Funtabulously Frivolous Friday Five 230

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Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 230.

Question 1:

Braille refined ‘night writing’ so it could effectively be used in the blind population. Who originally commissioned ‘night writing’ for the military? 

+ Reveal the Funtabulous Answer

  • It was developed by Charles Barbier after Napoleon commissioned a plan to develop a way for soldiers to communicate silently in the night without a light source. It proved too difficult for the soldiers and was abandoned.
  • Braille had blinded himself as a child by accidentally stabbing himself in the eye with his fathers awl (used for putting holes in leather). Having heard about Barbier’s night writing the pair met at the Royal Institute for the Blind in Paris. It took Braille a further 9 years to perfect his system. [Reference]

Question 2

Beards as we know, can be risky, particularly during bag-valve mask ventilation attempts. The problem has been solved with vaseline and tegaderm with the news spreading via social media. However, there was a mayor of Braunau am Inn on the Austrian-German border in the 16th Century who didn’t have the luxury of twitter. How did he succumb due to his facial hair?

+ Reveal the Funtabulous Answer

  • In 1567, Hans Steininger a popular mayor was known for his 4ft 6 inch beard. On September 28 of that year, there was a large fire in the town that caused a general panic. Steininger usually kept his prodigious beard hair rolled up and stuffed in a pocket, but during the commotion he was running around with it hanging free. In the midst of the chaos, he managed to step on his own beard, sending him tumbling down a flight of stairs and breaking his neck. 
  • Braunau am Inn is also known of the birth place of Adolf Hitler but for obvious reasons they celebrate Hans Steininger including a statue on the local church, his preserved beard and a tourist tour with its very own Hans Steininger actor. [Reference]
Hans Steininger beard

Question 3

What is Faget’s sign?

+ Reveal the funtabulous answer

  • Relative bradycardia in association with fever (Temperature-pulse dissociation).
  • 1859 – Faget published a review of the clinical historical accounts of multiple patients suffering from fever in the 1839, 1853 and 1858 Yellow fever epidemics in New Orleans.
  • ‘…I think I have arrived, at least for the differential diagnosis of yellow fever and our rural fevers, to a general fact of some importance; I mean the regular decay of the pulse, from the first or second day, to the fourth or fifth day, in the true yellow fever, at least in New Orleans, a regular and rapid decrease of the pulse, according to almost a hundred observations already, we may recognize that this is the true character of this fever. I do not know, indeed, that there is another serious acute illness, whose febrile reaction falls so early, so quickly, and with such regularity.‘ [Faget JC 1859 p84-85]
  • Faget sign has been recorded with Salmonella typhi (Typhoid Fever); Yellow Fever (viral hemorrhagic disease); Legionella; C. Brunetti (Q Fever); Legionella; Chlamydia; Mycoplasma; Tularemia; Colorado Tick Fever (Coltivirus); Leshmaniasis; Brucellosis; Psittacosis and Dengue Fever. [Reference]

Question 4

“A previously well 30-year-old woman re-presented to the emergency department complaining of worsening central abdominal pain initially colicky at first presentation 2 days earlier. She was tachycardic at 105 and other vital signs were normal. Her abdomen was peritonitic. At initial presentation, she was thought to have biliary colic, even though ultrasound and hepatobiliary iminodiacetic acid scans were normal. She did not have plain abdominal films. Laboratory studies were normal. CT of the abdomen revealed a metallic wire-shaped foreign body at the mesenteric root of a small bowel volvulus.” What is the diagnosis?

+ Reveal the Funtabulous Answer

  • A laparotomy a mid–small bowel section of ischaemia and adhesions were found related to the perforation of a 7 cm piece of orthodontic wire.
  • Most inert ingested objects, if they pass the cricopharyngeal sphincter, will pass spontaneously. The most common site for perforation or obstruction is the ileocaecal valve. The patient made a full recovery and recalled having braces 10 years prior but not of swallowing any wire. [Case of: Orthodontic braces come back to bite]

Question 5

What is Sutton’s law?

+ Reveal the Funtabulous Answer

  • AKA going for the obvious.
  • Takes it name from the apocryphal story of the Brooklyn bank robber Willie Sutton who, when asked by the Judge why he robbed banks, is alleged to have replied, “Because that’s where the money is!”.
  • The diagnostic strategy of going for the obvious is referred to as Sutton’s Law. The slip (Sutton’s slip) occurs when possibilities other than the obvious are not given sufficient consideration. [Reference]

…and finally

Someone didn’t think that design through.

Last update: Mar 16, 2018 @ 5:57 am

Funtabulously Frivolous Friday Five 230 Neil Long

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Author: Neil Long

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