FFFF is back after a 4-week gap! And this week’s quiz is about… (dramatic pause) gaps! So why not gauge the gaping gulfs in your emergency medical knowledge with the following five-fold fenestration finder?
Which embryological gap can be a headache for SCUBA divers?
- Patent foramen ovale (PFO)
- A high proportion of divers who suffer decompression illness have a PFO. The mechanism is thought to be paradoxical gas embolism of nitrogen micro-bubbles.
- PFO has also been linked to migraine with aura.
Recreational scuba diving, patent foramen ovale and their associated risks.
Schwerzmann M, Seiler C.
Swiss Med Wkly. 2001 Jun 30;131(25-26):365-74. Review.
What is the performance gap between male and female emergency physicians?
- Female consultants are better at communication and multitasking.
- A study in this month’s EMA finds that female consultants undertake 119 tasks per hour compared with 93 for males.
- Male consultants spend more time eating and (amazingly) in the toilet. What ARE they doing in there?
One hundred tasks an hour: An observational study of emergency department consultant activities.
Kee R, Knott JC, Dreyfus S, Lederman R, Milton S, Joe K.
Emerg Med Australas. 2012 Jun;24(3):294-302. doi: 10.1111/j.1742-6723.2012.01540.x. Epub 2012 Mar 16.
Which two chemical gaps could you have got from drinking Austrian Riesling circa 1985?
- A high anion gap and a high osmolar gap.
- These would have been the consequence of addition of di-ethylene glycol (also used as automotive antifreeze) to improve the taste of cheap Austrian wine.
- Austrian wine can also cause a memory gap.
Which surgical gap helped Dr William Beaumont study alimentary physiology in the 1820s?
- A gastric fistula.
- The fistula was created by the accidental shooting of a Canadian canoeman named Alexis St Martin, with a duck gun. Beaumont described the injury thus:
The wound was received just under the left breast, and supposed, at the time, to have been mortal. A large portion of the side was blown off, the ribs fractured and openings made into the cavities of the chest and abdomen, through which protruded portions of the lungs and stomach, much lacerated and burnt, exhibiting altogether an appalling and hopeless case. The diaphragm was lacerated and a perforation made directly into the cavity of the stomach, through which breakfast food was escaping.
- St Martin survived – with a permanent hole in his abdominal wall – and went on to become one of the most famous human guinea-pigs in medical history.
Which sonic gap can be elicited in hypertensive patients?
- An auscultatory gap.
- An auscultatory gap sometimes occurs between the first and third Korotkoff sounds. It’s cause remains somewhat of a mystery but it is more common in hypertensive patients and may be related to decreased vascular compliance.