Funtabulously Frivolous Friday Five 119 • LITFL • FFFF

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 119

Question 1

Which surgeon had a mortality rate of 300% during a single operation? How did this happen?

Reveal the funtabulous answer

Robert Liston (1794-1847)

Liston operated in a time before anaesthesia. It was recognised that a speedy operation could significantly improve the outcomes for a patient, and Mr Liston was known for his speed.

The amputation of a leg in 2 and a half minutes was certainly quick.

Unfortunately it also involved the accidental amputation of the fingers of his assistant and Mr Liston also cut through the coat of a spectator.

The spectator ‘dropped dead of fright’ whilst the assistant and the patient died after their wounds became gangrenous…bringing the mortality for a single operation to 300%. [Reference]

Question 2

You’re asked to see a patient who presents with a history of nausea, diarrhoea and vomiting, but then went onto develop headache, ataxia, and paraesthesia. He cooked a large snapper (fish) for dinner with his wife, but states it can’t be related to the snapper as his partner didn’t suffer any similar symptoms. What might be the cause?

Reveal the funtabulous answer

Ciguatera poisoning

Fish that have consumed the algae Gambierdiscus toxicus accumulate the toxin in their flesh and this can accumulate through the food chain.

The ciguatoxin is odourless and tasteless and very heat resistant.

It can remain intact after cooking. There has been a case report that suggested the toxin could be transmitted sexually – although diagnostic tests were not conclusive. Treatment is supportive and neurological symptoms can last for weeks to years for multiple relapses [Reference]

Question 3

The USA fingerprints foreign visitors on entry, a patient of your asks you to give him a letter explaining why he has no fingerprints. Which specialty are you likely to be working in and why does your patient have no fingerprints?

Reveal the funtabulous answer

Specialty: Oncology. Drug: Capecitabine

The chemotherapy agent capecitabine can cause hand-foot syndrome as a side effect.

This is characterised by erythema, tingling, paresthesia, and if severe can be associated with blistering and ulceration.

Patients who experience severe hand-foot syndrome or repeated episodes can “lose” their fingerprints.

Question 4

Where would you find this statue and what is the story behind it?

Reveal the funtabulous answer

Paris and the first rabies inoculation

The statue is outside the Pasteur Institute in Paris. The statue is of nine-year old Joseph Meister who was bitten by a rabid dog several times. He was the first person to be successfully inoculated against rabies by Louis Pasteur and lived into his seventies.

Question 5

If you were in Berlin, you might come across this monument. What does the statue represent and whom does it honour?

Reveal the funtabulous answer

The statue depicts the fight between man and disease.

The man it honours is Rudolf Virchow.

Virchow is known for several remarkable contributions to medicine – including coining the term “zoonoses” and having an autopsy procedure named after him.