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Pathoma error with Reid Index and Uworld.

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Jonari

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My subscription to Pathoma ended, so I can't check to see if this was corrected or not. Dr. Sattar, mentions the Reid Index and it's use with chronic bronchitis. On page 89 at the bottom bullet point "1" it states "leads to increased thickness of mucus glands relative to overall bronchial wall." He mentioned this a few more times, and even said it again in the picture.

Unfortunately, there was a UWorld question which showed the bronchial wall asking how to calculate RI. I picked the option of submucosa divided by the entire wall. However, the correct answer is submucosa divided by entire wall, excluding the cartilage.

It's Q. Id: 525, if it helps. I really don't want to get another subscription to Pathoma just to see the errata list.
 

withrye

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The FA2012 errata just says total thickness of the bronchial wall, which is how Dr. Sattar mentions it in the video. You can KINDA make the case that he doesn't mean the wall including cartilage, because in the video he draws two thickness lines and the one he draws with "wall thickness" doesn't include the cartilage in its depth.

But at the end of the day you're right, both sources should specify that cartilage is not included in the concept of "bronchial wall."
 

Jonari

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The FA2012 errata just says total thickness of the bronchial wall, which is how Dr. Sattar mentions it in the video. You can KINDA make the case that he doesn't mean the wall including cartilage, because in the video he draws two thickness lines and the one he draws with "wall thickness" doesn't include the cartilage in its depth.

But at the end of the day you're right, both sources should specify that cartilage is not included in the concept of "bronchial wall."

2012 errata says gland layer/wall thickness.

C33fAba.png


However, 55% of the population answered it correctly, and 16% of the population chose the answer which I did. I guess, I read into it too much.

Edit: Seriously though, is this kind of of a common sense thing, or am I just being too detailed about it?
 

withrye

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I personally assumed that cartilage was exempt, but that doesn't mean it was a smart assumption to make, just a lucky one.
 

wanderer

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Thanks! According to that, it seems the epithelial cells shouldn't be included either, so I think Uworld was technically incorrect (though the magnitude of error of such a calculation would be pretty small).
 

sanj238

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in case anyone else was wondering
ReidIndex.JPG

http://www.pathology-india.com/ReidIndex_image.htm
Seem like wikipedia agrees too
View attachment 177933
Makes sense given that the thickness of the epithelium and cartilage are basically fixed. Pathoma is misleading in this small point.
My subscription to Pathoma ended, so I can't check to see if this was corrected or not. Dr. Sattar, mentions the Reid Index and it's use with chronic bronchitis. On page 89 at the bottom bullet point "1" it states "leads to increased thickness of mucus glands relative to overall bronchial wall." He mentioned this a few more times, and even said it again in the picture.

Unfortunately, there was a UWorld question which showed the bronchial wall asking how to calculate RI. I picked the option of submucosa divided by the entire wall. However, the correct answer is submucosa divided by entire wall, excluding the cartilage.

It's Q. Id: 525, if it helps. I really don't want to get another subscription to Pathoma just to see the errata list.

In my notes I have that cartilage is excluded. I think this was either from sattar or from FC. I definitely think he may have mentioned it because I was very careful about that fact.
 

alicealicealice

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Agreed. Though I haven't gotten to that U world q yet mentioned in the OP (might have been changed in the interim regardless), it seems that given the option the truly correct answer would be to exclude the epithelium as well, making the denominator the length from the BM to the perichondrium (making the Uworl q as the OP described incorrect). This is extremely nitpicky and not clinically relevant, but it would be frustrating to get something wrong on such a simple topic.

Also you may have gotten that from FC just because I was just listening to pathoma and got confused, which is why I googled and wound up bumping this thread.
 

sanj238

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Agreed. Though I haven't gotten to that U world q yet mentioned in the OP (might have been changed in the interim regardless), it seems that given the option the truly correct answer would be to exclude the epithelium as well, making the denominator the length from the BM to the perichondrium (making the Uworl q as the OP described incorrect). This is extremely nitpicky and not clinically relevant, but it would be frustrating to get something wrong on such a simple topic.

Also you may have gotten that from FC just because I was just listening to pathoma and got confused, which is why I googled and wound up bumping this thread.
this is for vet school...
 
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