Funtabulously Frivolous Friday Five 243

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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 243

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Question 1

[real case] – A 12 year old boy is brought in by his mother with concerns about fatigue, increasing shortness of breath on exertion, easily bruising, swollen gums and ?loose teeth over the last few months. His background is significant Austism Spectrum Disorder with multipe restrictive and repetitive behaviours, in particular a very restrictive diet. On examination you note diffuse ecchymoses and a petechial rash which occur around the base of his fair follicles on his legs.

What is the diagnosis?

+ Reveal the funtabulous answer

  • Scurvy.
  • The patient’s severely restrictive food habits have included generally only reheated fish fingers and nuggets, with little to no fruit or vegetables.  Serum vitamin C confirmed low levels of vitamin C.
  • Although classically a disease of sailors, Scurvy still occurs in developed countries in some at risk populations, especially people with mental health disorders, unusual or restrictive dietary habits, alcoholism and aged persons who typically live alone. It still occurs in developing nations and regions during times of famine.
  • James Lind, a Scottish surgeon in the Royal Navy is credited with proving that scurvy could be treated with the ingestion of citrus fruits in 1753, although it would still be another 40 years until 1795 when the British Royal Navy would be convinced to routinely give lemon juice to its sailors. [Reference]

Question 2

What is Darier sign?

+ Reveal the funtabulous answer

  • A dermatological finding in those affected by macrocytosis.
  • Named after Hungarian born, French dermatopathologist Ferdinand-Jean Darier (1856-1938).
  • Rubbing an area of skin affected by mastocytosis activates the mast cells, the skin becomes erythematous, oedematous and pruritic in a matter of minutes.  In young children, the area may progress to a blister. [Reference]

Question 3

The Siamese Twins, Chang and Eng, are arguably the most famous conjoined twins, verily the name “siamese twins” is attributed to the pair as they were born in the Kingdom of Siam (now Thailand) in 1811.  What do the names ‘Chang’ and ‘Eng’ mean?

+ Reveal the funtabulous answer

  • ‘Left’ and ‘Right’.
  • Conjoined twins are rare with an approximate rate of 1.5 per 100,000 births. [Reference]
  • There are, unsurprisingly, multiple medical, personal and ethical issues surrounding cases of conjoined twins.  More recently the case of ‘Mary and Jodie’ was of both ethical and legal importance in the UK. Real names, Gracie and Rosie Attard, were conjoined twins born in August, 2000.  Rosie would certainly die if separated from Gracie, whereas if separation did not proceed both were predicted to pass away by age 6 months.  The dilemma of the case was adjudicated in the Court of Appeal of England and Wales, each of the three presiding judges used different legal arguments in their reasoning, but the separation proceeded and was a success – Gracie survived.
Chang and Eng Bunker

Question 4

Who wrote: “Of the heart. This moves of itself and does not stop unless forever.”?

+ Reveal the funtabulous answer

  • Leonardo da Vinci (1452 – 1519)
  • Instrumento mirabile, invenzionato dal sommo maestro…‘ [admirable instrument by the supreme Master] Dell’Anatomia Fogli B 12r (1510)
  • Del core. Questo simoue dasse enosiferma seno etternal mete.‘ [Of the heart. This moves of itself and does not stop unless forever.] [Du cœur. Celui-ci se meut par lui même, et ne s’arrête pas, si ce n’est éternellement] Dell’Anatomia Fogli B 13r (1510) Translation 1901

References:

  • Piumati G. I manoscritti di Leonardo da Vinci della Reale biblioteca di Windsor. Dell’anatomia, Fogli B. 1901
  • Anatomy the Teacher: On the Impact of Leonardo’s Anatomical Research on His Musical and Other Machines. Proceedings of the American Philosophical Society. 1967;111(4):234-247

Question 5

Who was the first woman to receive an M.D.?

+ Reveal the funtabulous answer

  • Dr Elizabeth Blackwell (1821 – 1910)
  • Blackwell was the first woman to achieve an M.D. degree from an American medical school.
  • She was born in Bristol, England and moved to America at age 11.  She graduated from New York’s Geneva Medical College in 1849.
  • She opened the New York Infirmary in 1857 which allowed future female medical graduates employment if they were rejected from internships elsewhere.
  • She published several books on the issue of women in medicine, including “Medicine as a Profession For Women” (1860) and “Pioneer work in opening the medical profession to women” (1895). [Reference]

…and finally

Grounded

Funtabulously Frivolous Friday Five 243 Mark Corden

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Author: Mark Corden

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