Funtabulously Frivolous Friday Five 086

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 086

Question 1

Can a patient with an ectopic pregnancy have a negative serum BhCG (pregnancy test)?

Reveal the funtabulous answer

Yes – never say never.

It is sufficiently rare that I’ve only been able to find two case reports:

  • Grynberg M, Teyssedre J, Andre C, Graesslin O. Rupture of ectopic pregnancy with negative serum beta-hCG leading to hemorrhagic shock. Obstet Gynecol. 2009 Feb;113(2 Pt 2):537-9. PubMed PMID: 19155948.
  • Lee JK, Lamaro VP. Ruptured tubal ectopic pregnancy with negative serum beta hCG–a case for ongoing vigilance? N Z Med J. 2009 Jan 23;122(1288):94-9. PubMed PMID: 19182846.

However up to about 3% of patient’s with ectopics can have negative urine pregnancy tests. Not that I’m trying to scare you or anything…

  • Aboud E. A five-year review of ectopic pregnancy. Clin Exp Obstet Gynecol. 1997;24(3):127-9. PubMed PMID: 9478294.

Question 2

What did the wife of French philosopher and writer Denis Diderot say to him just before he died?

Reveal the funtabulous answer

Don’t eat that!

Diderot died while eating an apricot.

Simon Critchley has much more on the deaths of philosophers in his talk featured in A Philosophical Death.

Question 3

What is the highest blood alcohol concentration ever measured in a human being?

Reveal the funtabulous answer

1.6% or 1.6g/100mL

According to South Africa’s Sowetan:

“The man was allegedly 32 times over the legal alcohol limit. His blood had an alcohol content of 1.6g/100ml. The legal limit is 0.05g/100ml. He was driving a Mercedes-Benz Vito and was arrested near Queenstown in Eastern Cape… Five boys as well as a woman who were also in the vehicle with 15 sheep, allegedly stolen from nearby farms, were also arrested.”

Why the sheep were arrested is anybody’s guess…

Question 4

What is Pott’s puffy tumor?

Reveal the funtabulous answer

Frontal bone osteomyelitis resulting in a subperiosteal abscess presenting as a fluctuant mass over the forehead and scalp.

Today the condition is rare and only a few dozen cases have been reported in the literature of the postantibiotic era (mostly in adolescents).

The ultimate eitiologies include local trauma, insect bites, sinusitis, hematogenous spread and snorting drugs like cocaine and metamphetamines.

 “But the inflammation of the dura mater and the formation of matter between it and the skull, in consequence of contusion, is generally indicated and preceded by one [sign] I have hardly ever known to fail; I mean a puffy, circumscribed, indolent tumor of the scalp and a spontaneous separation of the pericranium, from the skull under such tumor.

Percival Pott

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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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