The Appendix: What Is It Good For?

War, huh, yeah
What is it good for
Absolutely nothing
Uh-huh
War, huh, yeah
What is it good for
Absolutely nothing
Say it again, y'all
-Edwin Starr, War

Until recently, one could probably say the same about the appendix. But, that's all the appendix wants: respek', yo. Well, now perhaps it can. This New York Times article explains one idea about an evolutionary role for the appendix, specifically, that the appendix serves to 'reboot' the gut if other flora are wiped out by diarrhea or dysentry. But, what if the appendix houses something like C. difficile? (Quick! How does one diagnose C. diff diarrhea? How does one treat it?)

Even if this idea stands the test of time, the appendix faces an uphill battle. Think about its name: the appendix. Something that's added on, tacked on the end, easily removed without affecting the main work (Q! What's the most common etiology of appendicitis?). Poor lil appendix. Even some cancers that start in the appendix don't get no 'respek' til they spread to the liver (Q! Name the cancer and some common symptoms).

Alright, I think I've stretched that out far enough... heh, and in the end, the appendix, what is it good for? Still pretty much nothing. Now, to start a (hopefully) new feature on the blog, here is Check It Out, where I link to something interesting I either found or have been reading about recently.

Check It Out: Radiology Picture of the Day

Answers:
1. C. difficile stool toxin; PO metronidazole (or vancomycin)
2. Lymphoid hyperplasia
3. Carcinoid Syndrome; Flushing, Diarrhea, R sided heart failure, Bronchospasm.

Laughter is the best medicine

Just a few mild to moderately humorous tidbits related to medicine...

• My family medicine review book notes that some patient might refuse "sigmoidoscopy because they find it distasteful." I think they should find another gastroenterologist, because if their sense of taste is any way involved with their sigmoidoscopy, something's not right.
  
• Same review book: "Physiologic fatigue is common in mothers of newborns, individuals who do shift work, athletes who overtrain, and in third-year medical students."
  
• "We got an issue in America. Too many good docs are gettin out of business. Too many OB/GYNs are unable to practice their love with women all across this country." -President George W. Bush
  
• From First Aid for Step 1: "Horner's syndrome clinically presents as Ptosis, Anhidrosis, and Miosis. Mnemonic: PAM is horny."
  
• A joke I heard from a friend: An internist, psychiatrist, surgeon, and pathologist go duck hunting. They go out into the blind and wait for a duck. The internist is up first and sees a bird fly over. He looks out and says, "I think it's a duck... but it could be a quail, or pheasant, or dove, or maybe..." and the duck flies away. The pyschiatrist is up next. She sees a bird fly over and thinks, "There's a duck! But... does it know it's a duck? Is it self-actualized as a duck?" and the bird flies away. The surgeon is up next. He sees a bird fly over, and *BOOM* goes his gun. He then says, "Pathologist, go over there and tell me if it's a duck."
  

Rev 20200305

A brief history of French mothers and STDs

Here's a little story I heard from a friend that I found both interesting and educational. I cannot vouch for its veracity, but like Stephen Colbert, my gut says it's true.

Back in 18th century France, French mothers were very concerned about who their daughters consorted with. In order to save them from men of suspect character who may be intent upon sowing their wild oats, the mothers would warn their daughters to avoid men with bobbing heads. The question for modern day medical students is, why?

The answer? The bobbing head, also known as De Musset's sign, is a sign of severe aortic regurgitation caused by syphilitic aortitis. Had the daughters flaunted their mother's warnings and flirted with these loathsome Lotharios and perhaps gone in for the proverbial French kiss, they may have also noted a bobbing uvula, also known as Muller's sign.