Funtabulously Frivolous Friday Five 309

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 309:

What is Albers-Schonberg Disease?

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Albers-Schönberg disease is the most common form of osteopetrosis.

Also known as autosomal dominant osteopetrosis type II (ADO II). Heinrich Ernst Albers-Schönberg (1865 – 1921) was a German radiologist and named the disease in 1904.

Osteopetrosis is a group of conditions characterized by increased skeletal mass due to impaired bone and cartilage resorption

Albers-Schönberg disease marble bone osteopetrosis 2

Other names include: Marble bone disease or ‘`marmorknochenkrankheit’; ‘morbo marmoreo’; ‘os de marbre’

Reference: Albers-Schönberg disease – LITFL

Who said:

Drug therapies are replacing a lot of medicines as we used to know them

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George W. Bush (1946 -)

I imagine he was on most people’s shortlist for this great, October 2000 contribution to the understanding of medicine…

At the end of the 19th century, hot irrigations with large volumes of saline were administered with Kemp’s double-current rectal tubes for what purpose?

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To stimulate urine flow in non-obstructive renal failure.

The technique was first described in 1897 by Robert Coleman Kemp (1865 – 1918).

Sir William Osler (1849-1919) writes of anuria and kidney injury in his textbook ‘The Principles and Practice of Medicine’…

In the obstructive cases surgical interference should be resorted to. In the non-obstructive cases, particularly when due to extreme congestion of the kidney, cupping over the loins, hot applications, free purging, and sweating with pilocarpine and hot air are indicated. When the secretion is once started diuretin often acts well. Large hot irrigations, with normal salt solution, with Kemp’s double-current rectal tubes, should be tried, as they are stated to stimulate the activity of the kidneys in a remarkable way.

Osler 1904: 851


Who discovered a form of heart block using a tuning fork and a Sphygmogram?

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Karel Frederik Wenckebach (1864 – 1940)

In 1898 Karel Wenckebach consulted a 40-year-old woman with an irregular pulse which he interrogated using a sphygmogram and tuning fork. He noted there were regular pauses every 3 to 4 beats, but the small extra pulse seen during pauses were longer, and subsequent intervals were smaller. The first interval after each pause was longer, and subsequent intervals were shorter.

However, Wenckebach credited Luigi Luciani (1840 – 1919) as the first to describe this recurrent pattern in his 1873 frog heart experiments and defined this form of group beating as ‘Luciani’schen Perioden’ (Luciani periods)

Man spricht in diesen Fällen von einer “periodischen Function” des Herzens; die Gruppen werden nach dem Entdecker “Luciani’sche Perioden” genannt.…es sich hier um eine regelmässige Herzthätigkeit handelt, welche von einem constantcn schädlichen Einfluss gestört wird. Dieser Einfluss ist ein negativ dromotroper Einfluss, wie aus einer sorgfältigen Vergleichung dieses Pulses mit der Ventrikelthätigkeit des in Luciani’schen Perioden klopfenden Froschherzens hervorgeht.

Wenckebach 1899; 37: 478

In these cases one speaks of a “periodic function” of the heart; the groups are called “Luciani periods” after the discoverer… it is a regular cardiac activity, which is disturbed by a constant harmful influence. This influence is a negative dromotropic influence, as can be seen from a careful comparison of this pulse with the ventricular activity of the frog heart pounding in Luciani’s periods.

Wenckebach 1899; 37: 478

Wenckebach’s figure demonstrates a constant atrial rate (top line) with diagonal lines (representing AV conduction) progressively lengthening before a beat being missed/dropped. This is followed by the recommencement of the cycle. With the advent of electrocardiography in the early 20th century, this form of group beating became known as ‘Wenckebach periodicity‘ and later as ‘Mobitz type I atrioventricular block‘.

Wenckebach periodicity Type I AV block


**Note: The true title of Wenckebach’s work is “Zur Analyse des unregelmässigen Pulses” rather than the copy and past version found through the internet of “Zur Analyse des unregelmassigne Pulses”. The correct title will lead the reader to be able to review all four sections of the body of work as referenced above.

What is this, and where can it be found in the body?

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Phrygian cap or liberty cap is a soft conical cap with the apex bent over, associated in antiquity with several peoples in Eastern Europe and Anatolia, including Phrygia, Dacia, and the Balkans. During the French Revolution it came to signify freedom and the pursuit of liberty.

A Phrygian cap is a congenital anomaly of the gallbladder with an incidence of 4% and has no pathological significance or symptoms.

…and finally

People are dying who have never died before
See FFFF 311 in the next couple of weeks where we fact check this statement – looks like we were wrong…
Social distancing flowchart

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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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