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LITFL • Life in the Fast Lane Medical Blog – Emergency medicine and critical care medical education blog

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 Funtabulously Frivolous Friday Five 226.

Question 1

Between 1995 and 2000 the CDC in the USA reported 15 to 18% of cases of tetanus in which particular subset of the population?

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  • Intravenous Drug Users, from contaminated drugs. [Reference]

Question 2

Which famous author developed a new shunt for hydrocephalus when his 4 month old son was hit by a taxi in New York?

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  • Roald Dahl (developer of the Wade-Dahl-Till valve 1962).
  • Theo suffered a traumatic brain injury resulting in secondary hydrocephalus and back in the UK his ventricle-atrial shunt kept blocking the Holter valve. Dahl, determined to find a solution contacted Stanley Wade a toy maker specialising in small hydraulic pumps. Meanwhile the care of his son was handed to Kenneth Till, a neurosurgeon at Great Ormond Street in London who took Dahl and Wade into theatre to show them the process.
  • They both soon realised that brain tissue initially blocked these shunts so developed a trochar to introduce the shunt into the ventricle without ever having to push the shunt through the brain. Instead of non-return slits, a valve was developed with a moving steel disk. This reduced the cost to less than a third and meant a wider opening for drainage could be established.
  • The WDT valve went into production in 1962 and was used on 3,000 children worldwide before being superseded by more novel types of valves. [Reference]
  • Roald Dahl also developed stroke rehabilitation, to read more about Roald Dahl’s interest in medicine I would highly recommend Tom Solomon’s book “Roald Dahl’s Marvellous Medicine

Question 3

Seldinger technique is widely known but when was it introduced and who was Dr Seldinger?

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  • 1953: prior to this method cannulas were used for percutaneous arteriography.
  • Dr Sven Ivar Seldinger, (1921–1998) was a Swedish Radiologist. During his landmark paper he referenced the work of Farinas in 1941 who used a urethral catheter in the aorta for angiography but the femoral vessels required surgical exposure. Once a suitable, thin-walled polyethylene tube was created, Seldinger expanded on the work of Peirce, Donald, Kesmodel, Rollins and Paddison who passed the tubing through large bore needles.
  • He tested his technique of using a smaller bore cannula and flexible guide wire on 40 cases and quoted “the technique is simpler than appears on paper and after a little practice should present no difficulties” [Original Paper – Lancet The Seldinger technique: 50 years on]

Question 4

Who was the world’s oldest Lucy?

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  • Paleoanthropologist Donald Johanson spotted a small part of an elbow bone. It was the most ancient early human – or hominin – ever found. Later it became apparent that it was also the most complete: 40% of the skeleton had been preserved.
  • It would be another four years before Lucy was officially described. She belonged to a new species called Australopithecus afarensis and it was clear that she was one of the most important fossils ever discovered.
  • At the group’s campsite that night, Johanson played a Beatles cassette that he had brought with him, and the song “Lucy in the Sky with Diamonds” came on. By this time Johanson thought the skeleton was female, because it was small. So someone said to him: “Why don’t you call it Lucy?” The name stuck immediately. [Reference]
DGXGG4 Replica skull of Australopithecus afarensis, Lucy, evolution of human species

Question 5

To cure which complaint in the middle ages might you have hung the beak of a magpie round your neck?

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  • Toothache
  • Humans have long suffered from dental disease, as early as 200 BCE, a bronze wire root canal filling was found in the skull of a Nabataean warrior. [Reference]

…and finally

Funtabulously Frivolous Friday Five 226
Neil Long

Article source here:Life in the Fast Lane

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