Autopsy 3: Adult Organ Findings

Question 1

what are the four types of pericardial effusion

Answer 1

transudative, exudative, hemorrhagic, and malignant

Question 2

what is often referred to as “bread and butter” pericarditis

Answer 2

fibrinous pericarditis

Question 3

what is an empyema

Answer 3

intrapleural fibrinosuppurative reaction
usually develops from spread of bacterial or fungal infections of the lung parenchyma

Question 4

what is a chylothorax

Answer 4

accumulation of milky fluid of lymphatic origin in the pleural cavity

Question 5

what is the most common malignant tumor of the larynx

Answer 5

squamous cell carcinoma

Question 6

what is dorsal lividity in the lung

Answer 6

blood settling in the lungs due to gravity postmortem

Question 7

what are the 4 types of emphysema

Answer 7

centriacinar
panacinar
paraseptal
irregular

Question 8

what are the four stages of lobar pneumonia

Answer 8

congestion
red hepatization
gray hepatization
resolution

Question 9

where is the most common location for carcinoma in the esophagus

Answer 9

50% of cases occur in the middle third

Question 10

what are the most common malignant tumors of the esophagus

Answer 10

squamous cell carcinomas

Question 11

where are stress ulcers most commonly located

Answer 11

stomach

Question 12

where are peptic ulcers most commonly located

Answer 12

proximal duodenum

Question 13

what is a common, benign incidental finding of the stomach

Answer 13

gastrointestinal stromal tumors (GISTs)

Question 14

what is the most common type of malignant tumor found in the stomach

Answer 14

gastric carcinoma

Question 15

what is the diffuse type of gastric carcinoma

Answer 15

linnitus plastica

Question 16

in which condition would you see yellow plaques in the colon

Answer 16

pseudomembranous enterocolitis

Question 17

what is the cause of pseudomembranous enterocolitis

Answer 17

clostridium difficile

Question 18

what are some colonic features of Crohn disease

Answer 18

narrowing of lumen
thickening of wall
cobblestone
fissures
skip lesions

Question 19

what are some colonic features of ulcerative colitis

Answer 19

mostly found in distal colon
ulcerations
continuous pattern of involvement - no skip lesions

Question 20

what is the most common location for diverticula of the colon

Answer 20

sigmoid

Question 21

what are grooves on the liver called

Answer 21

leibermeister grooves

Question 22

what is nutmeg liver

Answer 22

chronic, passive congestion of the liver

Question 23

what is cholesterolosis of the gallbladder

Answer 23

yellow stippling of the mucosa - made of cholesterol

Question 24

what is the one of the first organs to go through autolysis post mortem

Answer 24

pancreas

Question 25

what is an ococytoma

Answer 25

benign, classic mahogany colored tumor of the kidney

Question 26

at which pole do 90% of horseshoe kidneys occur

Answer 26

lower pole

Question 27

what is the normal texture of the mucosa of a bladder

Answer 27

trabecular

Question 28

what happens to the bladder postmortem

Answer 28

epithelial shedding which can cause urine to look cloudy and give the bladder a more smooth appearance

Question 29

what does a highly trabeculated bladder suggest

Answer 29

long term catheterization

Question 30

what is a communicating hydrocele

Answer 30

collection of clear fluid in the tunica vaginalis - leads to a enlarged scrotal sac which is a common finding at autopsy mostly commonly due to excess abdominal fluid (ascites)

Question 31

what is a non-communicating hydrocele

Answer 31

collection of fluid in the tunica vaginalis that is not associated with fluid from the peritoneal cavity can be caused by trauma or inflammation

Question 32

what is the most common testicular tumor in men over 60 years of age

Answer 32

lymphoma

Question 33

what is the most common testicular tumor in young men (15-34 yrs of age)

Answer 33

germ cell tumors

Question 34

what should you pay special attention to if a male patient has cystic fibrosis

Answer 34

testicles and epididymis - look for atrophy of the epididymis

Question 35

what is BPH

Answer 35

benign prostatic hypertrophy - enlarging of the prostate, typically due to age

Question 36

what must you do with fresh bone

Answer 36

fix first then decalcify

Question 37

what can small holes in the bone be confused with

Answer 37

small holes (which are actually vertebral blood supply) can be confused with osteoporosis

Question 38

what is the best muscle to take a representative section from during autopsy

Answer 38

iliopsoas muscle

Question 39

what three things should you take generally sections of for documentation purposes in an autopsy

Answer 39

skin, muscle, and nerve

Question 40

what would an Alzheimer brain look like

Answer 40

you would see degeneration of the sulci, leaving elevated gyri

Question 41

what should you look for in the brain of a Parkinson's patient

Answer 41

look at the midbrain, specifically the substantia nigra lack of darkly pigmented line is suggestive of Parkinson's

Question 42

what is a subfalcine herniation (cingulate)

Answer 42

expansion of the cerebral hemisphere displaces the gyri under the falx

Question 43

what is a transtentorial herniation

Answer 43

medial aspect of temporal lobe is compressed against the free margin of the tentorium

Question 44

what is a tonsillar herniation

Answer 44

displacement of the cerebellar tonsils through the foramen magnum

Question 45

what are concentrations on either side of the superior sagittal sinus of the brain

Answer 45

arachnoid granulations - not meningeal pathology

Question 46

what is the arterial border (water-shed) zone of the brain - mostly likely to harbor small ischemic lesions

Answer 46

superior and middle frontal gyri

Question 47

what is seen in a "ventilator" brain

Answer 47

swollen with areas of necrosis

Question 48

what is the most frequent cause of spontaneous subarachnoid hemorrhage

Answer 48

rupture of a berry aneurysm in a cerebral artery

Question 49

what is the most common location for a saccular (berry) aneurysm

Answer 49

anterior communicating artery

Question 50

what is the most common cause of sudden death in the United States

Answer 50

ischemic heart disease

Question 51

how can you get color back to a specimen after its been fixed to take a better photograph

Answer 51

run it under 80% ethanol (alcohol) for 30 minutes

Question 52

what is the ideal tissue size for submission

Answer 52

2.5 x 1.5 x 0.3 cm

Question 53

according to CAP, how long does tissue need to be held onto after the final autopsy report is signed out

Answer 53

3 months

Question 54

what does CAP stand for

Answer 54

college of american pathologists accreditation

Question 55

when should a PAD be finished by according to CAP

Answer 55

2 working days

Question 56

when should a final diagnosis be finished by according to CAP

Answer 56

30 days for routine cases; 90 days for complicated cases

Question 57

when should a PAD be finished according to the joint commission for hospital accreditation

Answer 57

2 days

Question 58

when should a FAD be finished according to the joint commission for hospital accreditation

Answer 58

60 days

Question 59

what is the most important complication of atherosclerosis

Answer 59

myocardial infarction

Question 60

what is the most common location for a coronary artery MI

Answer 60

left anterior descending

Question 61

you have a heart that has a dark, mottled appearance with NO yellowing, how old is this MI?

Answer 61

anywhere from 4-24 hours

Question 62

you have a heart that has a mottled appearance with a yellowing center, how old is this MI?

Answer 62

anywhere from 1 to 7 days

Question 63

you have a heart that has a yellow, tan appearance with red margins, how old is this MI?

Answer 63

7-10 days

Question 64

you have a heart that has a scar, how old is this MI?

Answer 64

anywhere from 2-8 weeks

Question 65

how do you structure a PAD

Answer 65

list diagnosis in order of clinical importance 1.) underlying disease process that lead to the patients demise 2.) consequences of pervious disease or injury 3.) list of all findings (diagnosis first, then comma. then site or organ)

Question 66

what is the main difference between a PAD and a death certificate

Answer 66

PAD: underlying causes death certificate: terminal event (ex. cardiac arrest due to coronary artery atherosclerosis)