1/6/20, 9:28:19 PM
Compare Results
New File:
Old File:
First Aid for the USMLE Step 1 2020, Thirtieth
FA 2019.pdf
versus edition-1.pdf
44 pages (293.11 MB)
46 pages (109.99 MB)
1/5/20, 12:57:57 PM
1/5/20, 12:52:18 PM
BY u/verified-idiot
To the only girl i've ever loved, to soufia.
BLUE new in FA 2020
YELLOW text of FA 2019 was edited; the note box next to the yellow highlight will
show the difference between them the old text and the new text of FA 2020
Some pages might look scary! because of note boxes and highlighting , but it is
not, my recommendation for you is to study your book and after than look for the
new stuff and edits.. I DONT recommend comparing while you are studying since
it will consume your time.
Go to First Change (page 1)
file://NoURLProvided[1/6/20, 9:28:19 PM]
,HIGH-YIELD SYSTEMS
Cardiovascular
“As for me, except for an occasional heart attack, I feel as young as I ever ` Embryology 280
did.”
—Robert Benchley ` Anatomy 283
“Hearts will never be practical until they are made unbreakable.” ` Physiology 284
—The Wizard of Oz
` Pathology 298
“As the arteries grow hard, the heart grows soft.”
—H. L. Mencken ` Pharmacology 316
“Nobody has ever measured, not even poets, how much the heart can
hold.”
—Zelda Fitzgerald
“Only from the heart can you touch the sky.”
—Rumi
“It is not the size of the man but the size of his heart that matters.”
—Evander Holyfield
The cardiovascular system is one of the highest yield areas for the
boards and, for some students, may be the most challenging. Focusing
on understanding the mechanisms instead of memorizing the details
can make a big difference, especially for this topic. Pathophysiology of
atherosclerosis and heart failure, MOA of drugs (particular physiology
interactions) and their adverse effects, ECGs of heart blocks, the cardiac
cycle, and the Starling curve are some of the more high-yield topics.
Differentiating between systolic and diastolic dysfunction is also very
important. Heart murmurs and maneuvers that affect these murmurs
have also been high yield and may be asked in a multimedia format.
279
,280 SEC TION III C ARDIOVASCULAR ``
CARDIOVASCULAR—EMBRYOLOGY
``
CARDIOVASCULAR—EMBRYOLOGY
Heart morphogenesis First functional organ in vertebrate embryos; beats spontaneously by week 4 of development.
Cardiac looping Primary heart tube loops to establish left-right Defect in left-right Dynein (involved in L/R
polarity; begins in week 4 of development. asymmetry) can lead to Dextrocardia, as
seen in Kartagener syndrome (1° ciliary
Dyskinesia).
First aortic
arch Aortic roots Pericardium SVC Aortic arch
Bulbus Truncus Ascending aorta
cordis Primitive
arteriosus left atrium Pulmonary trunk
Sinus Left
horn atrium
Ventricle Right
Cardinal atrium
veins Atrium
Sinus
venosus
Left ventricle Ventricles
22 days 24 days 35 days 50 days
Septation of the chambers
Atria Septum primum grows toward endocardial 6. Septum primum closes against septum
cushions, narrowing foramen primum. secundum, sealing the foramen ovale soon
Foramen secundum forms in septum after birth because of LA pressure and RA
primum (foramen primum regresses). pressure.
Septum secundum develops on the right side 7. Septum secundum and septum primum fuse
of septum primum, as foramen secundum during infancy/early childhood, forming the
maintains right-to-left shunt. atrial septum.
Septum secundum expands and covers most
of foramen secundum. The residual foramen Patent foramen ovale—caused by failure of
is the foramen ovale. septum primum and septum secundum
Remaining portion of septum primum forms to fuse after birth; most are left untreated.
the one-way valve of the foramen ovale. Can lead to paradoxical emboli (venous
thromboemboli entering the systemic arterial
circulation) as can occur in ASD.
Septum Foramen Developing
primum secundum septum
secundum
Foramen
primum RA LA Dorsal Foramen
endocardial Septum Septum
primum secundum
cushion primum
Foramen
primum
Septum Foramen Degenerating
secundum secundum septum primum
Foramen Septum Foramen
ovale primum ovale
Septum (closed)
secundum
, CARDIOVASCULAR ``
CARDIOVASCULAR—EMBRYOLOGY SEC TION III 281
Heart morphogenesis (continued)
Ventricles Muscular interventricular septum forms. Ventricular septal defect—most common
Opening is called interventricular foramen. congenital cardiac anomaly, usually occurs in
Aorticopulmonary septum rotates and fuses membranous septum.
with muscular ventricular septum to form
membranous interventricular septum, closing
interventricular foramen.
Growth of endocardial cushions separates
atria from ventricles and contributes to both
atrial septation and membranous portion of
the interventricular septum.
Aorticopulmonary
septum
RA LA RA LA RA LA
Interventricular
foramen
Membranous
Atrioventricular interventricular
canals septum
Muscular
interventricular
septum
Outflow tract Neural crest and endocardial cell migrations Conotruncal abnormalities associated with
formation truncal and bulbar ridges that spiral failure of neural crest cells to migrate:
and fuse to form aorticopulmonary septum Transposition of great vessels.
ascending aorta and pulmonary trunk. Tetralogy of Fallot.
Persistent truncus arteriosus.
Valve development Aortic/pulmonary: derived from endocardial Valvular anomalies may be stenotic, regurgitant,
cushions of outflow tract. atretic (eg, tricuspid atresia), or displaced (eg,
Mitral/tricuspid: derived from fused endocardial Ebstein anomaly).
cushions of the AV canal.
Heart embryology EMBRYONIC STRUCTURE GIVES RISE TO
Truncus arteriosus Ascending aorta and pulmonary trunk
Bulbus cordis Smooth parts (outflow tract) of left and right
ventricles
Primitive ventricle Trabeculated part of left and right ventricles
Primitive atrium Trabeculated part of left and right atria
Left horn of sinus venosus Coronary sinus
Right horn of sinus venosus Smooth part of right atrium (sinus venarum)
Endocardial cushion Atrial septum, membranous interventricular
septum; AV and semilunar valves
Right common cardinal vein and right anterior Superior vena cava (SVC)
cardinal vein
Posterior, subcardinal, and supracardinal veins Inferior vena cava (IVC)
Primitive pulmonary vein Smooth part of left atrium
Compare Results
New File:
Old File:
First Aid for the USMLE Step 1 2020, Thirtieth
FA 2019.pdf
versus edition-1.pdf
44 pages (293.11 MB)
46 pages (109.99 MB)
1/5/20, 12:57:57 PM
1/5/20, 12:52:18 PM
BY u/verified-idiot
To the only girl i've ever loved, to soufia.
BLUE new in FA 2020
YELLOW text of FA 2019 was edited; the note box next to the yellow highlight will
show the difference between them the old text and the new text of FA 2020
Some pages might look scary! because of note boxes and highlighting , but it is
not, my recommendation for you is to study your book and after than look for the
new stuff and edits.. I DONT recommend comparing while you are studying since
it will consume your time.
Go to First Change (page 1)
file://NoURLProvided[1/6/20, 9:28:19 PM]
,HIGH-YIELD SYSTEMS
Cardiovascular
“As for me, except for an occasional heart attack, I feel as young as I ever ` Embryology 280
did.”
—Robert Benchley ` Anatomy 283
“Hearts will never be practical until they are made unbreakable.” ` Physiology 284
—The Wizard of Oz
` Pathology 298
“As the arteries grow hard, the heart grows soft.”
—H. L. Mencken ` Pharmacology 316
“Nobody has ever measured, not even poets, how much the heart can
hold.”
—Zelda Fitzgerald
“Only from the heart can you touch the sky.”
—Rumi
“It is not the size of the man but the size of his heart that matters.”
—Evander Holyfield
The cardiovascular system is one of the highest yield areas for the
boards and, for some students, may be the most challenging. Focusing
on understanding the mechanisms instead of memorizing the details
can make a big difference, especially for this topic. Pathophysiology of
atherosclerosis and heart failure, MOA of drugs (particular physiology
interactions) and their adverse effects, ECGs of heart blocks, the cardiac
cycle, and the Starling curve are some of the more high-yield topics.
Differentiating between systolic and diastolic dysfunction is also very
important. Heart murmurs and maneuvers that affect these murmurs
have also been high yield and may be asked in a multimedia format.
279
,280 SEC TION III C ARDIOVASCULAR ``
CARDIOVASCULAR—EMBRYOLOGY
``
CARDIOVASCULAR—EMBRYOLOGY
Heart morphogenesis First functional organ in vertebrate embryos; beats spontaneously by week 4 of development.
Cardiac looping Primary heart tube loops to establish left-right Defect in left-right Dynein (involved in L/R
polarity; begins in week 4 of development. asymmetry) can lead to Dextrocardia, as
seen in Kartagener syndrome (1° ciliary
Dyskinesia).
First aortic
arch Aortic roots Pericardium SVC Aortic arch
Bulbus Truncus Ascending aorta
cordis Primitive
arteriosus left atrium Pulmonary trunk
Sinus Left
horn atrium
Ventricle Right
Cardinal atrium
veins Atrium
Sinus
venosus
Left ventricle Ventricles
22 days 24 days 35 days 50 days
Septation of the chambers
Atria Septum primum grows toward endocardial 6. Septum primum closes against septum
cushions, narrowing foramen primum. secundum, sealing the foramen ovale soon
Foramen secundum forms in septum after birth because of LA pressure and RA
primum (foramen primum regresses). pressure.
Septum secundum develops on the right side 7. Septum secundum and septum primum fuse
of septum primum, as foramen secundum during infancy/early childhood, forming the
maintains right-to-left shunt. atrial septum.
Septum secundum expands and covers most
of foramen secundum. The residual foramen Patent foramen ovale—caused by failure of
is the foramen ovale. septum primum and septum secundum
Remaining portion of septum primum forms to fuse after birth; most are left untreated.
the one-way valve of the foramen ovale. Can lead to paradoxical emboli (venous
thromboemboli entering the systemic arterial
circulation) as can occur in ASD.
Septum Foramen Developing
primum secundum septum
secundum
Foramen
primum RA LA Dorsal Foramen
endocardial Septum Septum
primum secundum
cushion primum
Foramen
primum
Septum Foramen Degenerating
secundum secundum septum primum
Foramen Septum Foramen
ovale primum ovale
Septum (closed)
secundum
, CARDIOVASCULAR ``
CARDIOVASCULAR—EMBRYOLOGY SEC TION III 281
Heart morphogenesis (continued)
Ventricles Muscular interventricular septum forms. Ventricular septal defect—most common
Opening is called interventricular foramen. congenital cardiac anomaly, usually occurs in
Aorticopulmonary septum rotates and fuses membranous septum.
with muscular ventricular septum to form
membranous interventricular septum, closing
interventricular foramen.
Growth of endocardial cushions separates
atria from ventricles and contributes to both
atrial septation and membranous portion of
the interventricular septum.
Aorticopulmonary
septum
RA LA RA LA RA LA
Interventricular
foramen
Membranous
Atrioventricular interventricular
canals septum
Muscular
interventricular
septum
Outflow tract Neural crest and endocardial cell migrations Conotruncal abnormalities associated with
formation truncal and bulbar ridges that spiral failure of neural crest cells to migrate:
and fuse to form aorticopulmonary septum Transposition of great vessels.
ascending aorta and pulmonary trunk. Tetralogy of Fallot.
Persistent truncus arteriosus.
Valve development Aortic/pulmonary: derived from endocardial Valvular anomalies may be stenotic, regurgitant,
cushions of outflow tract. atretic (eg, tricuspid atresia), or displaced (eg,
Mitral/tricuspid: derived from fused endocardial Ebstein anomaly).
cushions of the AV canal.
Heart embryology EMBRYONIC STRUCTURE GIVES RISE TO
Truncus arteriosus Ascending aorta and pulmonary trunk
Bulbus cordis Smooth parts (outflow tract) of left and right
ventricles
Primitive ventricle Trabeculated part of left and right ventricles
Primitive atrium Trabeculated part of left and right atria
Left horn of sinus venosus Coronary sinus
Right horn of sinus venosus Smooth part of right atrium (sinus venarum)
Endocardial cushion Atrial septum, membranous interventricular
septum; AV and semilunar valves
Right common cardinal vein and right anterior Superior vena cava (SVC)
cardinal vein
Posterior, subcardinal, and supracardinal veins Inferior vena cava (IVC)
Primitive pulmonary vein Smooth part of left atrium
