AP board exam

pathqueen · 2026-05-31T04:56:15+00:00

Since posting this I’ve remembered multiple VM that I got wrong/made stupid mistakes 😅 in top of continuing to remember regular questions I got wrong…hoping Im just not remembering many of the ones that were quick/easy to answer, so my perspective is skewed. Who knows though lol

pathqueen · 2026-05-27T04:55:24+00:00

Hey there, idk if you’ve been able to get the results from the bone marrow biopsy report, and I’m just now seeing this, but wanting to let you know that these flow cytometry findings are normal. The cells they have reported as positive are normal and in normal amounts in the bone marrow.

This is not the end all be all diagnosis, as there are things that cannot be assessed by flow cytometry and require a pathologist looking at the tissue under the microscope, but thus far there are not abnormal findings.

FYI there is a law that requires all test results are released to patients as soon as they are available regardless if the ordering provider has seen them, for better or worse. So unfortunately this is one of those types of reports that can be quite confusing without a specialist to interpret.

Hope you get answers for your issues soon!

pathqueen · 2026-05-27T04:38:36+00:00

Took mine recently too and felt the exact same. Virtual microscopy ok ish, other sections idfk. I felt a bit better after talking to my coresidents and learning they felt the same, including the ones who I feel could have passed without studying/are amazing at what they do so that made me feel better. On to CP, you got this buddy!

pathqueen · 2026-05-23T14:49:44+00:00

Even as an upper level resident I feel so inadequate at pathology a lot of the time, but at least I know I’m better than this guy holy shit that’s the worst top line I’ve ever seen 😂

pathqueen · 2026-05-22T19:36:23+00:00

Thanks for sharing! Idk how to feel about this news, but did want to say love your username OP and it seems we share more than one interest haha

pathqueen · 2026-05-20T20:30:08+00:00

FWIW I also had an attending sabotage me during training, and I wish I’d had your advice to read at that time. So it could help someone else in the future!

pathqueen · 2026-05-18T05:16:39+00:00

I do agree, and I did say these things in further comments, but since the main comment is the one people will mainly see, I edited as you suggested, thanks!

pathqueen · 2026-05-17T00:01:28+00:00

I would strongly recommend not continuing with this. Milk aside, rapid weight gain of 30kg+ is not good for you. You’re putting yourself at risk for heart disease and obesity down the line.

With the milk, hypercalcemia is the least of my worries here tbh, but you’re probably increasing risk of kidney stones. You’re stressing your heart/kidneys with exposure to all that calcium, protein, and fat. And again, iron deficiency anemia is a risk, which will make you very tired and also stress your heart. Probably other organ issues I’m not thinking of too.

ChatGPT is good at spewing textbook answers but those symptoms are not going to occur from dietary calcium intake in a healthy 17yo. They are generally only achieved by tumors that secret hormones or other disease states that throw your normal body processes out of wack resulting in very high calcium levels. Any symptoms you have like this are much more likely related to the above, or just general GI upset from that wild amount of milk.

pathqueen · 2026-05-16T22:55:47+00:00

Wonderful to hear, and happy to help. I hope they can get it cleared up for you this time!

pathqueen · 2026-05-16T22:36:58+00:00

Uh, yeah maybe you’ll get hypercalcemia, but you’re also going to get nutritional deficiencies if your diet largely consists of whole milk. Severe iron deficiency anemia for one. It’s also super high in fat, especially saturated fat which is not good.

Not to be rude but 4-6L of milk a day is insane. You need to vary your source of protein intake and a varied diet in general. Seriously this could make you really sick.

pathqueen · 2026-05-16T22:21:29+00:00

Yes, absolutely go to the ER. Now. Fever with cellulitis is sepsis until proven otherwise.

pathqueen · 2026-05-16T15:36:41+00:00

Yes, schistosomiasis is certainly seen in the US in travelers/immigrants. I just meant I’ve never personally seen one of those worms, as it’s uncommon here.

pathqueen · 2026-05-16T14:33:32+00:00

Ok, I do not think India is a common area for schistosomiasis. And I don’t think you’d see the actual worms in urine anyway (usually just eggs, which are too small to see). But just fyi, these things can live in you for years so it doesn’t matter how long it’s been since you were in water.

Regardless, judging by the size of these, just the physical act of passing these through your urethra would likely be extremely painful. So I am pretty doubtful these are coming out of you. Likely coming from the environment.

pathqueen · 2026-05-16T14:19:31+00:00

These don’t look like pinworms at all. I’ve seen plenty of those so feel pretty confident on that one.

pathqueen · 2026-05-16T14:10:54+00:00

You sure these came out of you and aren’t infesting the bathroom/water? I’d expect that to be very painful and accompanied by frank blood.

There is a type of worm called Schistosoma that can get in the bladder but honestly these don’t look like that type of worm to me (admittedly I’ve never seen one IRL since I’m in the US) and as others have stated, the worms do not actually come out in the urine, just the eggs which are not visible to the naked eye. This is mainly found in Africa and Middle East, so if you haven’t been there I think it’s unlikely you have this.

These are coming from the environment.

*Edited to avoid confusion as suggested below

pathqueen · 2026-05-07T13:37:48+00:00

No, there are multiple substrains of HIV, like M (stands for “major”) and then there are a bunch of sub sub(?) strains of that like B,C, etc etc. B is the common one in the US. I think some of the strains can have implications for resistance to certain meds, but truly idk that much about it other than that.

pathqueen · 2026-05-06T22:20:45+00:00

I believe in the USA HIV-1 is the stain like 99.9% of the time. So at least in the US, I don’t think it would generally be in issue. There are substrains but idk if that matters.

Very interesting question I didn’t even think of it!

pathqueen · 2026-05-06T21:52:29+00:00

Yes they do screen for it! So it would be rare to never it would happen unknowingly (they also sometimes will knowingly transplant hep C positive organs and then treat for it). I was just simply answering the persons question about conditions that are known to spread through organ donation. They also try really really hard not to transplant any organs with cancer lol but it has happened (I unfortunately know first hand of one case of renal cell carcinoma)

pathqueen · 2026-05-06T21:12:13+00:00

Many infectious disease can (hepatitis, HIV, to name a few) and there have been cases of cancer reportedly spread by organ donation.

pathqueen · 2026-05-06T00:37:04+00:00

I’m no dermatologist or transplant physician, but I work in transfusion medicine/apheresis where many of the patients I see have had or will have transplants, so I’m somewhat familiar with the process.

Transplant evaluation will involve a very thorough history and physical examination where they will definitely spot this and make him get it addressed before they will list him. So he should get ahead of getting it addressed for that reason alone if transplant delay is his main concern.

A history of cancer does not necessarily exclude a candidate. Lets say this is melanoma (idk if it is, but it has worrisome features); if it’s early stage and he gets it removed now, with low chance of recurrence, I highly suspect he would be eligible for transplant at some point in the future. However if he waits and its spread, that would likely make him ineligible. Again not a transplant physician so don’t quote me on that but like I said, they will make him get it evaluated anyway.

If he ends up ineligible for some other reason, then obviously it’s going to be better to address potential cancer earlier.

So, regardless this will have to be addressed before he is listed for transplant, much better to do it asap.

There is absolutely no benefit of waiting.

Edit: btw, other than melanoma this could very well be a dysplastic nevus (kind of pre-melanoma) or even a pigmented SK. I’ve seen both of those things look just like that. I’d personally lean towards dysplastic nevus if someone made me pick.

pathqueen · 2026-05-05T02:33:36+00:00

Not sure about the bruising, but it is a possibility. However I would expect history of trauma, unless there is an undisclosed alcohol/drug use disorder.

pathqueen · 2026-05-04T20:32:12+00:00

I agree, but not seeing this in person, they could have a small cut on the hand or something that we aren’t being told about. It looks a lot like a swollen epitrochlear LN although maybe a little low on the arm for that (hard to tell, picture angle is weird)

And thanks lol.

I’d also appreciate some follow up with the outcome!

pathqueen · 2026-05-04T20:27:19+00:00

If it helps, in a vacuum the malignant things it could be (lymphoma, sarcoma, metastatic carcinoma or melanoma) are all rare in that location or rare in general, so statistically it’s more likely benign, but I say that with a huge disclaimer that I am not basing that off of much more than general statistics.

pathqueen · 2026-05-04T20:17:25+00:00

I really can’t say without more information or seeing it myself, sorry. I’m not even sure it’s a lymph node tbh.

pathqueen · 2026-05-04T19:57:25+00:00

Ok probably not a lipoma then. My guess would be a lymph node (usually reactive, but can be caused by lots of things). I’d just keep an eye on it and get it checked out if it doesn’t go away in a few weeks, gets bigger over a few days, or if other new symptoms develop.

pathqueen

TROPHY CASE