Funtabulously Frivolous Friday Five 122

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 122

Question 1

What is a Clay-shoveler’s fracture and how do you get one?

Reveal the funtabulous answer

Fracture through the spinous process of a vertebra occurring at any of the lower cervical or upper thoracic vertebrae, classically at C6 or C7.

Originally described in Australia associated with (no prizes for guessing) labourers shoveling clay…

As Clay-shoveler’s tossed the shovel upward, the clay sometimes stuck to it which produced a sudden flexion force on the neck and back muscles, resulting in the fracture. [Reference]

Question 2

What antibiotics are associated with the development of rhabdomyolysis?


Reveal the funtabulous answer

  • Trimethoprim-sulfamethoxazole
  • Macrolides
  • Quinolones


Question 3

Erythema multiforme is an acute hypersensitivity reaction with a characteristic rash: an erythematous ring or target lesion with a dusky or pale centre. Infections and drugs are the most common causes. What are the 2 most common infectious causes?

Erythema multiforme

Reveal the funtabulous answer

Herpes simplex virus and Mycoplasma pneumonia

Question 4

What infection typically causes  double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness (a classic descending symmetrical paralysis with eventual loss of deep tendon reflexes)?

Reveal the funtabulous answer


If left untreated symptoms may progress to paralysis of the respiratory muscles, arms, legs, and trunk.

Infants with botulism appear lethargic, feed poorly and have a weak cry and poor muscle tone.

In food-borne botulism, symptoms generally begin 18 to 36 hours after eating a contaminated food, but they can occur as early as 6 hours or as late as 10 days.  [Reference]

Question 5

Adrenal crisis is a life-threatening emergency, and clinical suspicion alone warrants immediate administration of stress-dosed glucocorticoids, usually in the form of hydrocortisone or dexamethasone. When would dexamethasone be preferred?

Reveal the funtabulous answer

Dexamethasone is preferred if the diagnosis of adrenal insufficiency has not yet been confirmed to reduce interference with cortisol assays that may later be necessary for diagnostic workup. [Reference]

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Funtabulously Frivolous Friday Five

Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Kelowna hospital, British Columbia. Loves the misery of alpine climbing and working in austere environments (namely tertiary trauma centres). Supporter of FOAMed, lifelong education and trying to find that elusive peak performance.

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