Funtabulously Frivolous Friday Five 075

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 075

Question 1

A forensic pathologist examines the body of a recently deceased man. The pathologist notes a drop of seminal fluid at the tip of the dead man’s penis. Does this indicate that the man was engaged in sexual activity just before death?

Reveal the funtabulous answer


The seminal vesicles may contract as part of rigor mortis, resulting in the expulsion of seminal fluid.

Rigor mortis is the post-mortem contraction of muscle fibers due to the locking of actin-myosin filaments when ATP is depleted.

  • Shkrum MJ, Ramsay DA. Forensic pathology of trauma: common problems for the pathologist. Humana Press, 2007. [link]

Question 2

Are patients with pacemakers allowed to use mobile phones?

Reveal the funtabulous answer


Pacemaker interference can occur from cell phones, but they have to be within 10 cm of the pacemaker. Reported effects include inappropriate inhibition, atrial oversensing or synchronous rapid ventricular pacing from misinterpretation of the cell phone signal as atrial activity. Only about 1 in 100,000 pacemaker patients have mobile phone-related problems.

Practical advice to give to pacemaker patients is to use mobile phones in the hand opposite the side of the implanted pacemaker, and to avoid carrying the phone in the breast pocket near the pacemaker.

  • Irnich W, Batz L, Müller R, Tobisch R. Electromagnetic interference of pacemakers by mobile phones. Pacing Clin Electrophysiol. 1996 Oct;19(10):1431-46. PMID: 8904533.
  • Myerson SG, Mitchell AR. Mobile phones in hospitals. BMJ. 2003 Mar 1;326(7387):460-1. PMID: 12609917; PMCID: PMC1125359.

Question 3

Which Australian town with a population of about 27,000 has over 40,000 emergency department presentations per year?

Reveal the funtabulous answer

Alice Springs, in the very center of Australia.

Do the math — this suggests that every person in Alice Springs has an average of 1.5 presentations to the ED every year!

Possible reasons for this include:

  • social deprivation of the local indigenous population contributes to greater prevalence and severity of a wide range of medical illnesses.
  • high rates of violence, particularly related to alcohol.
  • a large catchment area with presentations from out of town – Alice Springs Hospital has 189 beds servicing an area of 1.6 million square kilometres.

Question 4

What is coprolalia?

Reveal the funtabulous answer

Coprolalia is involuntary swearing or the involuntary utterance of obscene words or socially inappropriate and derogatory remarks.

The term comes from the Greek κόπρος (kopros) meaning “feces” and λαλιά (lalia) from lalein, “to talk”. Literally, “talk sh!t”.

Coprolalia is most commonly attributed to Tourette Syndrome (coprolalia occurs in about 10-20% of cases) but can occur in other tic disorders, and other neurological conditions including stroke, encephalitis, seizure disorders and dementia.

Interestingly,  there are reports of deaf patients with Tourette’s who involuntarily swear using sign language. Related phenomena include copropraxia (performing obscene or forbidden gestures) and coprographia (making obscene writings or drawings).

Question 5

An elderly patient awoke in the middle of the night and noted brisk bleeding from a varicose vein on his shin. Why should you carefully examine the patient’s feet?

Reveal the funtabulous answer

Look for long toenails on the contralateral foot.

A fatal case of varicose vein injury inflicted by an excessively long toenail occurred in New Zealand and was described in the Lancet in 2003.

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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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