Errors in First Aid for the USMLE (2007): Miscellaneous

I’m working on the Microbiology section now and it will be up shortly. In the meantime, I’m compiling all of the errors/suggestions/figures into Word documents so that you don’t have to keep clicking around here (you can all thank Jarrad for this).

Each section will be updated seperately, but for those following along, it’s a pain in the ass to recheck. Here are the most recent additions:


  1. P.204, Paraneoplastic effects of tumors:
    1. Hepatocellular CA is also capable of expressing erythropoietin as a PNP syndrome.
  2. P.218, Sympathomimetics
    1. Clonidine and a-methyldopa are centrally acting alpha-2 agonists. They are listed here as simply “alpha”.
  3. P.230, High-Yield Clinical Vignettes
    1. The sixth vignette concerning Temporal Arteritis belongs in the Musculoskeletal section as this topic is not covered in Cardiovascular.
  4. P.231, Auscultation of the heart
    1. Pulmonic Area: Pulmonic stenosis is a systolic murmur, not diastolic as listed
    2. Tricuspid Area: ASD is a soft midsystolic murmur on the upper left sternal border, not a diastolic murmur as listed (Merck, 18th, p.2407)
    3. You might as well label the Left sternal border as Erb’s Point.
  5. P.242, Eisenmenger’s syndrome
    1. “As pulmonary resistance [up arrow], RV hypertrophies, the shunt reverses…”
  6. P.243, Coarctation of the Aorta
    1. “Infantile type: …of ductus arteriosus (preductal). Rapidly fatal.”
  7. P.249, Bacterial endocarditis
    1. “(round white spots on retina surrounded by hemorrhage)” should be placed after “Roth’s spots” and not after “Osler’s nodes”.
  8. P.263, Adrenal Steroids
    1. 3B-hydroxysteroid dehydrogenase is listed as 33-hydroxysteroid dehydrogenase.
  9. P.284, Salivary secretion
    1. Serous on the Sides (Parotids)
    2. Mucous in the Middle (sublingual)
  10. P.290, Stomach cancer
    1. Virchow’s node – involvement of left supraclavicular node by mets from stomach.
  11. P.293, Colorectal cancer
    1. “’Apple core’ lesion seen on barium enema x-ray.”
    2. I think it’s worth mentioning that colonic adenocarcinoma is most commonly found in the Ascending colon.
  12. P.293, Cirrhosis and portal hypertension
    1. Because of the role that cirrhosis plays in increased levels of estrogen and the effects that these estrogen levels have, I think the following symptoms should be grouped:
      1. Hyperestrinism
        1. Spider nevi
        2. Gynecomastia
        3. Loss of Sexual hair
        4. Testicular atrophy
        5. “liver palms”
  13. P.297, Carcinoid
    1. There should be some mention that the “Classic symptoms” refer to carcinoid syndrome, and that this occurs only after metastasis of the carcinoid tumor to the liver.
  14. P.298, H2 blockers
    1. Cimetidine and Ranitidine [down arrow] CR clearance.
  15. P.298, Bismuth, sucralfate
    1. I think it’s worth mentioning that bismuth is directly toxic to H.pylori.
  16. P.300, Pro-kinetic agents
    1. Metoclopramide’s anti-emetic effects are due to central D2-antagonism while it’s peripheral pro-kinetic effects are due to its M1 agonism. I think this should be mentioned.
  17. P.315, Histocytosis X
    1. There is no mention of Birbeck granules on EM in this section, despite the fat that on P. 439, this is the classical finding for Histocytosis X.
  18. P.327, Osteopetrosis
    1. “chalk stick” fractures are characteristic of Osteopetrosis but are not mentioned here. They are instead mentioned on P.328 under Paget’s disease.
  19. P.328, Polymyositis/dermatomyositis
    1. Under dermatomyositis, I think it’s worth mentioning the Gottron papules over the knuckles and the heliotrope rash.
  20. P.332, Primary bone disorders
    1. Osteosarcoma is listed as the “Most common [primary] malignant tumor of bone.” As stated on P.312, multiple myeloma is the most common primary malignant tumor of bone. I think that “(excluding multiple myeloma)” should be added.
  21. P.335, Arachidonic acid products
    1. “Neutrophils arrive B4 others” to help remember that LTB4 is neutrophil chemoattractant.
    2. “LTC4 Contracts”
  22. P.367, Herniation Syndromes and Uncal Herniation
    1. By far, the best figures to illustrate each of these sections can be found in Fix’s High-Yield Neuroanatomy. His descriptions are confusing and would have to be changed, but please consider Fig. 2-2 and Fig. 2-3 for the next edition.
  23. P.401, Wilm’s Tumor
    1. Hemihypertrophy is seen in Beckwith-Weidman syndrome with deletion of the WT2 gene, not in Wilm’s tumor with WT1 deletion.
  24. P.401, Transitional cell carcinoma
    1. Schistosomiasis is responsible for bladder wall irritation, leading to squamous metaplasia and then squamous cell carcinoma. It is less often responsible for Transitional cell carcinoma.
  25. P.433, Pancoast tumor
    1. There is no mention that Pancoast tumors can invade the lower portion of the brachial plexus (nerves T1 and T2). I think this should be mentioned as vignettes commonly have paresthesias in these dermatomes.
  26. P.439, Classic Findings
    1. C-ANCA, P-ANCA – polyarteritis nodosa is listed. This contradicts P.333. This should be changed to “microscopic polyangiitis”.
  27. P.450, Most Common Associations
    1. H. Influenzae type B is no longer the primary cause of bacterial meningitis in kids and E.coli is not the primary cause of bacterial meningitis in newborns. The causes are in the correct order on P.165. Group B strep in newborns, S. Pneumoniae in children.
  28. High-Yield Images, Image 12
    1. Left ventricular hypertrophy typically involves an expansion of the cardiac outline on both the right and left of the mediastinum. Right ventricular hypertrophy typically expands the cardiac outline left of the mediastinum alone. This picture looks like the “boot shape” of RVH.

6 Responses to Errors in First Aid for the USMLE (2007): Miscellaneous

  1. Student says:

    Point 24.

    Schistosomiasis produce SCC 70% of the time and TCC 30% of the time.
    ~Rapid Review: Pathology, p432

  2. nice catch. my error has been corrected.

  3. candi says:

    About point 28 – did you mean 128? Image 12 is syphilis.

  4. Bryan Brindeiro says:

    According to Edware Goljan, P-ANCA is associate with Polyarteritis Nodosa.

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