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Funtabulously Frivolous Friday Five 128

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 128

Question 1

Melena suggests a proximal GI bleeding source in which there is time for enzymatic breakdown to transform blood to melena. How much blood in the stomach does it take to cause melena?

Reveal the funtabulous answer

50mL

In clinical experiments, placing as little as 50 mL of blood in the stomach can cause melena.


Question 2

What is a Morel-Lavallée lesion?

Reveal the funtabulous answer

Closed de-gloving injury in which the skin remains intact but the subcutaneous tissue is sheared away from the underlying fascia.

This results in either serous or blood forming a collection in this are of tissue damage. They are associated with considerable morbidity in trauma patients.

Strictly speaking a Morel Lavallée lesion only overlies the greater trochanter, but similar biomechanical forces can result in identical lesions occur in other areas of the body.

Morel-Lavallee

Question 3

What is an Essex–Lopresti injury?

Reveal the funtabulous answer

An Essex-Lopresti injury consists of a radial head fracture with dislocation of the distal radioulnar joint (DRUJ) and disruption of the interosseous membrane (IOM)

If not diagnosed acutely, the radius migrates proximally and the ruptured IOM results in forearm instability.

These can be subtle and a high index of clinical suspicion is needed. Careful examination of the wrist to look for subtle disruption of the distal radio-ulnar joint is required.


Question 4

What is the number one cause of fatal ingestions in children under 5 years of age (in the US)?

Reveal the funtabulous answer

Disk batteries (button battery)

The majority of deaths reported have been due to aorto-esophageal fistula or fistula with another major vessel. 

Button_Battery

Question 5

What topical medication has been reported as a cause of methemoglobinemia in infants and children?

Reveal the funtabulous answer

EMLA (Eutectic Mixture of Local Anaesthetics)

The topical anaesthetic EMLA (lidocaine plus prilocaine)


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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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