

Vitamin B3 (Niacin) synthesis requires vitamins B2 and B6. 6 / 2 =

For Ethanol metabolism the 2 enzymes used are: Alcohol

This is a popular Mnemonic

The Lovely Coenzymes For

in FA2015 positive regulators of gluconeogenesis are ATP and

As correctly mentioned in the text NAPDH is mainly the product of

ARsenic poisoning and association with gARlic odor

FA 2016 p. 92 (just a mnemonic)

One Can Consume Amino Acids

should be 6-phosphogluconolactone (which is subsequently

FA 2016, Kaplan Biochemistry

To remember that cystinuria is treated with urinary alkalization, I

Mnemonic-reference not needed

Mnemonic-reference not needed

FA 2016 pg. 100

Robbins & Cotran 9th Edition pg.

Kaplan Biochemistry 2016 page

(Glucocerebrosidase) and the accumulating substance

In starvation days 1-3, hepatic glycogenolysis is not a significant

Medical Microbiology (Jawetz),

Medical Microbiology (Jawetz),

Mycoplasma and ureaplasma are listed in the Gram Positive

In gram negative table, I think you should add "Fusobacterium" as

Pasteurella is a catalase-positive organism as well

GN bugs that use TIII secretion system: SHigella, E.coli,

First Aid 2015, First 2014, First

The algorithm seems to state that all alpha-hemolytic streptococci

Growth of Listeria monocytogenes can occur at temperature as

"Langerhans" giant cells is spelled incorrectly; the correct spelling

Mycobacteria Tuberculosis cord factor, in addition to it's

Copyright (c) UWorld, Please do

None, this is a consistency and