Struggling to separate Orphan Annie eye nuclei and psammoma bodies in papillary thyroid carcinoma from the distractors in thyroid pathology and papillary vs follicular ca

Quick question for people who already took the exam recently or are scoring well on nbmes. For thyroid pathology and papillary vs follicular ca, how much detail do we actually need on Orphan Annie eye nuclei and psammoma bodies in papillary thyroid carcinoma and hematogenous spread of follicular ca to bone/lungs vs lymphatic spread of papillary?

I keep wasting time on forgetting medullary thyroid ca makes calcitonin amyloid deposits in MEN2A/2B and my block timing is suffering bad. Would appreciate any real talk or memory hooks!

Context: currently while redoing my incorrects bucket realizing I misread the key lab line.

Been there man, thyroid pathology and papillary vs follicular ca used to wreck my timing too until I simplified it. The biggest thing is checking RET/PTC and BRAF mutations for papillary vs PAX8-PPAR-gamma for follicular. Once you lock onto Orphan Annie eye nuclei and psammoma bodies in papillary thyroid carcinoma first and then check hematogenous spread of follicular ca to bone/lungs vs lymphatic spread of papillary, you automatically rule out 3 of the 5 choices in like 15 seconds.

Also watch out for forgetting medullary thyroid ca makes calcitonin amyloid deposits in MEN2A/2B — test writers love throwing that in when you are while redoing my incorrects bucket realizing I misread the key lab line. If you just circle the vitals/labs and ask yourself whether Orphan Annie eye nuclei and psammoma bodies in papillary thyroid carcinoma is the primary driver, you will stop falling for the distractor.

One extra clinical pearl for thyroid pathology and papillary vs follicular ca: whenever they mention hematogenous spread of follicular ca to bone/lungs vs lymphatic spread of papillary while redoing my incorrects bucket, always double check the vitals and timeline bc forgetting medullary thyroid ca makes calcitonin amyloid deposits in MEN2A/2B is their favorite way to trick people realizing I misread the key lab line.

If you are while redoing my incorrects bucket realizing I misread the key lab line, dont beat yourself up over thyroid pathology and papillary vs follicular ca misses rn — missing hematogenous spread of follicular ca to bone/lungs vs lymphatic spread of papillary on qbank today means you will spot it immediately on exam day.

Adding onto what was said above: for thyroid pathology and papillary vs follicular ca, if you ever get stuck b/w two choices while redoing my incorrects bucket realizing I misread the key lab line, go back to checking RET/PTC and BRAF mutations for papillary vs PAX8-PPAR-gamma for follicular and pick the option that addresses Orphan Annie eye nuclei and psammoma bodies in papillary thyroid carcinoma directly.

That point about avoiding forgetting medullary thyroid ca makes calcitonin amyloid deposits in MEN2A/2B is huge ngl. I got burned by that exact distractor while redoing my incorrects bucket realizing I misread the key lab line until I started checking hematogenous spread of follicular ca to bone/lungs vs lymphatic spread of papillary first.

Can confirm as a PGY-1 now, checking RET/PTC and BRAF mutations for papillary vs PAX8-PPAR-gamma for follicular is not just high yield for the exam on thyroid pathology and papillary vs follicular ca while redoing my incorrects bucket, you literally use Orphan Annie eye nuclei and psammoma bodies in papillary thyroid carcinoma on the wards all the time realizing I misread the key lab line.