Autopsy Flashcards
Implicit questions asked from autopsy
- were we right
- did we miss something
Giovanni Battista Morgagni - Padua
- out with Galen’s evil humours, in with structure/function
- 60 years careful correlation of clinical symptoms & anatomic findings
- 1700s
Karl Rokitansky - Vienna
- one of the first PATHOLOGISTS: gross tissue morphology became basis of medicine
- pathologic anatomy to clinical abnormalities
- 70,000 autopsies!!!!!
- 1800s
Rudolph Virchow - Berlin
- narrowed gross tissue morphology to separate organs
- cellular pathology as the basis of medicine
- late 1800s
William Osler
- wished he could see his autopsy
- what to why
- 1849-1919
Richard Cabot
- landmark JAMA paper 1912
- couple quotes
1912 Cabot listed common diseases inaccessible to diagnosis
Diabetes Mellitus - 95% Typhoid - 92% Aortic Regurgitation - 84% Cancer of Colon - 74% Lobar Pneumonia - 74%
Diseases discovered or clarified via autopsies in 20th century
- coronary artery atherosclerosis & thrombosis, angina pectoris, MIs
- congenital heart malfomations
- cystic fibrosis
Diseases discovered or clarified via autopsies late 20th century
AIDs, hantavirus pulmonary syndrome, dementias, inhalation diseases of lungs, creutzfeldt-jakob disease, infectious complications of drug therapies, hospital-acquired infections
Why autopsies
- medical education (now rare)
- quality assessment of diagnosis and treatment
- risk management
- public health
- family
UIHC QA program from autopsies
- list major validated/refined diagnoses
- list major clinicopathologic discrepancies
- list major unexpected findings
why decline of autopsy
- payment: hospitals & pathologists unpaid under fee for service model
- public perception
- clinical medicine: overconfidence & litigation
- medical education
autopsy decline statistics
1950s:>50%
UIHC: 25%
US:
when can autopsies be performed
- after obtaining informed consent from family, process is aprt of physician family communication
- ME cases don’t need consent
define autopsy
autopsy - to see for oneself
postmortem - after death