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CONTENT CORRECTIONS & UPDATES—DECEMBER 201918th Edition Internal Medicine CoreEndocrinology:Page 1-6, Anterior Pituitary Gland Pituitary Tumors Other Pituitary TumorsText currently reads:Recall that they are the most common typeof no functioning adenomas, usuallymacroadenomas. Gonadotroph tumors canpresent variably:Text should read:Recall that they are the most common typeof nonfunctioning adenomas, usuallymacroadenomas. Gonadotroph tumors canpresent variably:Endocrinology:Page 1-37, Diabetes Mellitus Treatment of T2DM Dipeptidyl-Peptidase 4 Inhibitors (DPP4Is)Text currently reads:Like GLP-1 antagonists, DPP4Is are reserved forpatients who are intolerant or cannot takemetformin, sulfonylureas, or TZDs.Text should read:Like GLP-1 agonists, DPP4Is are reserved forpatients who are intolerant or cannot takemetformin, sulfonylureas, or TZDs.Endocrinology:Page 1-47, Hypercalcemia of MalignancyText currently reads:The elevated Ca2 inhibits production of PTHby the parathyroid glands, so PTH levels are.Text should read:The elevated Ca2 inhibits production of PTHby the parathyroid glands, so PTH levels aresuppressed.Dermatology:Page 3-16, Skin Infections Bacterial Skin and Soft Tissue Infections FolliculitisText currently reads:Folliculitis (inflammation of follicles) andfuruncles (deep folliculitis or “boils”) are typicallycaused by S. aureus. Treatment includes oral orparenteral antibodies and moist heat; considersurgical drainage of fluctuant lesions.Text should read:Folliculitis (inflammation of follicles) andfuruncles (deep folliculitis or “boils”) are typicallycaused by S. aureus. Treatment includes oral orparenteral antibiotics and moist heat; considersurgical drainage of fluctuant lesions.Dermatology:Page 3-29, Pigment Changes HyperpigmentationText currently reads:Diffuse hyperpigmentation may occur inprimary biliary sclerosis, scleroderma, Addisondisease, and hemochromatosis (patients havea grayish/bronze coloration) and with the use ofthe cancer drug busulfan.Text should read:Diffuse hyperpigmentation may occur inprimary biliary cirrhosis, scleroderma, Addisondisease, and hemochromatosis (patients havea grayish/bronze coloration) and with the use ofthe cancer drug busulfan.

CONTENT CORRECTIONS & UPDATES—DECEMBER 2019Infectious Disease:Page 4-12, Gastrointestinal Infections Diarrhea Due To Chlostridium Difficile TreatmentText currently reads:Treat nonsevere disease (WBC count 15,000 cells/ μL [15 109/L] or a serumcreatine 1.5 mg/dL [132.6 μmol/L]) withPO vancomycin (VANC) or PO fidaxomicin (FDX).Text should read:Treat nonsevere disease (WBC count 15,000 cells/ μL [15 109/L] and a serumcreatine 1.5 mg/dL [132.6 μmol/L]) withPO vancomycin (VANC) or PO fidaxomicin (FDX).Infectious Disease:Page 4-13, Liver and Biliary Infections PeritonitisText currently reads:It is critical to differentiate SBP from secondarybacterial peritonitis because: mortality is 80% for patients with SBP whoundergo an exploratory laparotomy, and mortality is 100% for patients with SBP whodo not go to surgery!Text should read:It is critical to differentiate SBP from secondarybacterial peritonitis because: mortality is 80% for patients with SBP whoundergo an exploratory laparotomy, and mortality is 100% for patients with secondarybacterial peritonitis who do not go to surgery!Infectious Disease:Page 4-63, Viruses Varicella-Zoster Virus Herpes Zoster (Shingles) Vaccination for Herpes ZosterText currently reads:The most recent zoster vaccine, called Shingrix,was approved by the FDA in October 2017.In those 50–69 years of age, Shingrix has aneffectiveness of 97% and 91% in preventingherpes zoster and PNH, respectively.Text should read:The most recent zoster vaccine, calledrecombinant zoster vaccine (RZV; Shingrix),was approved by the FDA in October 2017.In those 50–69 years of age, recombinant zostervaccine (RZV; Shingrix) has an effectiveness of97% and 91% in preventing herpes zoster andPNH, respectively.Infectious Disease:Page 4-71, Bacterial Agents Beta-Lactam Antibiotics Cephalosporins 3rd Generation CephalosporinsText currently reads:Cefpodoxime is the only oral 3rd generationcephalosporin.Text should read:Cefdinir (Omnicef), cefditoren (Spectracef),cefixime (Suprax), cefpodoxime-proxetil(Vantin), and ceftibuten (Cedax) are3rd generation cephalosporins.

CONTENT CORRECTIONS & UPDATES—DECEMBER 2019Pulmonary Medicine:Page 6-8, Respiratory Physiology HypoxemiaText currently reads:5) High altitude (low FiO2) results in a reducedPAO2. The A-a gradient is normal unless lungdisease is present.Text should read:5) High altitude decreases atmospheric pressureand results in a reduced PAO2. The A-a gradient isnormal unless lung disease is present.Page 6-3, Pulmonary Hypertension Pulmonary Function Tests Lung Volumes, Table 6-2Text currently oracicObstructive Table 6-2: Typical PFTsTLCFEV1FEV1/FVC or ( 80%)Nlnormal or ( 80%)NlnormalNl to ( 70%)RVDLCO Nl Nl to RVDLCO Nl Nl to Text should racicObstructive Table 6-2: Typical PFTsTLCFEV1FEV1/FVC or ( 80%)Nlnormal or ( 80%)NlnormalNl to ( 70%)Page 6-46, Pulmonary Hypertension Treatment of PH Exercise, Anticoagulants, Diuretics, andOxygenText currently reads:Give anticoagulants for Group 1 onIV prostaglandins, according to the ACCF/AHA2009 Expert Consensus Document on PulmonaryHypertension.Text should read:Give anticoagulants for Group 4 PH, according tothe ACCF/AHA 2009 Expert Consensus Documenton Pulmonary Hypertension.

CONTENT CORRECTIONS & UPDATES—DECEMBER 2019Nephrology & Urology:Page 7-57, Potassium Disorders Hyperaldosteronism Bartter and Gitelman SyndromesText currently reads:Characteristics of Bartter’s and Gitelman’s aresummarized in Table 7-12. The easiest way todistinguish Bartter’s from Gitelman’s: patientswith Bartter’s have hypercalciuria,and patients with have hypocalciuria.Text should read:Characteristics of Bartter’s and Gitelman’s aresummarized in Table 7-12. The easiest way todistinguish Bartter’s from Gitelman’s: patientswith Bartter’s have hypercalciuria,and patients with Gitelman’s have hypocalciuria.Hematology:Page 8-5, Anemia Working Up Anemia The Anemia Workup Figure 8-9Text currently reads:Low iron and ferritin with low TIBCText should read:Low iron and high–normal ferritin with low TIBCOncology:Page 9-28, Cancer Therapies Use of Growth FactorsText currently reads:Erythropoietin is indicated for the treatmentof the following: Chemotherapy-induced anemiawith Hb 10 g/dL.Remember that there is a risk of thrombosis,especially if hemoglobin is 12 g/dL. Anemia of chronic kidney diseasewith Hb 10 g/dL. Anemia in HIV patients taking zidovudine (AZT)Text should read:Erythropoietin is indicated for the treatmentof the following: Chemotherapy-induced anemiawith Hb 10 g/dL.Remember that there is a risk of thrombosis,especially if hemoglobin is 12 g/dL. Anemia of chronic kidney diseasewith Hb 10 g/dL. Anemia in HIV patients taking zidovudine (ZDV)

CONTENT CORRECTIONS & UPDATES—DECEMBER 2019Rheumatology:Page 10-21, Systemic Lupus Erythematosus Drug-Induced LupusText currently reads:Drugs with the highest risk for drug-inducedlupus (DIL) are procainamide, hydralazine, andpenicillamine. Other drugs that have been linkedwith DIL are chlorpromazine, propylthiouracil,hydralazine, isoniazid, phenytoin, TNF inhibitors,minocycline, selective serotonin reuptakeinhibitors, proton pump inhibitors, and thiazidediuretics.Text should read:Drugs with the highest risk for drug-inducedlupus (DIL) are procainamide, hydralazine, andpenicillamine. Other drugs that have been linkedwith DIL are chlorpromazine, propylthiouracil,isoniazid, phenytoin, TNF inhibitors, minocycline,selective serotonin reuptake inhibitors, protonpump inhibitors, and thiazide diuretics.Rheumatology:Page 10-38, Less Common Arthropathies Adult-Onset Still DiseaseText currently reads:AOSD presents with a distinctive evanescent(6fleeting or vanishing), macular, salmon-pinkrash that coincides with a daily (quotidian)high-spiking fever and significant leukocytosis(Yamaguchi criteria).Text should read:AOSD presents with a distinctive evanescent(fleeting or vanishing), macular, salmon-pinkrash that coincides with a daily (quotidian)high-spiking fever and significant leukocytosis(Yamaguchi criteria).Rheumatology:Page 10-62, Office Orthopedics Monoarticular Joint Disorders Wrist De Quervain TenosynovitisText currently shows this figure:Text should show this figure:

CONTENT CORRECTIONS & UPDATES—DECEMBER 2019Rheumatology:Page 10-62, Office Orthopedics Monoarticular Joint Disorders Wrist De Quervain TenosynovitisText currently reads:Although there are several bedside tests usedfor diagnosis, the hallmark test is known asthe Finkelstein test (forced ulnar motion of thewrist with the thumb adducted and clasped bythe patient’s other fingers), which reproducesthe pain.Text should read:Although there are several bedside tests usedfor diagnosis, the hallmark test has come to becalled the Finkelstein test (forced ulnar motionof the wrist with the thumb adducted andclasped by the patient’s other fingers), whichreproduces the pain.Women’s and Men’s Health:Page 11-6, Obstetrics Cardiology Disorders in Pregnancy Cardiac IssuesText currently reads:Hypertensive cardiomyopathy (HCM) amongasymptomatic women is not a contraindicationfor pregnancy.Text should read:Hypertrophic cardiomyopathy (HCM) amongasymptomatic women is not a contraindicationfor pregnancy.Women’s and Men’s Health:Page 11-10, Obstetrics Endocrinology Disorders in Pregnancy Thyroid Disease HyperthyroidismText currently reads:This is normal physiology of pregnancy in whichhuman chorionic gonadotropin (hCG) stimulatesthyroid stimulating hormone () receptors,resulting in a mild elevation in T3/T4 andsuppression of TSH.Text should read:This is normal physiology of pregnancy in whichhuman chorionic gonadotropin (hCG) stimulatesthyroid-stimulating hormone (TSH) receptors,resulting in a mild elevation in T3/T4 andsuppression of TSH.Women’s and Men’s Health:Page 11-24, Erectile Disfunction Treatment OptionsText currently reads:Relative contraindications are heart failure,hypotension, unstable angina, hypertensivecardiomyopathy (HCM), and severe aorticstenosis.Text should read:Relative contraindications are heart failure,hypotension, unstable angina, hypertrophiccardiomyopathy (HCM), and severe aorticstenosis.

CONTENT CORRECTIONS & UPDATES—DECEMBER 2019Neurology: Page 12-8, Seizures Seizure Management Chronic Treatment of Seizures Table 12-2 “Notable Advantages and Disadvantages of Antiepileptic Drugs”Text currently reads:LamotrigineFocal (adjunctive use)GeneralizedText should read:Good: wide spectrum,good efficacy, welltolerated in elderlypatientsBad: can cause severe rashand SJS with rapidtitration; reduces efficacyof OCPsLamotrigineFocal (adjunctive use)GeneralizedGood: wide spectrum,good efficacy, welltolerated in elderlypatientsBad: can cause severe rashand SJS with rapidtitration; OCPs decreaseserum concentrationof lamotrigineCardiology:Page 13-1, Physical Exam PulsesText currently reads:While deflating the cuff very slowly, note thesystolic blood pressure where the 1st Korotkoffsound is heard only during inspiration.Text should read:While deflating the cuff very slowly, note thesystolic blood pressure where the 1st Korotkoffsound is heard only during expiration.Cardiology:Page 13-11, Cardiac MedicationsText currently reads: A negative inotrope is a medication thatdecreases cardiac contractility. A negative chromotrope is a medication thatslows heart rate.Text should read: A negative inotrope is a medication thatdecreases cardiac contractility. A negative chronotrope is a medication thatslows heart rate.