Funtabulously Frivolous Friday Five 336

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 336

Question 1

Prof Martin Landray, a doctor and designer of large-scale drug trials, and Sir Jeremy Farrar, director of the Wellcome Trust, and one of the funders of Recovery Trial were discussing what they were going to do about the inevitable tsunami of covid patients entering the UK.

On what mode of transport did this fateful planning of the Recovery Trial first take place?

Reveal the funtabulous answer

A London Bus

The Number 18 bus to be precise, and the height of the conversation peaked around Euston. Within 9 days they had enrolled their first patient. We’ve had many firsts within the pandemic but to set up such a massive trial in that time is unbelievable.

As you know Dexamethasone was shown to be of benefit to those requiring oxygen.

Four hours after the official announcement, treatment with dexamethasone became NHS policy and the rest of the world swiftly followed.

Recovery showed another drug, tocilizumab, also saves lives. But just as importantly it found the duds. The malaria drug hydroxychloroquine, the HIV combo lopinavir/ritonavir and the antibiotic azithromycin had all been hyped up, but ultimately shown to have no effect.


Question 2

Who holds the title for the world’s oldest geometrically tattooed individual?

Reveal the funtabulous answer

Ötzi the iceman

Ötzi also called the Iceman, lived some time between 3350 and 3105 BC, discovered in September 1991 in the Ötztal Alps (hence the nickname “Ötzi”) on the border between Austria and Italy.

He had a total of 61 tattoos which were geometrical creating the hypothesis that these tattoos were made along ‘healing’ lines and used to cure pains. Other tests revealed he liked a fine diet of Ibex meat and long walks in the hills suggesting he may have been a high altitude Shepard.

Prior to 2018,  Ötzi the Iceman held the title of world’s oldest tattooed individual. In 2018, a separate group of researchers found the world’s “oldest figurative tattoos” on 5,000-year-old (in other words, pre-pharaoh) Egyptian mummies. Infrared scans revealed the image of a bull and Barbary sheep on the shoulder of an 18- to 21-year-old male who was killed by a stab to the back. A series of “S” shapes was found on the upper shoulder of the female mummy. Both individuals had been housed in the British Museum’s mummy collection for more than 100 years by the time the tattoos were finally rediscovered.

The Egyptian tattoos were figurative rather than geometrical so technically Ötzi is still the winner of the question.

It’s likely the practice of tattooing extends much further back than either the Iceman or the Egyptian mummies. But finding a well-preserved human canvas older than these specimens will remain a challenge.

Ötzi the Iceman while still frozen in the glacier, photographed by Helmut Simon upon the discovery of the body in September 1991


Question 3

Patients with Familial Adenomatous Polyposis (FAP) are predisposed to what tumours?

Reveal the funtabulous answer

Desmoid tumours (DTs)

FAP is a hereditary condition which is characterised by numbers adenomatous polyps in the colon. It accounts for 1% of colorectal cancer.

Desmoid tumours are bening neoplasms that occur in 10-20% of patients with FAP. They originate from facial or muscle-aponeurotic structures that foster fibroblast proliferation.

Although composed of benign fibromatous lesions, DTs display aggressive behavior. They are locally aggressive tumors with infiltrative growth in adjacent tissues. The outcome is unpredictable. In some circumstances, they remit spontaneously, whereas in most cases, they grow implacably, culminating in death. Seventy percent of all DTs are intra-abdominal. DTs also occur in the retroperitoneum, abdominal wall (incisions), inguinal region, and gluteus.

The presence of a palpable mass in patients with FAP should lead physicians to suspect a DT

Other extracolonic manifestations include, osteomalacia, pigmented lesions of the retina, adenomas of the upper GI tract and epidermoid cysts.

Image Credit: MedicalImage.ro


Question 4

What happened to Ivan Pavlov’s dogs after his famous experiment?

Reveal the funtabulous answer

They lost their classic conditioning after a stressful event.

Pavlov was studying dog digestion and noted that when the researchers entered with white lab coats the dogs started to drool. Curious he set up his famous experiment. Although, lets get the facts correct… there was no bell. He associated food with a buzzer, metronome, electrical shocks and light (see FFFF 192). Once the dogs learned to associate these stimuli with food they salivated at everything. Pavlov won the Nobel prize in 1904 for his paper on classical conditioning.

What is less known about was the dogs were kept in cages and during a flood in 1924 the laboratory filled with water. For hours the dogs struggled to keep themselves alive. Pavlov’s assistants came to help but in order to free the dogs they had to forcibly submerge them underwater and then make them swim another quarter of a mile to the main laboratory. Due to the trauma they suffered, they lost the conditioning effect and even in later experiments refused food. Pavlov starved the dogs but still they would not eat.

Pavlov had stubbled across a far more interesting observation that stress can lead animals to shut down. He then spent much of the remainder of his careers understanding how stress-induced trauma could be reversed.


Question 5

What is this sign?

AUSLAN (Australian Sign language)

Reveal the funtabulous answer

COVID-19, coronavirus

Drs Kit Rowe and James Hayes explain…

AUSLAN is the Australian Sign Language and is the majority sign language of the Australian Deaf community. The term was coined by the Australian linguist Trevor Johnston in the 1980s. However, the language itself is much older.

Auslan is related to British Sign Language (BSL) and New Zealand Sign Language (NZSL); the three have descended from the same parent language, and together comprise the BANZSL language family. Auslan has also been influenced by Irish Sign Language (ISL) and more recently has borrowed signs from American Sign Language (ASL).

AUSLAN’s grammar and vocabulary is quite different from spoken English. The origins of these languages cannot be attributed to any one individual; rather, they are natural languages that emerged spontaneously, and like any spoken language has evolved over time; they have a truly dynamic nature that remains unmatched by any spoken language.

The AUSLAN sign, for COVID, is quite interesting! The symbolism should be something universal and easily understood by the masses. It’s a twisting of an open palm, on the side of a clenched fist. Whilst its origin again is uncertain, it first really took hold on social media, and I have it on good authority that it colloquially represents a dual phenomenon

The first represents the “crown” or corona if you like, of the coronavirus. The second is the action is the opening of a “Corona beer”…it must be a symbol universally recognized and loved by the ‘people’.


…and Finally

25 years ago, on October 29, 1996, the entire World Wide Web was only 2.5 terabytes in size. Most connections were dial-up, and important records were stored on tape. Broken links (404 errors) were a growing problem, and most Web pages were short-lived.

Enter Brewster Kahle and Bruce Gilliat and their revolutionary project – a way to archive the growing Internet.

Kahle and Gilliat invented a system for archiving Web pages before they vanished. The tools for this project were not terribly sophisticated; they were essentially PC applications built to capture entire websites by following the links from the main page.

The Wayback Machine’s First Crawl 1996

Today, the Internet Archive is one of the world’s largest digital libraries and home to more than 70 petabytes of data; 588 billion web pages; 28 million books and texts; 14 million audio items; and 580,000 software titles.

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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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