Funtabulously Frivolous Friday Five 185

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 185 with an Easter twist

Question 1

Where was Rapamycin discovered?

Reveal the funtabulous answer

Easter Island (Papa Nui)

If you are lucky enough to climb upto the extinct volcano Rano-Kau on Easter Island you will discover a plaque commemorating the discovery of Rapa-mycin. Found in the soil on Rapa Nui and originally marketed as an antifungal but had some side effects, most notably its potent immunosuppressive and antiproliferative properties.

It is now used to prevent organ rejection in transplant patients (prevents activation of T cells and B cells by inhibiting interleukin-2), coronary stent coating (eliminates abnormal white cells) and is used in the treatment of autoimmune lymphoproliferative syndrome (ALPS). Also if you are lucky enough to be a mouse then it will increase your life expectancy, however due to its immunosuppressant properties I wouldn’t go ordering it over the internet just yet.

Question 2

Who gets the most traumatic auricular amputations at this time of year?

Reveal the funtabulous answer

It appears that chocolate rabbits are most likely to suffer from this trauma.

One survey found that 59% of the 28,113 respondents preferred to eat chocolate rabbits starting with the ears, 33% indicated that they had no starting point preference, and 4% indicated that they started with the tail or feet

Question 3

Eggs are used to symbolize new life or in Christianity the empty tomb of Jesus, but if you were new to this world and had an “egg on a string” on your chest X-ray what condition would you have?

Reveal the funtabulous answer

Egg on a string sign refers to the cardiomediastinal silhouette seen in transposition of the great arteries.

Dr Vincent Tatco, Radiopaedia.org. Case rID: 43062

Question 4

What is ‘theobromine poisoning’ often termed (wrongly…)?

Reveal the funtabulous answer

Chocolate poisoning.

It is an overdosage reaction to the xanthine alkaloid theobromine, but it is in other products including tea, cola beverages, and acai berries, not just chocolate.

Median lethal (LD50) doses of theobromine in humans is 1000 mg/kg. In dogs it is 300mg/kg hence why chocolate can poison dogs. Symptoms include nausea, vomiting, diarrhoea, cardiac arrhythmias, seizures and eventually death.

The amount found in highly refined chocolate candies or sweets (typically 1.4–2.1 g/kg) is much lower than that of dark chocolate or unsweetened baker’s chocolate (> 14 g/kg).

Question 5

What disease can the Easter Bunny pass onto humans resulting in fever, ulceration and lymph node swelling?

Reveal the funtabulous answer

Tularemia caused by the intracellular bacterium Francisella tularensis.

There are varying strains of virulence. F. tularensis tularensis (Type A), which is found in lagomorphs (rabbits, hares and pikas) is highly virulent in humans and domestic rabbits.

See the CDC signs and symptoms for the varying Tularemia signs and symptoms.

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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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