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Corrections and Updates

This Errata section presents corrections and/or updates to the content of MedStudy products and categorizes them by Internal Medicine or Pediatrics specialities.

Click on the appropriate title below to view the associated Errata information.

Internal Medicine Products

17th Edition Internal Medicine Review Core Curriculum

Pulmonary Medicine: Page 3-21, Diagnosis and Assessment of COPD

Current text uses:

The same two CT scans for images 3-1 and 3-2.

CT Scans Errata

 

Gastroenterology: Table 1-10, Page 1-54, Liver > Hepatitis Notes

Text in table currently reads:

Vaccinated (immune): HBsAg +; Anti-HBs IgG

Text should read:

Vaccinated (immune): HBsAg ; Anti-HBs IgG +

 

Endocrinology: Page 7-11, Diagnosis of Hypothyroidism

Text currently reads:
Routine TRH stimulation test is generally done because management is the same: Replace thyroid hormone to achieve a normal FT4 level.

Text should read:

Routine TRH stimulation test is generally not done because management is the same: Replace thyroid hormone to achieve a normal FT4 level.

 

Cardiology: Page 5-39, Internal Carotid Artery Dissection

Text currently reads:

Suspect spontaneous dissection of the internal carotid artery (cervical area) in a patient with unilateral headache along with either TIAs or a dilated pupil.

Text should read:

Suspect spontaneous dissection of the internal carotid artery (cervical area) in a patient with unilateral headache along with either TIAs or a constricted pupil.

 

Cardiology: Page 5-24, Mechanical Complications after STEMI

Text currently reads:

You may (or may not) hear a short, early systolic murmur.

Text should read:

You may (or may not) hear a murmur (early, mid, to holosystolic) at the left sternal border to base of heart, and it may radiate to the back. Intensity of this murmur does not correlate with the severity of mitral regurgitation.

Infectious Disease, page 5-56, under Diagnosis

Text currently reads: Possible infective endocarditis is diagnosed with 1 major + 3 minor criteria.
Text should read: Possible infective endocarditis is diagnosed with either 1 major criterion + 1 minor criterion OR 3 minor criteria.

Endocrinology Section, Book 4, Page 7-41, Diabetes Mellitus section, middle of second column:
Currently reads: “Like GLP-1 antagonists, DPP4Is are reserved as 1st line drugs…”
This should instead read: “Like GLP-1 agonists, DPP4Is are served as 1st line drugs…”

Nephrology Section, Book 2, Page 4-19, Renal Tubular Acidosis section:
Currently reads: “Dietary restriction of sodium or bicarbonate administration may be sufficient treatment.” This should instead read: “Dietary restriction of potassium or bicarbonate administration may be sufficient treatment.”

Cardiology Section, Book 3, Pages 5-34 and 5-35:

Information in Tables 5-10 and 5-11 should be read across the 2 tables when side-by-side. Text in Table 5-11 is incorrect in several rows when reading across both tables.

Table 5-11 has been corrected.

Click here for pdf of tables >

Answer #195
The correct answer should be: A. Dissection of the ascending aorta should be treated with aggressive medical therapy and close observation.

Add the following sentence to the beginning of the explanation: The patient has Marfan syndrome and is suffering a dissection of the aorta.

The Board Testing Point should read: Recognize the clinical characteristics of a dissection of the aorta in a patient with Marfan syndrome.

Question/Answer #255
Question and Answer/Explanation #255 in Infectious Disease topic should be moved to the Nephrology topic.
The scenario, answer choices, correct answer indication, and explanation are still valid.

Answer #271
The first paragraph in the explanation currently reads:
Alkalosis is generated when H+ is lost or bicarbonate is gained by the body or contraction of the plasma volume around a fixed amout of total body bicarbonate; i.e., loss of bicarbonate-free fluid. Less common causes of alkalosis generation are H+ shifts from the extracellular to the intracellular space. The alkalosis is then maintained by the inability of the kidneys to excrete excess bicarbonate in the urine (usually driven by aldosterone and decreased distal chloride delivery). The urinary chloride concentration is the most important lab test in the workup of metabolic acidosis. Chloride-responsive alkalosis (urine chloride < 10 mEq/L) is characterized by volume depletion; examples include vomiting, nasogastric suction, and contraction alkalsois (due to remote diuretic use).

The first paragraph in the explanation should read:
Alkalosis is generated when H+ is lost or bicarbonate is gained by the body or contraction of the plasma volume around a fixed amount of total body bicarbonate; i.e., loss of bicarbonate-free fluid. Less common causes of alkalosis generation are H+ shifts from the extracellular to the intracellular space. The alkalosis is then maintained by the inability of the kidneys to excrete excess bicarbonate in the urine (usually driven by aldosterone and decreased distal chloride delivery). The urinary chloride concentration is the most important lab test in the workup of metabolic alkalosis. Chloride-responsive alkalosis (urine chloride < 10 mEq/L) is characterized by volume depletion; examples include vomiting, nasogastric suction, and contraction alkalosis (due to remote diuretic use).

Answer #291
The explanation currently reads:
Answer: Na 136, K 5.0, Cl 102, HCO3 20, Serum Creatinine 3.5, Arterial pH 7.36, Urine pH 5.0. With a moderate glomerulonephritis, metabolic acidosis is usually mild, and the anion gap is only slightly elevated, if at all.

The explanation should read:
Answer option “Na 136, K 5.0, Cl 102, HCO3 20, Serum Creatinine 3.5, Arterial pH 7.36, Urine pH 5.0” best fits the laboratory pattern of someone recovering from acute kidney injury due to glomerulonephritis. With a moderate glomerulonephritis, metabolic acidosis is usually mild, and the anion gap is only slightly elevated, if at all. The other answer options are incorrect for the following reasons: these choices portray a more severe metabolic acidosis; hypokalemia is not typically seen in acute glomerulonephritis; the presence of significant hyperkalemia would not be expected in a patient who is in renal recovery. In addition, a high urine pH with a mild metabolic acidosis signifies a tubulointerstitial process (i.e., distal RTA), whereas acute post-infectious glomerulonephritis is primarily a glomerular disease.

Pulmonary Medicine: Card Number 458

Text currently reads:

Diagnosis is idiopathic pulmonary hemosiderosis. More often we see pulmonary-renal vasculitides present in adults. IPA is one of the rare causes of pulmonary hemorrhage that can present in young adults.

Text should read:

Diagnosis is idiopathic pulmonary hemosiderosis. More often we see pulmonary-renal vasculitides present in adults. IPH is one of the rare causes of pulmonary hemorrhage that can present in young adults.

 

Nephrology, Core Script card #371, On the Answer side

Currently reads: DX: Clinical + persistently low UOsm after water restriction; administration of ADH increases UOsm in nephrogenic DI, but does not increase UOsm in central DI.

Should read: Clinical + persistently low UOsm after water restriction; administration of ADH increases UOsm in central DI, but does not increase UOsm in nephrogenic DI.

 

Endocrinology Script Number 70:

The explanation currently reads: “Rarely, this disease can be confused with familiar hypercalcemic hypocalciuria…”
It should instead read: “Rarely, this disease can be confused with familial hypercalcemic hypocalciuria…”

Pediatrics Products

Cardiology: Page 12-26, Complete (d-) Transposition of the Great Arteries

Text currently reads:

Because the great arteries are completely transposed, the aorta is connected to the right ventricle instead of the left ventricle, and the pulmonary artery is connected to the left atrium instead of the right atrium.

Text should read:

Because the great arteries are completely transposed, the aorta is connected to the right ventricle instead of the left ventricle, and the pulmonary artery is connected to the left ventricle instead of the right ventricle.

 

Allergy & Immunology: Page 6-12, Phagocyte Disorders > Overview

Text currently reads:

  1. Neutropenia (< 1,000 PMN, severe = < 100):
    • Kostmann syndrome (AD)
    • Severe chronic neutropenia (AR)

Text should read:

  1. Neutropenia (< 1,000 PMN, severe = < 100):
    • Kostmann syndrome (AR)
    • Severe chronic neutropenia (AD)

 

Growth & Development: Page 1-1, Overview of Growth

Text currently reads:
Remember that 5% of the population have heights, weights, or head circumferences that normally lie outside of 2 standard deviations from the mean. (By definition, 2.5% are > 95th percentile, and 2.5% are < 5th percentile.)

Text should read:

Remember that 5% of the population have heights, weights, or head circumferences that normally lie outside of 2 standard deviations (SDs) from the mean. (By definition, 2.5% are > +2 SD and 2.5% are < –2 SD).

 

Cardiology: Page 12-26, Complete (d-) Transposition of the Great Arteries

Text currently reads:

Because the great arteries….and the pulmonary artery is connected to the left atrium instead of the right atrium.

Text should read:

Because the great arteries….and the pulmonary artery is connected to the left ventricle instead of the right ventricle.

 

Infectious Disease: Page 5-2, Gram-Positive Bacteria/Staphylococcus aureus

Text currently reads:

Mild: Patients with a fever, who are immunocompetent can sometimes be managed similarly to those with mild cases. Or, patients with moderate infections may require hospitalization if the area of involvement is extensive, if they have significant systemic symptoms, or if medication adherence is an issue.

Note: The D-test determines if there is macrolide-inducible clindamycin resistance. The test must be done when the S. aureus isolate is erythromycin-resistant but shows clindamycin susceptibility. If the D-test is positive, do not use clindamycin as treatment. Most microbiology laboratories perform this test routinely and report only clindamycin susceptibility based on its result.

Moderate: Previously healthy patients who have fever can be managed similarly to the mild cases. Or, they may require hospitalization and managed similar to severe cases if the area of involvement is extensive; if they have significant systemic symptoms; or if medication adherence is an issue.

Text should read:

Mild: Afebrile patients who are immunocompetent can sometimes be managed with incision and drainage alone. Often they require oral antibiotic therapy which includes trimethoprim/sulfamethoxazole, clindamycin, or doxycycline (if > 7 years old).

Note: The D-test determines if there is macrolide-inducible clindamycin resistance. The test must be done when the S. aureus isolate is erythromycin-resistant but shows clindamycin susceptibility. If the D-test is positive, do not use clindamycin as treatment. Most microbiology laboratories perform this test routinely and report only clindamycin susceptibility based on its result.

Moderate: Previously healthy patients who have fever can be managed similarly to the mild cases. Or, they may require hospitalization and managed similar to severe cases if the area of involvement is extensive; if they have significant systemic symptoms; or if medication adherence is an issue.

 

Growth & Development / Preventive Pediatrics: Page 1-19, Cholesterol and Lipid Screening

Text currently reads:

Consider pharmacologic therapy at 10 years of age in children with an LDL-C ≥ 190 mg/dL…

Text should read:

Consider pharmacologic therapy at 8 years of age in children with an LDL-C ≥ 190 mg/dL…

 

Adolescent Health and Gynecology: Page 4-27, Pelvic Inflammatory Disease

Text currently reads:

Recommended treatment:

  • Cefoxitin 2 gm IV every 6 hours, plus

Doxycycline 100 mg orally or IV every 12 hours for 14 days

Outpatient treatments for PID:

  • Other 3rd generation cephalosporins, plus
    Doxycycline 100 mg 2x/day for 14 days +/

Text should read:

Recommended treatment:

  • Cefoxitin 2 gm IV every 6 hours, plus

Doxycycline 100 mg 2x/day PO x 14 days

Outpatient treatments for PID:

  • Other 3rd generation cephalosporins, plus
    Doxycycline 100 mg 2x/day PO x 14 days +/

 

Metabolic Disorders: Page 10-6, Phenylalanine-Tyrosine Disorders, Tyrosinemia,
Hereditary Tyrosinemia Type I

Text currently reads: You can treat liver failure and Fanconi syndrome of hepatorenal tyrosinemia with 2-(nitro-4-trifuoro-methylbenzoyl)-1,3-cyclohexanedione…

Text should read: You can treat liver failure and Fanconi syndrome of hepatorenal tyrosinemia with 2-(2-nitro-4-trifluoro-methylbenzoyl)-1,3-cyclohexanedione…

 

Metabolic Disorders: Page 10-7, Sulfur-Containing Amino Acid Defects, Homocystinuria

Text currently reads: Classically, the term was used specifically to indicate disease due to a defect in the cystathionine β-synthetase enzyme.

Text should read: Classically, the term was used specifically to indicate disease due to a defect in the cystathionine β-synthase enzyme.

Infectious Disease: Card Number 568

Text currently reads:

It can be treated with macrolides, including doxycycline, erythromycin, or azithromycin.

Text should read:

It can be treated with macrolides, including erythromycin or azithromycin. Tetracyclines and fluoroquinolones are also effective.

 

Infectious Disease Flash Card #565, On the Answer side

Last bullet currently reads: Persons undergoing immunosuppressive therapy (equivalent to < 15 mg/day prednisone)
Last bullet should read: Persons undergoing immunosuppressive therapy (equivalent to > 15 mg/day prednisone)