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Funtabulously Frivolous Friday Five 134

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…introducing Funtabulously Frivolous Friday Five 134

Question 1

You do a ketamine sedation and the patient develops laryngeal spasm. What physical manoeuvre can you preform to try and resolve the laryngeal spasm while the nursing staff draw up a paralytic?

+ Reveal the Funtabulous Answer

  • Larson’s point or the ‘laryngospasm notch’ [Reference]According to Phil Larson its location is:

“This notch is behind the lobule of the pinna of each ear. It is bounded anteriorly by the ascending ramus of the mandible adjacent to the condyle, posteriorly by the mastoid process of the temporal bone, and cephalad by the base of the skull.”

laryngospasm notch

Question 2

What is Fox’s Sign?

+ Reveal the Funtabulous Answer

  • Bruising over the inguinal ligament
  • It typically occurs in acute hemorrhagic pancreatitis.
  • Named after the the dermatologist George Henry Fox. [Reference]Fox's sign

Question 3

How did drug addicts in the 1970s and 80s help parkinson patients?

+ Reveal the Funtabulous Answer

  • They discovered the effects of MPTP
  • Barry Kinston a 23yr old chemistry graduate was synthesising MPPP (an opiate compound) and injected himself with his concoction.
  • Unfortunately it had MPTP as an impurity which converts to MPP+ once across the blood brain barrier and selectively kills dopaminergic cells resulting in parkinsonism.
  • Barry was treated with levodopa but died 18 months later from a cocaine overdose
  • The use of MPTP is used in research to produce parkinsonism in different animal models, there was some delay in this as rats were initially modelled but they have some resistance to MPTP at lower doses, hence it was not until 6 people were poisoned in 1982 in California that further work was done on MPTP. Read the case book The Case of the Frozen Addicts by J. William Langston.

Question 4

When would you expect to hear Hammon’s Crunch?

+ Reveal the Funtabulous Answer

  • Pneumomediastinum or pneumopericardium.
  • Hammon’s Crunch is commonly seen in Boerhaave syndrome and is typically a crunching, rasping sound, synchronous with the heartbeat. [Reference]

Question 5

Who drinks more coffee? Anaesthetists? Consultants or junior staff?
coffee

+ Reveal the Funtabulous Answer

  • On average orthopaedic surgeons purchased the most coffee per person per year (177, SD 191) followed by radiologists and general surgeons.
  • Anaesthetists purchased the least coffee (39, SD 48 – we wondered if they had their own machine)
  • Hierarchical position was positively correlated with coffee purchasing. Senior consultants (>5 years’ experience) bought most coffees per person per year and junior doctors and registrars bought fewest. Propensity of buying rounds also increased with hierarchical position, with heads of departments buying more rounds than junior doctors.
  • Problems with the study include only using a single site and we believe that further multi-centre studies should be performed
  • For the full article please click on the link: Black Medicine.

…and in other news

//www.youtube.com/watch?v=TcRJM4Rlgws

The post Funtabulously Frivolous Friday Five 134 appeared first on LITFL: Life in the Fast Lane Medical Blog.



This post first appeared on LITFL: Life In The Fast Lane Medical, please read the originial post: here

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