Funtabulously Frivolous Friday Five 236
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 236
Question 1
You see a patient who has returned from Uganda complaining of pain in his arm whenever he turns the key. What is the diagnosis?
Reveal the funtabulous answer
African trypanosomiasis (sleeping sickness).
Kérandel symptom or ‘signe de la clef‘ named after Jean Francois Kérandel (1873-1934) is a sharp, deep pain in the bones or muscles when a patient with sleeping sickness turns a key in a lock.
Kerandel sign is a delayed hyperasthesia following a painful stimuli.
Both are two distinct symptoms of African human trypanosomiasis [Reference]
Question 2
A patient from S.E. Asia presents with 5 days of fevers, being the maverick diagnostician you are you perform the tourniquet test to rule in Dengue fever. But how sensitive and specific is the tourniquet test?
Reveal the funtabulous answer
Sensitivity 58% (95% CI, 43-71%) and specificity was 71% (95% CI, 60-80%).
A meta analysis of 28,739 participants concluded that there is marginal benefit to performing this test. Also called the Rumpel-Leede test, it involves inflating a BP cuff to the mid point of the patients DBP and SBP. Keep the pressure for 5 minutes and then count the petechiae. Greater than 10 per square inch distal to the tourniquet constitutes a positive test. [Reference]
The tourniquet test does form part of the WHO diagnosis criteria, see below:
Question 3
During 1995-2014, were males or females more likely to receive the Darwin award?
Reveal the funtabulous answer
Males
Winners of the Darwin award must eliminate themselves from the gene pool in such an idiotic manner that their action ensures one less idiot will survive.
According the “male idiot theory” (MIT) many of the differences in risk seeking behaviour, emergency department admissions, and mortality may be explained by the observation that men are idiots and idiots do stupid things.
The Christmas BMJ paper added weight to this hypothesis by showing that of the 413 Darwin Award nominations for 20 years, 332 of them were male. [Reference]
- Lendrem B. The Darwin Awards: sex differences in idiotic behaviour. BMJ 2014;349:g7094
Question 4
A friend of yours is very excited as she over-heard her haematology partner talking about Cabot’s rings. She’s very excited believing an engagement maybe imminent. What is a Cabot ring?
Reveal the funtabulous answer
They are delicate threadlike inclusions in the red blood cells in the peripheral blood of some patients with severe/megaloblastic anaemia.
They may appear as rings, figures-of-eight, or twisted. They are blue-staining and their origin is unknown. Contrary to Cabot’s belief, these structures have nothing to do with the nucleus or the nucleus’ membrane.
First described in 1903 by American physician, Richard Clarke Cabot (1868-1939).
- Cabot RC. Ring Bodies (nuclear Remnants?) in Anemic Blood. J Med Res. 1903; 9(1): 15-18
Question 5
If you suffered from amblygeusia, what would least interest you…
- Going for a surf at the beach.
- Going to a fancy restaurant.
- Going to watch WWE SmackDown.
Reveal the funtabulous answer
Answer 2.
Amblygeusia refers to a diminution in the sense of taste. [ambly- + G. geusis, taste]
FFFF
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.