Funtabulously Frivolous Friday Five 328

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 328

Question 1

Although it’s not time for New Years resolutions you maybe wondering about what new diet fad is coming around the corner. Fancy eating a plane? Well Monsieur Mangetout (“Mr. Eat-All”) did just that.

Who was Monsieur Mangetout and how did he eat a plane?

Reveal the funtabulous answer

Michel Lotito (1950-2007), a french entertainer was famous for eating indigestible objects.

Credit: Guinness world records

He had the eating disorder pica and in his time he eat bicycles, shopping carts, televisions and his most famous stunt was eating a Cessna 150. It took him two years between 1978 and 1980 by eating approximately 1kg of material broken down into small bits along with mineral oil and lots of water.

It was estimated that between 1959 and 1997 he had eating nearly 9 tons of metal. He apparently died of natural causes at the age of 57 and holds the Guinness World Record for the strangest diet.

Reference:


Question 2

How many IQ points can you loose checking your emails constantly?

Reveal the funtabulous answer

10

Back in 2005 Hewlett Packard termed the rise of “insomnia” and found 62% of people check work messages at home of on holiday. I suspect its closer to 100% now. HP asked the Institute of Psychiatry to conduct a study with Dr Glenn Wilson a psychologist. He submitted 8 individuals to testing in noisy versus quiet conditions. The noisy conditions resulted in 10 IQ points, its difficult to entirely blame texting and emails but these were largely the distractions used on the subjects while completing other tasks.

The BBC then took these unpublished findings and with a quick google research made the claim “Infomnia” is worse than marijuana (as marijuana only drops your IQ by 4 points).

Dr Glenn Wilson made a rebuttal in 2010, stating his findings were blown out of proportion and while distractions and multitasking may drop your IQ, the effects are only temporary unlike smoking marijuana. So, finding you can’t think straight at work, given yourself a moment, focus on one task at a time and find some where slightly less noisy (if you find that place in an emergency department, let me know).

References:


Question 3

Which drug can treat Behçet disease and Familial Mediterranean fever and is also used to produce seedless watermelons?

Reveal the funtabulous answer

Colchicine – mind blown

Okay, if I gave you the clue of a drug that treats gout or pericarditis it would have been too easy. Here’s the science bit…

Since chromosome segregation is driven by microtubules, colchicine is used in plant cells during cellular division by inhibiting chromosome segregation during meiosis; half the resulting gametes, therefore, contain no chromosomes, while the other half contains double the usual number of chromosomes, and lead to embryos with double the usual number of chromosomes (i.e., tetraploid instead of diploid). While this would be fatal in most higher animal cells, in plant cells it is not only usually well tolerated, but also frequently results in larger, hardier, faster-growing, and in general more desirable plants than the normally diploid parents.

When such a tetraploid plant is crossed with a diploid plant, the triploid offspring are usually sterile. In the case of the watermelon, colchicine-induced triploidy creates “seedless” fruit.

References:


Question 4

Who treated Nepolean’s haemorrhoids (which have been blamed by some historians for his loss at Waterloo)?

Too hard? Here are some more clues:

  • He was without doubt the greatest French surgeon since Paré.
  • His greatest contributions were in the field of surgical pathology and his eponym has been applied to at least twelve diseases, operations, or instruments.
  • Born in poverty he purportedly became the richest physician of his time. He reputed saw up to 10,000 patients a year and amassed such a fortune he was able to offer Charles X a million francs to tide him over when he was de-throned

Reveal the funtabulous answer

Guillaume Dupuytren – click the link for more amazing facts.

While a remarkable surgeon, he was not popular amongst his peers. Lisfranc referred to Dupuytren as “the brigand of the Hôtel Dieu” and Pierre-François Percy (1754-1825) referred to him as “first among surgeons, last among men

Of the many crimes of which he was accused, no one ever suggested that he put his private interest above that of the meanest of his patients. His funeral cortege was interrupted as it made its way to the cemetery by crowds of workmen who took the coffin on their shoulders and bore it part of the distance.


Question 5

What did George Washington die of, blood letting, croup, quinsy, diphtheria or bacterial epiglottis?

Reveal the funtabulous answer

Most likely bacterial epiglottis, although draining 2365ml of blood probably didn’t help the situation.

The following explanation is paraphrased from: Morens DM. Death of a President. N Engl J Med 1999; 341:1845-1850

The final hours of George Washington:

It was December 1799 three physicians, gathered around George Washington, 69-year-old, Edinburgh-trained James Craik had frequently visited the president, Gustavus Richard Brown, was 52-year-old physician and Elisha Cullen Dick, a 37-year-old physician trained in Pennsylvania. He knew the latest medical literature and was clinically aggressive.

Craik, the first physician to arrive, at 9 a.m., obtained the medical history. On Friday, December 13, Washington had “taken a cold,” with mild hoarseness. At 2 the next morning, he awoke and had difficulty breathing. By 6 a.m., he was febrile, with throat pain and respiratory distress. Unable to swallow, he spoke with difficulty. At about 7:30 a.m., Rawlins removed 355 to 414 ml of blood, with Washington requesting additional bloodletting. The mixture of molasses, vinegar, and butter Lear gave him brought on nearly fatal choking.

Craik applied a blister of cantharides to Washington’s throat and removed approximately 18 oz (532 ml) of blood at 9:30 a.m., with a similar amount removed at 11 a.m. Washington repeatedly gargled sage tea with vinegar. Tilting his head back to drip the mixture down his throat, he nearly suffocated, unable to cough the fluid up. Still alert, he rose and walked about the bedroom, then sat upright in a chair for two hours. Returning to bed, he squirmed to find a comfortable position.

Arriving at 3 p.m., Dick argued that further bleeding might weaken Washington. Craik nevertheless ordered a fourth bleeding, with the removal of 946 ml of blood. Brown arrived at 4 p.m., at which time calomel (mercurous chloride) and tartar emetic (antimony potassium tartrate) were administered.

At 8 p.m., the physicians applied blisters of cantharides to his feet, arms, and legs and then applied wheat-bran cataplasms (poultices) to his throat. His condition deteriorated further. At 10:20 p.m., George Washington died.

What disorder led to Washington’s death?

Dick rejected Craik’s diagnosis of “inflammatory quinsy” and proposed three alternatives: “stridula suffocatis,” “laryngea,” or “cynanche tracheitis – the latter being the front runner.

Cynanche trachealis (literally, “dog strangulation”) was a relatively new diagnostic entity at the time. William Cullen, defined it as “inflammation of the glottis, larynx, or upper part of the trachea . . . a rare occurrence . . . [producing] such an obstruction of the passage of the air, as suffocates, and thereby proves suddenly fatal.”

Although historians do not agree on the cause of Washington’s death, the signs and symptoms point to acute bacterial epiglottitis. Medical reports during the period from 1776 to 1826 suggest that cynanche trachealis corresponded to the modern diagnosis of bacterial epiglottitis, but the term was probably also used to refer to some cases of laryngeal diphtheria and viral croup.

Other suggested diagnoses seem less likely. Quinsy causes unilateral neck swelling, which Washington did not have, and is seen almost exclusively in children. Washington had probably been exposed to streptococci as a child and had also apparently had diphtheria. Laryngeal diphtheria was a slowly progressive disease largely confined to childhood, as it is now, and diphtheria was not prevalent in Virginia in 1799. Pneumonia, Ludwig’s angina, Vincent’s angina, and other proposed diagnoses have largely been ruled out in prior literature.

George Washington was laid to rest in a lead lined coffin for fear of an infectious disease.


…and Finally

Emergency Medicine is kind of like being an airline pilot

…where passengers can walk into the cockpit unannounced and tell you they know how to fly a plane; they ask if you can talk to their friend’s cousin who hang glides on weekends; and request to be dropped off at another spot besides your intended destination.

Two flight attendants called in sick so you also have to go down the aisles and make sure everyone fastens their seatbelts, but they won’t. The plane is at 150% capacity with people sitting in the aisles, whilst someone is trying to open the door and jump out. Air traffic control, at your target destination, is actively hostile informing you that you don’t need to land the plane there…and there is always turbulence.

All the passengers get for a meal is a turkey sandwich. And someone just took a shit in the aisle. And then they send the passengers a survey on whether you flew the plane well or not.

Anon

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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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