Funtabulously Frivolous Friday Five 074

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 the Funtabulously Frivolous Friday Five 074

Question 1

What underlying condition might make you want to treat a patient’s nose bleed by inserting nasal tampons made of salted pork?

Reveal the funtabulous answer

Glanzmann thrombasthaenia

Patients with this condition have defects in their gpIIb/IIIa receptors that prevent their platelets from aggregating. As a result they are prone to bleeding complications, including epistaxis (nose bleeds). Various blood products or surgical procedures are often needed to control epistaxis in patients with this platelet disorder. An alternative approach, using nasal tampons consisting of salted pork (!), has been described in at least one case.

How the pork works is unclear – it could that it is rich in tissue factor, or the salt may induce mucosal edema and assist the tamponading effect of the pork ‘tampons’… or it could be coincidence.

Unfortunately, given that Glanzmann thrombasthaenia is more prevalent among Arabic speaking people, I’m not sure this treatment will be well received by all those affected.

  • Humphreys I, Saraiya S, Belenky W, Dworkin J. Nasal packing with strips of cured pork as treatment for uncontrollable epistaxis in a patient with Glanzmann thrombasthenia. Ann Otol Rhinol Laryngol. 2011 Nov;120(11):732-6. PMID: 22224315.

Question 2

Is a full moon associated with increased behavioural disturbance in emergency departments?

Reveal the funtabulous answer


Well, it was at the Calvary Mater Hospital in Newcastle, Australia: “Of 91 patients with violent and acute behavioural disturbance, 21 (23%) presented during the full moon — double the number for other lunar phases (P = 0.002).”

  • Calver LA, Stokes BJ, Isbister GK. The dark side of the moon. Med J Aust. 2009 Dec 7-21;191(11-12):692-4. PMID: 20028313.

Question 3

What is the key component of the ‘William the Conqueror’ diet?

Reveal the funtabulous answer


Legend has it that William the Conqueror (also known as William the Bastard) was so fat he couldn’t get on his horse. To combat this he devised a personalised dietary regimen: he locked himself in a room with alcohol the only substance available for him to consume. Unfortunately, the effectiveness of the strategy has been scurrilously questioned on the following basis: when William the Conqueror died he was so obese he could not be squeezed into his sarcophagus and he stunk out the chapel with his decaying corpse

Question 4

What is Stendhal syndrome?

Reveal the funtabulous answer

Stendhal syndrome is also known as hyperkulturemia and Florence syndrome.

“It is a psychosomatic illness that causes rapid heartbeat, dizziness, fainting, confusion and even hallucinations when an individual is exposed to art, usually when the art is particularly beautiful or a large amount of art is in a single place.” (Wikipedia)

The renowned 19th century French author, Stendhal, experienced the condition on a visit to Florence in 1817.

  • Nicholson TR, Pariante C, McLoughlin D. Stendhal syndrome: a case of cultural  overload. BMJ Case Rep. 2009;2009. pii: bcr06.2008.0317. Epub 2009 Feb 20. PMID: 21686859;  PMCID: PMC3027955.

Question 5

A competitive athlete asks for your advice about an embarrassing medical problem she has developed… a unilaterally swollen labia majora. What sport does she most likely compete in?

Reveal the funtabulous answer


She most likely suffers from a condition known as ‘bicyclist’s vulva‘. That’s right, as if cyclist’s nipples, cycling-related peripheral neuropathies and saddle sores weren’t bad enough there is a condition known as ‘bicyclist’s vulva’.

Bayaens and colleagues described 6 cases in a 2002 paper in the BMJ – the patients cycled an average of 462.5 km per week).  They all had unilateral lymphoedema thought to be due to compression of the inguinal lymphatics, with identifiable abnormalities on lymphoscintigraphy.

  • Baeyens L, Vermeersch E, Bourgeois P. Bicyclist’s vulva: observational study. BMJ. 2002 Jul 20;325(7356):138-9. PMID: 12130610; PMCID: PMC117232.

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Funtabulously Frivolous Friday Five

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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