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Pag e Se c t i o n

13

IV.E.1

31

II. B. 2.

43

Li ne

Co m m e n t

…phagocytosis is enhanced by opsonins

CORRECTION – C3b (and not C3a) is the opsonin.

(IgG and C3a)

Should read “(IgG and C3b)”

S ymptoms of skin bleeding include petechiae, pe techiae, ecchymoses ecchymoses (>3mm), purpura (>1 cm)… Aminolevulinic acid dehydrogenase (ALAD)

IV. B. 2.

converts ALA to porphobilinogen

Dat e A d d e d

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COR RE CT ION – Ecchymoses are >1cm >1cm and purpura purpura are > 3mm. S hould read “…include petechiae, purpura

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(>3mm), and ecchym ecch ymoses ose s (>1cm)”  TY PO – The enzy enzym me is is ALA ALA dehy dehydr drat atase ase (not (not dehydrogenase).

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CLAR IFICATION – More recent studie studies s show that hemolysis occurs throughout the day. Hence, the color change (hemoglobinemia) seen see n in the first void upon

49

Intravascular hem hemolysis olysis occurs oc curs episodically, epis odically,

I. B

often at night during sleep

awakening is mostly due to urine production and concentration of hemoglobin overnight (as opposed to

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hemolysis occurring mostly at night). Of note, my explanation in the text remains partly true and is an excellent way to remember the pathophysiology of this disorder. CLARIF CL ARIF ICATION ICATIO N – Nitrates do result in coronary artery vasodilation. However, a more significant effect is

74

G. 3.

Nitrates – vasodilate coronary arteries

vasodilation of veins. This results in decreased venous

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return to the heart, which in turn, decreases preload and, hence, stress on the myocardium.  Table  Table 9.5, Squam Squamous ous 96

cell carcinoma (under characteristic

Kertain pearls or intracellular bridges

 TY PO – “in “inttracel racellu lula lar” r” shoul should d read read “inter cellular” cellular”

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histology) CORRECTION – The gastroduodenal artery lies posterior

105

VI. B. 3.

May rupture leading to bleeding from the

to the duodenum. Hence, rupture of a posterior (and not

gastroduodenal artery (anterior ulcer) or

anterior) ulcer would lead to bleeding from the GDA.

acute pancreatitis (posterior ulcer)

Should read “…gastroduodenal artery (posterior ulcer) or

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acute pancreatitis (posterior ulcer).” CLARIFICATION – ‘Tram-track’ appearance can be seen 128

V. A.

 Thick  Thick glom glomerul erular ar basem basement ent membran branes es on H&E, often with ‘tram-track’ appearance

in both type I and type II MPGN. However, it is more commonly seen with type I (USMLE examiners do ask

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about this!). COR RE CT ION – T he crystals crystals in in gout exhibit exhibit negative 199

F ig ig. 18.9

G ou out. A, Tophi. B, P os ostive birefringence.

birefringence (and not, positive birefringence). birefringence). This T his is correct in the text, but needs to be corrected in the image caption.

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