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USMLEStep1 CorrectionsListSeptember17, 2002

Below is a list of errata; please make these corrections directly to your books. If you happen to find any additional corrections or haveany questions, please contact us at medfeedback@kaplan.com. Thank you.

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PharmacologylectureNotes

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In Figure I-I-I, the arrow pointing right to the "Sites of Action" circle should be a left-right arrow (H) to showthe reversibility of most drug:receptor interactions.

In the equation for Loading Dose, a superscripted "(max)" should be added to the last variable so that the result

appears as "LD = Vd x CSS(max)'~

In the last line of the fourth paragraph up from the bottom, the equation sitting at the beginning of the line ismissing its operational symbol: A slash should be inserted between the "0.7" and "k".

It should be noted in the margin (alongside Figure 1-2-2) that "regarding potency, one cannot make a generalcomparison between drugs A and B b"ecausethe answer is contingent upon the size of the response. One cancompare drugs Band C because drug B is always more potent, regardless of the size of the resp.9nse."

In Figure 1-2-4, the curved line beneath the word "competitive" should be deleted.

In Figure 1-2-6, right center within the figure, change "ER" to "SR'~

In the second row in the third column of Table II-2-1, change "negative inotropy" to "negative chronotropy".

In the third row ("Esmolol"), fifth column ("Blood Lipids"), the direction of the arrow should be reversed to pointupward (i).

In Table II-4-2, under "Mechanism of Action:' bottom row, delete "canal of Schlemm" and replace with "theuveoscleral meshwork'~

Transpose only the two words "Depolarizing" and "Nondepolarizing" under the "Cholinergic ReceptorAntagonists" heading.

In the second paragraph under the heading "Prazosin," the first instance of "decreasing" should be replaced with"increasing" so that the revised text reads: "Also used in BPH, increasing urinary flow by decreasing the tone..."

The information in the fifth table cell beneath the "Antianginal" column ("AT-l antagonists... ") should beattached to the text found in the cell to its immediate left (in the "Antihypertensive" column). Final edit shouldread: "ACEIs:captopril, etc., and AT-l antagonists: losartan, etc:'

In the last sentence of the sidebar titled "Bridge to Pathology/Genetics:' insert the word "receptors" after"ryanodine" in the last sentence.

In the third paragraph under "Selective Serotonin Reuptake Inhibitors (SSRIs):' "PMS" should be substituted with"PMDD".

Under the "Lithium" heading, remove "affective" from the first line.

Under the "Adverse Effects" heading, the wording of the third line should be altered to read as follows: " ... V2receptors (treat with thiazides or amiloride)."

In Table IV-I-II, the drug "lamotrigine" is missing under the "Anticonvulsants" category.

In the penultimate line of the page, the drug "ropinirole" is misspelled as "topinirole'~

Under the heading of "Mode of Action" beneath "Aztreonam," replace the phrase "early step in cell-wall synthesis"with "transpeptidation".

Under "Adverse Effects:' the single sentence should read: "Headache and GI distress occur; bone-marrowsuppression is reported following >2 weeks:'

Note in the margins of this page that the activity of fluoroquinolones includes Bacillus anthracis. Anthrax may alsobe treated with penicillins or tetracyclines.

Under "Mechanisms" of "Amantadine:' the sentence beneath should be revised to read: "Blocks attachment,penetration, and uncoating of influenza A virus."

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The heading "Chlorine-Sensitive Regions" should be amended to read as"Chloroquine-Sensitive Regions':

In answer choice A of Question 20, "miscoding" should be changed to "misreading".

Substitute "misreading" for "miscoding" in the answer choice to Question 20.

Under the "PGE2" heading, the text should read, after the first right arrow, "either misoprostol (PGEI analog) or

dinoprostone can be used for cervical ripening.. .."

Under the "Adverse Effects of Probenecid and Sulfmpyrazone;' the word "nephritic" in the first line should becorrected to "nephrotic".

The stem of Question 14, second line, should read: ".. .mechanism of action that leads to a decrease in the activityof tumor necrosis factor?"

In the second column, row 4, of Table VII-I-I, replace the first word after the arrow ("Activity") with "Binding".

Replace the last sentence in the legend to Figure VII-I-I (beginning with "Heparins" and ending with "Xa") withtwo new sentences, as follows: "Heparins facilitate binding of antithrombin A (A-III) to factors IIa and Xa. A-IIIacts as a 'serpin; or serine protease inhibitor:'

In the chapter summary, last paragraph, second line, exchange the phrase "inducing platelet aggregate and theformation of a fibrin plug" with "resulting in platelet aggregation and formation of a platelet plug."

Under the heading "Ketoconazole," insert "prostate" so that the text reads: "... used in androgen receptor-positive

prostate CA:'

The second sentence under "Sulfonylureas" (beginning with "Glucose acts...") should read as follows: "Glucoseacts as an insulinogen by increasing intracellular ATP -7 membrane depolarization -71 Ca influx -7 insulinrelease."

In Figure VIII-I-I, the fourth drug listed under "Go phase" is misspelled; the correct spelling is "dacarbazine".

Revise the phrase beginning with "(dexrazoxane..." under the column "Adverse Effects" in the "Doxorubicin" rowof Table VIII-I-I to appear as follows:". ..(dexrazoxane is an iron-chelating agent preventing the formation of freeradicals; it is not a free radical 'trapper');..."

In TableVIII-3-I, in first row ("AChEinhibitors") and last column ("Intervention and Antidotes"),tack on, after"atropine + pralidoxime," the parenthetical detail: "(for irreversible AChE inhibitors)':

In Table VIII-3-3 tided "Summary of Antidotes;' in the "Atropine and pralidoxime" stub column, add "(forirreversible AChE inhibitors)':

ChoiceB for Question 7 shouldbe replacedwith "Increasesbinding of A-III,a serineproteaseinhibitor".

BehavioralScienceLectureNotes

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In ALL of the Chapter Summaries. References to the Tables and Figure use roman numerals. The Tables andFigures in the text are numbered with Arabic numerals. The Chapter summaries should be changes to match thetest. For exampleon Page48:TableIII-I should be Table3-1.

Chapter summary: Negative Predictive Value should be defined as: "% of negatives that are truly non-diseased."

In the first line of text on the page, the reference to "Figure II-5" should be fixed to "Figure 2-6':

Delete the "Child, elder, and spousal abuse" and "The elderly" lines under the margin note titled "The USMLERequires You to Know".

The margin note is missing a fundamental item that should be the last bullet: "Computing and understandingthe IQ':

In the first cell of Table 9-1 ("First year of life" row, "Physical Development" column), reallocate the "Walks alone(13 mo)" bullet to the cell directly beneath ("Age 1" row).

Move the" 'No' is favorite word" bullet ("Age 1" row, "Social Development" column) into the cell directly beneath("Age 2" row).

Move entire text in the cell located in the "Age 1" row and "Language Development" column to the cell beneath("Age 2" row). In this same cell ("Age 2" row, "Language Development" column), combine the first two bullets toread as: "Great variation in timing of language development;' then move this new statement to the cell above("Age 1" row).

Lastly, add one more bulleted point: "Uses 10 words" to the "Age 1" row, "Language Development" column.

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Under "H. Facts About the Elderly and Aging;' change "22%" to "25%" as the estimate in 2030 (listed as 1.c. in theoutline).

Question #92. option A: The second line "do as the patient requests" should be removed.

Under "B. HIV-Related Dementia;' include an additional statement: "6. HIV levels in the spinal fluid are good

predictors of onset:'

In the "Drugs to Highlight" margin note, under "Atypical antipsychotics," the line should read:"(serotonin/dopamine antagonists)"; i.e., the last word is incorrect as "agonist".

The first bullet point under "5. Nefazodone" in the margin note should be expanded to read as: "S-HT2postsynaptic receptor antagonist and antagonist of presynaptic S-HT reuptake."

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MicrobiologyLectureNotes

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In column three of the table ("Important Normal Flora"), two rows up from the bottom, "Streptococcusfaecalis"

should be "Enterococcus faecalis".

In the second line of the page, "structured" should be "structural" (i.e., "Serves as a structural toxin... ").

Figure 1-2-1 should appear as follows (note changes in cytoplasmic membrane placement on left side):

glycan

Flagellar -Hook

lasmiclace

Gram-

Figure 1-2-1. Bacterial Cell Structure

In Figure 1-2-2, the largest bracket on the far right should descend further to include "Lipoprotein".

Delete "so 50% are vaccine failures" from the second and third line under "Neisseria vaccine" in the marginside note.

In Table 1-2-12, move "Osteomyelitis" from the third column, first row, into the column to its immediate right(beneath "Suppurative lesions" in the "Common Diseases" row).

Under "Distinguishing Characteristics" of "Staphylococcus aureus;' delete "PYR test +" from the second bullet.

In Table 1-2-14, delete "(A disk)" and "(P disk)" from the first two rows of the third column.

In the same cell that "(P disk)" should be deleted from, capitalize the "c" in "cAMP".

In Table 1-2-16, in the "Rheumatic fever" row, last column, change "nodosum" to "marginatum':

There are three instances on the page where "cAMP" should begin with a capital letter.

The margin note ("In a Nutshell") is discussing "E. faecalis;' not "S. faecalis."

In the third bullet beneath "Distinguishing Characteristics;' change "from beginning of" to "from the middle of".

Near the end of the margin note on this same page, the penultimate line should be a separate item, appearing as"- Pertactin (OMP)".

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In the explanation to Question 14, the word "Atopy" should be "Anergy" in the fourth line down.

The label "Repeating Monomers" in Figure II-9-4 is incorrect; it should be "Repeating Epitopes':

Insert "variable region" before "beta chain of TCR" in answer choice A of Question 3.

Remove "(and B cells)" from the end of Question 10.

The explanation for Question 2 should read as follows (changes in bold):

A thymus-independent antibody response is one where the B cells respond to large molecular-weight carbohydrate molecules with a large number of repeating epitopes. The antibody formed isonly IgM, and there is no memory cells produced in these responses.

In the first line of the third paragraph within the Chapter Summary, "Th2" should be changed as "Th1" to rea(!:"...when activated by Th1-cell-generated cytokines."

Insert the word "by" in between "formation" and "perforin" in answer choice C for Question 4.

Replace the last sentence of the Question I explanation with the following: "It kills intracellularly with granuleenzymes, oxygen or halide radicals, or extracellularly with cytokines (TNF-a)."

Revise the second line of text (changes in bold): ". ..RhoGAMTM,a preparation of human anti-RhD IgD antib

l

dY

at 28 'reeks of gestation and anti-RhD IgG antibody again within 24 hours after birth."In the penultimate paragraph on the page, second line, "thrombocytic" should be "thrombocytopenic," Le.,"thrombocytopenic purpura':

In th~ last paragraph of this samepage,"pneumonia"in the fifthline should be "pneumonitis". In the penulti . ateline of this same paragraph, it should read as "hepatitis B."I

In the first Clinical Correlate, delete "Opsonization not efficient (leukocyte adhesion deficiency) from the lastbulleti..point, and replace with "systemic lupus erythematosus."

The s~cond word of the second paragraph of the Chapter Summary should be "systemic," not "systematic".I

At the, end of the second line of the third paragraph, "thrombocytic" should be corrected to "thrombocytopeni ':

ComBine the first two sentences of the explanation of Question 1 to read as follows: "This disease is characteril edby an;tenlarged thyroid gland, lymphocyte and plasma cell infiltrates, and hypothyroidism."

In thelsecond line of the first paragraph, insert the word "identical" between "find" and "haplotypes".

Remove the last sentence from the explanation for Question 3, beginning with "These grafts..." and addthe fohowing detailed explanation:I

In reality, even transplants between monozygotic (identical) twins must be followed byimmunosuppressivetherapies because somatic mutations create minor differences,whichultimately may be rejected. The amount of immunosuppression required, however,is minimal. Theonly type of transplant that requires no immunosuppression is an autograft.I

The first word of the last line in the figure legend should be "antibodies;' not "antisera".'II

PhysiologyLecturbNotesI

Pg.414 Remoye the last sentence ("It accelerates the metabolism of glucose to CO2 and H2O") under the heading"Summary ofInsulin's Effects on Carbohydrate (CHO), Lipid, and Protein Metabolism."

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AnatomyLecture~otesPg.275 In thdnargin note alongside Figure III-6-1, one cranial nerve is misnumbered, and another is missing. The firs

two sentences should read as follows (changes in bold): "Jugular foramen syndrome may be caused by a tumorpressing on CN IX, X, and XI. Patients present with hoarseness, dysphagia (CN IX and X). . .."I

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BiochemistryVideoCorrections:BK22071,BK22081,andBK23621Please note the revisions made to the 2002 Biochemistry Lecture Notes prior to watching these videos.

Figure 6-1 was of minor importance and has been deleted. The remainder of the information in Chapter 6 has been somewhatreorganized to make the presentation more logical.

. The first sections (pages 81 to 84) describe doning DNA restriction fragments and the applications of this procedure.

. The next sections (pages 84 to 88) describe doning cDNA and the important applications of this procedure. This materiainterfaces with pages 349 to 352 (Gene Cloning) in the Medical Genetics notes.

Old Notes

Fig. 6-1

Fig. 6-2

Fig. 6-3

Fig. 6-4

Fig. 6-5}Fig. 6-6

Fig. 6-7

Fig. 6-8

Fig. 6-9

Fig. 6-10

New Notes

Deleted; refer to note on page 81

Fig. 6-1

Fig. 6-2

Margin note on page 84 (Restriction Maps)

Combined into Fig. 6-3

Fig. 6-5

Fig. 6-4

Fig. 6-6

Fig. 6-7

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