A medical menu - Nature

European Journal of Clinical Nutrition (2001) 55, 812–817 ß 2001 Nature Publishing Group All rights reserved 0954–3007/01 $15.00

www.nature.com/ejcn

A medical menu IH Gewolb1* 1

University of Maryland School of Medicine, Department of Pediatrics, Division of Neonatology, Baltimore, Maryland, USA

Soups 1. 2. 3. 4.

Fish Pea soup meconium Rice water stools Pea soup stool Chicken broth fluid

Appetizers 5. 6. 7. 8. 9. 10. 11.

Caviar lesions Bone chips Chip fractures Egg-shell calcifications Egg-shaped heart (or egg-on-side configuration) Huevos a doces (‘eggs at 12’) Egg-shell nails

Sandwiches 12. 13. 14. 15. 16.

Hot cross bun skull Bread and butter pericarditis Hot dog headache Sandwich vertebrae Double-antibody sandwich assay

Seafood 17. 18. 19. 20. 21.

Lobster claw deformity Crab louse Molluscum contagiosum Crab yaws Snail fever

*Correspondence: IH Gewolb, University of Maryland School of Medicine, Department of Pediatrics, Division of Neonatology-UMMS Rm N5W68, 22 South Greene Street, Baltimore, MD 21201, USA. E-mail: [email protected] Received 16 February 2001

22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32.

Salmon patch Fish mouth Carp mouth Fishmouth valve F.I.S.H. Herring bodies Anchovy Sauce abscess Codfish vertebrae Fishmouth mitral stenosis Fishskin disease Salmon-ella!

Meat and poultry 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59.

Chickenpox Drumstick leukocyte Wing scapula Gooseneck flask Goose flesh Hamstring muscles Pigtail sign Cowpox Bird’s beak appearance Sausage-shaped fingers Bacon spleen Beefy tongue Bull’s eye lesions Waddling goose gait Chicken breast Goose breathing Sausage poisoning Bacon’s anoscope Birdshot retinochoroiditis Bull’s eye maculopathy Chickenfat clot Cow face Cow kidney Hen cluck stertor Pigtail catheter Gooseneck deformity ‘Frank’ breech presentation

A medical menu IH Gewolb

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Game 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79.

Tapir’s mouth Buffalo hump Staghorn calculus Pigeonbreast deformity Harelip Rabbit fever Frog-leg posture Rabbit test Swan-Ganz catheter Tree frog feet Crocodile tongue (not for everyone) Alligator forceps Blubber finger Crocodile tears syndrome Faun tail nevus Hare’s eye Ox heart Seagull murmur Frog belly Alligator (or crocodile) skin

Fruits 80. 81. 82. 83. 84. 85. 86. 87. 88. 89. 90. 91. 92. 93. 94. 95. 96. 97. 98. 99. 100. 101. 102. 103. 104. 105. 106. 107. 108. 109. 110. 111.

Strawberry hemangioma=nevus Cherry red spot Strawberry gallbladder Mulberry molar Berry aneurysm Raspberry patch Fig wart Strawberry tongue Red strawberry tongue Raspberry tongue Peau d’orange skin Adam’s apple Prunebelly syndrome MacIntosh blade Apple-peel atresia Grape cell Berry cell Mulberry cell Lemon sign Banana sign Pear-shaped nose Mulberry rash Mulberry calculus Coconut sound Strawberry nose Framboesiform (strawberry like) yaws Raspberry tumor Raspberry angioma Grape endings Melon-seed bodies Blackcurrant rash Carswell’s grapes

112. 113. 114. 115. 116. 117. 118. 119. 120.

Pear-shaped area Date boil Date fever Grape mole Banana fracture Watermelon lesion Pineapple test Apple-core sign and, of course . . . beri-beri

Vegetables 121. 122. 123. 124. 125. 126. 127. 128. 129. 130. 131. 132. 133. 134. 135. 136. 137. 138. 139.

Onionskin lesions=laminations Cauliflower ear Potato nose Hard corn Soft corn Beet (or beet-root) tongue Pyloric olive Onion bulbs Celery stalking Bean syndrome Rice bodies Spinach stools Tomato ketchup spleen Superior and inferior olives Potato tumor of the neck Guinea corn yaws Onionskin reaction Potato nodes Cardiac vegetations

From the bakery 140. 141. 142. 143. 144. 145. 146. 147. 148. 149. 150. 151. 152. 153.

Blueberry muffin baby Doughnut lesions Caked breasts Doughnut warts Oat cell carcinoma Sago spleen Pancake sign Tart cell Sago grain stool Sugar-loaf deformation Biscuit bite Cake kidney Pancake kidney Pie-in-the-sky quadrantanopia

Condiments 154. Horseradish peroxidase 155. Nitrogen mustard 156. Nutmeg liver European Journal of Clinical Nutrition


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157. 158. 159. 160. 161. 162. 163.

Salt & pepper chorioretinitis Mustard procedure Butter cyst Butter stools Mayo bunionectomy Pepperpot (or salt and pepper) skull Cayenne pepper spot

Dairy products 164. 165. 166. 167. 168. 169. 170. 171. 172. 173.

Milk leg Milk tooth Milk crust Milkman’s syndrome Milkmaid sign Milk urine Milk spots Milky ascites Swiss cheese endometrium Cottage cheese discharge

Beverages 174. 175. 176. 177.

Coca Cola urine Juices (gastric, pancreatic, etc) Prune juice sputum Wasserhelle (clear water) cells

Coffees 178. Cafe au lait spots 179. Coffee ground vomitus (with or without steroid cream — ask your waiter)

For the sweet tooth 180. 181. 182. 183. 184. 185. 186. 187. 188. 189. 190. 191. 192. 193. 194. 195. 196.

Popsickle panniculitis Maple syrup urine disease Chocolate cysts Wharton’s jelly Currant jelly stools Honey urine Sour ball sign Chocolate agar Currant jelly sputum Popcorn lesions Sugar Baby Kwashiorkor Floats (H-, plumb-bob, ball, non-rotating, skirted, etc) Honey crusted lesions Honeycomb lung Honeycomb choroiditis Chocolate stools ‘Zuckergussleber’ — Sugar-icing (or sugar-coated) liver (also spleen)

European Journal of Clinical Nutrition

197. Strawberry cream blood 198. Apple jelly nodules From the bar 199. 200. 201. 202. 203. 204. 205. 206. 207. 208. 209. 210. 211. 212.

Cocktail purpura Rum fits Burgundy red urine Brandy snifter sign Beer heart Liquor amnii Brandy nose Rum nose Screwdriver tooth Port wine stain Punch biopsy Hock bottle femora Oasthouse urine Ripple sign (tres declasse´) And the specialties of the house: 213. Gin and tonic – clonic seizures 214. Vodka and lyme arthritis Table settings, silverware and miscellany 215. 216. 217. 218. 219. 220. 221. 222. 223. 224. 225. 226. 227. 228. 229. 230. 231. 232. 233. 234. 235. 236.

Cup-and-spill stomach Growth plates Flat plates Spoon nails Silver fork deformity Clasp-knife effect Cupped disks Ground glass appearance Pot belly Pott’s disease Cracked pot sound Napkin dermatitis Corkscrew esophagus Bowl-shaped erythrocytes Cup-shaped ears Spooning Goblet cells Chalice cells (for the very rich) Jack-knife position Dish face Leather bottle stomach Napkin-ring sign

And for those for whom knives are not good enough: 237. Scimitar sign 238. Sickle cell

Definitions 1. 2.

Thick meconium In cholera


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3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51.

In typhoid fever In pancreatitis Sublingual varices Small pieces of bone used to fill in bony defects Small fractures Used to describe hilar lymph nodes in sarcoidosis, scleroderma, histoplasmosis (and other conditions) In transposition of the great vessels Used to describe 5-a-reductase deficiency Hapalonychia In congenital syphilis Fibrinous pericarditis Nitrite sensitivity headache In osteopetrosis Assay involving two antibodies to the same antigen Missing or fused medial digits of the hand or foot Tinea pubis A skin disease caused by a Poxviridae virus Foot yaw Schistosomiasis A type of macular hemangioma=also used to describe a type of corneal keratitis Describing the mouth in various genetic syndromes Describing the mouth in various genetic syndromes A one-way valve used in anesthesiology Fluorescence in situ hybridization Hyaline masses scattered throughout the pars nervosa of the pituitary gland Description of amoebic liver abscess Exaggeration of the concavity of upper and lower endplates of the vertebrae — as seen in osteopenia Extreme mitral valve stenosis Ichthyosis Salmonella (sorry!) Varicella Seen in 3% of XX genotypes Scapula alata; when the medial border of the scapula protrudes away from the thorax Describing a flask with a long, curved neck Cutis anserina Tendons of muscles around the popliteal space X-ray finding in Hirschsprung’s disease Vaccinia Smooth tapered appearance of the esophagus in achalasia In Coffin – Lowry syndrome Areas of amyloid degeneration in the spleen Erythematous or atrophic glossitis Metastases in the gastrointestinal tract In arthritis Pectus carinatum Hissing respirations Allantiasis, usually secondary to botulism A rectal speculum with a long slit on the side and a light opposite (named after Dr Bacon) Bilateral diffuse retinal vasculitis and depigmentation

52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 84. 85. 86. 87. 88. 89. 90. 91. 92. 93. 94. 95.

Edema=degeneration of the posterior pole of the retina causing alternating areas of light and dark Postmortem clots of leukocytes and plasma A description of the face in ocular hypertelorism A kidney with an abnormally large number of minor calyces Describing breath sounds heard with post-pharyngeal abscess Angiographic catheter with tightly curled end Angiographic description of the cardiac outflow tract in endocardial cushion defect Complete breech A description of the mouth in fascioscapulo-humeral syndromes In Cushing’s disease Calculus of the renal pelvis extending into multiple calyces Pectus carinatum Cleft lip Tularemia Posture of maximal abduction of the thigh Pregnancy test A flexible flow-directed balloon catheter used to measure pulmonary wedge pressure In Taybi syndrome (oto-palato-digital syndrome) Fissured tongue seen in Melkerson – Rosenthal syndrome Long forceps with a small hinged jaw Erysipeloid (self-limiting cellulitis of the hand) Tears upon eating or in anticipation of eating secondary to regrowth of injured salivary gland nerve into the lacrimal gland Hairy nevus in lumbosacral region, associated with diastematomyelia Lagophthalmia Cardiomegaly secondary to aortic valve disease Murmur mimicking a seagull’s cry The slightly distended belly in rickets Ichthyosis sauroderma A birthmark resembling a strawberry Seen in Tay – Sach’s disease With cholesterol gallstones In congenital syphilis Congenital aneurysm of a cerebral artery Pedunculated mass in external auditory cana Condylomata accuminata Seen early in scarlet fever In Kawasaki disease Seen later in scarlet fever Sign of breast cancer Prominentia laryngea Congenital absence of the abdominal musculature Type of laryngoscopic blade (after Dr McIntosh) X-ray sign of congenital small bowel atresia secondary to agenesis of the dorsal mesentery Plasma cell whose cytoplasm contains blue vesicular inclusions (seen in hypergammaglobulinemic conditions) European Journal of Clinical Nutrition


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96. 97. 98. 99. 100. 101. 102. 103. 104. 105. 106. 107. 108. 109. 110. 111. 112. 113. 114. 115. 116. 117. 118.

119. 120. 121. 122. 123. 124. 125. 126. 127. 128. 129. 130. 131. 132. 133. 134. 135. 136. 137. 138. 139. 140.

Another name for grape cells Another name for grape cells Scalloping of frontal bones on fetal ultrasound — seen in meningomyelocoele Anterior curvature of cerebellar hemispheres on fetal ultrasound — seen in meningomyelocoele In Tricho-rhino-palatal syndrome In typhus Calcium oxalate urinary calculus ‘Cracked pot’ sound heard in Paget’s disease of the skull Rhinophyma Used to describe secondary yaws Enteroteratoma Of the retinal vessels Of axons Seen in X-rays of TB arthritis=also small fibrous loose bodies in joints or tendon sheaths In xeroderma pigmentosum Masses of tubercules clustered around finer bronchioles in TB pneumonia Retromolar pad Lesion occurring in cutaneous leishmaniasis A synonym for Dengue fever Hydatidiform mole Transverse fracture in Paget’s disease Endoscopic appearance of angiodysplasia (Am. J. Radiol. 1982; 139: 115.) Test for butyric acid in the stomach; adding sulfuric acid and alcohol to gastric juice yields ethyl butyrate (pineapple odor) if butyric acid present Annular defect seen in barium enema studies of colonic carcinoma Polyneuritis secondary to thiamine deficiency Of the splenic arteries in lupus Boxer’s ear with thickening and induration Rhinophyma A small conical callosity caused by pressure over a toe joint Macerated corn caused by pressure between two toes In pellagra Seen in pyloric stenosis Nerve endings in Dejerine – Sotas disease Of the long bones in TORCH syndromes Blue rubber bleb nevus syndrome In the tendons and joints and in hygroma fluid Seen in infants secondary to the use of calomel Non-specific splenitis=inflammation Nucleus dorsalis corporis trapezoidei and nucleus olivaris Chemodectoma (carotid body tumor) Yaws resembling grains of Indian corn A type of periosteal new bone formation Large mediastinal nodes in sarcoidosis Clots of platelets, fibrin, and bacteria or fungi adherent to cardiac valves In congenital rubella syndrome


141. Rounded or oval radiolucent defects with a sclerotic margin seen in skull X-rays as an incidental finding; also seen in sickle-cell disease 142. Secondary to galactocoeles 143. Annular warts 144. Anaplastic small cell bronchogenic carcinoma 145. Amyloid infiltration of the spleen in amyloidosis 146. Flattening of the heart on ultrasound 147. A macrophagic or monocytoid reticuloendothelial cell containing a phagocytized nucleus and wellpreserved nuclear structures 148. Flecks of blood stained mucus seen in amebiasis 149. Dislocation of the acromioclavicular joint 150. Maxillomandibular record 151. Bizarre, irregular shaped midline kidney, caused by fusion of renal anlagen 152. Disk shaped midline kidney, caused by fusion of both poles of renal anlagen 153. Temporal lobe lesion causing short-term memory difficulties and personality disturbances 154. Enzyme used to label antigen – antibody complexes 155. Mechlorethamine hydrochloride, used to treat lymphoid tissue cancers 156. In right-sided congestive heart failure 157. In congenital rubella syndrome 158. Operative procedure to correct transposition of the great arteries (after Dr Mustard) 159. Necrotic mass in a lipoma 160. Steatorrhea 161. Excision of the head of the first metatarsal (after Dr Mayo) 162. X-ray pattern seen in hyperparathyroidism 163. Minute, punctate telangiectases (cherry angiomas) lying within individual dermal papillae in lesions of angioma serpiginosum 164. Phlegmasia alba dolens of pregnancy 165. Deciduous tooth 166. ‘Cradle cap’ 167. Mild form of osteomalacia with pseudofractures 168. Diagnostic test (grabbing of fingers) used to check steadiness of grip in chorea 169. Chyluria 170. Aggregations of macrophages in the omentum 171. Chylous ascites 172. Cystic hyperplasia of the endometrium 173. In vaginal moniliasis 174. In hepatitis 175. Various secretions 176. In pneumococcal pneumonia 177. Large clear cells found in the parathyroid gland 178. Seen in neurofibromatosis 179. Vomitus containing old blood 180. Panniculitis of the inner buccal mucosa secondary to sucking cold objects 181. Branched chain ketonaciduria 182. Ovarian cyst with intracavitary hemorrhage 183. Mucous connective tissue of the umbilical cord 184. In intussusception


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185. 186. 187. 188. 189. 190. 191. 192. 193. 194. 195. 196. 197. 198. 199. 200. 201. 202. 203. 204. 205. 206. 207. 208. 209. 210. 211. 212. 213.

Old term for glucosuria in diabetes mellitus In Sjogren’s syndrome Blood agar heated until the blood becomes brown In klebsiella pneumonia In osteogenesis imperfecta Skin depigmentation in kwashiorkor Floating indicators used in anesthesia equipment In impetigo Multiple small radiolucencies=cysts on chest X-rays Doyle’s familial choroiditis; light colored patches near optic disk and macula Seen in amoebic dysentery Hyaloserositis of the liver; non-specific splenitis In advanced lipemia Papular lesions of lupus vulgaris, as seen using diascopy Allergic reaction to quninie water Alcohol abstinence symptoms In porphyria X-ray finding in encopresis Cardiac hypertrophy Amniotic fluid Rhinophyma Phinophyma In congenital syphilis Capillary hemangioma seen in Sturge – Weber syndrome A biopsy in which a cylindrical piece of tissue is removed In Gaucher’s disease Characteristic odor of malt hops found in methionine malabsorption Another term for the ‘wave sign’ describing slight indentations on the thymus in newborn chest X-rays Sorry!

214. Sorry! 215. ‘Cascade’ stomach, a normal variant, not to be confused with a stomach volvulus 216. The cartilaginous zone between the epiphysis and the calcified cartilage; the physis 217. Survey radiograph of the abdomen 218. In iron deficiency 219. Colle’s fracture 220. Description of a form of spasticity 221. Depression of the optic disk 222. Chest X-ray feature of hyaline membrane disease 223. A descriptive term of the abdomen of many middleaged physicians 224. Tuberculosis of the spine 225. The sound heard in Paget’s disease of the skull 226. Dermatitis of the diaper region (Brit.) 227. Normal variant seen in barium swallow X-rays 228. Seen in newborns 229. Seen in CHARGE syndrome 230. Dystonic posturing (holding hands straight out and getting a spoon shape) 231. Mucus cells in the respiratory and intestinal tracts 232. Another name for goblet cells 233. A position used in back surgery 234. Scaphoid facies 235. Thickening and rigidity usually secondary to infiltrating carcinoma 236. Annular lesion of the colon seen in barium enema studies (usually secondary to carcinoma) 237. In partial anomalous pulmonary venous return below the diaphragm 238. In sickle cell anemia
