Funtabulously Frivolous Friday Five 300

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 300 – SAY WHAT – number 300!

After resurrecting the FFFF at number 101 one of our colleagues said ‘shit that means you’ll need to come up with another 100‘…well we’ve come up with 200 more and going strong. I’d like to thank all the contributors to this epic quiz who all write better questions than me and the on-going support from our readers, keep the suggestions coming and remember the occasional positive feedback nourishes the FOAMed soul a little more. Thank you again and enjoy this 300/titanic/epic related FFFF (apologies in advance for the loose ‘300’ connections).

Question 1

James Lind a physician in the Navy born just over 300 years ago conducted the first ever clinical trial, what disease was he trying to treat?

Reveal the funtabulous answer

Scurvy

Lind thought scurvy was due to putrefaction of the body and could be cured by acids. 2 months into a trip at sea, 12 sailors became ill. He split them into 6 groups of 2, each group received an addition to their normal diet. Group 1 – quart of cider, Group 2 – 25 drops of sulphuric acid, Group 3 – 6 spoonfuls of vinegar, Group 4 – half a pint of seawater, Group 5 – 2 oranges and 1 lemon, Group 6 – a spicy paste plus a drink of barley water.

Group 5 recovered by six days and were fit for work. This trial was ignored and the results not fully implemented for another 47 years until 1795 when the British Royal Navy would be convinced to routinely give lemon juice to its sailors.

Reference:

  • Lind J. A treatise of the scurvy, in three parts. Containing an inquiry into the nature, causes, and cure, of that disease. Together with a critical and chronological view of what has been published on the subject. 1753

Question 2

In the film 300, Leonidas (Gerard Butler) kicks a Persian messenger down a well. During a second shoot he sustained what injury to make this iconic scene.

Reveal the funtabulous answer

An Inguinal hernia

According to interviews most of the actors sustained multiple soft tissue injuries from fighting all day. Gerard Butler has been quoted as having his entire arm black and blue from having to throw fighters over his shoulder and at one point his throat caught a flame secondary to a stray cigarette mixing with glycine on his facial make up.


Question 3

Salbutamol recently celebrated 50 years but the inhaler has a much longer history. 300 years ago its inventor was born, do you know who they are and what device inspired his design?

Reveal the funtabulous answer

Dr John Mudge (1721-1793) english physician and he based his design on a pewter tankard. Ah, beer we thank you.

Hot water was placed in the bottom, lid closed and a flexible leather tube was used to inhale the steam. Often opium was mixed inside and the owner would tuck the whole apparatus under their arm to keep warm.

Once ether was used for anaesthesia, Mudge’s inhaler became the ideal delivery device.

Atomisers and nebulisers were invented in France in the mid-1800s. These devices were based on perfume sprays, and delivered drugs in the form of a liquid spray.

Finally in the 1950s the thirteen-year-old daughter of George Maison, president of Riker Laboratories in the United States was suffering from severe asthma and was feed up with inaccurate dose deliveries and largely just a jet of liquid that never reached the lungs. She challenged her father to do better:

“Why can’t they put my asthma medicine in a spray can like they do for perfume?”

Using a gas propellant, alcohol to dissolve the drug, an old ice-cream freezer, empty soda bottles as pressure containers and a bottle capper, the Maison’s team soon devised a working prototype. By 1956, a new drug application was approved for a PTC bronchodilator Medihaler-Epi (epinephrine) and the prescription only version of Medihaler-Iso (isoproterenol) for the treatment of asthma.

References:


Question 4

In 1912 the titanic sank after failing to navigate some 300 icebergs. The next day only 300 bodies were recovered despite over 1500 losing their lives. But out of the tragedy one device was invented that we now use daily in medicine. What was this device?

Reveal the funtabulous answer

Ultrasound

In 1794, physiologist Lazzaro Spallanzani was the first to study echolocation among bats, which forms the basis for ultrasound physics. Then in 1877, brothers Pierre and Jacques Currie discover piezoelectricity which is what most devices today use (piezoelectric can both emit and receive ultrasound waves). Then in 1915, Inspired by the sinking of the Titanic, Physicist Paul Langevin was commissioned to invent a device that detected objects at the bottom of the sea. Laugevin invented a hydrophone – what the World Congress Ultrasound in Medical Education refers to as the “first transducer”.

Neurologist Karl Dussik is credited with being the first to use sonography for medical diagnoses in 1942. He transmitted an ultrasound beam through the human skull in attempts of detecting brain tumors but came up with rudimentary ventriculograms. Unfortunately they were also not ventriculgrams but artefact as proven 10 years later as we now know the ultrasound beams would not have penetrated the skull.

First ultrasound images from Dussik

Reference:


Question 5

How does 300 help you determine the heart rate on an ECG?

Reveal the funtabulous answer

We can calculate the beats per minute (bpm) by dividing 300 by the number of LARGE squares between two R waves (R-R interval = one beat)

REGULAR rhythms

  • Rate = 300 / number of LARGE squares between consecutive R waves.

Very FAST rhythms:

  • Rate = 1500 / number of SMALL squares between consecutive R waves.

Example of 1500 (small squares) versus 300 (large square) method

ECG RATE calculation 300 1500 rules 25 mm sec
1500 (small square) and 300 (large square) methods

And Finally…

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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

One comment

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