Funtabulously Frivolous Friday Five 075

This week’s dose of funtabulous frivolity combines a drop of seminal fluid, pacemakers and mobile phones, a town in Australia, coprolalia and a bleeding varicose vein.

Do you think you’ve got what it takes?

Let’s find out.

Question 1

A forensic pathologist examines the body of a recently deceased man. The pathologist notes a drop of seminal fluid at the tip of the dead man’s penis. Does this indicate that the man was engaged in sexual activity just before death?

  • No
  • The seminal vesicles may contract as part of rigor mortis, resulting in the expulsion of seminal fluid.
  • Rigor mortis is the post-mortem contraction of muscle fibers due to the locking of actin-myosin filaments when ATP is depleted.

Shkrum MJ, Ramsay DA. Forensic pathology of trauma: common problems for the pathologist. Humana Press, 2007. [link]

Question 2

Are patients with pacemakers allowed to use mobile phones?

  • Yes
  • Pacemaker interference can occur from cell phones, but they have to be within 10 cm of the pacemaker. Reported effects include inappropriate inhibition, atrial oversensing or synchronous rapid ventricular pacing from misinterpretation of the cell phone signal as atrial activity. Only about 1 in 100,000 pacemaker patients have mobile phone-related problems.
  • Practical advice to give to pacemaker patients is to use mobile phones in the hand opposite the side of the implanted pacemaker, and to avoid carrying the phone in the breast pocket near the pacemaker.

Irnich W, Batz L, Müller R, Tobisch R. Electromagnetic interference of pacemakers by mobile phones. Pacing Clin Electrophysiol. 1996 Oct;19(10):1431-46. PMID: 8904533.

Myerson SG, Mitchell AR. Mobile phones in hospitals. BMJ. 2003 Mar 1;326(7387):460-1. PMID: 12609917; PMCID: PMC1125359.

Question 3

Which Australian town with a population of about 27,000 has over 40,000 emergency department presentations per year?

  • Alice Springs, in the very center of Australia.
  • Do the math — this suggests that every person in Alice Springs has an average of 1.5 presentations to the ED every year!
  • Possible reasons for this include:
  • social deprivation of the local indigenous population contributes to greater prevalence and severity of a wide range of medical illnesses.
  • high rates of violence, particularly related to alcohol.
  • a large catchment area with presentations from out of town – Alice Springs Hospital has 189 beds servicing an area of 1.6 million square kilometres.
alice panorama

Click to enlarge (Source: Wikipedia)

Question 4

What is coprolalia?

  • Coprolalia is involuntary swearing or the involuntary utterance of obscene words or socially inappropriate and derogatory remarks.
  • The term comes from the Greek κόπρος (kopros) meaning “feces” and λαλιά (lalia) from lalein, “to talk”. Literally, “talk sh!t”.
  • Coprolalia is most commonly attributed to Tourette Syndrome (coprolalia occurs in about 10-20% of cases) but can occur in other tic disorders, and other neurological conditions including stroke, encephalitis, seizure disorders and dementia.
  • Interestingly,  there are reports of deaf patients with Tourette’s who involuntarily swear using sign language. Related phenomena include copropraxia (performing obscene or forbidden gestures) and coprographia (making obscene writings or drawings).

Question 5

An elderly patient awoke in the middle of the night and noted brisk bleeding from a varicose vein on his shin. Why should you carefully examine the patient’s feet?

  • Look for long toenails on the contralateral foot.
  • A fatal case of varicose vein injury inflicted by an excessively long toenail occurred in New Zealand and was described in the Lancet in 2003.

Fraser R. Nail in the coffin. Lancet. 2003 Jan 4;361(9351):90. PMID: 12517518. [free fulltext]

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Comments

  1. pete w says

    I got question 3 correct… easy one! :)

    but actually the catchment area population is closer to 40,000 (15,000 Indigenous, 25,000 non)

    -pete

Comments