Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Forensics > Clinical > Flashcards

Clinical Flashcards

1
Q

When may a MP take the blood of a suspect for DUI? (3)

A
  • with consent
  • by order of police officer (SAP 308 a)
  • if dr is of opinion that it will be required in further criminal procedures (criminal procedure act 51 of 1977 section 2)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How should a blood sample be obtained for a DUI? (4)

A
  • collect at least 5 ml, preferable 20
  • sterilise arm with sterile water, not alcohol swab
  • Place specimen in special prepared container with anticoagulant and preservative
  • record time and site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name 7 red flags indicating child abuse

A

1 treated at different hospitals or different doctors

  1. Delay in seeking medical help
  2. Discrepancy in history
  3. Abnormal affect and behaviour of parents
  4. Abnormal affect and behaviour of child
  5. Different injuries in different stages of healing
  6. Specific injuries: skull fractures ( more than 1, in more than 1 place), subdural haemorrhage, retinal haemorrhage, rib fractures especially if history doesn’t support injury.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What damage does the light component of lightning cause?

A

Eyes! Most commonly cataract with posterior subscapular haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What damage can the electrical component of lightning cause? (3)

A

Abrupt cerebral salt wasting syndrome, delayed onset psych and cognitive symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 4 primary targets for blast overpressure (barotrauma) injury?

A

Hollow organs, ear, lung, GIT

Lightning: pneumomediastinum (bubbles on post wall)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name 3 causes of hyperthermia ( 2 drugs, 1 endocrine)

A
  1. Cocaine
  2. amphetamine
  3. Hyperthyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is mild hypothermia?

A

Core temp 32-35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is moderate hypothermia?

A

Core temp 30-32

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is severe hypothermia?

A

Core temp below 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name 3 illnesses included in high altitude illness

A
  1. Acute mountain sickness
  2. High altitude cerebral oedema
  3. High altitude pulmonary oedema
    (Due to hypobaric hypoxia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What causes epidural haematoma ?

A

Traumatic rupture of middle meningial artery over parieto -temporal area with associated skull #
Arterial bleed therefore develops rapidly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes subdural haematoma? (5)

A

Trauma to communicating veins with no associated skull fracture. By rotational/shearing forces applied to brain
Other: rupture of cerebral aneurysm or arteriovenous malformation, cerebral hypotension, rarely malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is needed for a subdural haematoma present clinically?

A

Venous bleed. Needs enough volume of about 35 ml to become a space occupying lesion /cortical irritant to be clinically apparent.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complication of epidural or subdural haematomas?

A

Brain herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which 3 arteries, in order, are common sites of aneurysm in the brain?

A
  1. ant communicating
  2. int carotid/post communicating
  3. Middle cerebral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name 3 causes of spontaneous subarachnoid haemorrhage

A

Cerebral aneurysms (85 % ), cocaine, amphetamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Duret haemorrhage?

A

Primary brainstem haemorrhage secondary to raised ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is and causes pontomedullary runt?

A

Brainstem snaps. Hyperextension injury associated with ring fractures, fractures - dislocations to c1 -c2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Is diffuse axonal injury traumatic brain injury?

A

No. But is most common path feature noted in TBI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define diffuse axonal injury and give cause

A

Damage to axons of any etiology which traumatic axonal injury (tai) is example.
Primarily a non-impact rotational acceleration-deceleration phenomenon, deformation by stretching probably being most significant factor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How diagnose TAI?

A

Special stains (B APP ) to demonstrate subtle microscopic damage to nerve fibres: axonal bulbs/ retraction balls or globes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a “coup” lesion? How acquired?

A

Mobile head struck with object, maximum cortical contusion site is beneath or at least on same side as blow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is “contrecoup” lesion acquired?

A

Moving head is suddenly decelerated eg fall, cortical damage on opposite side of head to blow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

See picture 3 and label the brain herniations.

A 
A: subfalcine hernia
B. Lateral transtentorial DTH /uncal hernia
C. central DTH (transtentorial)
D. Transcalvarial (extracranial)
E.tonsillar hernia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How old is a bruise that is red to purple- black?

A

Day 0-1 (haemoglobin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Name 4 types skull vault fractures

A
  1. Base of skull
  2. Facial fractures
  3. Open skull #
  4. GSW to skull
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Name 5 complications of assault /injuries

A
  1. Haemorrhage
  2. Infection
  3. Haemo/ pneumo thorax
  4. Bronchopneumonia
    5-pulmonary thromboembolism
  5. Metabolic disturbances
  6. Renal failure
  7. Air and fat embolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Name 11 differentials for altered level of consciousness, with 2 examples of each

A
  1. Toxicologic: carbon monoxide, opioids, alcohol,
  2. Trauma: intracranial haemorrhage, diffuse cerebral oedema, concussion, anoxic brain injury,
  3. Neurologic.: seizures, encephalopathy, complicated migraine, ruptured av malformation or aneurysm, stroke, CSF shunt malfunction, cns vasculitis, post-infec disorders eg acute disseminated encephalomyelitis
  4. Cardiac: syncope, dysrhythmias, hypertensive crisis, posterior reversible encephalopathy syndrome, hypotension, mi
  5. Pulmonary: hypoxia, hypercarbia
  6. Endocrinology: hypoglycaemia, DKA, hyperglycemic hyperosmolar state, hashimoto encephalopathy
  7. Git: intussusception, acute abdomen
  8. Renal/genetic / metabolic: electrolyte abnormal, dehydration, uraemia, inborn errors of metabolism
  9. Haematologic/oncologic: hyperleukocytosis, space occupying lesion, severe anemia
  10. Infections: meningitis, encephalitis, intracranial abscess, tick- borne diseases, sepsis
  11. other: psych delirium, shock ( hypovolaemic, cardiogenic, distributive, obstructive), hyper/hypo- thermia, porphyria, thiamine def / wernicke encephalopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Classify wound picture 18

A

Sliding abrasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Classify wound picture 19

A

Pressure abrasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Classify wound picture 20

A

Patterned abrasion and tramline contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Classify wound picture 21

A

Contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Classify wound picture 22

A

Tramline contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Classify wound picture 23

A

Tramline contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Classify wound picture 24 and what it indicates

A

Raccoon eyes - basal skull fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Classify wound picture 25

A

Laceration: irregular edges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Name 6 types abrasions

A 
DIG FLIP
Dicing (small edged/rectangular caused by fragments of glass, usually from mva)
Imprint
Gravel
Friction
Linear
Post mortem insect bites,
Also scratches and brush abrasions.
39
Q

Name 3 conditions that mimic death

A
  1. Hypoglycaemia (hyper)
  2. Hypothermia
  3. Barbiturate coma (sodium thiopentone)
  4. Depressant drugs eg narcotics, hypnotics, tranquilizers
  5. apnea due to neuromuscular blocking agents
40
Q

How do CPR chest injuries usually present (3)

A

Anterior, lateral, symmetrical.

41
Q

How old is a bruise that is bluish - brown?

A

2 days (haemosiderin)

42
Q

How old is a bruise that is greenish-brown?

A

3 days ( haemosiderin and biliverdin)

43
Q

How old is a bruise that is green?

A

4-5 days (biliverdin)

44
Q

How old is a bruise that is yellow?

A

7-10 days (bilirubin)

45
Q

How old is a bruise that is fading/disappearing?

A

12-15 days

46
Q

Properties of first degree burns- description, appearance, capillary refill, sensation/pain, healing

A
  • Superficial thickness: only epidermis
  • erythematous
  • fast cap refill
  • sensation and pain present
  • 7-14 days to heal
47
Q

Properties of second degree burns superficial and deep - description, appearance, capillary refill, sensation/pain, healing

A
  • Either superficial partial thickness or deep partial thickness: epidermis and part of dermis
  • wet, pink, blisters vs less wet, red, with or without blisters
  • fast cap refill vs sluggish/absent
  • extreme pain vs with or without sensation
  • 2-4 weeks healing vs 3-8 weeks with severe scarring, need grafting
48
Q

Properties of third degree burns- description, appearance, capillary refill, sensation/pain, healing

A
  • Full thickness: epidermis and entire dermis and fat
  • dry, white
  • absent cap refill
  • absent sensation or pain
  • needs grafting to heal
49
Q

Name 4 cold injuries

A
  • Frostbite
  • trench foot
  • chilblains
  • hypothermia (core <35, hide and seek phenomenon)
50
Q

Bright Red abrasion age?

A

Fresh

51
Q

Bright scabs abrasion age?

A

12-24 hours , after lymph and blood dried

52
Q

Red-brown scab abrasion age?

A

2 to 3 days

53
Q

Epithelium covering scab abrasion age?

A

4 to 7 days

54
Q

How long does it take abrasion scab to fall off?

A

After 7 days

55
Q

Name 5 symptoms subdural haematoma

A 
• Headache
• drowsy
. Weakness
• paraesthesia / numb
• nausea vomiting
. Confusion
• poor balance
56
Q

Location of extradural haemorrhage?

A

Between skull bone and dura

57
Q

Pathophysiology of extradural haemorrhage?

A

mostly Rupture middle meningeal artery on temporal surface of skull - associated fracture skull
Rarely by venous bleeding from perforating veins or dural sinuses

58
Q

Clin presentation extradural haematoma?

A

History trauma
Skull fracture
Lucid interval followed by unconciousness

59
Q

appearance ct extradural haematoma?

A

Convex

60
Q

Location subdural haemorrhage?

A

Between dura and arachnoid

61
Q

subdural haemorrhage pathophysiology ?

A

Rupture bridging communicating cranial veins - shearing or rotational injury , no skull fracture

62
Q

subdural haemorrhage clin presentation

A 
History trauma
Older
Alcohol misuse
Child non accident. injury
Gradual deterioration
63
Q

Subdural haematoma ct appearance?

A

Concave or crescent shaped

64
Q

Subarachnoid haemorrhage location

A

Between arachnoid and pia

65
Q

Subarachnoid haemorrhage pathophysiology

A

Rupture berry aneurysm

66
Q

Subarachnoid haemorrhage clin presentation

A

History trauma
Thunderclap headache
Sudden onset symptoms

67
Q

Subarachnoid haemorrhage ct appearance

A

Hyper-attenuation around circle of willis

68
Q

Intracerebral haemorrhage location

A

Within brain parenchyma

69
Q

Intracerebral haemorrhage pathophysiology

A

Haemorrhagic stroke

70
Q

Intracerebral haemorrhage clin presentation

A

Sudden onset neuro deficits

71
Q

Intracerebral haemorrhage ct appearance

A

Hyper- attenuation in brain parenchyma

72
Q

Describe brush/sliding/friction/ graze or gliding abrasion appearance

A

Uneven, longitudinal parallel lines with epithelium heaped up at the ends of these lines, which indicates direction applied force

73
Q

Describe appearance of scratch/linear abrasions.

A

Length but no significant width. Caused by sharp/pointed objects eg fingernail , pin,. Thorn

74
Q

Explain and name the rule of nines. (6)

A 
To identify body surface area burnt
• head 9%
• genitalia 1%
• arm 9%
• leg 18%
• torso 36%
75
Q

Characteristics Pressure abrasion?

A

Caused by crushing superficial layers epidermis. Associated bruise. Eg ligature mark from hanging or strangulation, teeth Bite

76
Q

Pathophysiology tramline bruises?

A

Skin struck with rod-like object , squeezing blood from vessels at point of impact thus emptying them and preventing them from leaking blood . edges of wound are stretched, and blood vessels torn, causing blood to leak to surrounding tissues. 2 parallel linear bruises separated by paler, undamaged skin results.

77
Q

Name 10 types skull fractures

A
  1. comminuted
  2. Ring or foramen fracture
  3. Simple linear most common or fissured
  4. Depressed
  5. Pond or indented
  6. Gutter:long, narrow fracture caused by gunshot wound
  7. Penetrating
  8. Basilar fracture
  9. Diastatic: along suture lines of skull in infants
  10. Hinge: separate floor of skull into 2 halves ( 9 and 10 types of linear)
  11. Mosaic or spider web fracture: comminuted depressed fracture
  12. Contre-coup fractures: usually from hard surface striking occipital region of mobile head causing coup damage, - transmitted force may be sufficient to fracture thin bone on floor of ant fossa.
78
Q

What is a pond or indented skull fracture?

A

Seen only in infants - like depressed fracture but in infants

79
Q

What is a Gutter skull fracture?

A

Caused by gunshot wound

80
Q

What causes split laceration?

A

Blunt object makes perpendicular contact with skin and skin is tightly stretched over bones, causing skin to split eg scalp

81
Q

Name the 4 classes of electrical injuries

A
  • True electrical injuries: person becomes part of the electrical circuit and has an entrance and exit site.
  • flash injuries: superficial burns caused by arcs that burn the skin, no electrical injury travels through skin.
  • flame injuries: caused by ignition of clothing by arc , electricity may or may not flow through body
  • lightning injuries: extremely high voltages for shortest duration, majority of electrical flow occurs over body
82
Q

Name 3 major mechanisms of electricity induced injury

A
  1. Electrical energy causing direct tissue damage alternating cell membrane resting potential and eliciting muscle tetany.
  2. Conversion into thermal energy, causing massive tissue distruction and coagulative necrosis
  3. Mechanical injury with direct trauma resulting from falls or violent muscle contraction
83
Q

Is ac or dc current more dangerous?

A

Ac

84
Q

How protect eyes after lightning injury?

A

Keep them wet and closed

85
Q

Name, in order, the appearance of contusions over time. (6)

A
  • Day 0-1: red to purple black due to haemoglobin
  • 2: bluish-brown due to haemosiderin
  • 3: greenish brown- haemosiderin and biliverdin
  • 4-5: green - biliverdin
  • 7-10: yellow-bilirubin
  • 12-15: fading to disappear
86
Q

What is a mosaic or spider web’s fracture?

A

Comminuted depressed fractures with fissures radiating away from fracture

87
Q

Name 3 distinct structural abnormalities in pathology of TAI

A
  • Corpus callosum lesions
  • brain-stem lesions
  • diffuse axonal damage
88
Q

Describe characteristics of superficial or first degree burn by depth, appearance, pain and prognosis

A

• Epidermis only
. Dry, blanching erythema
. Painful very
• heals without scarring in 5-10 days

89
Q

Describe characteristics of superficial partial thickness or second degree burn by depth, appearance, pain and prognosis

A
  • upper dermis
  • blisters, wet, blanching and erythema
  • painful
  • heals without scarring <3 weeks
90
Q

Describe characteristics of deep partial thickness or second degree burn by depth, appearance, pain and prognosis

A

• lower dermis
. Yellow or white dry, nonblanching
• decreased sensation
• Heal in 3-8 weeks, likely to scar if heal >3 weeks

91
Q

Describe characteristics of full thickness or third degree burn by depth, appearance, pain and prognosis

A

• Subcutaneous structures
• white or black/brown, nonblanching
. Decreased sensation
• heal by contracture >8 weeks. Will scar.

92
Q

What are six penny bruises?

A

Bruises left by fingers usually, round or discoid shape. Usually in manual strangulation or tight gripping in child abuse

93
Q

What is a butterfly bruise?

A

Pinch marks

94
Q

Name 5 microscopic changes of skin in electrothermal burn.

A
  1. Metallization
  2. Homogenization, fuzziness of stratum corneum (melt)
  3. Honeycomb vacuolisation
  4. Demarcation zone _ separation dermis and epidermis
  5. Streaming of nuclei

Forensics (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions