2017FirstAidfortheUSMLEStep1

OfficialUpdates,Corrections,andClarifications
March31,2017

Despiteourbestefforts,errorsdooccurduringtherevisionprocess.Thislistprimarilyaddressescontenterrors
thatmaycreateconfusion.Redsignifiesspecifictexttobedeletedandgreenisspecifictexttobeadded.We
checkeverysubmissionagainstyourreference(s),authoritativereferences,andexpertfacultytomaximizeclarity
andaccuracy.Pleasenotethatourgoalistoprovideahighyieldframeworkforoptimalexampreparationand
notacomprehensivetextbook.Ifyouwerethefirstindividualtosubmitareferencedcorrectionorclarificationto
usatwww.firstaidteam.comthatappearsintheerrataorinthenextedition,youwillreceiveagiftcertificatein
thanks.Goodluckwithyourstudies!

TheFirstAid/USMLERxTeam

CATEGORIESOFUPDATES

MajorCorrections Factualerrorsthatcouldinterferewithcomprehension

MinorCorrections Lesssignificanterrorsthatmaycauseconfusion

Clarifications Thetextisaccurate,butcouldbewrittenmoreclearlyorminorformattingissues
(misalignments,indents,etc)thatmayconfuse

MAJORCORRECTIONS

Page FactName Revision

33 Nucleotides Incolumn2,replacethelines:
"Deaminationofadeninemakesguanine."
Withthefollowing:
Deaminationofadeninemakeshypoxanthine.
Deaminationofguaninemakesxanthine.
Deaminationof5methylcytosinemakesthymine.

69 Enzymeterminology Thedefinitionsforsynthase/synthetaseareinaccurate.
Thetextshouldread,"Combines2moleculesinto1(condensationreaction)
eitherusingenergyfromATPorotherhighenergyphosphates(synthetase,eg,
PRPPsynthetase)orenergyfromothersources(synthase,eg,citrate
synthase,glycogensynthase)."

109 Hypersensitivity ForTypeIV:

types 1)Incolumn3,deleteExample:Type1diabetesmellitus
2)Incolumn3,moveExamples:Contactdermatitis,Graftversushost
diseasetothetopofthecolumn,soastonotspecificallyconfinethemto
CD4+mediatedorCD8+mediated.TheyaresimplyclinicalexamplesofType
IVhypersensitivityreactions.

291 Hyperlipidemia Inthetendinousxanthomarow,imageCisatuberousxanthoma,nota

signs tendinousxanthoma.

383 Laxatives Intheemollientsrowundermechanism,replaceOsmoticdrawintolumen

waterabsorptionbystoolwith"Promotesincorporationofwaterandfatinto
stool."

515 Benzodiazepines Incolumn3ofthemechanismrow,replaceOxazepam,Temazepam,and

LorazepamaremetabolizedOutsideTheLiverwithOxazepam,Temazepam,
 andLorazepamundergofirstpassmetabolismOutsideTheLiver(ie,donot
undergoP450oxidation)."

551 Glomerularfiltration Incolumn3,replace"all3layerscontainchargedglycoproteinspreventing

barrier chargedmoleculeentry(eg,albumin)"with"all3layerscontaincharged
glycoproteinspreventing chargedmoleculeentry(eg,albumin)."

553 Filtration Incolumn3,replace"ACEinhibitorsConstrictEfferentarteriole(ACE)"with

"AngiotensinIIConstrictsEfferentarteriole(ACE)."

MINORCORRECTIONS

Page FactName Revision

60 Geneticdisordersby Inthechromosome11row,thecloseparenthesisinthecolumn3textshould
chromosome movetoread,Wilmstumor,globingenedefects(eg,sicklecelldisease,
thalassemia),MEN1.

86 Ketonebodies Inthelastsentenceofcolumn2,replaceBothprocessescauseabuildupof
acetylCoA,whichshuntsglucoseandFFAtowardtheproductionofketone
bodieswith"BothprocessescauseabuildupofacetylCoA,whichshunts
aminoacidsandFFAtowardtheproductionofketonebodies."

105 Respiratoryburst Fortheitalictextunder"(5)Glutathionereductase,"replace"requires

(oxidativeburst) selenium"with"requiresriboflavin."

106 Cellsurfaceproteins UnderTcells,delete"CXCR4/CCR5"fromthecytotoxicTcellsrow,andadd

"CXCR4/CCR5"tothehelperTcellsrow.

110 Bloodtransfusion Underpathogenesisinthefebrilenonhemolytictransfusionreactionrow,

reactions replace,"TypeIIhypersensitivityreaction.HostantibodiesagainstdonorHLA
antigensandW BCs."with"Twoknownmechanisms:1)TypeIIhypersensitivity
reactionwithhostantibodiesagainstdonorHLAantigensandW BCs2)
inducedbycytokineswhicharecreatedandaccumulateduringthestorageof
bloodproducts."

123 Anaerobes Incolumn3ofthefacultativeanaerobesrow,replace"Streptococci,

staphylococci,andentericgrambacteria."with"Streptococci,staphylococci,
andentericgrambacteria."

297 Cardiomyopathies Incolumn3oftherestrictive/infiltrativecardiomyopathyrow,replace"L

offler
syndromeendomyocardialfibrosiswithaprominenteosinophilicinfiltrate
with"Loefflerendocarditisassociatedwithhypereosinophilicsyndrome,
histologyshowseosinophilicinfiltratesinmyocardium."

312 Thyroiddevelopment Atthebottomofcolumn2,notethatparafollicular(Ccells)arederivedfrom

neuralcrest,notendoderm.Thelastsentenceofcolumn2shouldread,
Thyroidfollicularcellsarederivedfromendodermparafollicularcells(aka,C
cells,produceCalcitonin)arederivedfromneuralcrest.

324 Hyperaldosteronism Incolumn2,replace"Noedemaduetoaldosteroneescapemechanism"with

Primaryhyperaldosteronismdoesnotdirectlycauseedemadueto
aldosteroneescapemechanism.However,certain2causesof
hyperaldosteronism(eg,heartfailure)impairthealdosteroneescape
mechanism,leadingtoedema."

340 Diabetesmellitus Incolumn4ofthebiguanides(metformin)row,replace"(thusc ontraindicated

inrenalinsufficiency)"with"(thusu
sewithcautioninrenalinsufficiency)."
398 Macrocytic(MCV> Incolumn3oftheoroticaciduriarow,replace"Treatment:uridine
100fL)anemia monophosphate..."with"Treatment:uridinetriacetate..."

410 Leukemias Incolumn2oftheacutelymphoblasticleukemia/lymphomarow,replace

"AssociatedwithDownsyndrome."with"BcellALLassociatedwithDown
syndrome."

411 Chronic Incolumn2,replace"AssociatedwithV617FJAK2mutation."with"Associated

myeloproliferative withV617FJAK2mutation,withtheexceptionofCML."
disorders

418 Alkylatingagents Incolumn4ofthecyclophosphamide,ifosfamiderow,replace"o

r
Nacetylcysteine."with"oradequatehydration."

419 Microtubule Inthedrugcolumn,replace"Paclitaxel,othertaxols"with"Paclitaxel,other

inhibitors taxanes."

421 Tumorlysis Replace"Treatmentsincludeaggressivehydration,allopurinol,rasburicase."

syndrome with"Preventionandtreatmentincludeaggressivehydration,allopurinol,
rasburicase."

432 Signsoflumbosacral Inthedisclevelcolumn,replace"L5S1"with"S1S2"tocorrespondwith

radiculopathy Weaknessofplantarflexion,difficultyintoewalking,andAchillesreflex.

435 Achondroplasia Replace"Membranousossificationisaffected"with"Membranous

ossificationisnotaffected"

495 Neurocutaneous Inthetuberoussclerosisrow,replace"T

SC1/TSC2mutationonchromosome
disorders 16"with"TSC1mutationonchromosome9orTSC2mutationonchromosome
16."

498 Childhoodprimary Incolumn3oftheependymomarow,replace"Characteristicperivascular

braintumors rosettes"with"Characteristicperivascularpseudorosettes."

505 Aqueoushumor TheplacementofthePosteriorchamberlabelisactuallywheretheVitreous

pathway humorshouldbelocated.

521 Pentazocine Intheadverseeffectsrow,replace"Cancauseopioidwithdrawalsymptomsif

patientisalsotakingfullopioidantagonist"with"Cancauseopioidwithdrawal
symptomsifpatientisalsotakingfullopioidagonist."

530 Schizophrenia Incolumn3,replace"(males=females)"to"(males>females)."

533 Generalizedanxiety Intheadjustmentdisorderdefinition,replace"Ifstressorlasts>6monthsand

disorder causescontinualimpairment...withIfsymptomslast>6monthsandcause
continualimpairment..."

537 Eatingdisorders 1)IntheAnorexianervosarow,replace"pharmacotherapyincludesS SRIs"to

"pharmacotherapyincludesSSRIsforcomorbidanxietyand/ordepression.
2)IntheBulimianervosarow,revise"Treatment...antidepressants"to
"Treatment...antidepressants(ie,SSRIs)."

551 Glomerularfiltration Incolumn3,replaceSizebarrierfenestratedcapillaryepitheliumwithSize

barrier barrierfenestratedcapillaryendothelium.

567 Kidneystones Inthexrayfindingscolumnforcystine,change"Radiolucent"to"Faintly

radiopaque."

641 Mesothelioma Incolumn3,delete"Cytokeratinand"thesentencewillread,Calretininin

almostall.

CLARIFICATIONS

Page FactName Revision

51 Cloningmethods Replace"CloningistheproductionofarecombinantDNAmoleculethatisself
perpetuating"with"CloningistheproductionofarecombinantDNAmolecule
inabacterialhost."

55 Modesofinheritance Undermitochondrialinheritance,column3,replaceMELASsyndrome
(mitochondrialencephalopathy,lacticacidosis,andstrokelikeepisodes)with
MELASsyndrome(mitochondrialmyopathy,encephalopathy,lacticacidosis,
strokelikeepisodes).

117 Immunosuppressants Ontheupperrightoftheillustration,replace"Daclizumab"with"Daclizumab,

basiliximab,asbothareIL2Rinhibitorsdiscussedinthechapter.

123 Anaerobes Clarify"ExamplesincludeClostridium,Bacteroides,Fusobacterium,and

Actinomyces"with"ExamplesincludeClostridium,Bacteroides,
Fusobacterium,andActinomycesisraelii."

154 Protozoaothers UndertransmissionintheTrypanosomacruzirow,clarify"Reduviidbug

(kissingbug)"with"Triatominebugs,atypeofreduviidbug("kissingbug").

163 RNAviruses Incolumn5,undermedicalimportance,addasuperscriptatoZikavirusain

theFlavivirusesrowandtoChikungunyavirusaintheTogavirusesrow.

165 Rubellavirus Change"...fine,confluentrash..."to"...fine,maculopapularrash..."

205 Necrosis Replaceallinstancesoftheterm"malignanthypertension"withhypertensive

emergency(seepages205,290,401,562,745).

304 Calciumchannel Infirstlineoftheadverseeffectsrow,replace...c onstipation.with...

blockers constipation,gingivalhyperplasia.
Inthesecondlineoftheadverseeffectsrow,deleteg ingivalhyperplasia.

326 Pheochromocytoma Inthefindingsrow,replace"catecholaminesandm

etanephrinesinurine
andplasma."with"catecholaminesandcatecholaminemetabolites(eg,
metanephrines)inurineandplasma."

370 Polyposissyndromes Inthefamilialadenomatouspolyposisrow,replace"Autosomaldominant

mutationofAPCtumorsuppressorgeneofchromosome5q"with"Autosomal
dominantmutationofAPCtumorsuppressorgeneofchromosome5q21."

501 BrownSquard Thereisanextraneousleaderlinepointingtotherighthandintheillustration.

syndrome Thisleaderlineshouldbedisregarded.

589 Genitalembryology Intheillustration,replace"Testisdevelopmentfactor"with"Testisdetermining

factor."

599 Apgarscore ReplaceAssessmentofnewbornvitalsignsfollowinglabor..."with

Assessmentofnewbornvitalsignsfollowingdelivery..."