Lab Rats In Lab Coats

Moth-eaten appearance (Permeative process of the bone)

Here's the answer: A big osteophyte (red arrow) is externally compressing the esophagus, causing narrowing of the lumen (blue arrow).

Here's the answer: A big osteophyte (red arrow) is externally compressing the esophagus, causing narrowing of the lumen (blue arrow).

Did you figure it out?

Here's a very intriguing case: A 74 y.o. male presented with months hx of dyspagia. Upper GI endoscopy (OGD) was done yet the scope couldn't pass beyond the pharynx even after multiple attempts. It looked as if it was Zenker's diverticulum, fibrotic/malignant stricture, or external compression over the esophagus. The patient was scheduled for barium swallow and CT scan. It turned out he already did a lateral head and neck x-ray, and it revealed this:

MRI can measure iron amount in the liver using Signal Intensity Ratio (SIR) in which liver intensity (color) is compared to that of the spleen or skeletal muscles. If the liver is darker than these tissues, then it contains an excess of iron. There's a better way, called T2 relaxometry, but it's not widely available.

55 y.o. male patient, known case of DM-2, presented with recurrent episodes of jaundice (Total bilirubin fluctuating between 1.5 and 6) and progressively elevated LFTs (ALT ranges between 110- 951, AST 71-372, ALP ~250). He denied the use of any hepatotoxic drugs or herbal formulas. On physical examination: normal vital signs. Yellow sclera, his skin looks tanned or sunburned. Lab tests & imaging: Hb, WBC, RFT: normal PLT: 110 Virology: normal US: only fatty liver. MRI: No obvious liver abnormality was seen, but the liver was more hypointense (darker) than usual. It was even darker than the spleen. Then, a comprehensive liver panel was done: Serum ceruloplasmin: normal 24-hour urine copper: normal ANA: +ve (borderline) ASMA, LKM, LC1 antibodies: normal Ferritin: 571 (elevated. ULN <400) Transferrin saturation: 51% (elevated. ULN <50%) Diagnosis: The MRI results, elevated ferritin, and transferrin saturation all point towards a diagnosis of primary hemochromatosis.

Diagnostic criteria for acute cholecystitis

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*It turns out we have the larger volume*

I remember finding this website when I was wondering if spider monkeys have more cerebellum-to-body volume than humans, since they have much more complex locomotion than us (and the cerebellum is responsible for locomotion and proprioception)

Ever seen an elephant's brain?

It's a museum, for brains... from all kinds of animals and creatures

rT3 is a metabolite of T4, but instead of increasing metabolism like T3, it lowers metabolism (acts like an endogenous anti-thyroid)

Euthyroid Sick Syndrome It's a condition in which serum levels of thyroid hormones are low in patients who have nonthyroidal systemic illness (even though they are euthyroid). Typical pattern includes: ↓T3, ↑rT3; TSH/T4/fT4 levels vary with illness severity. Diagnosis is based on excluding hypothyroidism. Treatment is directed toward the underlying illness; thyroid hormone replacement is not indicated.

ALT, AST, and ALP

The standard D-dimer threshold is not applicable in pregnant or post-op patients, as D-dimer levels are often high in this patient group.