Merry Funtabulously Frivolous Friday Five 330

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 330 – Christmas Edition

[Past XMAS editions…072131170219264302]

Question 1

Christmas 1877, BMJ retold of a young man aged 22 who had been painting Christmas cards. It was noted that he used copious amount of Scheele’s Green. He presented with the following:

Vomiting and purging, accompanied with pain in the abdomen of a colicky character, and so severe as to be best expressed by the word excruciating. Along with these conditions were great weakness and quickness of the pulse (120), faintness, paleness of the face….

Joseph Farrar 1977

What has he poisoned himself with?

Reveal the funtabulous answer

Arsenic

The young man was so focussed on painting Christmas cards that he neglected to wash the copper hydrogen arsenite from under his nails before eating and often put the paintbrush in his mouth. At the time most green colours contained arsenic.

He was treated with sinapism (a mustard plaster), linseed poultices (as hot as could be borne). Tincture of opium for the diarrhoea, and half an ounce of brandy (it was Christmas after all). His condition improved the next day.

Karl Adolph von Basedow (1799 – 1854) first presented proof (1844, 1846) of the poisonous effect of wallpapers printed with the paint colour ‘Schweinfurther Grün‘ (Parisian green) and Scheelesgrün in ‘Arsenikdunst in Wohnzimmern‘ [Arsenic fumes in living rooms 1846;52(1):89].

In 1848, Basedow found that glue-bound Schweinfurter green releases organic arsenic compounds leading to arsenic vapours filling the confined spaces of living rooms. This was later (1935) deemed to be the production of trimethyl-arsine from fungus (Penicillium brevicaule)

References


Question 2

What incidental finding is found on the slit lamp below:

Anterior segment photograph of left eye (by slit lamp) Natung et al 2016

Reveal the funtabulous answer

Christmas Tree Cataract or CTC for short.

This anterior segment photograph (Natung et al) of left eye (by slit lamp) shows highly refractive, multi-coloured, iridescent crystals in the inferior cortex and nucleus of the crystalline lens.

The colours change with the angle of the light giving a colourful display. Its cause is largely unknown, hypotheses include cholesterol crystals, stacks of fused cell membranes, and cystine crystals. No treatment is required if it does not impact vision.

Reference


Question 3

Excess alcohol as a cause of atrial fibrillation is now well known. Of the cases originally described in 1978, the peak occurred between Christmas Eve and New Year’s Day.

What did the authors name this alcohol associated cardiac disorder?

Reveal the funtabulous answer

Holiday Heart

The authors observed 24 different patients who had a total of 34 presentations with excess alcohol resulting in atrial fibrillation, flutter or tachycardia. They observed there seemed to be a spike in presentations at the end of the year and not at other national celebrations and hence the term ‘holiday heart’ was adopted from jokes around their departments.

Arrhythmias-and-the-Holiday-Heart-alcohol-associated-cardiac-rhythm-disorders-1978
Fig. 2. Monthly distribution of “holiday heart” hospital admissions (top), compared with mean monthly admissions for “traditional” alcohol associated illnesses (bottom). The apparent year-end peak of alcoholic arrhythmias is not present for the “traditional” alcoholic illnesses. Ettinger et al 1978

Cardiac arrhythmias presenting during weekend or holiday drinking episodes are associated with conduction delays and depressed cardiac performance indicative of early cardiomyopathy and suggest a “holiday heart” syndrome.

Ettinger et al 1978

Reference


Question 4

The Christmas BMJ 1999 includes an article which won an Ig Nobel prize, and is purported to be the journals most viewed article of all time

What is the article?

Reveal the funtabulous answer

Magnetic resonance imaging of male and female genitals during coitus and female sexual arousal

Leonardo da Vinci “The Copulation”

This Renaissance sketch shows a transparent view of the anatomy of sexual intercourse as envisaged by the anatomists of his time. The semen was supposed to come down from the brain through a channel which can be seen in the spine of the man. In the woman the right lactiferous duct is depicted as originating in the right female breast and ending in the genital area. Many people thought the penis would be straight during coitus and it wasn’t until this MRI study that we discovered it forms a boomerang shape. 

References


Question 5

James Lind a physician in the Navy born just over 300 years ago conducted the first ever clinical trial treating scurvy. What beer did he discover that gave him his original ideas?

Reveal the funtabulous answer

Spruce Beer

Spruce beer, made of the black spruce, either fresh or dried, or from its essence, is an excellent medicine. This beer must be drank daily, and the parts affected with the eruption [of scurvy] bathed with it night and morning

Lind 1753: 220-222

References:

  • Lind J. Chapter IV: Of the scurvy being connate, hereditary, and infectious. In: 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

…and Finally

Thanks to @hollymorgs

EPONYM ANSWERS
  1. ADDER SONS – Addison’s disease
  2. BOAR HALVE – Boerhaave syndrome
  3. SHARK O MARY TOOTH – Charcot-Marie-Tooth disease
  4. FAN CONE E – Fanconi syndrome
  5. GRAVES – Graves disease
  6. CORE SACK OFF – Korsakoff encephalopathy
  7. MUNCH HOUSE ZEN – Munchausen syndrome
  8. NOON NAN – Noonan syndrome
  9. RAM Z HUNT – Ramsay Hunt syndrome
  10. 4 KNEE ER’S GANG GREEN – Fournier gangrene
…and Finally Finally
via @EDMusos
…and Finally Finally Finally
via @ZDoggMD

FFFF More More

FFFF

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

  1. Thanks great entertainment 🌲

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.