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Funtabulously Frivolous Friday Five 325

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 325

Question 1

What is the streetlight effect?

Reveal the funtabulous answer

It is a type of observational bias that occurs when people only search for something where it is easiest to look – like the first page on a google search.

A policeman sees a drunk man searching for something under a streetlight and asks what the drunk has lost. He says he lost his keys and they both look under the streetlight together. After a few minutes the policeman asks if he is sure he lost them here, and the drunk replies, no, and that he lost them in the park. The policeman asks why he is searching here, and the drunk replies, “this is where the light is”

David H. Freedman (2010). Wrong: Why Experts Keep Failing Us

Reference:


Question 2

In 2005 a South Korean 28 year old man died after playing computer games. How many hours was he playing for?

Reveal the funtabulous answer

50 hours only to stop for his cardiac arrest.

During this time he had few toilet breaks, micro sleeps and very little to eat. Unfortunately this man was not alone, there have been several subsequent reports of gamers dying after marathon sessions. Including a 2012 incident where other gamers in the cafe continued to play for a further 10 hours after one man died before they noticed his corpse.

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Question 3

While on the question of technology, 559 pedestrians in the USA in 2004 suffered an injury whilst on their mobile phone. Did that number double, triple or quadruple by 2010?

Reveal the funtabulous answer

Almost tripled to 1506.

While the number are low, this data only includes those people who actually presented themselves to the emergency department. Equally the breakdown of injuries and exact causes are unknown but listed in the research paper are some anecdotes to pedestrians walking in front of cars and we’ve all seen a few people in our time walk into static objects.

Think you are immune? Equally astonishing is the fact we check our phones 150x a day, maybe stop doing it while walking!!

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Question 4

When for what infectious disease would you perform a spatula test?

Reveal the funtabulous answer

Tetanus

Most people when you shove a tongue depressor onto the posterior pharyngeal wall will gag and try to push the tongue depressor out. Those with tetanus have been shown to clamp down on the tongue depressor.

This test had a specificity of 100% and a sensitivity of 94% in a group of 400 patients with suspected tetanus.

References


Question 5

What is carotid blowout syndrome?

Reveal the funtabulous answer

Carotid blowout syndrome (CBS) is a rare but life-threatening complication of head and neck cancer. Commonly a squamous cell carcinoma following radial neck dissection and radiotherapy. This results in the obliteration of the vasa vasorum causing fibrosis of the adventitia and weakness overall of the arterial wall.

CBS occurs in 4.3% of all head and neck malignancies and has a mortality of 40%. Bleeding is common into the oral cavity or from the surgical wound itself and can occur many months later.

CBS can be classified as threatened (where the carotid artery is exposed to the oral cavity or external environment), impending (a patient with sentinel bleeds) or acute (active bleeding).

CT angiogram is the diagnostic gold standard with therapies ranging from surgical ligation to endovascular stents and embolisation as shown below:

Carotid blowout syndrome: An oncological emergency less discussed

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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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