Autopsy

Question 1

What are the 3 main types of an autopsy

Answer 1

1. Coronal
2. Hospital
3. Forensic

Question 2

What is a hospital biopsy

Answer 2

A biopsy requested to learn the nature/process of a disease

Question 3

When can a hospital autopsy be carried out

Answer 3

When there is a death certificate

There is a known cause of death

Question 4

Who can consent be obtained by

Answer 4

Partner
Parent
Child
Sibling 
Grandparent o
Grandchild

Question 5

What is a coronal post mortem autopsy

Answer 5

When a coroner request for an autopsy in order to identify the nature and cause of the death

Question 6

Who is a coroner

Answer 6

Independent judicial officer appointed and part of the local authority i,e they are not NHS empolyed. (Qualified lawyer with at least 5 years of experience)

Question 7

What is the aim of the coronal post mortem

Answer 7

Detect the cause of the any death where there is a reasonable cause to detect that is of unnatural or unkown nature

Question 8

What can be a unnatural or unkown nature of death

Answer 8

• sudden or unexpected death
• unnatural i.e drug related
• patient that died less than 24 hours post admission from hospital and not seen by a clinic within the last 2 weeks

Question 9

As a junior doctor if there is a death of unkown or unnatural nature what do you do

Answer 9

1. Call the coroner office/ medical examiner

2. Discuss the case and give a basic rundown of the history

Question 10

What is the difference between coronal and hospital autopsy

Answer 10

Coronal autopsy: coroner wants to determine if the death was unatural
Hospital autopsy: death must be a natural cause and must have a death certificate, we are answering the fine detail for interest.

Question 11

What is a forensic autopsy

Answer 11

Forensic autopsy investigates cases of a suspicious death

Question 12

How do we start an autopsy, what are the 2 things we need to consider

Answer 12

1. Is it a natural or unnatural cause of death

2. Special circumstances: safety precautions, histology, toxicology, microbiology

Question 13

What is the first step to an autopsy

Answer 13

External examination

Question 14

What does an external examination involve

Answer 14

Looking at:
Height 
Weight 
Identification of patient 
Document patient of disease process, identify marks, evidence of surgery

Question 15

What is the next step to an autopsy

Answer 15

Evisceration

Question 16

What is evisceration

Answer 16

Exposing internal organs ready for removal and disection

Question 17

How do we carry out evisceration

Answer 17

1. Incision in the neck to the suprapubic region and retract the skin and muscles from the anterior chest wall to expose the rib cage
2. Remove the rib shield to see the lungs and heart
3. Remove the bowel from the jejenum to the rectum for evidence of perforation, dilation or ischaemia

Question 18

What is the next step after evisceratons

Answer 18

Dissection of organs

Question 19

What is the most common technique in disecction to examine the organs

Answer 19

En bloc/ en masse technique

Question 20

What is the en bloc/ en masse technique

Answer 20

Removal of the organs within their systems such as thoracic , cervical, abdominal and pelvic organs

Question 21

After an autopsy what are the further investigations that you can do

Answer 21

• histology
• immunochemistry
• blood
• urine
• hair
• skeletal muscle
• csf
• spleen for genetic testing
• toxicology: drugs, metabolities

Question 22

What is a ct/digital autopsy

Answer 22

When the body is scanned by a ct scan and a report is formualted