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'''Causes'''
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Unlike the majority of diseases that have multiple causes or no known or a poorly-understood cause, the etiology of '''sandwich deficiency syndrome''' is simple: a lack of a sandwich.
'''Types'''
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Type 1 and type 2 '''SDS ''' are labelled based on onset: type 1 '''SDS ''' is characterized by paroxysmal onset and systemic collapse, while type 2 '''SDS ''' is anything else less acute. Furthermore, both types of '''SDS ''' can be further specified by the type of '''sandwich deficiency''': a general sandwich deficiency defined by treatment with any sandwich whatsoever or more specific sandwich deficiencies in which treatment is dependent on the right sandwich. The most classic example of a specific '''sandwich deficiency syndrome ''' is the [[Turkey Sandwich|turkey sandwich]] deficiency syndrome. The list of specific sandwich deficiencies is long, with research unlocking new permutations of this condition. Below are some of the most common:
* Bologna '''SDS'''* Breakfast '''SDS''', which can include egg sandwich '''SDS ''' and other variants* BBQ sandwich '''SDS''', which can further be subdivided into pulled pork '''SDS ''' and brisket '''SDS'''* Ham or ham & cheese '''SDS'''* Jewish deli '''SDS ''' including pastrami '''SDS''', corned beef '''SDS''', and numerous others* Muffaletta '''SDS'''* Philly cheesesteak '''SDS'''* Po' boy '''SDS'''
'''Signs'''
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Vital signs can range from normal to totally out of whack, depending on the level of a patient's sandwich depletion. Important The most important [[Physical Exam|physical exam]] findings include:
* ''Point-in-mouth sign'': patient points finger into mouth as if wanting to eat something
* ''Tummy rub sign'': patient rubs belly in a pattern resembling a hoagie or muffaletta
* ''Sandwich sign'' - patient says "I want a sandwich"or some variation of the phrase ("SANDWICH, NOW!" or "I might die if I don't get a tuna on rye")
There are several studies that can aid in the diagnosis:
*''Serum sandwich levels'': Helpful though woefully inaccurate at timesmany false positives and false negatives
*''Serum sandwich IgG antibodies'': Lack of antibodies suggest lack of sandwiches
*''Abdominal imaging'': an abdominal X-ray, CT of the abdomen, and MRI abdomen can help reveal the presence or absence of digested sandwiches.
'''Treatment'''
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First-line treatment for a '''sandwich deficiency syndrome''' is a stat sandwich. If a patient presents with a generalized '''SDS''', any sandwich will do. If a patient is suffering from Reuben '''SDS''', then - by [[God]]! - get that person a Reuben. No matter what the intervention, the health care professional providing the intervention must never forget to document a [[Sandwich Note|sandwich note]], a form of [[Progress Note|progress note]] dedicated to the appropriate record-keeping of sandwiches.
'''Related Reading'''
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* [[ChipotleMexican Grill]]
* [[Double Portions]]
* [[McDonald's]]
