Sunday, February 22, 2015

Study group discussion: Food analogies in Medicine

Who likes oreo cookies? I came to know about the Oreo Cookie sign today!
It's seen on a chest x ray (lateral view) when there is a pericardial effusion!
The anterior most layer (the chocolate part!) is the epicardial fat.
The mid layer (the cream part...yumm!) Is the fluid.
And the posterior layer (again, the  chocolate part) is the pericardial fat!

Coffee bean sign seen in?
Sigmoid volvulus! Also called omega sign!

Name some terms that starts with strawberry referring some conditions in our body:
Strawberry cervix - Trichomonas vaginalis infection
Strawberry tongue - Kawasaki disease, scarlet fever.
Strawberry scrotum - multiple sebaceous cysts (They're actually calcified epidermal cysts aka calcinosis cutis)
Strawberry haemangioma!

Speaking of food analogies.. Let's catch em all!

Oat cell carcinoma - Small cell carcinoma of the lung.

Cafe au lait spots - Neurofibromatosis.

We had a chart in pathology department - 'Pathology restaurant'

Apple birefringence - Amyloidosis!

Apple peel sign - Intestinal atresia.

Bread and butter appearance -  Fibrinous pericarditis.

Bread crumbs appearance in complicated cataract!

Honeycomb appearance of lungs.
Interstitial fibrosis.
Also pneumocystis, not sure.

Honey comb appearance of liver too.
Which condition is honey comb liver seen?
Seen in actinomycosis infection of liver. Burkholderia is a gram - bacteria. The honeycomb liver is seen in burkholderia infection....Which causes abcess...It's a radiologic sign!
Woah.

There's nutmeg liver - right heart failure!

Onion skin appearance - Ewings sarcoma!

Another Onion skin appearence seen in?
It's seen in Hyperplastic arteriolosclerosis!

Swiss cheese appearance - Metropathica hemorrhagica.

Also swiss cheese pattern in multiple serpingenous ventricular septal defects in VSD.

What appareance is in caseous necrosis, tuberculosis granuloma?

Cheese like?

Yeah. Here in spain is called: Queso fresco!

Cheesy necrosis in tuberculosis!

Dry cheese appearance in candida growth.

Cottage cheese appearance is found in which pathology?
Histological finding of caseous necrosis e.g in tuberculosis.

Anchovy sauce - Amoebic liver abscess!

Salt pepper appearance in?
EBV.

Salt and pepper skull - Hyperparathyroidism.

Rice water stools - cholera!! :)

Currant jelly sputum in?
Klebsiella pneumonia

Currant jelly stools in?
Intussuception!

So this is obvious - Maple syrup urine in?
Maple syrup urine disease!

Blue berry muffin rash - Congenital rubella.

Mulberry molars - Late congenital syphilis.

Olive shaped mass - Hypertrophic pyloric stenosis.

I know about Peau de orange!
Breast carcinoma.
And why is that?
Blockage of cutaneous lymphatics due to infiltration.
Blockage of lymphatic causes accumulation in the third space so it swells and the point where ligament is attached to the skin becomes pitted. Just like the skin of orange which has many small pits.

What about orange eyes?
Orange eyes are seen in Leptospirosis.

Apple core sign is found in which disease?
Colon cancer
Oesophageal carcinoma
Also a sign of IBD, I think.

What disease have Chicken drumsticks like fingers?
Psoriatic arthritis.

Napkin ring appearance also in colon cancer.

Which disease had grapefruit appearance?
Hyadatidiform mole.

There's chocolate cyst of ovary - endometriosis.

And chocolate agar!

Updated on 28th February, 2015:
A sandwich sign (sometimes known as a hamburger sign) refers to a mesenteric +/- para-aortic nodal mass giving an appearance of a hamburger. Confluent lymphadenopathy on both sides of the mesenteric vessels gives rise to an appearance described as the sandwich sign. The sign is specific for mesenteric lymphoma (typically non-Hodgkin’s)

Sandwich vertebra - Osteoporosis!

Updated on 1st March, 2015:
IkaN, did you get salt and pepper retinopathy on your foodie blog?

Yes, EBV!

Okay, I read that as a part of rubella. Could you explain what exactly happens tho?

Salt-and-pepper fundus with diffuse pigmentary lesions can be the signature of a previous systemic infection that had ocular involvement. Examples include inactive chorioretinal scars secondary to Lyme disease, tuberculosis, syphilis, congenital rubella, toxoplasmosis and bartonellosis.

There's a salt and pepper appearance in skin too! Systemic sclerosis and scleroderma have salt and pepper skin.

I found another salt and pepper term! In osteitis fibrosa cystica, punched out lesions produce a salt and pepper appearance on radiography. Multiple myeloma as well!

Updated on 3rd March, 2015:
Potato tumor: Carotid body tumor
Coconut appearance: Hyatid cyst

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