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APT Level 4 > Advanced Mortuary Practice > Flashcards

Advanced Mortuary Practice Flashcards

1
Q

Does computerised radiography still involve the use of plain x-ray films?

A

No- It instead uses digital images

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2
Q

Stroke: where the blood supply is stopped because of a blood clot is termed?

A

Ischaemic- This accounts for 85% of all cases.

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3
Q

Stroke: Where a weakened blood vessel supplying the Brian bursts is termed?

A

Haemorrhagic

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4
Q

What are the four guiding principles relating to actions and activities involving donations of organs and tissue for transplantion

A

Consent, Quality and Honesty and dignity.

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5
Q

Is Fetal tissue under 24 weeks gestation considered the mothers tissue?

A

Yes

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6
Q

Does fetal tissue include stillbirths after 24 weeks gestation?

A

No

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7
Q

Does the law treat fetal tissue as it would other tissue from the living?

A

Yes

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8
Q

Is tissue from neonatal deaths classed as fetal tissue?

A

No

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9
Q

What fetal anomaly is not caused by too few or too many chromosomes?

A

Achondroplasia

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10
Q

Genetic or inherited defects in the fetus cab have serious adverse affects on the child; usually referred to as defects and increase the chance of stillbirth. What are the 4 groups/types of defects?

A

1.Chromosonal defects (Down syndrome/Turner syndrome)
2.Single gene defects (cystic fibrosis, sickle cell amemia)
3.Dominant inheritance (Marfans, Achondroplasia)
4.Recessive inheritance (Tay-Sachs)

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11
Q

Give an example of a Chromosonal birth defect

A

(Down syndrome/Turner syndrome)

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12
Q

Give an example of a Single gene defect

A

(cystic fibrosis, sickle cell amemia)

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13
Q

Give an example of a dominant inheritance birth defect

A

(Marfans, Achondroplasia)

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14
Q

Give an example of a dominant inheritance birth defect

A

(Marfans, Achondroplasia)

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15
Q

Give an example of a Recessive inheritance birth defect

A

(Tay-Sachs)

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16
Q

What percentages of miscarriages occur after 20 weeks gestation?

A

1%

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17
Q

When is a miscarriage most likely to occur
?

A

Within the first 3 months of pregnancy

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18
Q

Does skin tissue need to be donated before death?

A

No

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19
Q

Computerised Axial Tomography (CT) canning method utilises what for imaging?

A

X-rays

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20
Q

What are neurological disorders

A

Brain, spine and nervous system disorders

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21
Q

Which endocrine hormone is tested for during a pregnancy test?

A

hCG (Human chorionic gonadotrophin)

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22
Q

Does immunisation of a baby increase the risk of SIDS

A

No

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23
Q

What does SICP stand for

A

Standard infection control precautions- the minimal control measures to manage the infection risk of exposure from all work activities involving the deceased.

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24
Q

What does TBP stand for

A

Transmission based precautions- based on the route of transmission of the infectious microorganism.

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25
Q

What does TBP stand for

A

Transmission based precautions- based on the route of transmission of the infectious microorganism.

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26
Q

How many types/progressions are there for MS?

A

4

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27
Q

When must a doctor inform the coroner about a death?

A

When the cause of death is uncertain, the death was sudden, or occurred soon after an operation

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28
Q

Who appoints coroners?

A

Coroners are appointed by the government and are usually medically or legally trained

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29
Q

Does the family need to give permission for a coroner’s post-mortem?

A

No, permission is not required from the family in cases where a post-mortem is legally necessary

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30
Q

Who conducts post-mortems in cases of suspected criminal activity?

A

A forensic pathologist conducts post-mortems in cases involving criminal activity

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31
Q

What is the role of a forensic pathologist at a death scene?

A

They assist with medical advice, gather forensic trace samples, and help ensure evidence is not lost.

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32
Q

Why is continuity of evidence important in criminal investigations?

A

Breaking the chain of evidence can compromise the integrity of the investigation and lead to wrongful conclusions.

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33
Q

What is the role of the APT (Anatomical Pathology Technologist)?

A

The APT assists the forensic pathologist during the autopsy, ensuring proper dissection and documentation.

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34
Q

What must be done with photographs during a forensic post-mortem?

A

Photographs should be taken of the body and any injuries before dissection begins, under the supervision of the forensic pathologist.

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35
Q

When should radiological examinations be performed?

A

In cases of suspected non-accidental injury, firearms or explosives deaths, or when the body is badly decomposed.

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36
Q

What should be included in post-mortem notes?

A

Time, date, place of the post-mortem, names of all present, and their roles.

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37
Q

What is the importance of collecting trace evidence?

A

Trace evidence must be collected to avoid contamination and support the investigation, ensuring all samples are preserved properly.

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38
Q

How should internal specimens be collected for toxicology?

A

Blood should be taken from a peripheral vein, and samples should be preserved for toxicological analysis.

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39
Q

What is histology’s role in a post-mortem?

A

Histology helps confirm or evaluate the role of natural diseases in the cause of death, and may also be used to age injuries.

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40
Q

What happens to tissue or organs after a post-mortem?

A

Tissue may be retained for further analysis, or returned to the family after discussions with the coroner.

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41
Q

What is a “defence post-mortem”?

A

A second post-mortem conducted by a different pathologist, usually to review the first autopsy findings in criminal cases.

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42
Q

What do Scene of Crime Officers (SOCO) do?

A

They collect, preserve, and process forensic evidence from crime scenes, including post-mortem evidence.

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43
Q

How must retained materials from a post-mortem be handled?

A

They must be stored securely with a clear record of their location and handling to ensure proper continuity and integrity.

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44
Q

What is an oocyte?

A

An oocyte is an egg that develops in the ovary in preparation for ovulation.

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45
Q

What is a follicle?

A

A follicle is a small fluid-filled cyst in the ovary where oocytes develop.

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46
Q

When can hCG be detected in pregnancy tests?

A

It usually takes 3-4 weeks after the first day of the last period for hCG to reach detectable levels.

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47
Q

What is the definition of an embryo?

A

An embryo is the developing baby from conception to the eighth week of pregnancy.

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48
Q

When does the developing baby become a fetus?

A

After the eighth week of pregnancy, the developing baby is called a fetus.

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49
Q

What are the three trimesters of pregnancy?

A

The three trimesters are:

First trimester: Weeks 1 to 12
Second trimester: Weeks 13 to 27
Third trimester: Weeks 28 to 40 / birth

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50
Q

What is a miscarriage?

A

A miscarriage is the spontaneous loss of a pregnancy, typically occurring before 20 weeks’ gestation.

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51
Q

What percentage of pregnancies end in miscarriage?

A

About 10-20% of pregnancies known to be pregnant end in miscarriage.

52
Q

What is a teratogen?

A

A teratogen is an environmental agent (such as drugs, alcohol, infections, or toxins) that can cause birth defects.

53
Q

What is a Fetal Post Mortem (PM)?

A

A post-mortem examination for fetuses up to 23 weeks gestation.

54
Q

What is the time frame for a Perinatal Post Mortem (PM)?

A

A perinatal PM is for fetuses from 24 weeks gestation to 7 days of life.

55
Q

hat is the difference between Early Neonatal and Late Neonatal PM?

A

Early Neonatal PM: Birth to 7 days of life.
Late Neonatal PM: 8 days to 28 days of life.

56
Q

What is the classification for post-mortems of children older than 1 year?

A

Pediatrics: For individuals over 1 year old to 18 years old.

57
Q

What are Hospital Consented Post Mortems?

A

Post-mortems performed with signed consent from the parents, often to confirm a known cause of death or disease progression, especially in cases of miscarriage or stillbirth.

58
Q

What is the role of a Fetal Autopsy?

A

Provide information to the family.
Identify the cause of pregnancy loss and factors contributing to it.
Detect genetic conditions and assess recurrence risks.
Contribute to audit purposes.

59
Q

What are some examples of pathology found during a fetal autopsy?

A

Amniotic infection
Oligohydramnios (lack of amniotic fluid)
Growth restriction
Viral or protozoal infections (e.g. CMV, toxoplasmosis)
Congenital disorders
Hydrops fetalis
Placental and umbilical cord disease

60
Q

What is the required consent for a fetal post-mortem?

A

Informed consent is required, typically from the mother or both parents. Fetal tissue is legally considered the mother’s tissue.

61
Q

What are some autopsy procedures for fetal post-mortem?

A

Whole body X-ray for gestational assessment and malformations.
Routine external body measurements.
Detailed external and internal organ examinations.
Evisceration (removal and examination of internal organs).
Photography for documentation of abnormalities.

62
Q

What is organ retention in post-mortem examinations?

A

Short-term retention for fixation does not require specific consent, but long-term retention for further examination requires specific consent.

63
Q

What pathology disciplines are involved in testing for fetal post-mortem?

A

Histology
Toxicology
Bacteriology/Virology
Genetics
Biochemistry

64
Q

What samples are taken during a Hospital Consented Post Mortem?

A

Microbiology: Lung and heart swabs, tissue.
Frozen tissue: Muscle, liver, or lung.
Genetics: Sent to Regional Genetics Department if dysmorphic features are present.

65
Q

What is included in the SUDI (Sudden Unexpected Death in Infancy) protocol?

A

Samples from A&E: Blood, urine, nasal swabs, skin biopsy.
Toxicology: Blood, bile, urine, stomach content.
Biochemistry: Blood, bile, urine.
Microbiology: Blood, tissue, swabs.
Skeletal survey.

66
Q

What pathology examples are common in neonatal post-mortem?

A

Hypoxia (ante-, intra-, or post-partum).
Growth restriction.
Infection (e.g. septicemia, pneumonia).
Congenital disorders.
Birth trauma and complications of neonatal care.
Effects of maternal diseases (e.g. diabetes, hypertension).

67
Q

What are neurological disorders?

A

Neurological disorders are diseases of the brain, spine (spinal cord), and the nerves that connect them.

68
Q

How are neurological disorders broadly categorized?

A
  1. Sudden onset conditions (e.g., acquired brain injury, spinal cord injury)
  2. Intermittent and unpredictable conditions (e.g., epilepsy, ME)
  3. Progressive conditions (e.g., motor neurone disease, Parkinson’s disease, multiple sclerosis)
  4. Stable neurological conditions (e.g., cerebral palsy in adults)
69
Q

What factors contribute to the predicted rise in neurological disorders?

A

The extension of life expectancy and aging populations globally.

70
Q

What is Parkinson’s disease?

A

Parkinson’s disease is a progressive nervous system disorder that affects movement, starting gradually with symptoms like tremors. It is caused by the loss of certain brain cells.

71
Q

What causes Parkinson’s disease?

A

The exact cause is unknown, but genetic and environmental factors, such as exposure to toxins, may contribute.

72
Q

What is Creutzfeldt-Jakob disease (CJD)?

A

CJD is a fatal degenerative brain disorder caused by prions, abnormal proteins that lead to rapid brain degeneration.

73
Q

What are the symptoms of Creutzfeldt-Jakob disease (CJD)?

A

Early symptoms include memory issues, behavioral changes, and poor coordination. Later symptoms include dementia, involuntary movements, blindness, and coma.

74
Q

What factors may contribute to the development of MS?

A

Genetic factors, geographic location (distance from the equator), viral infections (e.g., Epstein-Barr virus), gender, and smoking.

75
Q

What is motor neurone disease (MND)?

A

MND is a condition affecting the brain and nerves, causing muscle weakness and atrophy. It is always fatal and usually impacts older adults.

76
Q

What are early symptoms of motor neurone disease (MND)?

A

Symptoms include leg weakness, slurred speech, weak grip, muscle cramps, twitches, and weight loss.

77
Q

What is Alzheimer’s disease?

A

Alzheimer’s disease is the most common type of dementia, leading to a decline in memory, thinking skills, and other mental abilities due to neurodegenerative changes.

78
Q

What factors increase the risk of Alzheimer’s disease?

A

ncreasing age, family history, untreated depression, lifestyle factors associated with cardiovascular disease.

79
Q

What role do MRI scans play in Alzheimer’s diagnosis?

A

MRI scans can detect small brain lesions not visible during macroscopic examination and aid in selecting tissue samples for histological analysis.

80
Q

What is a stroke?

A

A stroke is a serious condition where the blood supply to part of the brain is interrupted, leading to brain damage.

81
Q

What is the F.A.S.T. acronym used for?

A

F.A.S.T. helps identify stroke symptoms:
Face – Drooping or inability to smile.
Arms – Weakness or numbness in one arm.
Speech – Slurred speech or difficulty speaking.
Time – Call emergency services immediately.

82
Q

What are the two main types of strokes?

A
  1. Ischaemic stroke (caused by blood clots)
  2. Haemorrhagic stroke (caused by a burst blood vessel).
83
Q

What are common risk factors for stroke?

A

High blood pressure, high cholesterol, atrial fibrillation, diabetes.

84
Q

What is traumatic brain injury (TBI)?

A

TBI refers to brain injuries caused by trauma, which can be focal (localized) or diffuse (widespread).

85
Q

What are focal injuries in traumatic brain injury (TBI)?

A

Focal injuries include scalp bruising, skull fractures, haematomas, contusions, and lacerations.

86
Q

What are diffuse injuries in traumatic brain injury (TBI)?

A

Diffuse injuries include diffuse axonal injury, diffuse ischaemic brain injury, and brain swelling.

87
Q

What is diffuse axonal injury?

A

A type of injury where rapid head movement causes shearing of axons in the brain, often due to shaking or strong rotational forces.

88
Q

What is the role of a neuropathologist in post-mortem examinations?

A

A neuropathologist provides detailed insights into trauma or underlying neurological diseases by examining brain and spinal cord tissue.

89
Q

What should be examined in post-mortem when traumatic brain injury (TBI) is suspected?

A

Scalp, skull, haematomas, contusions, and brain swelling should be examined for evidence of injury.

90
Q

How is histological examination used in traumatic brain injury?

A

Histology is used to examine diffuse injuries, such as diffuse axonal injury or ischaemic injury, which may not be visible to the naked eye.

91
Q

Why is blood vessel examination important in post-mortem neuropathology?

A

It helps identify aneurysms, vascular malformations, or traumatic tears that may have contributed to brain injury.

92
Q

What tissues may be retrieved during a post-mortem for neurological examination?

A

Brain, spinal cord, cerebrospinal fluid (CSF), and blood samples for toxicology.

93
Q

What is the importance of brain retention in post-mortem examinations?

A

Retention may be necessary for detailed neuropathological analysis, especially in cases of epilepsy, stroke, trauma, or dementia.

94
Q

What is the purpose of histological staining in neurological post-mortems?

A

Staining helps to identify specific proteins, the age of bleeds, or the presence of iron, providing additional information about the neurological pathology.

95
Q

What should be done for deceased with a known infection risk?

A

Deceased with an infection risk must be clearly identified with a biohazard sticker, placed in a body bag, and labeled as high risk at the earliest opportunity.

96
Q

What are the two main principles for managing infection risks in mortuaries?

A

Standard Infection Control Precautions (SICPs)
Transmission-Based Precautions (TBPs)

97
Q

What are Standard Infection Control Precautions (SICPs)?

A

SICPs are minimum control measures for managing infection risks from all work activities involving the deceased. They include practices such as PPE use, safe environment management, and decontamination.

98
Q

How many areas does SICPs cover in the mortuary?

A

SICPs cover nine key areas:

Safe management of the environment
Location and infection risk assessment
PPE
Hand washing
Safe management of equipment
Blood and body fluid spillages
Occupational safety
Safe management of linen
Safe disposal of waste

99
Q

What are Transmission-Based Precautions (TBPs)?

A

TBPs are additional measures used for activities that present an increased infection risk. They are based on the route of transmission of the infectious microorganism (airborne, droplet, or contact).

100
Q

What routes of transmission are considered in TBPs?

A

The three main routes of transmission are:

Airborne
Droplet
Contact (direct or indirect)

101
Q

What is a key element of a risk assessment in a mortuary?

A

Risk assessment involves identifying hazards, evaluating potential harm, and deciding if enough control measures are in place to protect staff from infection risks.

102
Q

What are the four main sources of infection to consider when handling the deceased?

A

Blood and body fluids
Waste products (e.g., faeces, urine)
Aerosols from the body
Direct contact with tissues

103
Q

What is the most common route of infection transmission?

A

Contact transmission (both direct and indirect) is the most common route.

104
Q

What infections present an increased risk to those handling the deceased?

A

infections like TB, flu, HIV, Hepatitis B, and rabies can pose increased risks during activities like post-mortems and embalming.

105
Q

What additional precautions are necessary for handling deceased with certain infections?

A

Post-mortem examinations and embalming should be carefully considered and additional TBPs may be required based on the type of infection (e.g., Category 4 infections may require specialized units).

106
Q

What training should be provided for staff handling deceased with increased infection risks?

A

Staff must receive training on:

Infection risks and TBPs
Proper use of PPE
Safe working practices and teamwork
Competence in handling invasive procedures

107
Q

What is the responsibility of employers in managing infection risks in mortuaries?

A

Employers are responsible for ensuring staff are adequately trained, competent, and equipped to handle infection risks, and that SICPs are implemented effectively.

108
Q

How should mortuaries be structured to minimize contamination?

A

Mortuaries should separate clean and dirty areas, with designated zones for changing PPE to prevent contamination transfer.

109
Q

Why is personal protective equipment (PPE) essential in the mortuary?

A

PPE provides a barrier against infection risks from handling the deceased, including gloves, masks, eye protection, and respiratory equipment when necessary.

110
Q

When should hand washing be performed in the mortuary?

A

After contact with body fluids, the deceased, or their immediate surroundings, and after any procedure that involves handling the deceased.

111
Q

What should be done in the event of blood or body fluid spillage?

A

Spillages should be immediately decontaminated by trained staff, with proper cleaning and disinfection materials available.

112
Q

What should be done if sharps or other hazardous objects are encountered?

A

Staff must follow procedures to prevent exposure, such as using safe sharps disposal practices and wearing appropriate PPE.

113
Q

How should contaminated linen be handled?

A

Contaminated linen should be placed in a water-soluble or alginate bag, then into a plastic bag before being disposed of or laundered as clinical waste.

114
Q

What is the importance of risk assessment in controlling infection?

A

Risk assessments help identify potential hazards and implement appropriate control measures to break the chain of infection.

115
Q

What types of infections require specific transmission-based precautions?

A

Airborne: TB, flu
Droplet: Influenza
Contact: HIV, Hepatitis B

116
Q

What is the procedure for handling airborne transmission risk?

A

Measures include using a dedicated room, smooth benches with exhaust ventilation, and wearing respiratory protection during post-mortems where airborne transmission risk is identified.

117
Q

What precautions are necessary for droplet transmission?

A

Use appropriate PPE (e.g., surgical mask with eye protection), avoid splashing, and use dedicated areas to prevent environmental contamination.

118
Q

What are the precautions for contact transmission risk?

A

Use leak-proof body bags, double gloving, dedicated instruments, and heavy-duty gloves. In some cases, use single-use instruments for diseases like Creutzfeldt-Jakob Disease (CJD).

119
Q

List 4 types of tissue the NHSBT deals with.

A

Blood
Organs
Bone marrow
Tissues (e.g., corneas, skin, heart valves)

120
Q

What are the 4 stages for the safe and reliable supply of blood?

A

Donor recruitment
Blood collection
Testing and screening
Distribution to hospitals

121
Q

Why is donation voluntary (rather than paid) in the UK?

A

To ensure the safety and altruism of the blood supply, as paid donations may be linked to a higher risk of unsafe or unqualified donations.

122
Q

Why are there questions on the donor questionnaire regarding lifestyle?

A

To assess potential risks for transmissible infections and ensure the safety of the blood supply.

123
Q

List 4 routine disease screening tests carried out on all donations.

A

HIV
Hepatitis B
Hepatitis C
Syphilis

124
Q

What are the 3 main products that can be obtained from whole blood?

A

Red blood cells
Plasma
Platelets

125
Q

Why does every unit have its own unique donation number?

A

To track and trace the donation, ensuring safety, accountability, and proper handling in case of any issues.

126
Q
A

APT Level 4 (3 decks)

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