Funtabulously Frivolous Friday Five 086

FFFF is running a little late this week – so let’s keep it short and sweet – the 86th edition is now at your service!

Question 1

Can a patient with an ectopic pregnancy have a negative serum BhCG (pregnancy test)?

  • Yes – never say never.
  • It is sufficiently rare that I’ve only been able to find two case reports:

Grynberg M, Teyssedre J, Andre C, Graesslin O. Rupture of ectopic pregnancy with negative serum beta-hCG leading to hemorrhagic shock. Obstet Gynecol. 2009 Feb;113(2 Pt 2):537-9. PubMed PMID: 19155948.

Lee JK, Lamaro VP. Ruptured tubal ectopic pregnancy with negative serum beta hCG–a case for ongoing vigilance? N Z Med J. 2009 Jan 23;122(1288):94-9. PubMed PMID: 19182846.

  • However up to about 3% of patient’s with ectopics can have negative urine pregnancy tests. Not that I’m trying to scare you or anything…

Aboud E. A five-year review of ectopic pregnancy. Clin Exp Obstet Gynecol. 1997;24(3):127-9. PubMed PMID: 9478294.

Question 2

What did the wife of French philosopher and writer Denis Diderot say to him just before he died?

  • “Don’t eat that!”
  • Diderot died while eating an apricot.
  • Simon Critchley has much more on the deaths of philosophers in his talk featured in A Philosophical Death.

Question 3

Which emergency medicine podcaster is famous for “owning the anus” and why?

  • Rob Orman of ERCAST.
  • At the end of his talk on atrial fibrillation in Colorado a member of the audience asked Rob a question: “How is that you’re famous for ‘owning the anus’?”
  • I’m not sure what Rob’s answer was, but the epithet was coined on an Australian medical blog in due reverence to the brilliant first ERCAST episode on ‘rectal foreign bodies’ (see the comment at the bottom of this post, and the reference had to be reiterated in Snookered).
  • To top it all off Rob gave a talk at Essentials 2011 titled “Juicy butt pus and how to drain it”.
  • Apparently Rob does not own this establishment:

anus lodge

Question 4

What is the highest blood alcohol concentration ever measured in a human being?

  • 1.6% or 1.6g/100mL
  • According to South Africa’s Sowetan:

“The man was allegedly 32 times over the legal alcohol limit. His blood had an alcohol content of 1.6g/100ml. The legal limit is 0.05g/100ml. He was driving a Mercedes-Benz Vito and was arrested near Queenstown in Eastern Cape… Five boys as well as a woman who were also in the vehicle with 15 sheep, allegedly stolen from nearby farms, were also arrested.”

  • Why the sheep were arrested is anybody’s guess…


Question 5

What is Pott’s puffy tumor?

  • frontal bone osteomyelitis resulting in a subperiosteal abscess presenting as a fluctuant mass over the forehead and scalp.
  • Today the condition is rare and only a few dozen cases have been reported in the literature of the postantibiotic era (mostly in adolescents).
  • The ultimate eitiologies include local trauma, insect bites, sinusitis, hematogenous spread and snorting drugs like cocaine and metamphetamines.

 “But the inflammation of the dura mater and the formation of matter between it and the skull, in consequence of contusion, is generally indicated and preceded by one [sign] I have hardly ever known to fail; I mean a puffy, circumscribed, indolent tumor of the scalp and a spontaneous separation of the pericranium, from the skull under such tumor.”
Sir Percival Pott, Observations on the nature and consequences of those injuries to which the head is liable from external violence, 1768

pott's puffy tumor
Pott’s puffy tumor from Upadhyay, 2010 (click image for source)

Raja V, Low C, Sastry A, Moriarty B. Pott’s puffy tumor following an insect bite. J Postgrad Med [serial online] 2007 [cited 2012 Apr 27];53:114-6. Available from:

Upadhyay S. Recurrent Pott’s puffy tumor, a rare clinical entity. Neurol India [serial online] 2010 [cited 2012 Apr 27];58:815-7. Available from:

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Let us finish with a public health announcement about coffee…

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