Quizmas-time: How sublime (or ridiculous) are your festive clinical skills?

Answers

1. d) Tuberculosis

The other three have the following Christmassy connections:

• Pityriasis rosea – skin rash in Christmas tree distribution.
• Myotonic dystrophy – associated with ‘Christmas tree cataract’.
• Cholangiohepatitis – shows Christmas tree sign on MRI cholangiogram.

2. b) Christmas cactus

The Christmas cactus blooms, appropriately, at Christmas and it’s pretty unique in being a Christmas-associated plant that has not yet found its way into homeopathy – just about everything else you’d care to name has, in some form or other. In small amounts, obviously.

3. b) Giardia

The consolation here is that at least, not being giardia, it’ll all be over by Hogmanay. Watch out for undercooked haggis, though.

4. a) The first patient diagnosed with the disorder was a boy named Stephen Christmas

Yes, it was Stephen Christmas. And the first report of its identification was published in the Christmas edition of the BMJ 1952 (yes, really).

5. a) Falling out of the loft while getting the decorations down

The percentages reporting these incidents were as follows:

• 18% have cut themselves preparing vegetables.
• 11% have spilled hot fat on themselves when cooking.
• 2.7% have suffered an electric shock due to badly wired Christmas lights.
• 2.1% have fallen out of the loft while getting decorations down.

6. d) Atrial fibrillation

Reason? Of course: Christmas may be a time of goodwill, but it’s also a time of stress and liberal amounts of alcohol, both of which are AF-ogenic

7. a) It can increase mental fatigue and stress

Yes, it’s true, there is some softish evidence to support this. But none to suggest there is a Christmas Hit Induced Psychosis, which might be hard to believe if you’ve just spent a few hours in your local shopping centre.

8.  a) Breast implant rupture

This is the characteristic feature of breast implant rupture – a jolly description for a definitely not very jolly scenario.

9. a) Button battery

‘Small child with battery included’ is definitely not what you want on your Christmas patient list.

10. a) Colles’ fracture

All of those listed are common consequences of a winter slip, but Colles is the winner. So the dinner fork A&E staff are most likely to see on Christmas day is the wrist deformity after a ‘FOOSH’.

Answers

1. Male age 18: My bauble is stollen and painful.

Translation: my ball is swollen and painful. Diagnosis: testicular torsion (until proven otherwise). Triage: A&E.

2. Wife of male age 43: for months he’s been getting suffering turkey movements, I think it might be epiphany.

Translation: for months he’s been getting jerky movements, I think it might be epilepsy. Diagnosis: focal epilepsy. Triage: routine appointment.

3. Female age 16: my tinsels are pinefall.

Translation: my tonsils are painful. Diagnosis: tonsillitis. Triage: pharmacist.

4. Male age 78: my eyes have turned all yule.

Translation: my eyes have turned all yellow. Diagnosis: jaundice. Triage: urgent appointment.

5. Farmer age 53: I’m feeling crackered with a fever, and I know it’s rare but I’d like to be tested to rule brussels sprout.

Translation: I’m feeling knackered with a fever, and I know it’s rare but I’d like to be tested to rule brucellosis out. Diagnosis: brucellosis. Triage: urgent appointment.

6. Female age 30: I’m pregnant and my psalms are all itchy.

Translation: I’m pregnant and my palms are all itchy. Diagnosis: cholestasis of pregnancy. Triage: urgent appointment.

7. Male, 48: I need an appointment at the elf Santa because I’m feeling fairy-light headed and my advent monitor has shown a turkey cardia.

Translation: I need an appointment at the health centre because I’m feeling very light headed and my event monitor has shown a tachycardia. Diagnosis: SVT, AF (take your pick). Triage: urgent appointment.

8. Female age 28: I need my post-nativity and I’d like a carol fitted.

Translation: I need my post-natal and I’d like a coil fitted. Diagnosis: post natal. Triage: routine appointment.

9. Male age 64: I woke up this morning with a pannetone. I don’t want to make a fuss but it’s red and holly painful.

Translation: I woke up this morning with a painful toe. I don’t want to make a fuss but it’s red and jolly painful. Diagnosis: gout. Triage: urgent appointment.

10. Male, age 72: I’m getting a Christingle and pine needles on one side of my chest. Now there’s a rash and I’m worried it’s jingles.

Translation: I’m getting a tingle and pins and needles on one side of my chest. Now there’s a rash and I’m worried it’s shingles. Diagnosis: shingles. Triage: pharmacist.