2025 Edition Book Updates

Setmelanotide is now approved for those 2 years and older 

In the table, the LAGB indication should be a BMI ≥ 30 kg/m2+ ABCD or ≥ 40 kg/m2

Wellbutrin DECREASES digoxin levels, not increases it (table)

Change answer B to Tanner stage 1 --> Pre-adolescent to incorporate a larger subset of patients.

Setmelanotide is now approved for those 2 years and older. 

Also tables 49 and 93.

In the referenced appendix table, the LAGB indication should be a BMI ≥ 30 kg/m2+ ABCD or ≥ 40 kg/m2

Answer A can also be correct (it is normal development). The patient does not have precocious puberty. Updated explanation: Excessive caloric intake and precocious puberty can lead to accelerated linear growth that is proportionate to weight gain. Precocious puberty is defined as the onset of secondary sexual characteristics before age 8 in girls; therefore, breast budding at age 9 falls within the normal spectrum of pubertal development and does not meet criteria for precocious puberty.

Replace the fourth sentence of the explanatio with this: In contrast, individuals with leptin receptor gene defects also have early-onset obesity and elevated leptin levels, but they do not exhibit tall stature, possibly due to impaired downstream signaling despite high circulating leptin.  

Wellbutrin DECREASES digoxin levels, not increases it (table)

Unfortunately, a block of questions in practice test 2 did not get the referenced appendix tables updated. A list of the affected questions and the correct referenced tables is provided here.

In the table in the Bardet-Biedl syndrome blog, the inheritance pattern of Fragile X should be in the X-linked syndromes, not AR.

 A caloric deficit diet is defined as a diet utilizing 500 kcal LESS (not more) than you consume. 

In the bulleted point on GLP-1 it states this hormone is secreted by the duodenum and jejunum. It is secreted by the distal small intestine and colon (table is correct).

GIP does not have a significant effect in slowing down gastric motility. This should be corrected in the table and text (updated online).