Funtabulously Frivolous Friday Five 143

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 143

Question 1

What is Fagan famous for in evidence-based medicine (nothing to do with Oliver Twist)?

Reveal the funtabulous answer

The Fagan nomogram converts pre-test porbabilities into post-test probabilities using the likelihood ratio for any given test.


Question 2

What do a sloth bear and local people in the Central Indian Highlands get from Madhuca flowers?

Reveal the funtabulous answer

A hangover.

They both eat them when they’ve fermented so as to get drunk.


Question 3

What was Dr Guedel’s dog called and what did he do to it?

Reveal the funtabulous answer

Airway.

…He intubated it of course.

Arthur Ernest Guedel (1883 – 1956) wanted to prove that a cuffed ETT tube would prevent aspiration so he famously submerged his dog with the cuffed ETT while it was anaesthetised. Pulled the dog out of the water and woke them up. “Airway” than ran out of the auditorium thus proving his invention was a success.

airway the dog of Arthur Ernest Guedel
Airway, Guedel’s dog

Question 4

A patient presents one week after having a CTPA with tachycardia, hyper-reflexia, heat intolerance and loose bowel motions, labs indicate hyperthyroidism. What phenomenon has occurred?

Reveal the funtabulous answer

Jod-Basedow phenomenon. 

Jod is the German word for iodine and Karl Adolph von Based was the German physician who first described the effect.

It is hyperthyroidism following administration of iodine or iodide either dietary or as contrast medium. It does not occur in those patients with a normal thyroid but in those with Graves, toxic multi nodular loiter or thyroid adenomas as it needs a part of the gland that is not suppressed by the actions of the pituitary.

Wolf-Chaikoff effect is the opposite which can occur in patients with a normal or diseased thyroid whereby large quantities of iodine or iodide suppress thyroid function.


Question 5

Dying on the throne can be embarrassing, who does the following describe?

He rose at the usual hour of six o’clock. His German valet de chamber (Schroder) stating he ‘never looked better’ on receiving his cup of chocolate. He threw up at the window and looked onto the South-east gardens. He asked Schroder about the weather and wind direction. Since he received favourable answers he announced his intention of walking in the gardens. At quarter past seven, he retired to “a little closet’ to empty his bowels. After a time there was a “noise louder than the royal wind” followed by a groan and a thud.

Reveal the funtabulous answer

King George the Second.

He died of a rupture in his right ventricle causing a pericardial tamponade.

Blood letting was the done thing and his doctor complained he was not able to perform this due to lack of circulation once he got to the king. Probably was not going to help. [Reference]


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Funtabulously Frivolous Friday Five

Dr Neil Long BMBS FACEM FRCEM FRCPC. Emergency Physician at Burnaby Hospital in Vancouver. Loves the misery of alpine climbing and working in austere environments. Supporter of FOAMed, toxicology, tropical medicine, sim and ultrasound

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