Funtabulously Frivolous Friday Five 206

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 206

Question 1

What condition is Ewart on the left, Conner on the right and when those two disappear Bamberger is present?

Reveal the funtabulous answer

Pericardial effusion

William Ewart (1848 – 1929): While percussing the posterior chest, dullness at the left lower lung field is Ewart sign of pericardial effusion

Lewis Atterbury Conner (1867-1950): dullness at the left lower lung field is Conner sign.

Heinrich von Bamberger (1822-1888): Disappearance of Ewart or Conner signs when the patient sits up and leans forward is Bamberger sign of pericardial effusion


Question 2

A young male keeps presenting with low back pain, you suspect they are drug seeking but before you aim to try and manage their chronic pain you take an X-ray.

What is the diagnosis?

Bertolotti Syndrome

Reveal the funtabulous answer

Bertolotti Syndrome

Sacralisation of the lower lumbar vertebrae. Partial or complete fusion of the transverse process of the L5 vertebra to the sacrum. Associated with scoliosis and symptoms of low back pain and sciatica. It can be unilateral or bilateral.

Bertolotti Syndrome is an atypical cause of low back pain or buttock pain caused by a transitional lumbar vertebrae with a large, “spatulated” transverse process that either fuses with the sacrum (sacral ala) or ilium, or forms a pseudo-articulation at that location (Seen on a lumbar spine AP X-ray).

This is a congenital abnormality, but doesn’t usually become symptomatic until a patient’s 20’s or 30’s.

  • Thurston M, Weerakkody Y. Bertolotti syndrome. Radiopaedia
  • Jahangiri A. Bertolotti syndrome. Radiopaedia
  • Mario Bertolotti (1876-1957)
  • Bertolotti M. Contributo alla conoscenza dei vizi differenzazione regionale del rachide con speciale riguardo all assimilazione sacrale della V. lombare. Radiol Med (Torino) 1917; 4: 113-144

Question 3

Who is patient zero?

Reveal the funtabulous answer

Gaëtan Dugas

One of the most demonised patients in history for allegedly spreading HIV to the US

Initially, however, the CDC researcher, who was studying cases in Los Angeles, California, referred to Dugas not as “patient zero”, but as “patient O”, the letter “O” standing for “outside California” and subsequently the term “patient zero” was born.

In 2016 Nature published a report from Dr. Michael Worobey’s team who conducted a genetic study that looked at blood samples taken from gay and bisexual men in 1978 and 1979 as part of a hepatitis B study, and based on the results of the data, concluded that Dugas was not the source of the virus in the U.S.

On the family tree of the virus, Dugas fell in the middle, not at the beginning


Question 4

What is the medical term for someone who has a severe case of ‘ants in their pants’ after being given a dose of metoclopramide?

Reveal the funtabulous answer

Akathisia

A syndrome characterized by an inability to remain seated, with motor restlessness and a feeling of muscular quivering; may appear as a side effect of antipsychotic and neuroleptic medication.


Question 5

What hereditary condition is associated with a urinary odour of swimming pools?

Reveal the funtabulous answer

Hawkinsinuria

Also called 4-Alpha-hydroxyphenylpyruvate hydroxylase deficiency, it is an autosomal dominant metabolic disorder affecting the metabolism of tyrosine.

Patients present with metabolic acidosis during the first year of life, which should be treated by a phenylalanine- and tyrosine-restricted diet. The tolerance toward these amino acids normalizes as the patients get older. Then only a chlorine-like smell of the urine indicates the presence of the condition, patients have a normal life and do not require treatment or a special diet.


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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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