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Khalil's fruits in usmle
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Fruit Pic Dis. & Notes
Strawberry -Scarlet fever - Kawasaki disease (strawberry tongue)
-Trichomonas vaginitis (strawberry vagina)
- Strawberry on a stick or mushroom appearance of
tubular adenoma that is precursor lesion for colonic
cancer
Blueberry -Rubella
-CMV (congenital disease)
-Blueberry muffin rash (congenital toxoplasmosis; a
term used to describe the characteristic distributed
purpura due to extramedullary hematopoiesis found in
infants.It was originally considered characteristic of
rubella, but is now considered to be potentially
associated with many other conditions,such as
cytomegalovirus and metastatic neuroblastoma.)
Mulberry -Tuberous sclerosis (mulberry tumor)
-syphilis(mulberry molar, neonatal finding)
-Mulberry-shaped colonies on sterol-containing media
in 10 days in M.Pneumoniae
Berry -Berry aneurysm ("worst headache of life"; this
aneurysm an outpoucing of intima and adventitia
ruptures producing SUB ARACHNOID
HEMORRHAGE)
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cherry -cherry-red macular spot (Niemann-Pick and Tay-
Sachs)
-Cherry colour of skin (carbon monoxide poisoning
which mask cyanosis)
-cherry red epiglottis in children : H.influenza
-Cherry hemangioma
- cherry red spot = occlution of retinal artery
- Strawberry & cherry hemangiomas (A benign lesion
which is the most commonly seen in infancy. Grows in
size n then resolves on its own , no treatment
required. May be of cosmetic concerns among parents
for their children who have it)
Orange peau d'orange (inflammatory breast cancer)
Banana -Banana shaped left ventricle of heart (Hypertrophic
cardiomyopathy)
-" banana-shaped" gametocyte : Plasmodium
falciparum
Fruit Fruity breath odor “acetone breath” ( Diabetic
ketoacidosis)
sausage -palpable sausage-shaped mass in children
(intussusception)
-sausage shaped fingers (psoriatic arthritis classically,
systemic sclerosis-Reiter's disease-ankylosing
spondylitis)
maple syrup -Maple syrup urine disease in branched chain ketoacid
dehydrogenase deficiency
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almond bitter almond odor in cyanide poisoning
garlic garlic odor in arsenic poisoning
cauliflower cauliflower adenomas,
Chocalate -Chocalate brown colour in post mortem lividity due to
Potassium chlorate poisoning,
-chocolate cysts in endometriosis
- Chocolate Agar: H.influenza
nut nutmeg congested liver
Rice Rice water Diarrhea (Cholera)
Apple -Apple bite (contrast media x-ray) colon cancer and I
think in diffuse esophageal spasm as well.
-apple peel atresia - duodenal , jeujunal or colonic
atresia d/t vascular accidents in utero
- Apple jelly nodules in Lupus Vulgaris, Lupoid
Leicshmaniasis & Sarcoidosis
-apple core appearance = colon cancer
Watermelon Watermelon stomach = Gastric antral vascular ectasia
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salmon -Salmon colored saliva in acute pulmonary edema.
-Fishy like smell : B.vaginosis
grapes -grapes like odour: pseudomonas infection
-Grapfruit juice inhibitor of c450,fructose intolerance
when baby denies juice
-Fruity breath odor (acetone breath) = Diabetic
ketoacidosis..
-Grapes-like vesicles= hydatiform mole-vesicular
mole/molar pregnancy
-Grape like mass protruding from the vagina / penis in
children... ---> rhabdomyosarcoma (sarcoma
botryoides)
honey honey crusted lesion(impetigo) : group A streptococci
Café cafe au lait spots (neurofibromatosis type I)
Jelly -red current jelly stools – intussuception
-red currant-jelly sputum- klebsiella
crocodile crocodile like skin-ICTHYOSIS VULGARIS (a/k/a
sauroderma)
Cranberry -Cranberry juice to acidify urine and increase
elimination of weak bases (Amphetamines, PCP,..)
egg fried egg apperance in :
1. oligodendroma , a cns tumour cells show "fried egg"
appearance
2."fried-egg" colonies on mycoplasma or eaton's
media (all mycoplasma, except mycoplasma
pneumonia)
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Bread and
butter
Bread and butter pericarditis: Fibrinous pericarditis
Spaghetti &
Meat Ball
Spaghetti & Meat Ball appearance in Tiena Versicolor
Blue Bleb nevus
champagne -inverted champagne bottle appearance in venous
ulcers
Port wine -Port wine stain
- Port wine urine in acute intermittent porphyria
Anchovy
sauce
Anchovy sauce-Thick Chocolate brown secretion
formed due to mixture of bile,dead tissue,blood in
Amoebic liver abscess......
Tomato Tomato Splash Appearence( Ophthalmoscopic view) -
Retinal vein occlusion.
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Cottage
Cheese
Cottage Cheese appearance on gross examination-
Retinoblastoma.
Cola -Cola colored urine(Streptococcal Glomerulonephritis)
- tea/cola coloured urine(unconjugated
hyperbilirubinemia)
signet-ring
signet-ring trophozoite: P.vivax
Coffee bean Coffee bean nuclei in Brenner Tumor
Fava beans
fava beans (avoid in G6PDD)
Olive olive-shaped mass - pyloric stenosis
MUSHROOM -MUSHROOMS >> RNA-Polymerase II inhibited by
alpha amanitin
-Strawberry on a stick or mushroom appearance of
tubular adenoma that is precursor lesion for colonic
cancer
crew cut "crew cut" appearance of the skull x-ray= Erythroid
hyperplasia-occurs in sickle cell anemia and
thalassemia
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swiss cheese swiss cheese appearance- taenia solium
Onion -Onion appearance of lysosomes for Tay Sachs disease.
(in addition to cherry red macula)
-onion skin layering - ewing sarcoma
Beef beef cardiolipin- RPR “Rapid Plasma Reagin” (syphilis)