Known Errors for the PBR Core Study Guide and Q&A Book

2022 EDITION OF THE CORE STUDY GUIDE

- ALLERGY & IMMUNOLOGY: Nasal steroids are more effective, especially for nasal congestion.

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PAGE 174 (Logged 8-6-21)
- NEONATOLOGY: Glucagon does not work on babies with low birth weight due to lack of liver stores of glycogen (not muscle stores as erroneously stated in the Core Study Guide).
PAGE 99 (Logged 7-22-21)

- ALLERGY & IMMUNOLOGY: The information in this chapter around testing for peanuts in children with eczema and other food allergies prior to the introduction of peanuts has been updated. The new version will read as follows:
  - PEARL: If there is a known, IgE-mediated food allergy, or if there is moderate to severe eczema that's considered “recalcitrant” (difficult to control with standard, or conventional, therapies), then testing for a peanut allergy (skin testing or RAST) is recommended prior to the introduction of peanuts. If positive, an oral food challenge should be done (ideally in a doctor’s office) and if there are no symptoms of a food allergy, then early introduction of peanut products between the ages of 4 and 6 months is recommended. Early introduction, rather than avoidance, has been shown to be protective against developing a true peanut allergy. If the child has mild to moderate eczema and does not have any known food allergies, peanuts may be introduced at home.

- ALLERGY & IMMUNOLOGY: We state that Type IV reactions are Delayed Hypersensitivity Reactions because that’s what Type IV reactions were typically called (like a synonym). That seems to have fallen out of favor. Any of hypersensitivity reactions that occur after 60 minutes are considered delayed. Meaning, Type II, Type III and Type IV hypersensitivity reactions are all considered delayed.

- VITAMIN AND NUTRITIONAL DISORDERS: Since we can’t seem to find a reference to why early vitamin D repletion would have normal phosphorus, and because it seems like something that is not likely to be tested because it’s such a unique scenario, we’ll be removing it from the PBR Core Study Guide. This is listed on this ERRATA page because we can't say with complete certainty that our current content is correct or incorrect.

- NEPHROLOGY: There are various types of MPGN. C3 levels can be, but are not always, low in the more common types of MPGN that you would be tested on. For the various types of MPGN, C4 levels are usually normal.

- GASTROENTEROLOGY: For the diagnosis of vascular rings, the first step would be an upper GI with barium swallow. This will help evaluate other disorders such as webs, slings, eosinophilic esophagitis, etc. That said, a firm DIAGNOSIS cannot be made with a barium swallow. So, the phrasing of the question is critical. If you are forced to choose between using CT angiography or MRA to make a firm diagnosis, we suggest that you choose CTA since it's cheaper, quicker and would not require any sedation in most cases.

- NEUROLOGY: For Tourette syndrome, starting ADHD medications (especially methylphenidate) can unmask a tic or make tics worse. If such a scenario is presented on the exam, do “something.” You may stop treatment with stimulant medications, decrease the dose or change to another stimulant in order to get the tics back to baseline!

- RHEUMATOLOGY: In the SLE section under the Lupus Nephritis PEARL/REMINDER, we are updating the text to state that PSGN and MPGN typically only have a low C3.

- INFECTIOUS DISEASES: The “(DOUBLE TAKE) LACTOSE INTOLERANCE (AKA LACTASE DEFICIENCY)” topic was noted to be duplicated on this page. The content matches the same topic on the previous page exactly.

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