Funtabulously Frivolous Friday Five 152
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 152
Question 1
On a typical Autumn ward round, your team walks in the next side room to review the next patient (the fourth patient in this corridor that the team has seen) who presented with non-specific malaise. The consultant wanders over to the window, glances out and says
I see our patient here had a high fever – probably above 39°C – earlier this morning.
The house surgeon checks the observation chart and confirms this was indeed the case. The patient currently looks quite comfortable, and you know that the consultant hasn’t been updated on the patient, nor checked the notes. How did the consultant know the patient had a fever?
Reveal the funtabulous answer
The consultant noticed condensation on the window; none of the other rooms in this corridor had any present. He correctly surmised that this was due to the febrile patient acting as a heat source for the windows (chilled by the cool Autumn morning). Having met this consultant, I can attest to this Sherlockian attribute.
Question 2
Your colleague has a patient with a “vaselinoma” and wants your advice on which service to refer them to. Having seen a man with a “paraffinoma” the previous week, you reply…?
Reveal the funtabulous answer
Plastic surgery – or possibly urology.
“Vaselinoma” and “paraffinoma” are terms coined to describe the collection of vaseline (or mineral oil) that has been self-injected by patients in attempt to enlarge their genitalia. This often ends in penile ulceration, necrosis and infection. [Reference]
- Sejben I et al. Petroleum jelly-induced penile paraffinoma with inguinal lymphadenitis mimicking incarcerated inguinal hernia. Can Urol Assoc J. 2012 Aug;6(4):137-9.
Question 3
A patient is brought in having fallen off a ladder at work. It is fairly obvious that he is drunk. Luckily he is not seriously harmed. While suturing a laceration on his arm, he explains that he only had a fruit juice at lunch and the yeast in his guts have converted the sugar in this to alcohol. He wants a note from you supporting this proposed “auto-intoxication” to avoid losing his job. Is this even plausible?
Reveal the funtabulous answer
Endogenous alcohol production or “auto-brewery syndrome” is rare, but has been reported.
The cases described have been in patients with short gut syndrome or similar structural changes to their small bowel, who become intoxicated following a carbohydrate-rich meal.
There is no significant evidence for this in healthy individuals with an intact gastro-intestinal system
- Logan BK, Jones AW. Endogenous ethanol production in a child with short gut syndrome. J Pediatr Gastroenterol Nutr. 2003 Mar;36(3):419-20
Question 4
How did the James Bond villain Dr. No survive a shot to the chest?
Reveal the funtabulous answer
The wound would have penetrated his heart, except that he had dextrocardia.
Question 5
Who received mail with no address and were simply mailed:
To the Greatest Physician in the World
Reveal the funtabulous answer
Boerhaave
However, the most specific evidence to date was recorded by Burton, in his 1743 biography,
…a remote part of Asia afforded another instance of [Boerhaave’s] extensive fame, by a Letter from thence with this address – To Mr Boerhaave, Physician in EUROPE
Hermann Boerhaave (1668 – 1738) became famous through his teachings as his discoveries and writings were few.
He was the Sir William Osler of the 18th century, or more accurately, Osler was the Boerhaave of the 19th century.
After all, Boerhaave’s methodology was the more impressive, being original and taught in an era when medical diagnostics were in its infancy, and medical therapeutics virtually non-existent.
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Funtabulously Frivolous Friday Five
Medical Registrar fascinated by the quirky history of medicine and those crazy microbes.