Adult Autopsy Flashcards
where it originated
in situ
certain groupings of organs
en bloc
everything together
en masse
one by one
piecemeal
autopsy technique where organs are removed piecemeal
Virchow
autopsy technique where the thoracic, cervical, abdominal, and GU are removed as separate organ blocks, en bloc
Ghon
autopsy technique where there is in situ dissection in part combined with en block removal (neck to rectum)
Rokitansky
autopsy technique thoracic, cervical, abdominal and pelvic organs are removed en masse and subsequently dissected
Letulle
typical amount of pericardial fluid
15-60 cc
typical color of pericardial fluid
straw colored and clear
most common site a blood culture is taken from in a hospital based autopsy
left atrium
how long is a brain fixed for
3 weeks
where is the stomach opened along
the greater curvature
what should you always do with the lungs before perfusion
weigh them
yellow stones in the gallbladder are most likely made of
cholesterol
grey-white stones in the gallbladder are most likely made of
calcium carbonate
black stones in the gallbladder are most likely made of
bilirubinate
what should the seminiferous tubule parenchyma do if it is normal
string with ease
to orient the eye, the temporal side has this anatomic landmark
inferior oblique muscle
to orient the eye, the nasal side has this anatomic landmark
superior oblique tendon
what stain gives adequate examination of Descement’s membrane, the lens capsule, and Bruch’s membrane
PAS (periodic-acid Schiff)
most common cause of direct maternal death
thromboembolic disease
common finding within the hepatobiliary system during a maternal autospy
fatty change
postmortem purpura or petechial type hemorrhages
Tardieu spots
skin turns white when applying firm pressure within the first 12 hours
blanching
blood pooling in areas of dependency under the force of gravity, develops from 30 min to 2 hours, lasts 8-18 hours
livor mortis
localized, elevated, yellow-white areas that develop on the conjunctiva and cornea, mostly caused by solar damage and often bilateral
conjunctival pterygia
constellation of profound weakness, anorexia, anemia, wasting
cachexia
irregular pigmented areas
vitiligo
round to ovoid hyperpigmented macules often lying over nerve trunks; presence of six or more macules >1.5 cm in an adult indicated neurofibromatosis type I
cafe au lait spots
common red scaly patches that become vesicular and crusted that can be hyperpigmented or atrophic scarring
stasis dermatitis
chronic version with brawny indurations and a scaly irregular surface
lymphedema
marked erythema of the skin and swelling of subcutaneous tissues; microvascular vasodilation is largely maintained postmortem and is critical to guide the prosector to areas of inflammation
cellulitis
bruises
contusion
often seen in patients receiving long term corticosteroid therapy and in elderly people after minor trauma
ecchymoses
putrefaction of erythrocytes within superficial blood vessels that leads to the formation of greenish blue discoloration which is observable through the skin
marbling
can appear on the neck, groin, or axilla, associated with obesity, endocrine dysfunction, insulin resistance and sometimes malignancy
acanthosis nigricans
nail fungus, dermatophyte fungus
onychomycosis
soft nails with a spoon shaped dent due to a nutritional deficiency
koilonychia
nails that indicate heart or lung disorders
cyanotic or clubbing of the nails
nails with these are indicative of a systemic disease
splinter hemorrhages
deposition of phospholipid and cholesterol in the peripheral cornea in patients over the age of 60 which appears as a hazy white, grey, or blue opaque ring
arcus senilis
donation of these may cause periorbital bruising
eyes
donation of this often leaves wide, clean edged, even depth, rectangular abrasions
skin
what must you always do with a foley catheter
always point down, towards a sink
there should be only this in the dissection field at any time
a single blade
minimum PPE (3)
gloves, aprons, eyeprotection
For preliminary reports based on gross examination only,_____________ is
the recommended TAT.
two working days
if the patient has had a CABG, you want to know these three things
if the ostia are patent, the lumen is patent, and the lumen of the native vessel is patent
effusion that occurs due to tuberculosis, spread from empyema
exudative
effusion that occurs due to trauma, rupture of aneurysms, malignant effusion
hemorrhagic
effusion that occurs due to fluid accumulation caused by metastasis
malignant
pericarditis produced by non infectious inflammatory diseases such as a rheumatic fever, SLE, scleroderma, tumor, or uremia; or from an infection in tissues close to the pericardium that produces a sterile effusion
serous pericarditis
most frequent type of pericarditis and composed of serous fluid mixed with a fibrinous exudate
fibrinous and serofibrinous pericarditis
pericarditis that occurs when there is an invasion of the pericardial space by microbes
purulent or suppurative pericarditis
pericarditis with an exudate composed of blood mixed with a fibrinous or suppurative effusion most commonly caused by the spread of a malignant neoplasm to the pericardial space
hemorrhagic pericarditis
pericarditis that occurs when there is direct spread from tuberculous foci within the tracheobronchial nodes
caseous pericarditis
post myocardial infarction pericarditis
Dressler syndrome
myocardial inflammatory lesions that are pathognomonic for rheumatic fever
Aschoff bodies
filiform fibrous projection from the peak of a valve leaflet, can be seen in endocarditis
Lambl excresence
this stain is used to macroscopically differentiate ischemic vs non-ischemic areas of the myocardium
triphenyltetrazolium chloride (TTC)
located between the atria and ventricular septum adjacent to the point where the tricuspid, aortic and mitral valve annuli meet
AV node
located along the lateral aspect of the junction between the superior vena cava and the right atrium
SA node
most common primary tumor of the heart
myxoma
where do majority of myxomas occur
left atrium
emphysema associated with an alpha1 -antitrypsin deficiency
panacinar emphysema
four stages of inflammatory response in lobar pneumonia
1.congestion
2. red hepatization
3. gray hepatization
4. resolution
most common bacterial etiologic agent
streptococcus pneumonia
bronchopneumonia type of spread
diffuse, patchy, spread out
dilated and tortuous submucosal veins produced by chronic portal hypertension
esophageal varices
where does 50% of esophageal carcinomas arise
middle 1/3
most common site of peptic ulcers
proximal duodenum
this ulcers occur due to shock, sepsis, or severe trauma
stress ulcer
duodenal ulcers associated with severe burns or trauma
curling ulcers
gastric duodenal and esophageal ulcers in those with intracranial disease
cushing ulcers
diaphragmatic grooves on the superior anterior surface of the right lobe on the liver
Leibermeister grooves
accumulation of iron resulting in a rusty brown liver
hemochromatosis
a yellow orange cast to the liver parenchyma and the tissue is also greasy
hepatic steatosis
liver becomes green and accentuated after fixation
hepatic cholestasis
this form of cirrhosis is typically seen in cases of viral hepatitis, drug induced, and hereditary diseases, >0.3cm
Macronodular cirrhosis
this form of cirrhosis is typically due to alcoholic liver disease, nonalcoholic steatohepatitis, hemochromatosis, primary and secondary biliary cirrhosis, metabolic disorders and autoimmune hepatitis, <0.3cm
micronodular cirrhosis
bile duct hamartoma
von Meyenburg complex
centrilobular necrosis and hemorrhage leads to variegated, mottled red hepatic parenchyma
nutmeg liver- passive congestion
yellow flecks visible on mucosa represent accumulations of cholesterol within macrophages
cholesterolosis of the gallbladder
cystically dilated endocervical glands
Nabothian cysts
most common tumors in women
uterine leiomyomas
cysts filled with serous fluid and common incidental finding in the femal reproductive system
paratubal cysts
paratubal cysts occuring near the fimbriae
hydatids of Morgagni
the most common form of skeletal malignancy
metastatic tumors
decreased bone density that is more prevalent in women and with aging
osteoporosis
muscle that is easily accessible during an autopsy and can be sampled to show effects of general systemic disease on the skeletal muscles
iliopsoas
type of brain herniation that occurs when unilateral or asymmetric expansion of the cerebral hemisphere displaces the cingulate gyrus under the falx
subfalcine herniation (cingulate)
type of brain herniation that occurs when the medial aspect of the temporal lobe is compressed against the free margin of the tentorium
transtentorial herniation (uncinate)
secondary hemorrhagic lesions in the midbrain and pons that often accompanies a transtentorial herniation
duret hemorrhages
type of brain herniation that refers to the displacement of the cerebellar tonsils through the foramen magnum
tonsillar herniation
the watershed zones in the brain that are most likely to harbor small ischemic lesions
superior and middle frontal gyri
2 types of tumors that make up 80% of primary brain tumors
astrocytoma and glioblastoma
most common location for a berry aneurysm in men
anterior communicating artery or anterior cerebral artery
most common location for a berry aneurysm in women
junction of internal carotid with posterior communicating artery
according to CAP, wet tissue should be held onto after the final report is signed out for an autopsy for how long
3 months
what is a PAD
provisional/preliminary anatomic diagnosis
how long do you have to submit a written PAD according to CAP
2 working days
how long do you have to submit a final diagnosis for a routine autopsy according to CAP
30 days
how long do you have to submit a final diagnosis for a complicated case according to CAP
90 days
the most common testicular tumor in men over 60
lymphoma
at autopsy cirrhotic livers should be serially sectioned, rinsed, and examined for this
small carcinomas
postmortem autolysis occurs in these two organ mucosa, exposing submucosal blood vessels
bladder and stomach
chronic bladder obstruction can cause this and trabeculation
smooth muscle hypertrophy
where does majority of prostate adenocarcinomas arise
in the peripheral zone
most frequent cause of spontaneous subarachnoid hemorrhage
rupture of a berry aneurysm
most common cause of sudden death in the US
ischemic heart disease
percent of major discrepancies between clinical diagnosis and the underlying cause of death as recorded on the death certificate
30%
intentionally, recklessly, or negligently removes, mutilates, or operates upon of a dead person or when they prevent the proper burial or cremation of the dead body
violating tort law
spontaneous esophageal rupture/full thickness tear
Boerhaave syndrome
diffuse metastatic seeding of the peritoneum occurs most commonly due to what two carcinomas
ovary and pancreas
acquired mitral stenosis is almost always due to
rheumatic heart disease
hallmark lesion in infective endocarditis
vegetations on the aortic and mitral valves
significant or severe atherosclerosis is classified by coronary vessel occlusion of what percent
at least 75%
the most common form of myocardial rupture
rupture of the left ventricular free wall
common cause of right ventricular hypertrophy
pulmonary hypertension
common finding in intubated patients
iatrogenic laryngeal ulcers
larynx swelling in anaphylactic reactions, infections, or after trauma
laryngeal edema
most common malignant tumor of the larynx
squamous cell carcinoma
pts with hypertension and severe atherosclerosis have this combination of injury in the kidney
nephrosclerosis and cortical infarcts
associated with stagnant concentrated urine due to underlying voiding dysfunction
bladder stone
uncommon tumors that are associated with previous radiation therapy
meningiomas
Systemic inflammatory response syndrome in response to an infection
sepsis
dysfunction is present in 2 or more organ systems
multiple organ dysfunction syndrome (MODS)
most common lethal arrhythmias (2) that cause ischemic heart disease
ventricular tachycardia or fibrillation
immersion in 80% ethanol for 30 minutes does what to specimens previously fixed in formalin
restores natural colors
killed in a fixative of 10% formalin in 50% ethyl alcohol
mycobacteria
