What do you get when you combine salted pork, a full moon, William the Conqueror, Stendhal and a swollen labia majora?
The 74th edition of the FFFF of course!
What underlying condition might make you want to treat a patient’s nose bleed by inserting nasal tampons made of salted pork?
- Glanzmann thrombasthaenia
- Patients with this condition have defects in their gpIIb/IIIa receptors that prevent their platelets from aggregating. As a result they are prone to bleeding complications, including epistaxis (nose bleeds). Various blood products or surgical procedures are often needed to control epistaxis in patients with this platelet disorder. An alternative approach, using nasal tampons consisting of salted pork (!), has been described in at least one case.
- How the pork works is unclear – it could that it is rich in tissue factor, or the salt may induce mucosal edema and assist the tamponading effect of the pork ‘tampons’… or it could be coincidence.
- Unfortunately, given that Glanzmann thrombasthaenia is more prevalent among Arabic speaking people, I’m not sure this treatment will be well received by all those affected.
Humphreys I, Saraiya S, Belenky W, Dworkin J. Nasal packing with strips of cured pork as treatment for uncontrollable epistaxis in a patient with Glanzmann thrombasthenia. Ann Otol Rhinol Laryngol. 2011 Nov;120(11):732-6. PMID: 22224315.
Hat tip to Joe Lex for this one!
Is a full moon associated with increased behavioural disturbance in emergency departments?
- Well, it was at the Calvary Mater Hospital in Newcastle, Australia: “Of 91 patients with violent and acute behavioural disturbance, 21 (23%) presented during the full moon — double the number for other lunar phases (P = 0.002).”
Calver LA, Stokes BJ, Isbister GK. The dark side of the moon. Med J Aust. 2009 Dec 7-21;191(11-12):692-4. PMID: 20028313.
What is the key component of the ‘William the Conqueror’ diet?
- Legend has it that William the Conqueror (also known as William the Bastard) was so fat he couldn’t get on his horse. To combat this he devised a personalised dietary regimen: he locked himself in a room with alcohol the only substance available for him to consume. Unfortunately, the effectiveness of the strategy has been scurrilously questioned on the following basis: when William the Conqueror died he was so obese he could not be squeezed into his sarcophagus and he stunk out the chapel with his decaying corpse.
- Learn about other UCEM-approved weight loss regimes here!
What is Stendhal syndrome?
- Stendhal syndrome is also known as hyperkulturemia and Florence syndrome.
- “It is a psychosomatic illness that causes rapid heartbeat, dizziness, fainting, confusion and even hallucinations when an individual is exposed to art, usually when the art is particularly beautiful or a large amount of art is in a single place.” (Wikipedia)
- The renowned 19th century French author, Stendhal, experienced the condition on a visit to Florence in 1817.
(Hat tip to Michelle Johnston for submitting this paper to R&R in the FASTLANE)
A competitive athlete asks for your advice about an embarrassing medical problem she has developed… a unilaterally swollen labia majora. What sport does she most likely compete in?
- She most likely suffers from a condition known as ‘bicyclist’s vulva‘. That’s right, as if cyclist’s nipples, cycling-related peripheral neuropathies and saddle sores weren’t bad enough there is a condition known as ‘bicyclist’s vulva’.
- Bayaens and colleagues described 6 cases in a 2002 paper in the BMJ – the patients cycled an average of 462.5 km per week). They all had unilateral lymphoedema thought to be due to compression of the inguinal lymphatics, with identifiable abnormalities on lymphoscintigraphy.
Want An Easy Way To Score Higher On The FFFF?
It’s easy — write the questions yourself!
You can submit a question to the FFFF using this form.