Funtabulously Frivolous Friday Five 186

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 186

Question 1

What is Darwin’s tubercle?

Reveal the funtabulous answer

A congenital ear condition which often presents as a thickening on the helix at the junction of the upper and middle thirds.

This atavistic (evolutionary throwback) feature is so called because its description was first published by Charles Darwin in the opening pages of The Descent of Man, as evidence of a vestigial feature indicating common ancestry among primates which have pointy ears.

However, Darwin himself named it the Woolnerian tip, after Thomas Woolner, a British sculptor who had depicted it in one of his sculptures and had first theorised that it was an atavistic feature.

Darwins-tubercle

Question 2

What is Haglund syndrome?

Reveal the funtabulous answer

Haglund syndrome refers to the triad of:

  • Insertional achilles tendinopathy
  • Retrocalcaneal bursitis
  • Posterosuperior calcaneal exostosis [Haglund deformity]

This results in a noticeable bump on the back of the heel, pain in the area of the Achilles tendon, swelling to the back of the heel and erythema to that area. Commonly associated with high heels but also nicknamed “pump bump” due to the irritation wearers of sneakers notice due to the rigid backs on some sneakers


Question 3

With your new found knowledge of Patrik Haglund syndrome you jovially jest with a male patient with the condition that it can occur with women wearing high heels. While he looks insulted by your poor joke, you try to recover by explaining who originally wore heeled shoes. So, who originally wore heeled shoes?

Reveal the funtabulous answer

First reports of a healed shoe come from Egypt where butchers would wear them instead of sandals to keep their feet out of the entrails.

However, there are scattered reports in various civilizations from Mongolia, Persia and Europe of fighters and soldiers at various times throughout history wearing high heels of some description to keep their feet from slipping out of the stirrups.

It is probably around the 17th century when they became fashionable, King Louis XIV of France decreed that only nobility could wear heels, and that only members of his specific court could wear red ones.


Question 4

While trying to consent a patient for a CT abdo you discuss background radiation exposure. During a google search you find a place that has the equivalent mGy of a CT abdominal as background radiation. Where is this place?

Reveal the funtabulous answer

Ramsar, Iran, it is the most radioactive area inhabited on earth. Average 10 mGy background (CT abdominal 8mGy)

The prevailing model of radiation-induced cancer posits that the risk rises linearly with dose at a rate of 5% per Sv. If this linear no-threshold model is correct, it should be possible to observe an increased incidence of cancer in Ramsar.

Early anecdotal evidence from local doctors and preliminary cytogenetic studies suggested that there may be no such harmful effect, and possibly even a radioadaptive effect, raising the theory of radiation hormesis.


Question 5

What is the Dunning-Kruger effect?

Reveal the funtabulous answer

Nobel prize winners David Dunning and Justin Kruger noted that those with low ability failed to recognize their ineptitude and evaluate their competence accurately. The corollary to this was, high-ability individuals may underestimate their relative competence and may erroneously assume that tasks which are easy for them are also easy for others. [Reference]

Commonly experienced in medicine by our increased confidence at PGY2 and then our feelings of imposter syndrome at the end of training.


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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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